Sep 22

To pay, pay a little, or not to pay: That IS the question!


A subject that has taken up quite a lot of my time recently is the subject of the payment of those with lived experience who become involved in various ways within healthcare higher education institutions. It must be said here and now that no one person (living or dead!), is intended to be singled out for criticism in this blog!Ā  However, it is plain that many healthcare education institutions have been less than flexible when it comes to paying people. IĀ read that one hapless institution (in order to honour a bus ticket) took six weeks to post a cheque for 80 pence! Clearly the issue of paying those with lived experience a fair rate in a speed and format that is acceptable to them has challenged even the most flexible of finance managers! What then then is the solution, in my view?

It seems plain that systems that institutions have been using for decades are probably not going to change. Although it seems logical to pay people in cash on the day, thisĀ option appears clearly beyond most institutions to facilitate, so I believe other options need to be considered. One possibility if the person is associated with an organisation such as a charity, is the charity being paid and then they reimburse the person. This would take account of slow reimbursement from the institution and the charity could then reimburse the person Ā more conveniently. However, I don’t believe that service user/carer reference groups within higher healthcare education should be exclusively supported by organisations as articulate individuals can also have a valuable role to play.

What about payment rates? (In addition to travel expenses of course!) This is a tricky question for some people, although in my mind it is straightforward. There should be a sliding scale of payment depending on the involvement activity, with face to face sessions coming out top at the same payment rate as any external speaker. Travel expenses should ALWAYS be paid in addition as otherwise the person who has the furthest travel is penalised. There should also be a paymentĀ rate if we expect people to prepare for meetings by reading policy documents, for example, in advance, and of course it is a persons right to refuse payment of any kind.

To me the actual detail of the arrangements, which can be easily agreed, are less important than the principle that is at stake here. This is the importance of having the discussion about payment rates in the first place which indicates thatĀ institutionsĀ are serious about the whole subject of including those with lived experience in the education of future healthcare professionals. It is up to each institution to be flexible enough and to have the will to succeed and make payment happen in a fair and equitable way.



  1. Adam Warren

    Another related issue is ‘expert by experience’ fatigue – my sister had a rare operation to control her cancer, and has since been regularly invited to talk at cancer conferences. It helps that she is a confident and expressive public speaker, but she is now getting tired of these events. She knows that it is helpful to pass on her lived-experience, but is now starting to feel that these talks trap her into being a ‘medical case’ and she really just wants to get on with her life. So although she is paid and has her travel and accommodation costs covered, the cost to her of attending is not just financial,but also emotional – and there are also the lost opportunity costs of other things she could have been doing that weekend.

  2. Trevor Kettle

    You have made an excellent point there Adam. Overusing the same people can often happen in healthcare education. Clearly having some experience builds confidence but over exposure is the distinct danger of continual face to face sessions. Hence I am arguing that involvement is FAR more than just face to face. I will explore these other opportunities for involvement in a future blog. Thanks for your contribution.

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