Overcoming the organisational challenges of paying public contributors: how can we put the NIHR guidance into practice?

In January 2023, professionals and public contributors from the health and care research sector across Kent, Surrey and Sussex joined an online event tackling the challenges of paying public contributors.

Attendees heard from Silvia Bortoli, Senior Public Involvement Manager at the National Institute for Health and Social Care Research (NIHR) who is leading on work looking into the challenges of paying public contributors. The event was facilitated by the NIHR Applied Research Collaboration (ARC) Kent, Surrey and Sussex, Clinical Research Network (CRN) Kent, Surrey and Sussex and Research Design Service (RDS) South East through the Regional PCIE and Co-production Forum. Silvia shared the NIHR’s payment guidance for researchers and professionals, the latest version published in August 2022, focuses in particular on how to navigate the complexities of employment status and benefits - a practice that raises many individual and organisational questions and challenges for those seeking to offer payment to public contributors.

After a brief introduction from Silvia on the development and key elements of the guidance, attendees shared experiences of organisational issues that they have experienced with regard to paying public contributors. Frequently experienced issues cited were:

• inflexible organisational practices
• guidance and employment status is open to interpretation
• lack of clarity on who is responsible for decision making
• risk of burden to members of the public to manage the implications of tax and benefits

Attendees also made suggestions on what might help:

• flexibility and choice in methods of recognition and processes
• examples of patient and public involvement friendly payment systems
• more clarity on what constitutes employment status

Despite their relevance, the implications of employment status and benefits are not widely understood by those facilitating involvement, or by public contributors. For many, the implications feel like a potential barrier to the involvement of the public in health and care research, particularly members of under-served communities.

Pippa Shaw, ARC Kent, Surrey and Sussex said: "Paying public members shows respect and value for their contributions, helping to create equity. However, in my experience, the current complex and confusing payment systems have the adverse effect and are creating barriers to inclusion. The NIHR has tried to bring some clarity but it is down to individual organisations as to how they interpret the guidance and this is often where the confusion arises.’

Silvia outlined new guidance, developed in partnership with the Health Research Authority and Health and Care Research Wales, around the employment status of public members involved in research and the implications this has for tax for organisations, posing the question: is involvement work?

Silvia Bortoli: "The aim of this work is to provide direction to those managing and administering payment arrangements to navigate challenging systems. This work is particularly important because appropriate and efficient payment of public contributors can help include people from diverse backgrounds and ensure involvement in research is inclusive."

What does the future look like?

The authors of the newest employment status guidance are considering developing guidance for the public to complement the guidance for organisations. This guidance could include real examples of public contributors, the activities they have undertaken, whether or not they are employed, and how payment (if desired) has been arranged.

From the discussions during the event, it became clear that there are a number of institutions who have successfully navigated the organisational issues associated with employment status and benefits in order to offer payments to public contributors and that there is an advantage in sharing experiences and best practice in how this has been achieved. It is our hope that as a community of practice, we will reconvene to share such approaches.

About the Forum:

The south east Regional Public and Community Involvement and Engagement (PCIE) and Co-production Forum is a space for NIHR public contributors, NIHR organisations and local partners to come together to share plans, ideas, best practice and resources for patient and public involvement, engagement and co-production. The Forum also helps to facilitate a coordinated approach to patient and public involvement, engagement and co-production across Kent, Surrey and Sussex.