User voice is too important to be treated as a box-ticking exercise. For regulators and commissioners, the challenge is not only to ask whether people have been consulted, but to understand how their experiences have been heard, interpreted and reported. This is particularly important when working with vulnerable people whose experiences may not fit neatly into a survey form or performance dashboard. Good regulation needs space for context, judgement and explanation, not just more feedback data.
Professor Andrea Mennicken, Professor of Management and Organisation at King’s Business School and co-author of the study
16 July 2026
Why care regulators should rethink how they listen to vulnerable people
New research from King’s Business School warns that user feedback is not simply “captured” through surveys, interviews and case studies, but actively shaped by the systems used to collect it.
Policymakers and regulators increasingly expect health and social care providers to put ‘user voice’ at the centre of service evaluation, inspection and commissioning. But new research cautions against treating feedback from vulnerable service users as a straightforward measure of service quality.
The study, published in Accounting, Organizations and Society, examines how a large UK social care organisation collected, processed and reported feedback from people using services for mental health, homelessness, substance misuse and elderly care.
In health and social care, ‘user voice’ means the views and experiences of people who use services, gathered through surveys, interviews, case studies, inspections or informal conversations to help assess and improve care. Such user feedback is increasingly used to judge service quality, demonstrate regulatory compliance and inform funding decisions.
The researchers found that user voice is not a fixed thing waiting to be captured. Instead, it is “made up” through everyday organisational practices, including survey calls, inspection conversations, databases, case studies, satisfaction scores and reports to commissioners and regulators. In this process, user feedback can become distorted, reshaped or lost.
The paper shows that apparently simple feedback, such as a tick-box answer in a satisfaction survey, can involve complex interpretation by staff, especially when service users are distressed, confused, traumatised or unable to respond in the terms required by the form.
The study argues that policymakers should avoid assuming that more feedback automatically means better insight. For vulnerable users, formal consultation can be difficult, and the search for “authentic” voice may itself be problematic if people’s experiences do not fit the categories available to them.
The authors suggest that regulators and commissioners should pay closer attention to how feedback is produced, not just whether it has been collected. This includes recognising the labour of frontline and reporting staff, allowing space for contextual explanation, and avoiding over-reliance on simplified scores.
The paper, “Making up” user voice: Accounting for experiences of the vulnerable, was authored by Dr Finia Kuhlmann of HEC Paris, Professor Andrea Mennicken of King’s Business School and Professor Emeritus Peter Miller of the London School of Economics and Political Science.
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Professor of Management and Organisation