Foundation trusts are facing an increased focus on their membership development performance.

While the "my membership is bigger than yours" game will be with us for some time, the new compliance framework will monitor turnout at elections, and the question of the quality of membership will come to the fore.

Most urban trusts overly attached to number crunching could be forgiven for having already developed a bit of an inferiority complex over response rates for service user and staff surveys, even before confronting the membership challenge.

Mental health trusts in some cases approached their membership strategies in an ostensibly smug manner. Because many of them have a record of service user engagement, there have been assumptions that this will effortlessly translate into a gold standard membership position. If only life were so simple.

In Camden and Islington, we have come to the conclusion that the membership agenda and the service user engagement agenda should not be lazily intertwined. We got a heads up on this early on, when some of our service user activists raised concerns that foundation membership offered rather less than existing service user engagement initiatives.

The next warning shot came when some public members started saying that the members' newsletters were "too service user-focused".

Whether or not we agreed with these analyses, it was our job to decide if there was anything we could do to deal with the underlying issues. Service user members of the foundation trust do not want their voices to be pitted in competition with the wider body of membership. At the same time, public members want their voices heard on their own merits, whether or not they have used our services.

Service user engagement and membership development can often helpfully cross-fertilise, but it is wrong to allow one to seek to consume or dominate the other. Established independent service user forums have the right to continue to stand on their own merits, in the same way that we will welcome constructive input from service users into the new local involvement networks.

That is not to discourage people from being active members, but it does recognise that the foundation trust cannot unilaterally dictate the terms of dialogue with service users.

One further issue we ignore at our peril is the engagement of our other membership constituency - staff. Many of the candidates in our staff governor elections majored on the importance of service user-centred decision making, but that does not detract from the need to remember that the needs of staff members cannot be simplistically viewed as part of a mythical unitary concept of "members' needs".

Of course, our governors are still new to their job, but I doubt anyone will fall into the trap of interchangeably using the terms "service user engagement" and "membership development".