David Lee on the members' club

Of all the many and varied challenges faced by a foundation trust project director, few hold so many joys as membership.

First of all, you have to be able to communicate the suspension of disbelief involved in recruiting people to an organisation that does not yet exist. This becomes even more interesting when you ask people to participate in elections to a body that still does not legally exist.

Explaining to people that NHS trusts are becoming membership organisations, owned by their members, is not dissimilar to the believability hurdle faced by the Labour Party in the mid-1990s when it was trying to reposition itself as a tax-cutting party. But foundation trust project directors who falter at such barriers are in the wrong line of work.

Then, for mental health trusts, as with so many aspects of the foundation regime, there is the issue that the rules were written with acute hospitals in mind. Being blunt, the issue here is stigma. Many people who use the services of a mental health trust do not want to say so openly, while they would do so if it was, say, Moorfields Eye Hospital. And persuading the person on the Clapham omnibus to be a member of the local mental health trust requires a different sort of soundbite than if you were asking them to sign up for the friendly local district general hospital.

But the overall concept of membership involvement is close to the model and culture of service-user empowerment that mental health has been promoting for many years.

Seeking new members

So we have tried to harness that experience locally to build a foundation trust membership that is representative and growing. We have involved service users in our membership and communications project team to try to keep our membership campaign as well targeted as possible.

After twiddling a couple of legal knobs, we sent out a mail shot to service users, which has been the most productive activity to date. We have kept our membership form as simple and short as we can. We have also placed prominent advertisements in all the local newspapers.

One change that took place mid-project was the decision to have a service constituency of the membership. We had originally planned to just have a 'catch-all' public constituency, but responses to our public consultation persuaded us otherwise. Around 42 per cent of members are service users.

Being a relatively small and compact trust, we are also able to consider a door-to-door delivery of recruitment material. If it was good enough for the patient prospectus, why not for foundation trust membership?

We are helping to pay for this by managing our membership database in-house rather than paying a private organisation to do this for us. We should also save a bit by using something other than the Electoral Reform Society for our elections.

When the historians write up early 21st century NHS reform, foundation trust membership may yet feature more strongly in the narrative than some planned.

David Lee is director of strategic development at Camden and Islington Mental Health and Social Care trust.