I have worked in many organisations for over three decades and experienced the joy of working with some great leaders, whose courage and integrity have been inspiring. Working for WentWest, the Primary Health Network in Western Sydney, since late 2021 is wonderful.

I acknowledge WentWest as an organisation that has shown remarkable courgage and innovation. They are a truly values-driven team.

In my experience building health partnerships with communities, I believe one of the most authentic ways to hear the voice of a well-informed public is to convene a citizen jury. WentWest leadership took on the challenge to host and sponsor two citizen juries in Western Sydney in 2023, aiming to really understand the health and social care priorities of Western Sydney people. But it goes further. WentWest has taken the decision to make this permanent and that is unusual and important. The research is clear that this final step is what makes a huge difference. Over time our permanent citizens' assembly, with rolling membership, will grow in health literacy and collective power, and will be able to respectfully and intelligently lead change for the public good.

Its important to me that the capability of the teams who do this work is strong and supported. Although I am now pulling back slowly - reducing one day a year for the next few years - to take on more work independently, I am confident the great team at WentWest has embraced this new way of listening and is enjoying the potential to partner with integrity and depth with the communities in Western Sydney.

Thank you WentWest for your leadership and courage, it is a great pleasure and privilege to be a part of the primary health journey in Western Sydney.

To understand what your community really thinks about an issue, I am convinced by the evidence that a citizen jury delivers in spades.

We often hear people talking about issues that are sometimes politicized - and they don't have access to good quality information to inform their opinions. This is the particular merit of a citizen jury. The organisers have a responsibility for providing good quality evidence before asking the citizens to come to consensus with a view on the question before them.

To organise a jury, firstly you have a question. You are interested in a topic and you want to know what your community thinks about it. Then you need to consider what the community needs to know about the topic to be well-informed. This might include information about population health, ethics, data, technology, science - depending on your question. You also need local advice to ensure that your jury is going to work for your community. How should you present your evidence? What experts are available to speak to their part of the evidence? 

How you recruit your jury is important, there are many considerations here. Do you commission a social research company to recruit for you? There may be a few options available. You need a venue, and considerations of timing and budget are crucial. It's complex but it has an evidence base which will ensure you succeed.

Citizen or Community Juries are a grass roots method of hearing what the community really thinks when they are informed about an issue. They are life changing for jurors and the organisers behind them. The Citizen Jury is designed to allow decision-makers to hear the people’s voice. It provides an opportunity for citizens to learn about an issue and deliberate together to find a common ground solution¹. 

Citizens' juries permit citizens to engage with evidence, deliberate and advise on a range of complex and demanding health and policy topics ². They are a complex process that allows thoughtful input from a well-informed microcosm of the public ³ on behalf of communities rather than as a consumer or an advocate ⁴.

Use of a trained and experienced facilitator can support citizens to make a well-informed largely consensus decision ⁵.  Deliberation is aimed at transforming participants’ perspectives from initially a self-regarding and limited perspective to take account of a broader perspective inclusive of the public interest.

There are presumptions that individuals are motivated by things beyond self-interest and are not separate entities detached from those around them ⁶

1. The Jefferson Center, Citizens Jury Handbook. 2004.
2. Street J, Duszynski K, Krawczyk S, Braunack-Mayer A. The use of citizens' juries in health policy decision-making: a systematic review. Social science & medicine. 2014;109:1-9.
3. Tully MP, Bozentko K, Clement S, et al. Investigating the extent to which patients should control access to patient records for research: a deliberative process using citizens’ juries. Journal of medical Internet research. 2018;20(3):e7763.
4. Degeling C, Carter SM, Rychetnik L. Which public and why deliberate?–A scoping review of public deliberation in public health and health policy research. Social Science & Medicine. 2015;131:114-121.
5. Street J, Fabrianesi B, Adams C, et al. Sharing administrative health data with private industry: A report on two citizens' juries. Health Expectations. 2021;24(4):1337-1348.
6. Simpson, P.L., et al., Identifying research priorities to improve the health of incarcerated populations:  The Lancet Public Health, 2021. 6(10): p. e771-e779.

Early in 2023 the Chief Executive of the Western Sydney Primary Health Network, aka WentWest, accepted an evidence review that pointed to the value in running a citizen jury in Western Sydney. A citizen jury could ask the community to identify the health and social care priorities, enabling targeted investment that would provide great returns for the people. We knew that our Community Advisory Council had provided great input to existing programs in our organisation but that it was difficult to go back to the basics. We wanted the first step - a foundation - so that we could build on it.

We soon realised that we needed to separate out two distinct populations in our community - First Nations and the rest of the population whose ancestors have been here for less than 250 years. A jury is a representative sample of a distinct population, however defined. The two groups have a lot in common but a lot that is not. I am so glad we made that decision.

It took us many months of preparation - listening to internal and external stakeholders and taking on board their advice for how a citizen jury would most effectively deliver in our community. It was a lot of work, but worthwhile. That advice really changed our directions many times. We understood that we needed to be very careful about how we provided the 'evidence' for the juries to deliberate upon. Western Sydney, perhaps moreso than many other communities, is richly populated with people who are more comfortable speaking a language other than English at home. This is important because health and social care facts can be complex and we wanted our juries to be able to come up with well-informed viewpoints.

The jury had been recruited to align with the Western Sydney population profile. The handbook containing the evidence had been shared with all the jurors and tonight we are meeting all the members of the jury for the first time.  The excitement and anticipation was palpable, not just for the jurors, but for all of us organisers as well.

My team was busy, we had a weekend in front of us, all the work, the thinking, the planning, this is it!

Last night, Friday night, we started to socialise how the jury will work over the weekend, and the importance of deliberating "for the public good".  The ice was broken and people were excited.

 What a wonderfully diverse group!

Today, Saturday we kick off with our carefully created program anchored by the experts we have been working with over the last few months to produce the program. Experts are presenting in panels representing life stages and using two hypothetical families to show (not tell) how the health system currently functions and alternative realities for how we (the people) could invest in the system.

After a panel presentation, equal time is given to jurors for question and discussions. In the breaks the jurors are excited about the new information they are learning about and want to share with their networks.

The day goes well. Now ... lets get some rest for the deliberations tomorrow! 

It's Sunday. Today I will be working hard to make sure the jury has considered and digested the evidence and (hopefully!) comes to consensus about how we should invest in the health system in our region.

Friendships between the jurors are forming. Conversations are alive, jurors are excited with the potential for system changes that better serve everyone. So am I!

We go through the evidence discussing what resonates. The discussion is really intelligent. Its always beautiful to witness how a well-informed group representing a community - thinking of the common good - comes up with spot on recommendations. 

Many different viewpoints are considered and it is clear this group is on fire. 

 Finally, we have some recurring linked themes and we are on our feet, jurors voting and prioritising recommendations. The Chief Executive has arrived, spokespeople are identified and the jury starts to share their findings.

The community of Western Sydney has spoken! The two WentWest Western Sydney Community Panels had a lot in common with their recommendations.

Our community wants more investment in prevention - data is increasingly important in a proactive General practice

And the team should support the GP and include allied health, navigators, social prescribers

The community wants community hubs which function as a one-stop shop

- and please, please, can we have more Urgent Care Service Centres.

There were more recommendations and WentWest is now preparing reports to go out more broadly to share what was learned.

1. “The recognition that our cultures are foundational to societal and ecological health and wellbeing - Culture is essential to all existence, connecting us to kin and Country and keeping our identity strong.
2.  Placing care at the heart of policy design - Policies informed by First Nations conceptions of care will form healthier, safer and more just societies.”