One of the highlights of the conference for me was the panel discussion ‘Do charities still speak truth to power?’ My own answer would be yes, of course they do. However, I think there is an interesting and overdue cultural shift starting to happen in corners of the voluntary sector. The panel debate and a workshop run by staff from Mind, the mental health charity, entitled ‘Are national charities having an identity crisis?’ picked up on this shift.

Some charities are adapting influencing methods in response to what some see as a rise in DIY campaigns, that is, campaigns led from the grassroots by people who are directly affected by an issue and are not paid to be professional campaigners. I’m not convinced there has been a huge increase in this type of campaigning – I suspect these volunteer-led campaigns are simply more visible and far-reaching than they used to be because of the prevalence of social media and other web-based tools. Whether volunteer-led campaigns are on the rise or not, some charities are recognising that they need to do more to work with the people they represent, and empower them to campaign for themselves. The days when charities campaign primarily for or on behalf of people rather than with them ought to be numbered and I hope the increased prevalence or visibility of grassroots action hastens change.

I was excited to hear Pragna Patel talk at the conference about her decades of experience campaigning with Southall Black Sisters, an excellent example of a community organisation that has managed to strike a balance between employing professional staff and empowering people affected by gender-related violence to campaign. Amongst the many pearls of wisdom Patel offered was the observation that involving service users in campaigning is important because without them an organisation (and its paid staff) lacks integrity and legitimacy. It is also impossible to campaign effectively without drawing on the insight of the people you work with. How do you know what the crucial issues that need to be addressed are if you don’t have a close connection with the group of people you seek to represent?

Patel acknowledged paid staff have a role in speaking truth to power. She said there is sometimes a danger that service users are more easily captured by Government because they may be less savvy than professionals are when it comes to recognising the tricks Government can use to co-opt campaigners to their own agenda (of course, professional campaigners are at risk of co-option too). Patel’s comment made me think about the current situation whereby some Government Departments are less willing to talk to charities than the previous administration was. Ministers and civil servants say they are more interested in seeking out small service-user led organisations to engage in dialogue about policies such as welfare reform. Some charities, especially the larger ones, are finding themselves marginalised.

Of course, it may suit some in Government to speak directly to service users and bypass large charities. However, to me, this is a challenge to charities to improve the way they work with people so that service users and other people affected by policies can speak truth to power directly rather than relying on a charity as a mouthpiece. Patel said organisations which cannot find ways of involving service users in a meaningful way are actually disempowering people. The goal, she said, should be to move away from a situation in which service users are an object of social policy towards being citizens with the power to shape their own lives. In my view, some charities need to do more to put people front and centre of their campaigning work.

Amy Whitelock and her colleagues from Mind made the important point at the conference that some people cannot campaign for themselves (perhaps they are too ill, for example) and look to charities to represent them and campaign on their behalf. That is completely legitimate. My argument is not for charities to completely hand over the reins of campaigning to people with direct experience of the issues. In my view, campaigning nirvana is when the professionals know they are campaigning on issues of importance to the people they represent because those people are involved in setting campaign priorities and strategy as well as taking action; and those who want to campaign autonomously at local level are enabled to do so.

It seems to me that charities need to strike a better balance between speaking truth to power on behalf of the people they claim to represent and empowering people to campaign for themselves when that is what they want and are able to do. Some charities, like Mind, are doing great work to figure out how they can do this. Others, like Leonard Cheshire Disability, have been doing it for years. Some others need to take a look at the way they work and figure out how they can adapt their methods so they are more often working with people, not for them. That means linking with informal structures and grassroots networks already in existence and helping new ones to thrive. It means giving people the skills to campaign and then trusting them to get on with it and do a good job. Charities need to get better at letting go of the message and feeling comfortable about putting people in control.

For more on People Power 2013, search for the #PeoplePower2013 hashtag on Twitter.

To take just one example, the NHS reforms require campaigners for better health treatments and services to adjust their tactics. Merely lobbying Westminster and Whitehall is no longer going to cut it – if it ever did – if your goal is to influence the quality of NHS services in England.

The NHS reforms are complex and I don’t claim to be an expert on them. I do however have a basic grasp of the proposals and a view as to how the reforms might impact on the way campaigners influence health policy and practice. The details of the reforms are a bit dull and full of the usual jargon but bear with me while I sum them up in a few sentences.

You could argue that the ‘N’ in NHS is about to be replaced by an ‘L’ for Local.

In future, the new NHS Commissioning Board – not the Department of Health – will be responsible for delivering clinical outcomes. The Outcomes Framework will describe the relatively few indicators by which the performance of the NHS is measured. NICE Quality Standards will set out what a high quality service looks like but will not be binding. Local GP-led clinical commissioning groups (CCGs) will be responsible for buying in services for the local population. Local Health and Wellbeing Boards will have the power to scrutinise local health services and a duty to involve local service users and the public.

No doubt there will continue to be a role for charities to influence at national level – for example by feeding into the development of NICE Quality Standards – but it seems to me that campaigners will need to adjust their tactics to have real impact on the lives of the patients and service users they represent. There will be a much greater need to lobby at local level – in particular to engage with commissioners – to secure the best possible treatment and services.

How can charities do this? The key is patient power – empowering and mobilising people at the grassroots to advocate on their own and others’ behalf for the type of services they want. In an NHS in which patient choice is increasing and local commissioning groups have more freedom to decide which services to buy for local people, health campaigners need to decide how they will leverage patient power to influence which services are commissioned and to what standard.

In my former life at Breakthrough Breast Cancer we created the Service Pledge to enable partnership between nurses and patients to improve local breast services, guided by Breakthrough’s gold standard. Breakthrough trains advocates who have recently been treated for breast cancer to present the template Pledge to local hospitals and persuade nurses and other clinicians to ask patients what improvements they think need to be made. Clinicians sign a locally-specific version of the Pledge setting out the standards they will meet and the improvements they will make. The Service Pledge led to many small but important changes – many of them cost-free – to local breast cancer services and is still going strong.

Right now the NHS is in flux and it won’t be possible to fully assess all the changes until the Health and Social Care Bill has completed its passage through Parliament and implementation begins. The Localism Bill gives greater power to local authorities to control how public services are delivered in their areas and will affect housing, social care and other services overseen by local government. It’s clear that the public services landscape is changing and those charities with an interest in securing the best possible services for the people they represent need to reappraise tactics to ensure they are fit for purpose.

The people who donate to your charity, sign petitions and email MPs need to be supported and trusted to be the local change makers. This means devoting more time and resources to facilitating local campaigning by volunteers – a challenge in the current economic climate but one that must be faced.

Working as I do with many different charities, I hear a lot of views about the Government. Recently I’ve been struck by the scorn directed towards the Big Society. The consensus seems to be it’s nothing more than a ruse to mask an ideological crusade to replace state provision of public services with an army of volunteers – public services on the cheap. I’ve been surprised by the apparent willingness to jump on the bandwagon of criticism with seemingly little attempt to engage with and shape the agenda.

I take a different view. As someone who makes no secret of her links to the Labour Party (a quick glance at my CV reveals my affiliation, having worked for a minister in the last Government) you might expect me to echo the derision surrounding the Big Society. However, I resist the temptation to dismiss it, and detect an anti-Tory bias that clouds many people’s ability to see its potential.

Where did the Big Society come from? Its genesis was as a piece of political positioning designed to erase the Thatcherite taint from Cameron’s party. “There is such a thing as society”, Cameron said in his first speech as Conservative leader, turning Margaret Thatcher’s famous line on its head, “it’s just not the same thing as the state”. It was an audacious attempt – on a par with Tony Blair’s “tough on crime, tough on the causes of crime” appropriation of law and order as a Labour issue – to clothe the Tories in progressive values. The Big Society alludes to an ethos that is more often associated with the left than the right. And therein lies its potential. One year into his term as Prime Minister, Cameron is desperate to make his big idea fly but finds himself surrounded by ministers whose instincts are often at odds with the concept. There is a yawning gap for sector campaigners to step into to shape the Big Society.

Ministers and civil servants find it difficult to articulate what the Big Society is and what it will do. They are crying out for help to define it. The opportunity exists to engage positively with policy makers rather than complain about cuts. Of course, charities face real and significant problems in the current economic climate. By all means, collect evidence of the effects of austerity on services and communities and shout about it in Whitehall and elsewhere. But whingeing alone never got us anywhere – campaigners who offer solutions to problems are the ones who wield influence. Provide examples of how the Big Society can be given wings and you might just find a harassed minister or civil servant biting your hand off to implement some of your solutions.

Cameron expended massive amounts of personal and political capital on the Big Society – a bit like the banks, it is too big to fail. He’s not going to stand by and watch his big idea crash. Instead of moaning from the sidelines, the sector needs to be a critical friend to Government – pointing out where policy is incompatible with the Big Society agenda but engaging positively to propose constructive and viable alternatives.