Bad omens for NHS patient involvement
pharmafile | October 22, 2003 | News story | |Â Â Â
The exclusion of frontline NHS staff from early work on patients' forums does not bode well for the future of the bodies, a new report warns.
Prof Chris Drinkwater, one of the principal authors of the NHS Alliance report, 'Patient Forums and PCTs models of engagement', says early indicators suggest that best practice in the field is being diluted.
The Bristol Royal Infirmary report by Prof Kennedy is the foundation for much of the Government plans for patient involvement in the NHS and recommended that healthcare professionals must be partners in involving the public and patients.
Prof Drinkwater said: "This message seems to have been forgotten. It is disappointing to see that the change assessment groups which have been set up at strategic health authority level to support the local establishment of patients' forums include managers, community health councils, local governments and the voluntary and community sector, but no clinicians. Doctors, nurses and allied professionals are currently excluded".
He added: "A great deal of the successful work currently supported by PCTs and health action zones could be lost".
Patients' forums were themselves the outcome of a bitter and long-running battle over how patient involvement could be updated in the new NHS, after the Government announced the abolition of community health councils. Their independence from local PCTs was a hard fought principle, but Prof Drinkwater fears they run the risk of being part of an overly bureaucratic system that will stifle efforts to give people a say in their local NHS services and be listened to.
The forums will share power with five other bodies the CPPIH, CHAI, PALS, OSCs and ICAS (see below) in attempting to improve patient and public experience of the health service.
The new report was commissioned by the Department of Health and the Modernisation Agency and attempts to provide guidelines on how to surmount this and other obstacles. Joint author of the report Dr Brian Fisher, a London GP, says it is based on sound experience and good practice across the country.
"We now have a new and firm basis for engagement with patients, carers and the public to plan, develop and implement the health service we all want. But the process must be collaborative, not confrontational". He added: "The independence of patients' forums is important, but it must not lead to institutional apartheid".
Among the report's recommendations is for PCT board members to attend patients' forum meetings to explain the trust's decisions and listen to views and concerns. Important PCT committees should provide annual reports to the forum to explain how they have carried out their duty, and all PCT documents should carry 'patient-impact' statements.
Ways of developing community links, such as patient-as-teachers and critical friends groups should be used in all areas, but these methods should be truly community-led rather than an NHS management tool, the report suggests.
NHS Alliance guide to the new patient involvement bodies
Patients' forums will be set up in every PCT area and for every NHS trust (hospitals and in some areas mental health trusts). They will be independent of the NHS and report directly to the CPPIH, which is expected to provide staff in each strategic health authority area.
CPPIH: the national Commission for Patient and Public Involvement in Health. Expected to be set up early 2003. Local patients's forums will report to this body.
CHAI: the Commission for Healthcare Audit and Inspection, a new national body to be proposed in a bill yet to go before Parliament. It is likely to have a direct or indirect role in connection with patients' forums.
PALS: Patient Advice and Liaison Services. These will be set up in all PCTs and NHS trusts. Unlike the patients' forums, they will be part of the NHS.
OSCs: Overview and Scrutiny Committees. New local authority committees whose job will be to monitor and scrutinise local health services. Patients' forums along with PCTs and NHS trusts will have to provide reports to them.
ICAS: Independent Complaints and Advisory Service. Every patients' forum will be responsible for providing ICAS. Most are expected to commission the service from expert providers.
