Select Committee on Health Written Evidence

100. Evidence submitted by Wandsworth Primary Care PPI Forum (PPI 69)

1.   What is the purpose of patient and public involvement?

  To give patients and public a voice in the design, development, provision and quality of health and social care services to the local population.

2.   What form of Patient and Public Involvement is desirable, practical and offers good value for money?

  The model should be independent of the NHS, Health Trusts and Local Authorities. The members should comprise a cross section of the local community, based on existing PPIF members, patient participation groups, local stakeholders and community groups.

3.   Why are existing systems for Patient and Public Involvement being reformed after only three years?

  Yes, why?

4.   How should LINks be designed?

4.1  Remit and level of independence

    —  To monitor and review services provided by Healthcare Trusts (Hospital and Primary Care) and other commissioners (eg Practice Based Commissioning) and Social services.

    —  To collate views of patient, users and carers about the services provided and report to and make recommendations to the appropriate body.

    —  To enter and inspect premises providing services and report on conditions found.

    —  To encourage public involvement in PCTs, Hospital Trusts and Social Services' consultations and policies.

    —  To encourage all LINk members to be involved at every level in the organisations providing health and social care to influence strategy and strategic thinking and to take part in decisions relating to the commissioning of services.

  The model should be independent of the NHS, Health Trusts and Local Authorities.

4.2  Membership and appointments

  The basic model contract should be for a host organisation to administer a LINk, not to "run it" which should be done by members.

  To attract members, building on existing activity in the voluntary and community sector needs to be done locally based to the extent possible on existing PPIF membership.

  The following will be required:

    —  The independent powers of the LINk need to be made very clear, as is now done for the PPIF.

    —  Develop a clear organisational structure for user involvement, building on lessons learnt with previous two types of organisations.

    —  Members of the LINk should appoint a Chairperson as leader.

    —  Define initial training and briefing needs of user and lay representatives.

    —  Define longer term development and support needs for user participants and support teams.

    —  Account needs to be taken of the lessons learnt in recruiting for the last two types of patient organisations. We can provide examples.

    —  Members should be able to claim attendance allowance when representing LINks in a meeting, as per recommendations in DoH January 2006 report on best practice.

4.3  Funding and Support

    —  The basic model contract should be for the host organisation to administer a LINk.

    —  It should provide adequate, competent and experienced administrative support for the LINk.

    —  Ideally it should have knowledge of the NHS and Social Care and be familiar with the local area and service provision.

    —  It must be able to support LINks to research and gather information, analyse data, write reports and present information. It must be independent of the local authority.

  Funding of the LINk should be very clear and managed by the local LINk members. The budget allocated to the Local Authority by the DoH for the LINk activity should be ring fenced to ensure it is wholly available to LINk members and not used for any other purpose. The amount of funding should be based on the size of the population, the geography and other criteria.

4.4  Statutory powers

  Link needs to be an independent body legally set up with powers of the PPIF as at present. LINk should retain the existing inspection powers of PPIF but the objectives of such inspections must be spelled out more clearly.

4.5  Relations with local health Trusts

  Links should build on the positive and constructive relationships which have been developed by the PPIF. Much good work has been achieved and care must be exercised that it is not dissipated in the changeover.

5.   How should LINks relate to and avoid overlap with

5.1  Local Authority structures including Overview and Scrutiny Committees

  LINks should retain the statutory powers held by PPI Fora. They should remain independent of OSCs but should actively cultivate a complementary and productive relationship with OSCs. LINks should have the power to refer issues to OSCs for action.

5.2  Inspectorates including the Healthcare Commission

  LINks should develop good working relationship with these bodies to ensure there is not unnecessary overlap with the regulators inspections but that their activities are complementary.

5.3  Formal and informal complaints procedures

  Whatever the format, it is essential that responses to complaints should be written in simple, plain non-ambiguous, non-technical language.

6.   Subjects not addressed

    —  Areas of Focus.

    —  National Coordination.

    —  Foundation Trust Boards and Member Councils.

    —  Wider Public consultation.

Bridie Tobin

Chair, Wandsworth Primary Care PPI Forum

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Prepared 6 February 2007