Select Committee on Health Written Evidence

105. Evidence submitted by Whipps Cross University Hospital NHS Trust (PPI 116)

Purpose of Patient and Public Involvement (PPI)

    —  To facilitate achieving the vision in the NHS Plan, particularly that set out in Chapter 10 para. 10.35 "...reforms which will bring patients and citizens into decision-making at every level... involvement of citizens in redesigning the health service from the patient's point of view."

Desirable, Practical Format Offering Good Value for Money

    —  A mixture of approaches would best meet the criteria above.

    —  At Whipps Cross we have a Patients' Panel comprising local people from a range of organisations eg Sickle Cell, Diabetes UK, Waltham Forest Asian Seniors Club plus a number of interested members of the public who may be patients, carers, ex-complainants. The Panel members have been invaluable in giving feedback, editing patient information, training staff and working with staff on project groups.

    —  We also link with about 45 local organisations building relationships and exchanging information about issues from patients, carers and visitors. They have been instrumental in helping us improve services eg helping us design and pilot a Carers Policy to heighten awareness of staff about the important role carers have in our patients' well-being.

    —  The PPI structure within NHS Trusts should facilitate:

      —  Patients being involved in decisions about their own care.

      —  Opportunities to shape, comment on, and monitor service provision.

      —  Equal access to services.

Why Reform after three years?

    —  Good question. The reforms should strengthen the good practices established and improve the weak ones.

    —  The new PPI structures should be piloted, evaluated and then given time to settle down before any further changes are made.

LINKs Design


    —  LINKs should not be set up in haste; the process should be properly managed.

    —  Each should be a small group formally appointed and accountable to the local population for representing their interests.

    —  The members should be able to provide evidence of achievements—this does not have to be at high level but it should not just be membership of a number of committees.

    —  Members should be able to demonstrate how they would involve local people in decisions about local services and how they would publicise the LINKs' work.

    —  They should understand that they are accountable for outcomes (or lack of them).

    —  Members should be independent of service providers particularly as the trend is to encourage the voluntary sector to provide services.

    —  It may be necessary to pay members a nominal sum in return for a contract - similar to that applied to Non-Executive Directors of health trusts.

Funding and Support

    —  Funding should be ring-fenced so that it cannot be absorbed into general local authority services.

    —  Resources should be structured, realistic and include dedicated good quality administrative staff.

Focus Areas

    —  Engagement with the local population should be a high priority so that residents are aware they have this mechanism of influencing health and social services.

    —  Priorities should link to the Public Health priorities and those agreed by the Overview and Scrutiny Committee.

    —  The LINKs should publicise their priorities widely and give local people the opportunity to influence them.

Statutory Powers

    —  These should be clearly set out and include the presentation of an annual report to the local health organisations and local authority. Those organisations should be required to respond as appropriate.

    —  Should include visiting rights, properly managed, with clear parameters.

    —  Should include the right to refer issues to the Secretary of State.

    —  Should cover health and social care.

    —  LINKs should be co-terminous with PCTs.

    —  Consideration should be given to a requirement for employers to give time off work for members—similar to that for magistrates.

Relationship with Local Trusts

    —  Should be businesslike and act as a critical friend.

    —  Work collaboratively but be independent.

National Co-ordination

    —  Necessary to give the LINKs a national voice—to give them "teeth"—and to give support to the local LINKs.

Shona Brown

Director of Nursing and Quality, Whipps Cross University Hospital NHS Trust

10 January 2007

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