Select Committee on Health Written Evidence

126. Evidence submitted by James Halsey (PPI 20)

  1.  I have been involved as a lay person in the NHS for many years in a number of different areas, namely:

    —  I work as a volunteer in A&E.

    —  I have sat on a number of committees in my local acute hospital trust.

    —  I am attached to the Patient and Carer Network at the Royal College of Physicians (London).

    —  I have sat on 63 Independent Review Panels (under the previous NHS complaints process).

    —  I accepted an appointment as an associate with the Healthcare Commission with a view to becoming involved in the new complaints process.

  2.  I was proud and felt privileged to be involved with the previous complaints process which I knew to be truly independent and free from interference from any quarter and hoped that the new complaints process under the Healthcare Commission would be likewise.

  3.  I believe that there have been very few independent review panels held since the Healthcare Commission took responsibility for complaints and that finance may be one of the major considerations when deciding whether or not to hold an Independent Review Panel.

  4.  In my view the new complaints process is not patient-focused and the correspondence from the Healthcare Commission to complainants is not personalised in any way and because I feel so strongly about the independence of any NHS complaints process have declined to be involved in the new complaints process, a decision that has given me real concern.

  5.  As far as I am aware there has not been any public satisfaction survey regarding the new complaints process but as you are aware the strength of any survey depends on the questions.

  6.  I was also appointed to the Patient and Public Involvement Forum at my local acute hospitals trust but resigned after six months as I felt the implementation process was rushed and the Forums were poorly trained, resourced and supported and despite having statutory powers to monitor and inspect healthcare services, lay people are not equipped to do so and need clinical advice and support to be effective.

  7.  The majority of the public are unaware of the existence and function of PPI Forums, the majority of which have had little impact and have been ineffective. Their function also depends upon the genuine co-operation of the Trust.

  8.  I am passionate about patient and public involvement in the NHS but unfortunately my experience is that in the majority of cases it is a tick-box exercise. The only exception is my involvement with the Patient and Carer Network at the Royal College of Physicians (London). Members are involved in all College activities where they have an equal voice as College members and their input is encouraged, welcomed and valued. I think the Patient and Carer network is a model of genuine Patient and Public Involvement in the NHS and you might like to consider contacting the Patient Involvement Unit at the College for more details.

What is the purpose of Patient and Public involvement?

  9.  To bring the voice of an informed public to those making decisions on the provision of healthcare with the aim of improving standards of healthcare and ensuring its availability as and when needed. To make robust efforts to try and ensure that it is a National Health Service and not a "Postcode Health Service."

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


    —  Volunteering (for reasons below).

    —  Choose to be involved.

    —  Not subject to any government targets, entirely patient and staff focused.

    —  Free from interference from any quarter.

    —  Criminal Records Bureau (CRB) checked.

    —  No cost involved apart from identifiable clothing.

    —  Know staff, geography and structure of NHS site.

    —  Can carry out in patient surveys for PALS officers and any other approved Agency.

    —  Eyes and ears of the public.

    —  Can address concerns before they become complaints.

    —  The Institute of Volunteering Research is undertaking a project to gauge the impact of Volunteering in the NHS.

Why are existing systems for patient and public involvement being reformed after three years?

  11.  The implementation process for PPI Forums was rushed and the Forums were poorly trained, support and equipped. Even though they had statutory powers to monitor and inspect Healthcare Services they were not equipped to do so, needing clinical support and advice to be effective. The majority of the public had no idea of the existence of PPI Forums and their function and the majority have had little impact and have been ineffective.

How should LINKS be designed?

  12.  Look at the failings and shortcomings of the PPI Forums, take stock, learn lessons and ensure that the same mistakes do not happen again.

In what circumstances should wider public consultation (including under Section 11 Health and Social Care Act 2001) be carried out and what form should this take?

  13.  There seems little point on many occasions of conducting a public consultation process when Government has already decided to implement major and minor changes to the NHS. The latest example of yet more changes goes under the title "reconfiguration", many facets of which have already been implemented despite public opposition. I would ask you consider obtaining evidence-based data which confirms that public opinion has changed Government thinking. Sir Ian Carruthers has been appointed to carry out a six month review of all plans around the country to cut services and close Units to see if more can be done to win public support for change which in my view will take place, despite public opposition.

  I am willing to appear before the Health Committee if required.

James Halsey

3 January 2007

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