House of Commons - Health - Written Evidence

Select Committee on Health Written Evidence

22. Evidence submitted by County Durham and Darlington Acute Hospitals PPI Forum (PPI 4)

EXECUTIVE SUMMARY

This submission has been written by David Taylor-Gooby, Forum Coordinator for the PPI Forum for the County Durham and Darlington Acute Trust.

David Taylor-Gooby works for the Forum Support Organisation (FSO) which supports the Forum. As from January 2007, however, he will work directly for the Commission (CPPIH). David was previously a Lecturer and taught the Health Studies Degree, so has some knowledge of the NHS. He also has some experience of local government, and has sat on a Health OSC subcommittee.

SUMMARY

(i) PPI must be seen to be independent and effectively raise the concerns of the public to the NHS, which must be obliged to respond.

(ii) Resources need to be concentrated on the "front line", but for effective investigations and projects to be done there needs to be a dedicated core of volunteers who will take the time to carry them out.

(iii) Forum members are concerned that the experience and expertise built up by Forums may be lost. There is a need to publicise our activities more and recruit new members. Forums must be seen to be independent of local government. There needs to be a Forum to relate to Acute Trusts.

(iv) Points which need to be made about LINks:

— Must be seen to be independent of local authorities.

— The public must be able to make their concerns made to LINks.

— There needs to be a core of dedicated volunteers to carry out projects.

— LINks will need adequate support to be effective.

— Its area of focus should include the Acute Trust.

— It will need powers for selected volunteers to visit NHS premises.

— PPI needs to establish a relationship of "consensual scrutiny" with Trusts.

— Large amounts of money should not be spent on national coordination.

(v) Conclusion

— PPI must be seen to be independent both of Trusts and the Local Authority.

— There must be ways in which it can respond to the concerns of the general public.

— There needs to be a team of dedicated volunteers to carry out effective investigations.

— Effective scrutiny of Acute Trusts should not be neglected.

— There needs to be adequate support, but excessive resources should not be spent on national coordination.

— Volunteers do need the right to visit Trust premises, but there does need to be proper controls on this.

— Existing Forums do need to publicise their activities.

The Forum wishes to submit some evidence of its activities which are relevant to these terms of reference.

1. The Forum has been established for three years, and has twelve active members. There has been some "churning" over the three years, with new members joining and others leaving because of personal circumstances, usually illness. Many of our members, because they are involved with the hospital trust, have long-term conditions. A dedicated team has emerged who have established a "team spirit" and work together. The Chair has been effective and provided good leadership. The Forum has undertaken various projects, but I should like to draw attention to two:

2. "Food for Thought" an investigation into catering at the main Trust sites. This looked at the various catering provided and the reaction of patients. Forum members visited all the main sites and actually tried the food themselves. As a result recommendations were made to the Trust, particularly about ensuring patients ate their food, and using local suppliers. We set up a working party with them, which has made some progress.

3. Stroke is a Medical Emergency. This was a one day conference drawing together representatives of Primary Care Trusts, GPs, PPI Forum Members, and workers from the Acute Trust to consider the whole issue of prevention, treatment and after care for Stroke Victims. The issue was raised by members of the public concerned about the low priority given to both the treatment and aftercare of Stroke victims, and was influenced by the recent Public Accounts Committee Report on Stroke and its effects, and how more effective prevention and treatment could save the country a considerable amount of money. The Conference drew together people from various sectors of the Health Service and the voluntary sector who do not normally talk to each other. The Forum members intend to publicise the results widely, and campaign on the issue.

4. Both these projects were the result of concerns brought to us by the public, and could not have been organised without a dedicated team of Forum Members doing the legwork. Both have been recognised by the Acute Trust as important and influential pieces of work. I now intend to deal with the specific issues:

(i) The purpose of public patient involvement is for issues to be raised independently by members of the public which can then be investigated and proposed to the NHS. The NHS must then be obliged to engaged in a dialogue to try and make some progress with them. This works best when there is mutual confidence and the Forum and Trust work together. The two projects outlined above are good examples of this.

(ii) Forum Members would be the first to acknowledge that value for money could be improved, and that more members of the public need to be involved. For effective projects to be done, however, there needs to be a small core of people willing to organise them, which a larger network might not be able to do. Neither of the two projects outlined above would have happened without the commitment of volunteers. The wider public can be consulted through conferences, or visits to community organisations as our Forum has done. There has been duplication in the management of Forums between the Commission and FSOs, and Forum Members would heartily agree that there is less need for national coordination and infrastructure, and more resources for their front-line work. The Conference, for example, was very successful and we have been asked to organise more, but they are very resource-intensive. The actual day-to-day operation of the Forum does not cost very much.

(iii) Forum Members are concerned that the existing systems are being reformed after three years. There is a need for streamlining the work of the Commission, but existing Forums, which have now developed a good sense of being a Team, and a good track record of projects and a knowledge of what works and what does not, should not be. They do need to publicise their activities more, and communicate more with the general public, but this is a problem faced by many organisations, including local authorities. A further concern of members of the Acute Trust Forum is that the emphasis of LINks will be on Commissioning and the work of the PCT, and that our concerns about the Acute Trust will be sidelined. The Forum has built up a good relationship with the Trust which seems keen for us to continue after they have achieved Foundation Status. The strong point of the Forum is that it is independent of both the Trust and the Local Authority. The new arrangements might give the impression of being too closely associated with the Local Authority which could upset some members who value their independence.

(iv) If LINks is established, members would like to see the following points taken on board:

— It must be seen to be independent of the Local Authority.

— There must be a mechanism for the public to take their concerns to LINks.

— LINks will need to have a "core" of committed people who meet regularly and are willing to undertake projects, without getting bogged down in committee procedures.

— LINks will need adequate support so that it can undertake research which will be taken seriously.

— Its area of focus should include the Acute Trust.

— It will need Section 11 powers to require Trusts to respond, and to work jointly with it. An important power which the present Forums have is the right to visit Trust premises, but in a wider, more diffuse organisation like LINks this would have to controlled. (People have to be CRB checked).

— PPI works best if there is a relationship of "consensual scrutiny" with Trusts.

— There may be a need for national coordination, but there is not a strong case to spend large amounts of money on this.

5. CONCLUSION

Members of the County Durham and Darlington Acute Hospitals Forum feel that much good work has been done since they were established, and are concerned that the expertise and sense of teamwork they have established may be lost. In particular they wish to make the following points: