Select Committee on Health Written Evidence

31. Evidence submitted by South East Essex PCT PPI Forums (PPI 136)

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

  The members view is that their primary purpose is to be aware of the health needs of their local population, to communicate these needs to the relevant organisations, and to assist all organisations connected with the provision of local healthcare services to match those needs in a timely, affordable and practical fashion. This assistance will include advising these organisations on the steps needed to be taken to assist the local population to manage their own and their families heath and to "live healthily". Members are expected to be aware of the needs of all groups including and not limited to ethnic minorities, young people, the elderly, hard to reach groups including commuters, a particular problem in south east Essex.

  In detail:

    —  To provide help with the design of services and commissioning.

    —  Ensure that the right services are developed and result in the best outcomes for the local population.

    —  To capture experience of using services.

    —  To hold the local services to account.

2.   What form of patient and public involvement is desirable, practical, and offers good value for money?

  Members believe that the present model, that is the local patient and public involvement forums in southeast Essex fulfil these criteria. Members believe that their remit needs to be expanded to include social care. Members are not paid for their work. They are dedicated to the task of improving local health. They are effective. They have many years of valuable experience of the local area and service providers and their organisation works. The costs of running the forum is low and is confined to members' expenses, which are modest, the forum support organisation, space, and office equipment. We understand that the forum costs are approximately £30,000 pa Members do not need an expensive headquarters organisation to support them, just good locally provided support. It has taken about three years to reach this position. On the grounds, if it is not broken, don't fix it; members believe that with some relatively minor changes, the current model can be made even more effective.


  Members consider that they have done a good job and are becoming more effective with the passage of time. Members do not understand why their forum is perceived to have failed and consequently are unable to answer the question with authority. To the members, it is change for change sake. Members are even more mystified why a change is being proposed when the replacement organisation has not been defined

4.   How should LINks be designed, including:

Remit and level of independence

  The remit must include social services in a similar way to health services. Members get similar numbers of complaints about social service provision as they do about NHS service problems. The boundary between health services and social services strikes members as artificial, and not helpful to the local population. Otherwise the remit should be similar to that of the existing forum remit. Members believe that they should not have conflict of interests which in any way reduces their independence from local service providers (including charitable organisations) and local pressure groups including local politicians.

Membership and appointments

  Members are not happy with the present arrangements for appointments. Members are aware of the long period of time taken by CPPIH to appoint new members and believe that a local mechanism has a lot to commend it. Ideally, forum members would like to see a local democratic process to recruit members and for forum members to be part of the selection process. We suggest that we should work with the local voluntary organisation to advertise, select and recruit. The evidence suggests that this process has worked well. The process of recruiting can be modified with experience gained.

Funding and support

  Note forum includes LINks or similar title.

  Each forum should budget its proposed costs, then hold its own budget and report on expenditure and achievement annually. The funding should cover: rental and operation of premises—a small office and meeting room, forum support (usually one person with limited arrangements for cover of holidays and illness), office equipment including Internet access, stationery, postage, telephones, lighting, heating and cleaning. Sharing premises with a local charity would make a lot of sense. The forum will also need capital for office equipment and running investigations.

  The local authority seems the best organisation to provide this money. We believe that there could be problems with this arrangement, but alternatives seem potentially worse. We believe that the Department of Health would be unwilling to provide monies without an excessive amount of "red tape".

  We believe that it would be sensible to gain charitable status so that we would be able to raise money to support the work of the members. We envisage it would take time and effort to make this work satisfactorily and we would need pump priming to get going.

We believe that the Department of Health might be willing to pay for patient and health and social service surveys and this source of revenue could be developed with time.

Areas of focus

    —  The patient journey experiences.

    —  Experiences of social services.

    —  Assisting with establishing practice based commissioning.

    —  Reducing health inequalities.

    —  Determining local health issues and recommending corrective action.

    —  Capturing and analysing the patient experience and reviewing this with the relevant organisations and follow up where necessary.

Statutory powers

    —  Similar to those of the patient forums.

    —  Sight of contracts for practice based commissioning (subject to non-disclosure agreements).

Relations with local health Trusts

    —  Critical friend.

    —  Constructive.

    —  Access to Directors, Chief Executives and Chairmen.

    —  Work in partnership where possible.

National co-ordination

    —  Minimal—restrict to codes of conduct and functional guidance. The emphasis is local at all times.

    —  Informal links to other Forums.

5.   How should LINks relate to and avoid overlap with:

Local Authority structures including Overview and Scrutiny Committees (OSCs)

  As now. Work together. Forums pass issues to the OSCs. OSCs get evidence from forums. Discuss common issues. Forums second members to OSCs with non voting rights.

Foundation Trust Boards and Members Councils

  Formally via the PCT and informal contacts.

Inspectorates including the Healthcare Commission

  Pass reports on local experiences to the Healthcare Commission.

Meet with the Healthcare commission when the commission requests a meeting. Have a formal agenda and respond to requests for information in a reasonable timeframe.

  Regular contact with the commission to understand commission objectives.

  Report on the commission to the Department of Health.

Formal and Informal complaints procedures

  We believe that the existing mechanisms are basically sound. Members should pass problems to the appropriate PALS (as now) and refer complaints to ICAS (as now). We are aware of public concern about complaints procedures, but believe that with the current changes in the NHS, that all trusts will become more responsive to complaints and for our members to get in the way of this change will be unhelpful. Our role should be to provide an evidence based big picture and not be another complaints handler. Trusts will need to get their acts in order to maintain income. We believe that this will result in the best outcome for all (patients and care providers). We would like to see all trusts welcoming complaints as a form of low cost marketing information and not as a cross they have to bear.


  Patient Forums are not perfect, but they are not beyond repair.

To replace them with another organisation when they have just got going is unhelpful to patients' interests.

  Members agree that social care must be added to the responsibilities of the forums. Members are already involved in this area and can absorb the additional work.

  Members believe that local is best and that national organisations are unhelpful.

  Members understand local issues. Use them where they can be most effective.

  Members believe that wider consultation under Section 11 would be helpful and this should be performed now.

Harry Chandler

South East Essex PCT PPI Forum

January 2007

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2007
Prepared 6 February 2007