50. Evidence submitted by Leicester, Leicestershire
and Rutland PPI Forum (PPI 64)
SUMMARY
We believe that our PPI Forums have built up
an effective network in our area, within which we can utilise
the considerable experience and expertise that we have gained
over the last three years, to monitor and influence the delivery
of NHS services to our population.
We fail to see why PPI Forums should be abolished
rather than being enabled and encouraged to evolve in partnership
with the voluntary sector. Such disruption is very disheartening
to the volunteers who have invested considerable time and effort
into the PPI Forums.
We consider that some of the key features of
PPI Forums that have enabled us to work productively are not being
replicated in the proposal for Local Involvement Networks which
is likely to prove very detrimental to the working of LINks.
Finally we have not been convinced that the
structure of LINks, with perhaps hundreds of members, has been
thought through to produce an effective operation that has to
cover Social Care as well as Health.
1. Purpose of patient and public involvement
1.1 To ensure that NHS Trusts are always
giving priority to the needs of Patients and the public in all
their decisions and service delivery
1.2 To ensure monitoring of the provision
of services from the Patients' viewpoint to check that the stated
policies of Trusts are being fully carried out on the ground.
2. Form of patient and public involvement
that is Desirable, Practical and Offers Good Value for Money
2.1 Needs to be able to attract capable
volunteers from various backgrounds representative of the community
and give them a structure within which they can feel that they
are making a useful contribution to society.
2.2 The structure must allow the volunteers
to be independent of the NHS and of Local Authorities. If not
independent of the NHS then there will be undue pressures to conform
to the NHS professionals. We see a difference between democratic
accountability of the NHS which is secured by Local Authority
Overview and Scrutiny Committees and the view of concerned groups
and individuals which has been provided by PPI Forums.
2.3 The structure must provide for the adequate
oversight of all parts of the NHS. In particular there need to
be separate groups to review and monitor the PCT services, and
for each Acute and Mental Health and Ambulance Trust with which
the PCT has major commissioning arrangements (if necessary jointly
with other commissioning PCT(s)) and for Social Care.
2.4 There needs to be a supporting structure
for the volunteers. In our area the Forum Support Organisation
(The Carers Federation) has provided administrative services and
this has worked well. But we have lacked policy and research support
which has reduced our effectiveness.
2.5 There needs to be a national organisation
to spread good practice and express the views of Forums on the
national scene. The Commission, CPPIH, has not been a vehicle
for the views of Forums. In the discussions leading up to Government's
present proposals CPPIH were advocating positions expressly antagonistic
to the views of most Forums.
2.6 The PPIF system of volunteers must be
seen to be complementary to the duty of NHS Trusts to undertake
their own PPI activities.
3. Why are existing systems for patient and
public involvement being reformed after only three years?
3.1 We wish we knew! Especially as the system
is not being reformed, it is being re formed. The reduction in
the number of PCTs has already reduced the number of Forums and
Forums are at a stage where development has become possible.
3.2 Perhaps the desire to abolish quangos,
which resulted in the statement that CPPIH would be abolished,
meant that something had to be done. Situating the PPI in Local
Authorities was the easy answer for cash distribution but the
ethos of Forums would not sit there easily. The option of establishing
a Community Interest Company to distribute grants and to monitor
Forums should have been explored.
3.3 Perhaps we were being too successful
for some people.
3.4 Perhaps Forum resistance to earlier
proposals to abolish the Forums for Specialist Trusts, which all
Forum members see as essential, triggered the decision.
4. How should LINks be designed
4.1 NOT based with Local Authorities.
4.2 If LINks are covering Social Care as
well as Health Care then the Health Care arm of LINks should be
separate, and satisfy the following conditions, though working
co-operatively with the Social Care arm.
4.3 WITH guaranteed powers of inspection.
The Bill does not enshrine powers of inspection, it only allows
the Secretary of State to give powers by Regulation.
4.4 NOT just for PCTs but for specialist
Trusts as well. If LINks are only established for PCT areas then
each LINk needs to have separate groups specialising in the PCT
and in each Acute and Mental Health and Ambulance Trust that the
PCT is heavily involved with. The Groups involved with the Acute
and Mental Health Trusts should be joint ones with involvement
of the LINks of all appropriate PCTs.
4.5 Foundation Trusts MUST be within the
system.
4.6 WITH guaranteed involvement of all Forum
members who are willing including Forum Members from Specialist
Trusts.
4.7 NOT performance managed by Local Authorities.
LINks should not become subservient to OSCs.
4.8 NOT financially controlled by Local
Authorities. If funding is through Local Authorities then it should
be ring-fenced.
4.9 There should be a national code of practice
for the operation of LINks.
4.10 HAVE adequate finance for administration,
for promotion, for consultation and for research.
4.11 CONTINUE the work of Forums, rather
than starting again as Forums did after the abolition of Community
Health Councils.
Leicester City PPI Forum
Leicestershire County and Rutland PPI Forum
The Leicestershire Partnership PPI Forum
and
The University Hospitals of Leicester PPI Forum
9 January 2007
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