Select Committee on Health Written Evidence

50. Evidence submitted by Leicester, Leicestershire and Rutland PPI Forum (PPI 64)


  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


The University Hospitals of Leicester PPI Forum

9 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