67. Evidence submitted by the National
Consumer Council (PPI 114)
Further to your correspondence of 18 December
regarding the Committee's inquiry into Public and Patient Involvement
in the NHS, I am pleased to respond with further information.
I am attaching two reports which detail key
recommendations further:
— Final Report from Having My Say Taskforce,
which met in October/November 2005 to find ways to promote people's
`say' in health and social care so that services develop in ways
that are genuinely responsive to their needs and choices. I chaired
the Taskforce in my capacity of Chief Executive of the National
Consumer Council (NCC).
— Department of Health Concluding the
review of patient and public involvement: Recommendations to ministers
from Expert Panel, which reported in May 2006. I co-chaired
this panel. [47]
For ease of reference I am detailing the main
recommendations from each report.
A. KEY RECOMMENDATIONS
FROM HAVING
MY SAY
TASKFORCE
1. The ability of people to have a say is
essential to ensure that high quality health and social care services
are available to meet their future needs.
— People, as active or potential service
users and as members of the public, want to be able to have a
better say in relation to health and social care services. Those
services are better all round when the views and experiences of
people using them are systematically taken into account. Without
such a say, they are significantly less effective.
— Service users should have a say through
the individual choices they make and encounters they have with
professionals. But they also need a say in shared ways, to shape
what choices are on offer and to ensure that more vulnerable users
do not lose out.
2. The right kind of involvement is needed
at every stage of the design, delivery and evaluation of services.
— There should be an involvement with
service users and the public at every level at which decisions
are taken in health and social care.
— The responsibility for giving service
users a say should rest with the decision makers responsible for
commissioning and providing services.
3. The quality of involvement matters but
can achieved in different ways.
— Arrangements to engage people need
to be simple, visible and consistent across local services. And
they need to include the voices of more vulnerable service users,
who may not always be heard.
— An effective way to promote a culture
of involvement is to build more inclusive governance into programmes
of health and care.
4. There needs to be a systematic way of
encouraging decision-makers to listen and to respond to what they
hear.
— There should be a less prescription
on the structures decision-makers use to engage, to allow for
more creative approaches, but an increased focus on their accountability,
through scrutiny, inspection and regulation, for the quality of
engagement and their responsiveness to it.
— There is a need to recognise and
support the independent voice of voluntary organisations in shaping
services for users.
B. KEY RECOMMENDATIONS
FROM DEPARTMENT
OF HEALTH
CONCLUDING THE
REVIEW OF
PATIENT AND
PUBLIC INVOLVEMENT
RECOMMENDATIONS TO
MINISTERS FROM
EXPERT PANEL
1. We recommend a more flexible framework
for supporting public and service user voices in health and social
care at the local level. This should draw on the strengths of
voluntary and community organisations and on interested individuals,
build wherever possible on existing or developing involvement
structures and be more closely connected with the scrutiny function
in local government.
2. We recommend the removal of the legislative
requirements for Patient Forums. We recommend that a Local Involvement
Fund is established to support a stronger public and user voice,
with a clear mandate, adaptable to local circumstances. The mandate
will be for the creation of what we call Local Involvement Networks
(LINks) for health & social care.
3. Our preference is for non-statutory bodies,
but we understand that it is not possible to achieve the formal
relationship we want the LINks to have with statutory bodies such
as OSCs and PCTs unless the LINks are defined in law. We recognise
that the LINks will need to have some statutory basis for them
to have rights of involvement and consultation drawn from the
duties placed on PCTs and Local Authorities. If new statutory
bodies are set up we strongly recommend that statute defines function
rather than form.
4. We also recommend that a specific relationship
is established between the LINk and the OSC—the LINk should
have a formal right to refer matters to the OSC.
5. We recommend that OSCs should focus their
reviews on the decision-making activities of PCTs and local authorities,
in particular scrutinising how well they have met the requirements
of the revised duties to involve, consult and respond.
6. We recommend the creation of capacity
for a stronger voice for patients, service users and members of
the public at the national level.
7. We recommend that commissioning organisations
across health and social care should have a duty to involve and
consult their communities at all levels.
8. We recommend that these duties to involve
and consult should be clearly set out in the forthcoming commissioning
guidance.
9. We recommend commissioners should be
required, as part of their existing planning arrangements, to
develop a forward plan for engaging service users and the public.
10. We recommend the commissioner should
have a duty to respond to the community, as well involve and consult
them.
11. We recommend that S11 is strengthened
and its scope extended. The new section should require every body
which is responsible for delivering health and social care services
(commissioners and providers) to involve, consult and respond
to users and the public.
12. We endorse the White Paper recommendation
that duties to involve patients and service users should be extended
to cover independent sector providers.
13. We recommend the simplification and
rationalisation of the legislation around health service consultation.
14. We recommend that the legislation merging
the regulators should set out how the single organisation will
both regulate stronger voice and how it will involve users of
services and the public and to put their interests at the heart
of its regulatory activities.
15. We recommend that explicit assessment
criteria are established to enable regulators to assess the performance
of commissioners.
I hope that you will find this information useful
and please do not hesitate to contact me if you require clarification
on any issue.
Dr Ed Mayo
Chief Executive, National Consumer Council
10 January 2007
47 Not printed here. Back
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