70. Evidence submitted by Norfolk &
Norwich University Hospital PPI Forum (PPI 27)
What is the purpose of PPI?
1. Just what it saysto involve the
wider public in the decision making, provision and monitoring
of everything involving health and social care. Also to obtain
an outside view of the rather enclosed world of the NHSwe
are told that this is very valuable.
What form of PPI is desirable etc?
2. At the very least, the form that the
best PPI forums were able to build up during their short lifetimes.
A "critical" friendship where the PPI viewpoint is sought
, respected and valued. Also, the PPI Forum should be responsive
to national and, more importantly, local needs and perspectives
which may vary from one locality to another.
Why are the existing systems for PPI being reformed?
3. A very good question, because Forums,
after a great deal of hard work, are already monitoring their
areas and gathering public opinion; plus building relationships
across the voluntary sector. But the extension to cover Social
care is very welcome, although many Forums were already, quietly,
doing just that. The emphasis away from organisations is damaging
especially in the case of Acute Trusts, and more especially PFI
Acute Trusts like ours. The new reforms should build on the best
PPI experience by bringing the less efficient and effective Forums
up to the same standardin effect many Forums are already
acting like LINks.
How should LINks be designed?
4. Firstly, with a great deal of care and
thoughtespecially about what has been achieved and what
were the mistakes of PPI Forums. Guarantee a long term with incremental
improvements based on experiencenot major change after
three years as per change from Community Health Councils to PPI
Forums.
Remit and level of independence
5. At least the same remit as PPI Forums
to cover Social Care as well as Health. A critical friend plus
statutory duties to monitor services and gather public opinion.
With rights of inspection. Independence is vital especially from
political pressures or the NHS itself.
Membership and appointments
6. Membership should be as open and inclusive
as possible; but to involve younger working members, special arrangements
must be madeperhaps giving consideration to companies to
allow their employees to drop in and out of LINKS. There might
need to be a two tier system of appointments for members who are
able to carry out inspections with a fairly formal interviewing
process. Consideration of paid appointees to guarantee that members
who commit to longer than average hours get additional benefit
(eg Chairs) and thus provide continuity.
Funding and support
7. This should be ring-fenced, robust (not
able to be plundered by local government for other things in times
of need) and upfront unlike that for PPI Forums; it should be
adequate to allow for more publicity than PPI Forums had; and
if working members are to contribute to allow for this. Also to
allow for such things as meetings in public to be successful.
Support is very important for arranging meetings, research and
collating; and for general administration. But, more support is
needed for marketing and publicity and perhaps less on the knowledge
side.
Areas of focus
8. The whole patient pathway including social
care provision. With special emphasis on under-represented and/or
under-funded areas like mental health and care of the elderly.
Also looking at commissioners and actual providers of care such
as hospitals and homes, including the private sector (if things
are not on the commissioning list they won't get funded, so these
people are key).
Statutory Powers
9. At least as strong as for Forums to include
social care and the private sector; and to be well publicised.
Government should undertake to act on clear recommendations made
across the board, otherwise there will be little point in the
whole exercise. It's all very well to listen but that is not always
enough, as has been proved often under the current regime. If
volunteers can see that it is worth their while, they might be
less reluctant to come forward. Lack of funds should not always
be enough reason for Government to reject ideas/proposals.
Relations with local health trusts
10. The same as for Forumsto be included
as equals in planning and decision-making (but Forums have learnt
that trust and respect has to be earned).
National coordination
11. Vital for national campaigns like Foodwatch
and for support, networking and training, but with more member
input and fewer regulations. Again, results of such campaigns
should carry more weight at Government level.
How should LINks relate to and avoid overlap with:
Local Authority structures including OSCs
12. Many OSCs are either unable or unwilling
to cover health in breadth or depth and the LINks could play a
major part in filling that gap; but workplans must be shared and
where possible co-ordinated.
Foundation Trust Boards and Members Councils
13. There would seem to be more reasons
for than against dual membership and sharing views etc.
Inspectorates
14. It is important that each knows what
the other is doing and where possible that the two areas liaise/co-ordinate
and do not overlap or clash. Make it a statutory obligation for
Healthcare Commission (and others) to consult and/or liaise with
LINks.
Formal and informal complaints procedures
15. It is important to be able to identify
trends so it is beneficial if the Complaints departments give
regular reports to the LINks/Forums and complaints have actually
worked together to solve problems.
In what circumstances should wider public consultation
be carried out?
16. When any change is proposed that will
seriously affect the publicfor example reconfiguration
of services (eg bed closures, moving units, rebuilding) and any
changes in PCT policy like patient records, rationing drug regimes
and so on. It should not have to wait for the circumstances outlined
in the white papersuch as, the unrealistic requirement
for a high percentage of people to complain or show concern about
a proposed change before that issue can be taken up.
Anthea Nicholson
Chair, Norfolk & Norwich University Hospital
PPI Forum
5 January 2007
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