Select Committee on Health Written Evidence

95. Evidence submitted by St Mary's NHS Trust PPI Forum (PPI 145)

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

  The purpose of patient and public involvement is so that members of the public in a diverse society can get there views across to the government as well as local NHS trusts and doctors practices. They also should be entitle to a say on how vast sums of money are spent on there behalf.

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

  The most desirable form of patient and public involvement is the unpaid volunteer as they are more likely to be independent. Having said that in today's society to encourage disadvantage groups, single parents and to attract the right caliber of people we might need to increase expenses to cover childcare and time spent in meetings.

  Trying to demonstrate valve for money is very difficult because of connecting outcomes to processes and structures.

  The Government needs to define what it wants a PPI system to deliver.

3.   Why are existing systems for patient and public involvement being reformed after only three years?

  One reason given for reforming the patient and public involvement system is that the government wants to widen the involvement of the public in health and social care although there have been no clear guidelines on how this is going to happen.

  Another was that the Forums were ineffective and the PPI will need to be more involve with the commissioning. This may be true but you cannot guarantee that the LINKs will be more effective and if Forums members disappear you will have the same situation as the change over from CHCs to Forums.

4.   How should LINks be designed, including

    —  Remit and level of independence

    The remit should cover all health issues from commissioning to providing.

    The LINks should be independent from the department of health and local authority control.

    —  Membership and appointments

    Membership should be open to all with rules on conflicts of interest and to ensure that organisations with a vested interest in single health issues don't dominate committees.

    —  Funding and support

    Funding should not be less than it is at present and control of the budget given to the LINks. This could be base on the population with separate funding for deprivation, rural or other reasons.

    The support for the LINks should be provided by a local organisation providing they are not a health pressure group. They should also be able to provide office, computers and telephones.

    —  Areas of focus

    The LINks should be able to look at any area of health they deem appropriate.

    —  Statutory powers

    The powers should not be less than that of the forums with some areas being strengthened to give access to any contracts for the provision of healthcare. Trust should not be allowed to use business confidentiality to stop LINks viewing contracts.

    —  Relations with local health trusts

    Forming a good working relationship with the local health trusts is desirable so that you work together in improving services to the patient.

    —  National coordination

    Ideally the organisation should be built from the bottom up. The main thrust should be local. If regional and national bodies are needed the remit for the person charge with setting them up should be to form regional and national bodies within 12-18 months by elections from local networks.

5.   How should LINks relate to and avoid overlap with

    —  Local Authority structures including Overview and Scrutiny Committees

    The LINks should have a voice on the OSC but not be part of it.

    —  Foundation Trust boards and Members Councils

    Again LINks should have a voice on the Members Councils and Trust Boards.

    —  Inspectorates including the Healthcare Commission

    The LINks should work closely with the Healthcare Commission and be consulted on areas that are failing.

    —  Formal and informal complaints procedures

    The ICAS side of the complaints procedure should be strengthen and given greater prominence.

6.   In what circumstances should wider public consultation (including under Section 11 of the Health and Social Care Act 2001) be carried out and what form should this take?

  There should be a consultation procedure between the trusts, local authorities and LINks for all changes at a local level which would have an effect on patient's health and social care.

Roy Oliver

Chair, St Mary's PPI Forum

10 January 2007

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