A brief history of Patient and Public Involvement

1
A brief history of Patient and Public Involvement
2
What is Patient and Public Involvement (PPI)?

• Patients drawing on experience.
• Not about ticking boxes.
• Building strong partnerships.
• Communicating effectively.
• Developing health services to meet patient needs.

3
The first PPI Groups

• Patient Participation Groups ran in doctors
  surgeries from 1972. They are still running
  today.
• Community Health Councils ran from 1974 to 2000.

4
Government reform 1980s and 1990s

• The Conservative governments of the 1980s and
  1990s conceptualised patients as consumers.
• From the mid-1990s, there was a shift in policy
  towards a greater emphasis on PPI.
• New Labour focused on communitarian policies,
  establishing PPI in service planning and priority
  setting.

5
Policy and history 2001-2003

• The Health Social Care Act 2001 a duty to
  involve and consult.
• Shifting the Balance of Power to primary care.
• Reaction to the Kennedy Inquiry greater PPI and
  transparency.
• Strengthening Accountability practical guidance
  on how to achieve PPI.

6
Results of 2003 policy changes

• Patient Forums.
• CPPIH (The Commission for Patient and Public
  Involvement in Health).
• Overview and Scrutiny.

7
Practical examples of PPI

• Guidelines from the Department of Health.
• Methods of approach vary from individual to
  community involvement.
• NHS Trusts instructed to facilitate involvement
  and treat patients as having valued opinions.

8
The NHS Improvement Plan 2004

• New Labour continued their reform of the modern
  NHS via the NHS Improvement Plan.
• Expert Patients. A focus on changing the NHS to a
  patient-led service.
• New core standards.
• Changes to commissioning.

9
New Practice-Based Commissioning

• Changed from the NHS Act 2006.
• A duty to consult patients in service planning,
  developing and decisions.
• Commissioning concerns the planning and
  prioritising of services.
• PPI included at all points in the commissioning
  cycle.

10
Recent history a new involvement system

• Abolishment of Patient Forums.
• New Local Involvement Networks (LINks).
• A statutory duty to consult patients.
• Service Providers now accountable.

11
Where are we now?

• All LINks were operational by December 2008.
• Lord Darzis NHS review continued PPI focus.
• The new NHS Constitution patients have a right
  to be involved.
• New White Paper on community empowerment.
• Section 242 of the NHS Act 2006 - guidance in
  October 2008.

12
For more information
www.nhscentreforinvolvement.nhs.uk
www.dh.gov.uk/ppe
13
Reading list
All policy documents are available online from
the Department of Health www.dh.gov.uk/en/index.h
tm There are other useful books and journals
that cover PPI in health and social care policy
and history. Just some of these are

• Alcock, P, Erskine, A, May, M (Eds) (2003) The
  students companion to social policy. 2nd
  Edition. Blackwell, London.
• Baggott, R. (2000) Public Health, Policy and
  Politics. Palgrave Macmillan, Basingstoke.
• Ham, C (2004) Health Policy in Britain Public
  Policy and Politics. 5th Edition. Palgrave
  Macmillan, Basingstoke.
• Kemshall, H Littlechild, R (Eds) (2000) User
  Involvement and Participation in Social Care.
  Jessica Kingsley. London.

14
Reading list cont.

• Leathard, A (2000) Health Care Provision Past,
  Present and into the 21st Century. 2nd Edition.
  Nelson Thornes.
• British Medical Journal
• Critical Public Health
• Health Expectations
• Health Social Care in the Community
• Health Policy Matters
• Health Research Policy and Systems
• Journal of Public Health Policy
• Journal of Social Policy