Patient and Public Involvement:

1

• Patient and Public Involvement
• The policy

2
What is Patient and Public Involvement (PPI)?

• Drawing on patients experience to evaluate,
  deliver and organise health services.
• PPI Policy develops and facilitates the PPI
  process.
• PPI Policy includes Acts of Parliament, White
  Papers and guidelines.

3
Early PPI policy

• No direct PPI Policy prior to the 1980s.
• No duty to consult patients or the public.
• Community Health Councils formed in the 1974 and
  Patient Participation groups in 1972.

4
Conservative PPI Policy1980s and 1990s

• Focus on a market, not a medical model.
• Griffiths Report 1988 and Caring for People
  1989.
• NHS and Community Care Act 1990.
• Citizens Charter and Patients Charter 1991.
• The Health of the Nation 1992.

5
New Labour Policy Reformlate 1990s

• New Labour Communitarian Policies that
  established PPI in service planning and priority
  setting.
• The New NHS, Modern Dependable 1997.
• Patient and Public Involvement in the New NHS
  1998.
• Our Healthier Nation 1999.

6
2000 The NHS Plan

• Evidence demonstrated that previous PPI Policy
  had not been effective.
• Community Health Councils replaced by Patient
  Forums.
• Introduction of PALS (Patient Advice and
  Liaison Services).

7
2001 The Kennedy Inquiry and Health and Social
Care Act

• Kennedy Report at Bristol - recommended greater
  PPI - July 2001.
• Health Social Care Act May 2001 a duty to
  consult.
• Learning from Bristol patients as equal
  partners Jan 2002.
• Shifting the Balance of Power Jan 2002.

8
2003 Strengthening Accountability

• Application of the Health Social Care Act.
• New Overview Scrutiny Committees.
• The Commission for Patient and Public Involvement
  in Health (CPPIH) fully operational.
• New Patient Forums.

9
PPI Policy Reform in 2004

• NHS Improvement Plan better experience July
  2004.
• Choosing Health Expert Patients November
  2004.
• Creating a Patient-Led NHS cultural change to
  patient-led services March 2005.
• New Commissioning September 2005.
• Now I Feel Tall December 2005.

10
The NHS Act 2006

• New focus on commissioning.
• PPI at all points of the commissioning cycle.
• Patients to be consulted in planning, developing
  and decisions regarding services.

11
The Local Government and Public Involvement in
Health Act 2007

• Abolishment of CPPIH and Patient Forums.
• New Local Involvement Networks (LINks).
• Section 221 changes to commissioning.
• Section 234 accountability for service
  providers.

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Local Involvement Networks (LINks)

• Deliver requirements of Sections 221 and 234 of
  the 2007 Act.
• Run by local people and facilitated by a host.
• Refer issues to Overview Scrutiny Committees and
  chase responses.
• Monitor services, and write reports and
  recommendations.

13
Where are we now?

• All LINks operational by January 2009.
• Lord Darzis NHS review 2008 continued PPI
  focus.
• The new NHS Constitution patients have a right
  to PPI - 2008.
• New White Paper on community empowerment - 2008.
• Section 242 of the NHS Act 2006 - guidance in
  October 2008.

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Where are we now - Commissioning?

• World Class Commissioning (WCC) with 11
  competencies.
• Competency 3 is Engaging with patients and the
  public
• Opportunity to promote PPI in order to achieve
  this competency.

15

• Any questions?

16
For more information
www.nhscentreforinvolvement.nhs.uk
www.dh.gov.uk
17
Reading list

• All policy documents are available online
  from the Department of Health www.dh.gov.uk/en/in
  dex.htm
• 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.

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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