www.publicinvolvement.org.uk

Includes:

Easy disembarking at the 'Involvement to Impact' Conference, another Millar consultation,  Consumer Policy Review - misprints and cultural biases in consultation

and the Christmas 6 principles for involvement

Speedy Boarding - Sudden Disembarkation

Arriving at the National Centre for Involvement Conference, the first thing the habitual easyjet user would have expected to hear was the call for "all those who have purchased Speedy Boarding to board the aircraft now". The colour scheme of the 'Involvement to Impact' Conference was easyjet orange - a bright start to what was a successful birthday party. "One year old yesterday" Prof. Tritter told the room packed with delegates - a full house with people there from all the home nations. Easy disembarking actually may have been more on Jonathan's mind. Just after the conference we heard that he is stepping down as the director and Sue Hodgetts is coming on board in January as the Interim Chief Executive of the Centre. For those who do not know Sue, a quick Google will tell you that she is the CEO of the Institute of Healthcare Management. A press release is promised for January.

Consultation Crazy

The consultation bandwagon is fully loaded and everyone is writing about it - not the same as doing it well of course. As well as the NCI conference, November saw consultation discussed in the pages of the Consumer Policy Review and within the M-A-C Partnership itself. December has already seen the publication of the responses to the consultation on 'Effective Consultation' ( http://bre.berr.gov.uk/regulation/documents/consultation/pdf/gov_response_071207.pdf) and we will put our comments up on this soon.

Millar consultation - short and sweet

To get  Partnership business (pleasure) out of the way - there was considerable discussion about yet another Caroline M consultation. You will remember the last one which nailed the problem of why children were not eating Jamie Oliver's delicious food. There was some controversy because it definitely had not lasted the full 12 weeks. The next Millar consultation was similarly indeed even more savagely curtailed.  ith this second consultation, there was a legal constraint that drove the short period given to soliciting opinion - you have to register a child's name within 45 days. The issue has some urgency, the community to be consulted fairly small and in direct touch with the parental policy makers and the result was the choice of Sarah for their latest arrival and we wish Caroline and Tom and Sarah and her four sisters well.

Sarah surrounded by siblings 

Consumer Policy Review: Misprints and Cultural Biases in Consultation

The Consumer Policy Review had an astonishing misprint with the article by Messrs Simmons, Birchall and Prout on 'hearing voices: user involvement in public services' billed on the cover as "Some implications of transportation technologies". We are used to public involvement hiding its light under a bushel but this was taking the tendency to extremes. (As a Which? Old Boy, it is hard to resist the temptation of uttering "It would never have happened in my day" but then things have moved on and Which? now allows manufacturers to cite Which?'s approval in their ads and so is indirectly responsible for one of the most sickening ads on TV at the moment - Ariel and the little girl in a witch's costume. You can imagine the rest. Let's hear it for the agency. I speak here not only as ex-Which? but as an ex-soap and detergent marketing man also. [Is there no end to the murkiness of this man's past? Ed].)

More pertinently, the trio above introduced the reader once passed their disappointment at not reading about transport technologies, to four 'cultural biases' that can be used as a framework for understanding relationships between public service users and providers. We can now introduce into the mix 'Heirarchy, Individualism, Egalitarianism, Fatalism'. I would give a web reference but I am not sure non-subscribers can access the article.

Mike Bartram canters through the current issues concluding that we have some way to go before the reality matches the rhetoric. Sally Brearley takes advantage of her long commitment to 'patient participation' dating from before joining a Community Health Council in 1994, to stake her claim to be allowed to be properly critical of the NHS - "chastising what she loves to make it stronger". She pinpoints the weird argument whereby accepting the invitation and being keen to join, is enough to disqualify you on the grounds of being one of the usual suspects.

Sally points out that the LINks set-up will not give a national voice for patients. There is now an organisation called National Voice which (in Sally's view) "may be an effective voice for the voluntary sector" but not for patients and citizens.

David Pink Chief Executive of the Long Term Conditions Alliance made a similar point at the National Centre for Involvement conference from a different angle - pointing out that the only organisation with a national overview of PPI and LINks etc. had no formal policy in place for taking the patient/citizen's voice on board in strategic decision making - step forward the Department of Health.

The NCI will I imagine be posting a full account of the proceedings - a camera crew was in attendance at both main sessions and part at least of the seminars and you can see a video summary at the website http://www.nhscentreforinvolvement.nhs.uk/

So no full note here but some of what we thought were the major take-aways.

1. the 'international' aspect - whatever the difficulties of vocabulary, the priorities and problems all seemed much the same with the home nations. One particular point - the smaller the community, the more careful the consulters have to be not to exhaust the community of consultees.
2. The PPI managers at PCTs will not disappear. The LINks will not eat them and indeed with the talk being of patient-centred commissioning, their roles will become more important. What sort of relationship will they develop with LINks - how will they both support them and benefit from them?
3. There was an interesting announcement on TUPE's - that TUPE's would not apply to LINks according to Meredith Vivian.
4. Meredith also said that primary care and GPs were now the area of most interest to him in seeing how they took on board the patient and public involvement messages

The Christmas Message

Finally for me the most interesting session was the one that focussed on motivating individuals. A conference like this inevitably focuses on institutions and institutional structures, plans and actions. The individual can be overlooked but Simon Christmas of  SHM Ltd ( http://www.shm-ltd.co.uk - not a very informative website but worth getting the link right - SHM Ltd googled gives you a Latvian security company) refocused us on what makes individuals join in. His iconoclastic approach became clear when he was the only person to mention the taboo subject of money and paying people to join in. He also made the radical point that involvement by citizens and patients is an emotional issue and that they do not want to be involved in decision making - they leave that to others. Things about decision making that make them wish to avoid that task are, for example, the process of selection which implies a knowledge of alternatives which they do not know and care about. Secondly they do not want to be in a position of saying yes to one and no to other worthwhile candidates and causes. They will get involved to RESIST if they feel threatened, COMPLAIN if they feel ignored and left out and BID/CAMPAIGN for their own campaign or point of view to be included and chosen.

Let me leave you with his six principles of successful involvement.

The Christmas 6 principles for involvement

1. the thing has to matter
2. the people convinced that they - the people - count
3. there is something that makes them want to join in
4. joining in has to beat the competition of other calls on their time and energy
5. Often involvement has to be jump-started? - how to make the first person dance? Think about money
6. Get the message out about impact ie that people have been listened to and have made a difference.

Disrespect: Double Damage

This last message is very important because as Simon said, one of the most damaging consequences of not feeling that their contribution made a difference is that people do not just lose faith/ trust in the organisation - "they invited me to talk but pay no attention" - but also lose faith in themselves i.e. confirmation of view that "I am not a person who ought to be listened to". The confidence to insist is often a matter of social class - the pushy middle class makes sure its demands are heard. This brings us back to the Brearley point and being categorised as the 'usual suspects'.

The briefing on Section 242 of the NHS Act 2006  previewed by Meredith at the conference, duly appeared as  http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081089 and of course it states a different view to Simon's - namely that users of services - directly or through representatives - are to be involved in planning, proposals for changes in service provision and decisions.

The debate will go on and we will be there we hope not just as commentators but participants as well. We announced on Monday, 3 December 2007 that:-

"Wandsworth Care Alliance (WCA) supported by the Moore Adamson Craig Partnership (M-A-C), a public involvement consultancy, has submitted an expression of interest to Wandsworth Council to be the host body for the Local Involvement Network (LINk) to be established in early 2008. WCA and M-A-C are combining their complementary skills and expertise in the tendering process. If WCA is successful, it will commission M-A-C Partnership to help it deliver the LINk Host function for Wandsworth".

We heard later that we had been included on the tender list.

Watch this space.