MAC advises commissioners and providers on meeting PPI duty
Posted: 26 October, 2010 by Andrew Craig
MAC Partnership has published policy advice for commissioners and providers on how to meet the duty to engage with patients and the public outlined in the White Paper Liberating the NHS.
We urge building on what exists already. Our recommended approach is to make patient participation groups in constituent practices of commissioning consortia and provider federations the bedrock on which to build robust user-led intelligence.
Linked to these policy papers, starting next week we will be publishing each week a series of five “how to do it” papers aimed at primary care practices to show them the many ways to get into patient engagement and “what counts” as patient participation. These are simple guides and based on our practical experience of ten years working with practices and patient groups. We know these things work and any practice can do them. The amazing thing is that so many don’t bother because they don’t see themselves as consumer-facing businesses. That culture will have to change and the sooner the better.
Keep an eye out for them.
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations.
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“Our recommended approach is to make patient participation groups in constituent practices of commissioning consortia and provider federations the bedrock on which to build robust user-led intelligence.”
Good call, I am thinking in similar terms. But I can see barriers to this. For a start the coverage of PPGs is patchy. Are patients whose GP does not run a PPG to have less of a voice than those who do? Or would the consortium attempt to make running a PPG mandatory? – good luck with that!
There are a range of views amongst GPs about them – some think they are old-fashioned, and some that they are giving a platform to serial complainers and patients wanting preferential treatment.
Others think that it’s OK for middle class people in leafy suburbs but not an appropriate mechanism for more diverse inner city areas, or OK for large health centres but too much hassle for single handed practices. Of course there are many GPs who swear by them.
Thought is also required about the PPGs, which are usually focussed downstream on services in particular practices suddenly being asked for views on strategic commissioning decisions. They are clearly going to need a great deal of support to engage meaningfully.
And what about people who wouldn’t go near a PPG but have views about commissioning in the wider health economy, would they be shut out of the process?
Don’t get me wrong, I think you are on the right lines but there is much work to do.
Indeed there is much work to do. And there is no one way to do it. We will be addressing some of these things in the series of articles on what counts for patient participation starting Monday 1st November. We hope these will stimulate comment and debate.
It’s good to see the the RCGP has agreed with our thinking about the differences between GP consortia (commissioning) and GP Healthcare Federations (providing services).
http://www.pulsetoday.co.uk/story.asp?storycode=4127542&cid=In-depth_1_291010&sp_rid=NDE0NjI3MzcxNgS2&sp_mid=35932988
As Pulse rightly observes “It was pretty inevitable that the two concepts would quickly become conflated, given that many early federations were born from practice-based commissioning groups.” But confusion resulted and it needed sorting out. It has been now.
The RCGP guidance on establishing Healthcare Federations was published last week.
http://www.rcgp.org.uk/PDF/Toolkit_Content_Final.pdf
It makes a good companion guide to the NAPC one on GP commissioning that also emerged recently. http://www.publicinvolvement.org.uk/2010/10/practical-ppi-advice-to-gp-commissioners
It is clear that GP Federations should be in the business of providing general practice services across a group of practices more efficiently, eg by more standardised chronic disease management and sharing common functions. And they can federate now, without waiting for consensus in their area about which and how many commissioning consortia there will be. In the meantime, Federations could well be doing much of the stuff that was called “commissioning” under PBC, but was really just extended provision and some secondary shifts into primary care. This needs a lot of explaining both by the RCGP and by the PCTs. Are they up to it?