Public sector cuts are promised but one area of immunity is already very evident. The Department of Health’s print and stationery budget is untouched as more and more pours off the presses about the ramifications of the new policies needed to liberate the Health Service. In this flood of paper and policy, we make no apology for re-stating our commitment to the personal in all the debates about patient participation and accountability to the public.
Participation Gets Personal
Val Moore returned to the theme of our October newsletter with her observations on how the value of the pearls of user and patient insights were not recognised and put to use either in the context of her work as a non-executive director of a hospital trust or her role in one of South London’s best GP Patient Liaison Committee. A tale of dental misfortune in Switzerland provided me a chance to experience in person a bit about how the Swiss healthcare system works. Excellent treatment but pricey – for a UK visitor because the £ is down to 1.60chf/ £1 from 2.20chf/£ and for the Swiss because healthcare premiums have gone up 8% at a time when inflation is less than 0.5%.
Big Boys Back Off?
Val was looking back to her long experience in the PPI field but the lack of importance attached to the patient voice was at the heart of Andrew’s 15th October blog . Big players like the General Practitioners Committee of the BMA seemed to be backpedalling on commitments to hear and act on the patients’ voices. This trend was worringly present in the Kings Fund response to the White Paper – worrying because of their stated commitment and track record in supporting patient engagement. But things change very fast at the moment and the public debate on participation always assumes like the proverbial cushion the shape of the last set of people who held forth on the issue. Andrew Craig gave the GPs a clear win over the Department of Health mandarins at the latest match in front of the Health Select Committee. For more on that Committee’s work and style, see below.
Doom and Gloom Anglo-Saxon Style
Our concerns about the downplaying of the patient voice were all the more pressing in the light of the axe being taken to the institutions of the consumer movement. Drawing on our rich cultural tradition of doom and gloom as voiced in Anglo-Saxon poetry we lamented the demise of such bodies as the National Consumer Council in its last incarnation as Consumer Voice, the Office of Fair Trading as well as the less well-known and much smaller AJTC (The Administrative Justice and Tribunals Council). A wake is in order – volunteers please to be on board the flaming funeral boat?
E-App Ahoy! A Celebration of Achievement
Our celebration of the launch of a new e-App for commissioners expressed in rather over-blown marine metaphors did not, we hope, disguise our appreciation of a new software application called Neuronavigator developed by the National Commissioning Support project of the three neurological charities Parkinson’s UK, the MS Society and the Motor Neurone Disease Association. The project took the comprehensive data of the pathway we helped the MND Association create as a huge piece of paper and made it an accessible web-based tool to be used by commissioners to plan and cost their treatment pathways. We were proud to have played a role in creating an outcome that will we believe meet the needs of commissioners now and in future the needs of individual patients and clinicians. The emphasis is on more efficient use of resources alongside great changes in the structures of commissioning and we think that NeuroNavigator will help the people working in the area of neurological commissioning where there are worrying signs of them being ‘all at sea’ steer a good course and reach a safe haven ( N.A.M Rodger/ Patrick O’Brian – eat your heart out) for the job of designing and providing excellent services for people with neurological conditions.
Practical Advice for Practitioners on PPI
NeuroNavigator takes a body of factual advice off a piece of paper stuck up on a wall and makes it much more accessible and useable. This was also the emphasis of a paper published by the National Association of Primary Care and United Health UK which we picked up on particularly for its no nonsense talk about the value of patient and public engagement and working in partnership with local authorities. The publication is a good example of that skill of consultancies of turning aspirational and exhortatory prose from politicians or the strategy people into what appear to be operational processes – thus not only making the future possible but giving the impression that it has already happened. This always reassures clients about to embark on some disastrous wonderful new initiative no doubt egged on by their consultants.
More Practical Advice – from us this time
Quite a nifty move and one we have used ourselves. You can see a good example in the series of papers which we are publishing over the next few weeks aimed at primary care practices discussing simple things that count as patient participation. Watch this space.
Throwing Snowballs at Moving Trucks
The phrase is Rosie Cooper’s – MP for West Lancashire and a member of the Health Select Committee of the House of Commons. She feared that
the ordinary member of the public will have less and less influence, and I don’t buy for one minute that a Wellbeing Board is actually going to exert any influence over a consortia grouping which will, in all probability, meet in private and may or may not have non-execs on it. I have not heard one noise from any of the panel to tell me I am wrong.
Andrew Craig summarises the proceedings by saying that the mandarins had to admit that they had not got to the page on accountability and that sharp questioning from Members made it clear that while the lines of accountability of the GP consortia in their commissioning role was to the National Board, there was a lot of uncertainty on how the consortia would be accountable to public and patients.