Our views on PPI in the new Bill prompted a thoughtful response from the patient and public involvement advisor of a major health trade union. Here’s what he wrote:
My observation is a little less fulsome, since I’m concerned that if we’re not careful, we’ll see ‘business as usual’, as a consequence of the rather weak instruction,
The consortium must make arrangements to secure that individuals to whom the services are being or may be provided are involved (whether by being consulted or provided with information or in other ways )
I’m with you on the point that the National Commissioning Board may well be key here, in ensuring that this definition is stretched in favour of users and local populations’ true involvement as much as possible.
However, with tightened budgets, and the confusion that will result from system wide change (not least of course, the broadening of AWP [any willing provider]), I have concerns that the democratic legitimacy issue may be lost in favour of a more ‘consumer satisfaction’ approach, i.e. are people getting what the want (with all of the pros and cons that such a construct generates, bread and circuses comes to mind for instance), rather than is the community being best served.
On your definitional point regarding involvement over engagement, we have a different take on the two terms, which necessitates them both being in place to effectively deliver on PPI.
- involvement = how individuals, groups, or communities are supported to participate in decisions about health and social care provision;
- engagement = how individuals, groups or communities are supported to effect benefit from decisions made about health and social care provision.
Interested to hear your thoughts.
Fair comment and very welcome. And here is what we replied:
Engagement is a subspecies of involvement in our book, not its opponent. Just like consultation is a technique and not an end in itself.
Our point is just that engagement on its own has no continuity and does nothing to develop capacity. It is used by the statutory services for their own ends; little or nothing is co-created.
So I think we are in agreement. On the “by other means” point, yes this could become a reductionist approach if it is the default. But as we warn in the posting – “don’t wait to be told” what the PPI duty on consortia means. It’s a glass more than half full.
Groups should get out there and start saying what they want in terms of involvement. Hammer it down as soon as possible with each consortium, starting with the Pathfinders. Community activism and lay leadership are essential. And why not make it part of LINks transition to Local Healthwatch to get added leverage?
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing. Feel free to contact us to discuss the opportunities.