So says a report from the great and the good – including Jeremy Taylor of National Voices – published by the NHS Confederation on 17th January. Liberating the NHS – what might happen? gets out the crystal ball to address a lot of “what ifs?” and other known unknowns about Mr Lansley’s radical proposals which will be included in this week’s Health and Social Care Bill. The “unknown unknowns” are anyone’s guess. We are particularly concerned about opportunities for patient and public involvement: is it going to be strong enough for users, carers and the public to really make a difference and share in decision making as the Government says it wants to happen?
Underpowered patients risk
The NHS Confederation is worried about this issue too. They say “ In particular there is too little emphasis placed on how patients, supported by patient groups, could become much more active in managing their own care and how they could utilise personal budgets and other more direct forms of control.”
They see a risk that the “new Monitor” regulator might be isolated from grass roots user views: “Given the very significant powers of the new regulator, there will be a need to address how it gets a public and patient viewpoint to inform its decision-making. “
It’s not just about information
The report points out that we do not utilise the information already available and aren’t equipped to handle what Mr Lansley’s promises in his “information revolution”.
This has to improve if patients are to realise the power they should have as individuals and in groups, for instance people with long term conditions managing their own health and care:
“The design of the reform proposals suggests that patients will be most able to influence the shape of health services through contributing to decisions made by GP commissioning consortia, yet the mechanisms for significant patient and public involvement at this point in the system have not been well articulated. “ … “The opportunity to harness patient groups’ expertise and ability to provide support, the potential for patients to support each other in the management of long-term conditions, and for providers to engage individual patients much more has not been taken in the radical way that the rhetoric of reforms suggest. Patient groups should be given the space to come forward with how they can support some of the changes that are required.”
“No commissioning about us without us”
The Confederation’s conclusion – “There is much more scope for making imaginative use of patient groups and individual patients as agents of change in this new system “ – is one that MAC strongly endorses.
Start making your banners now: “No commissioning about us without us.”
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.