Position Papers

Recent Articles

Patients United – the MAC approach to making the views of GP patient participation groups heard by decision makers (PDF, 415Kb)

The new clinical commissioning structures needs patient input at every level if it is to succeed. The patient participation groups (PPGs) which exist in many practices can make an important contribution to this but how can you ensure that they are able to contribute to this process above the level of the individual practice?  If you are trying to make patient engagement work for a clinical commissioning group then this paper, which draws on recent work in Lambeth, will help.

THE WINDOW AND THE MIRROR: the MAC Approach to making your organisation more transparent,reflective and responsive (PDF, 55Kb)

August 2014: When an organisation decides to put service users at the heart of its work, everyone – from the Board right through to front-line workers – needs to see this goal as being central to their work. But we know that, , effective user engagement only happens where all the people who work in the organisation from top to bottom feel valued and supported, have a sense of ownership and share a commitment to providing the highest quality of service to users at all times.

Ramping up patient participation close to home 

October 2013.  Big changes are coming in primary care as it responds to pressures and challenges – 7 day a week access being only one. This paper identifies what community nurses could do now to start leading the change process in partnership with patients, carers and the public in GP practices and community health services.  We argue that patient engagement won’t be enough; Patient Leadership is the way of the future if primary care is to survive, much less to prosper.  Co-authored with David Gilbert and Mark Doughty co-directors of Centre for Patient Leadership.

 Lay role in NHS complaints process

Too many NHS complaints which could be resolved locally get referred up before local resolution has really been tried.   Andrew Craig is sure that introducing an independent lay voice at local level can help.  And there is a model that could be adapted for this purpose.

The MAC Partnership has submitted a paper Putting an Independent Lay Voice Back in the NHS Complaints Process in June 2913 to the Clwyd/ Hart complaints review making a case for a local independent lay complaints reviewer to scrutinise where the process is getting in the way of local resolution.

Readiness of CCGs to embed patient and public engagement in local commissioning

Evidence submitted March 2013 by MAC and InHealth Associates to the Health Select Committee enquiry on enquiry “Implementation of the Health and Social Care Act 2012”.  Our paper focuses on the state of readiness and capability of CCGs to embed patient and public engagement (PPE) in local commissioning and what support they need to do this well.  It is based on in depth interviews with clinical, management and lay CCG leaders in late 2012.

 Services for People with Long Term Neurological Conditions: Memorandum of Evidence to the Public Accounts Committee, 18 January 2012

Services for people with long term neurological conditions are getting worse. Patient and carers are NOT at the heart of commissioning where they should be. MAC’s memorandum of evidence to the Public Accounts Committee hearing into this in January tries to bang the drum about what’s wrong. But why are there not lots more people and organisations shouting about this? You can bet there would be if the subject was heart disease or cancer. Scandalous really.

The Lay Role in Authorisation of Commissioning Consortia

Written in May 2011, this argument applies also to Clinical Commissioning Groups exactly as it did to their predecessor “consortia.” The need for a lay scrutiny role has not changed. Emerging CCGs could be effectively scrutinised and challenged by local lay people.  Once established, complaints about poor consortium performance post-authorisation should be made through the local OSC

The MAC 10 Point Plan Submitted to the NHS Future Forum 

We have taken advantage of the pause for thought to make 10 points that expand on our thoughts on the best way to involve patients and be accountable to them. We believe that GPs must earn the right to commission services on behalf of their patients by providing evidence they serve their patients well. We say NO to Health and Wellbeing Boards but do think that commissioning organisations be democratically accountable with patient groups integrated into Consortium Governance. Local government  can say yes or no but whatever the decision, it cannot interfere for the next two years. Finally we have a right to know how our views have been taken into account and if Commissioning Boards are doing a good job, they can have more money to spend on their patients.  (April 2011)

Farewell LINks and Hello Healthwatch

Published in Primary Health Care in July 2011, this paper looks at  the issues in the crucial transition period from LINks to Healthwatch and asks whether complaints should be part of the new Local Health Watch role.

MAC Evidence to the Health Select Committee, February 2011 

The Committee invited us to give evidence on the accountability arrangements in the Bill.  We followed this with a written submission.  Our main message: the public and patients are the moral owners of the health service – no commissioning about us, without us.  Public and user involvement should begin in GP practices and their views and experiences should inform decision-making at every level.

Patient Participation in Primary Care

A series of five linked articles commissioned by Primary Health Care journal and published during 2010 covering good engagement in primary care and particularly relevant to GP practices.

1. Why bother about user engagement in primary health care?

2. Getting ready for patient participation

3. Counting up patient participation

4. Get off on the right foot with your patient participation group

5. Patient and public participation can liberate the NHS


PRINCIPLES AND PRACTICE: An Experience of the Residential Property Tribunal Service considered in the light of the AJTC Consultation on Principles for Administrative Justice

We are all asked to participate now using our skills and time to make a contribution to the Big Society. This is a story by Colin Adamson of such a contribution based on the experience of being the frontman for a group of leaseholders living in a block of flats in London who challenged the service charges in a action before the Leasehold Valuation Tribunal.  September 2010


Take the MND Pathway to World Class Commissioning Wins

A discussion aimed at PCTs  for Year 2  (2009) of World Class Commissioning showing how the Motor Neurone Disease year of care commissioning pathway tool would score highly on WCC criteria if implemented to its full capacity.

Patient Engagement and Customer Focus: Getting it right in General Practice

Engaging patients in the delivery of primary care is important for everyone: for commissioners, for general practice and for patients themselves.  Increasingly GPs are being expected to demonstrate that they are patient focussed and that they are not just listening to patients, but actively involving them in decision-making.


A Patient Participation Case History From Primary Care

Written by The Moore Adamson Craig Partnership in 2008 about the experiences of the Balham park Surgery Patients Participation group (BPSPLG) in South West London

Older Public Involvement Blog posts

A number of other posts also feature on the first incarnation of the Public Involvement blog with articles posted from 2003-2007.