Health



Healthy Democracy

'Healthy Democracy: The future of involvement in health and social care'  is a  partnership publication between Involve and the NHS Centre for Involvement. It is an anthology on Patient and Public Involvement (PPI) in Health and was launched in November 2006. Leading thinkers, among others Harry Cayton, Anna Coote, Albert Weale and Jonathan Tritter, have contributed. 

The publication can be downloaded for free here. Hard copies cost £10 and can be ordered by phoning 020 7 6320120 or emailing Ali Howes. For more information on the book or Involve's wider work around involvment in health care please contact Edward Andersson on 020 7632 0122.

About the book

Healthy Democracy highlights current trends and the diversity within patient and public involvement and seeks to encourage debate around current practice and what the future may hold. The publication comes at a key point in time with recent proposals for new ‘Local Involvement Networks’ (LINks) to replace existing Patient and Public Involvement Forums in England.

Healthy Democracy contains the following chapters:

  1. Foreword by Rosie Winterton MP
  2. Introduction by Edward Andersson, Jonathan Tritter and Richard Wilson
  3. Overview: does Patient and Public Involvement matter? by Edward Andersson, Stella Creasy and Jonathan Tritter
  4. Patients as entrepreneurs: who is in charge of change? by Harry Cayton
  5. Patient engagement: why is it important? by Angela Coulter
  6. What is so good about citizens’ involvement in healthcare? by Albert Weale
  7. Supporting involvement: the new NHS Centre for Involvement by Jonathan Tritter and Ian Brittain
  8. The role of citizens and service users in regulating healthcare by Anna Coote
  9. A new vision for local democratic accountability of healthcare services by Jane Martin
  10. The role of the voluntary sector within involvement in health by Belinda Pratten
  11. Partners in participation? Involving people who use social care services by Frances Hasler
  12. Patient and Public Involvement and Practice Based Commissioning by Brian Fisher
  13. Public and Patient Participation in Primary Care: a Golden Age? by Graham Box
  14. Foundation Trusts and Patient and Public Involvement by Sue Slipman
  15. Creating reputations: Involvement beyond exit and louder than voice by Paul Hodgkin


About Involvement in Health

The principle of Patient and Public Involvement (PPI) is a widely supported cornerstone of the new 'patient-centred' NHS. However, beneath the surface of this consensus there are often tensions and divergent motives.

PPI has emerged as a distinct arena, seperated from the wider public involvement field. PPI has its own abbreviations and jargon which do not appear elsewhere. The field is also uniquely influenced by powerful actors (e.g. health care professionals) and very well developed supporting administrative and academic bodies. Also the vulnerability that many people feel when they suffer from ill health adds to the complexity.

The government is currently carrying out a radical restructuring of the social and health services in England. These proposed changes will amongst other things mean:
  • More complex provision (mix of public, private, and third sector providers)
  • More discretion for GPs in commissioning helath and social care services
  • A shift from secondary care to primary and community care
  • All NHS Trusts to become Foundation Trusts with the opportunities and responsibilities this brinds with it.
  • Primary Care Trusts to be reconfigured and the Commission for Patient and Public Involvement in Health (CPPIH) to be disbanded.
  • Proposals for PPI Forums to be replaced by Local Involvement Forums (LINKs), the main difference being that LINks would lack powers of inspection and woudl be open to groups as well as individuals. LINks would be funded through local authorities.
  • There is also a proposal to create a network for 'national patient voice', which would be made up of large patient organisations.
It remains to be seen what effects these reforms will have on PPI in practice. At Involve we would love to hear what you think of the upcoming reforms. Will the new LINk structures be up to the task or will they need to be replaced in a few years? Some of the most interesting innovations in health participation, such as Patient Opinion, have arisen from outside the mainstream NHS structures. Does this mean that PPI is better left to the local energy and creativity found at the local level? Or will this just lead to a postcode lottery for engagement?

Involve's director Richard Wilson was part of the Department of Health's expert panel set up to review the future of PPI in health. Involve will build on our experience of public participation from a wide range of fields to determine what kinds of PPI structures are appropriate in the new health and social care services.

As always comments and suggestions are welcomed. If you want to know more please contact Edward Andersson by email or telephone 0207 632 0122.