Public Participation in Health and Social Care

Proposed RSA South West Network: call for expressions of interest in contributing to a network event and working group

The following paper has been prepared by the network champion, James Lynch FRSA. RSA South West is calling for expressions of interest from Fellows who:

  • Have a personal or professional interest, and/or
  • Have expertise, and/or
  • Wish to participate in shaping the direction and work of this proposed network, including participation in a working group.

There will be a network event to be held at a time and place that matches the availability of Fellows who express an interest in contributing to the network.

If you would like to participate in this network or would like more information, please contact:

Ian Hosker FRSA, Chair RSA South West, 57 Winslade Road, Sidmouth, Devon, EX10 9EX
Tel: 0117 385 0541
Email: ian@quasarconsultancy.biz

Network champion: James Lynch FRSA

This is a time of great change in the health and social care sectors.  With the abolition of the Commission on Public and Patient Involvement in Health (CPPIH) and the PPI Forums from the end of March 2008 and the commencement of Local Involvement Networks (LINks) from 1 April 2008, a new era of potential public participation in these two sectors has opened up.  Unlike the PPI Forums, which were concerned solely with the health sector, the new LINks system will cover both health and social care.  In addition, a new, unitary organization (The Care Quality Commission) and system for quality control is to be introduced in both sectors from April 2009.

The Government has allocated £84 million over a three-year period for the support of the new system and, although nationally many Local Authorities have not yet appointed an administrative support organization, called a Host, many in the South West already had such an organization in place on 1 April 2008 and have also begun to fulfil their statutory obligation to organize and support transitional arrangements (sometimes also called ‘Continuity Groups’).

In this region and as part of the national ‘Darzi’ review, the draft strategic framework for Improving Health in the South West 2008/9 to 2010/11 is now available and the Strategic Health Authority is seeking the Public’s views (the summary document Improving Health: Ambitions for the South West is available from the SHA or online at www.southwest.nhs.uk).  The NHS Constitution is being published alongside Lord Darzi’s Report at the end of June and the Constitution is to be put out to consultation, in what has been described as the most important development in the history of the NHS.

In spite of Government protestations to the contrary, the above transition will almost inevitably involve a damaging gap in the monitoring of services and some loss (perhaps considerable loss) of expertise in civic engagement, monitoring, inspection and report-writing.  Although the administrative support organizations (Hosts) for the LINks have been established in most areas in the South West, it is likely that the LINK itself will take several months to establish in each case and many more months before it can function effectively and hold providers to account. 

Even apart from this inevitable gap, as a recent Kings Fund report has pointed out, Public expertise in such critical areas as commissioning is sadly lacking and surveys of health service staff seem to confirm this gap.  Understanding the 'commissioning cycle' is one of the most difficult aspects of health scrutiny to understand, not least for those with little or no prior experience of the NHS or social care. There is a need for members of the Public to learn about and subsequently be able to examine 'the commissioning cycle', understand what 'strategic commissioning' is and where accountability and scrutiny fits.  Unless provision is made for training in such areas, it is likely that, as the BMA has suggested, members of the public will be outthought and out-manoevred in their efforts to make health and social care more accountable and sensitive to Public needs.

The question, therefore, arises whether the RSA (South West) should consider initiating some exploratory work in the two sectors of health and social care and what form such work might take.  Are these sectors, which come within the remit of the RSA?  Does the Region possess expertise in these sectors?  Should a working group be established to map out a provisional work programme?  Should the Region act as a facilitator to share and foster expertise, conduct monitoring and research and to work collaboratively with other organizations in the field of health and social care in the region?  What do you think?