Select Committee on Public Administration Appendices to the Minutes of Evidence


Memorandum by the Department of Health

  Thank you for your letter of 16 February asking for information for the Committee's inquiry into "Innovations in Public Consultation". I apologise for the delay in replying.

  For a number of years now this Department has had a strategy aimed at increasing the involvement of patients and the public in its work. This is particularly well illustrated by our National Survey of NHS Patients programme which is part of our commitment to listening to the views of patients and giving them a voice in shaping the NHS. It consists of a rolling programme of questionnaire surveys examining patients' experiences. The first part of the Survey, on GP services, was completed last year and the full findings were published in October. The second part of the programme, a questionnaire for Coronary Heart Disease patients, is nearing completion and results will be available in summer. Work on the third part of the programme, a survey of Cancer patients, is also underway and fieldwork is due to begin shortly.

  We have also invested £2.5 million in a research programme designed to inform understanding on the effect of user involvement in the NHS. This will be taken forward in parallel with other policy research programmes, including the evaluation of the NHS White Paper, evaluation of Primary Care Groups and research being commissioned under the "Information for Health" strategy.

  In terms of promulgating our patient and public involvement policy internally we have issued guidelines on good practice to staff and periodically conduct trawls to enable us to gauge, over a period of time, whether the level of involvement is increasing.

  So far we have not attempted to advise on appropriate forms of consultation or involvement nor to undertake a comprehensive study of the various methods being used. The extent to which it is appropriate for individual business areas to involve the public, and the means of doing this, will vary greatly depending on the nature of their work. In some areas it is virtually impossible to see how they could progress without obtaining the patient perspective, in others the benefit may be much less obvious. Our main emphasis to date has therefore been on encouraging patient and public involvement and providing the tools to help staff do this ie good practice advice, training and a database of NHS users and carers who are prepared to become involved in the Department's work.

  Last year we commissioned a small-scale audit to see how public involvement in the Department was progressing. We particularly wanted to identify examples of good practice and lessons learned to supplement the guidance we had already disseminated. We also wanted to know whether any evidence had emerged that involving the public had influenced the outcome of the work concerned and the cost, both in human and financial resource terms, of such involvement.

  Three specific areas of work were looked at—Continuing Health Services (physical disabilities), Communicable Diseases (HIV/AIDS) and Disabilities and Mental Illness (learning disabilities)—and a detailed report was produced. A copy is attached for your information.

  The overall impression gained from the audit was that staff are trying to involve patients and the public as much as possible and to broaden representation on working groups etc. However, the extent to which the Department's guidance is being followed varies considerably and there is a good deal of scope for the adoption of better practice.

  We are presently in the process of summarising key points under the broad headings mentioned above. We will be circulating this to staff shortly together with a strong reminder that effective patient and public involvement is key to delivering the objectives of the Modernising Government White Paper and our "quality" priority for the NHS. We are also exploring with Organisational Development colleagues the scope for embedding patient and public involvement more firmly in staff objectives and Branch business plans.

Gisela Stuart MP

Parliamentary Under Secretary of State

26 March 2000

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