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
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
Three specific areas of work were looked atContinuing
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