Patient and public involvement: what next for the NHS?

Area of Science:

• Health Services Research
• Public Health Policy
• Civic Engagement Studies

Background:

• UK National Health Service (NHS) patient involvement structures have historically been fragmented and unstable since 1974.
• Previous initiatives like Patients' Forums and the Commission for Patient and Public Involvement in Health (2003) are being replaced.
• Local Involvement Networks (LINks) are the latest proposed arrangement, with the Commission to be abolished in 2007.

Purpose of the Study:

• To review research on the effectiveness of patient and public involvement arrangements in the NHS.
• To analyze debates surrounding accountability, independence, performance consistency, and representation.
• To explore how NHS involvement structures align with broader citizenship and democratic renewal agendas.

Main Methods:

• Overview of existing research on patient and public involvement effectiveness.
• Review of key debates concerning governance, equity, and citizen engagement.
• Exploration of historical themes to inform the development of Local Involvement Networks (LINks).

Main Results:

• The effectiveness of past patient involvement arrangements remains a subject of ongoing debate.
• Key issues from the 1970s regarding user and public involvement persist.
• Understanding the successes and failures of previous models (CHCs, forums) is crucial for LINks' success.

Conclusions:

• Local Involvement Networks (LINks) offer a chance to integrate patient involvement with local democracy and citizen engagement.
• Unresolved historical debates on user and public involvement continue to challenge current initiatives.
• Addressing the strengths and weaknesses of prior structures is essential for the success of new Local Involvement Networks (LINks).