Date Published: 18 February 2009

Plans to involve patients in local healthcare decisions are failing

UK Government attempts to involve patients and the public in local health services are failing according to a new report launched today by the Royal College of Nursing and National Voices.

The report "Local healthcare commissioning: grassroots involvement?", reveals that many patients feel local healthcare commissioning (LHC), the process intended to ensure health and care services effectively meet the needs of the local population by engaging with patient representatives, is not working effectively.

Of 226 local patient organisations who volunteered to be interviewed, less than half (48%) reported any involvement with healthcare commissioning in their local area. The study also found that nearly a quarter (22%) of the groups had received no encouragement to be involved, and most felt that local healthcare commissioning has not brought about beneficial change. 70% of the respondent groups reported no improvement in the “joining up” of health services to provide seamless care.

The report also identifies specialist nurses as the best placed healthcare professionals to make the commissioning process a success. Respondents ranked specialist nurses higher than other healthcare professionals in all aspects of the process, with 81% reporting that specialist nurses understand patients’ needs and 74% indicating they are good at designing care pathways.

Commenting on the report, Janet Davies, Executive Director of Nursing and Service Delivery at the Royal College of Nursing said:

“This independent report clearly shows that commissioning at a local level is inaccessible, fragmented and over complicated. We do believe that it is a good idea in principle, but if it's going to work, it is vital that local people know that they can get involved in setting priorities for their local health services. The report clearly highlights that specialist nurses have a unique role in the process, and are central to its success. This is yet another example of how important specialist nurses are to the future of the health service, in terms of getting patients involved in local health decisions, and delivering a health service fit for the 21st century.”

David Pink, chief executive of National Voices said:

“Local commissioning of NHS services is not living up to its promise, because it is failing to involve local people. We believe that patient groups, and the official structures for engaging service users and the public, such as LINks, are key to ensuring the success of local healthcare commissioning. Support to ensure patients’ voices are heard is vital. That is the way to make sure that local healthcare commissioning genuinely involves patients, and truly reflects patients’ experience. The Government and the NHS needs to start taking this much more seriously.”

In response to the findings, the report recommends:

• Deploying and making greater use of specialist nurses in commissioning services
• Raising public awareness of local healthcare commissioning to increase service user involvement
• Providing greater support for and involvement of LINks (Local Involvement Networks)
• Reducing complexity and clarify lines of responsibility within the commissioning process

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