Patient engagement: A ‘win-win’ for people and services

In this guest blog, the Director of Policy for National Voices throws his support behind NHS England’s refreshed statutory guidance on the importance of involving patients and the public in commissioning:  

In January 2012, as the Health and Social Care Bill was being finalised, over 40 charities who were members of National Voices placed a letter in The Times calling for the legislation better to reflect the priority of ‘no decision about us, without us’.

We were acting both on the basis of an already well developed research literature, which has only grown since – see the tools and resources for commissioners produced by Realising the Value.

But equally importantly, we were driven by that other source of evidence – the things that people with a need for health services, especially those with long term conditions who now use the majority of NHS resources, had been telling us for years.

In short – that the benefits of patient engagement create a ‘win-win’ for people and for services.

The letter was the last leg of an 18 month campaign that resulted in a new NHS duty in the Act. This requires both NHS England and clinical commissioning groups to “promote involvement of each individual, their carer and (should there be any) their representatives in decisions relating to the prevention or diagnosis of illness, or their care or treatment”.

Five years and many reform initiatives later, NHS England, whose commissioners also share the duty, has produced a welcome new version of the guidance on what this means.

Our Times letter referred to shared decisions about treatments, personalised care planning, and support for self-management, noting that these approaches “are proven to create better health outcomes, with more appropriate treatment, a better experience of care, and better use of healthcare resources”.

The ‘Involving People in their own care’ guidance reinforces this, crisply outlining each intervention and its benefits, and linking to useful resources such as NHS England’s handbook for care and support planning.

The ‘refresh’ also adds new resources that have appeared since 2012, notably the availability of personal budgets as a key tool to put commissioning power in the hands of people and enable them to tailor their own care and support.

While there are now more enthusiasts around the system than ever for designing person centred care, it sometimes feels that we take two steps forward, and one and a half back.

The progressive initiatives taken in recent years by pioneers and vanguards are at constant risk of being reduced to merely instrumental programmes to reduce hospital usage.

Commissioners can play a key role in resisting these pressures. We would urge you to be fully confident in pressing ahead, using all the tools and resources now available. The guidance offers ten practical ways to advance policies and practice that fulfil the duty, with case studies.

The evidence from both research and from people themselves tells us one thing very clearly. If you can put in place known approaches that effectively engage people in health-related decisions, you will directly create better health and wellbeing — more so than much of the routine provision of reactive medical treatments.

Don Redding

Don Redding is Director of Policy for National Voices, the coalition of charities that stands for people being in control of their health and care.

He has led National Voices’ work on integrated care, including the production of five ‘narratives’ demonstrating what people themselves want from ‘person-centred coordinated care’. More recently Don was part of the Realising the Value programme working with NHS England to develop a new articulation of value in health and care, based on what matters most to people and communities.

A former social care journalist, Don has worked for leading national voluntary organisations since 1991, and was previously head of policy and communications for Picker Institute Europe.


  1. Kassander says:

    As ‘Chad’ might say:
    No Reply, Don Redding Director of Policy for National Voices, the coalition of charities that
    ***stands for people being in control of their health and care.***?
    Or is one to assume that you can’t be bothered to answer valid questions from ordinary P&P, even tho’ it’s Our=NHS?

  2. Fred Bloggs says:

    I agree wholeheartedly that patient engagement is critical to better services.
    However, caution needs to be exercised by NHSE as well as patients to ensure engagement does not take a tokenistic turn.
    Tokenism, when allowed to flourish, leads to disenchantment, disengagement, and bad policy and practice swiftly ensues.
    Something that, I hope, NHSE is as keen to prevent as patients and their leaders are…

  3. Kassander says:

    Do these reforms really involve “patients and the public in commissioning”?

    What they do is at last comply with that part of S13 of the Lansley Act addressing individual patient’s concerns about their OWN treatments
    The control of commissioning is held firmly in the hands of NHSE and the 210 CCGs
    CCGs are Quangos controlled by GPs who have no training in such functions Given the crisis in supply of GP capacity might they revert to their Day Job?
    Note: GPs are NOT part of NHSE, they are private contractors TO NHSE = SMEs
    These Non-NHSE, unelected bodies now distribute Our=NHS’£70bn/yr
    Where’s the involvement of “patients and the public in commissioning”?
    Oh, yes – the Lay NEDs charged with representing us, the P&Ps.
    Those lay-NEDs are selected by CCG Boards NOT by the P&P they supposedly represent
    After shocking reports NHSE has @ last strengthened the rules on ‘interests’of commissioners but still we P&P don’t have OUR voice where it matters