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As NHS England publishes refreshed statutory guidance on the importance of involving patients and the public in commissioning, NHS England’s National Director: Operations and Information, reflects on how successful implementation of this guidance can support the NHS and Care services to meet the objectives of the Five Year Forward View:
Our job as commissioners is challenging – we have many factors to consider before we make decisions.
With increasing demand and ever tighter budgets, we are under pressure to improve health outcomes, deliver quality services and make good use of resources. But how can we be sure that the services we commission best meet the needs – and preferences – of the populations we serve?
Patient and public participation is key to understanding what matters to people, and how we can respond most effectively to that.
The refreshed statutory guidance on patient and public participation in commissioning, for CCGs and our own staff at NHS England, will support us to embed participation in our work. This will be particularly important in the context of our new commissioning approaches, through sustainability and transformation plans, co-commissioning and the development of accountable care systems.
What I like most about the guidance is that it supports us as commissioners to involve patients and the public in our work in a timely and meaningful way. There is no ‘one size fits all’; good participation requires a ‘pick and mix’ approach, where we choose the most appropriate methods to fit the circumstances. The guidance sets out principles of effective participation that can be embedded throughout the commissioning cycle.
It’s impressive to see good practice examples from across the NHS showing how participation has improved services in the eyes of those who use them.
Involving people isn’t always straightforward, it can be uncomfortable and even challenging, and we will never please all of the people all of the time. It takes time to engage people properly and to feed back to them on the impact of their participation. But what’s clear to me is the value of doing it well and that there are some fantastic examples of where the NHS is getting it right.
The guidance also demonstrates the value of working in partnership with others in local government and the voluntary sector to reach communities and understand their needs, whether that be with charities, local Healthwatch, faith groups or patient and carer groups. The guidance highlights the importance of engaging people who may be harder for us to reach, but who experience worse health outcomes and who could, arguably, be more disadvantaged by changes to health and care services.
Not only is involving patients, carers and the public the right thing to do, it’s also a legal duty and as commissioners we need to be able to assure ourselves, and others, that we have engaged people in a fair and proportionate way. The guidance gives clear advice and practical tools to commissioners to meet their legal duties.
As with any guidance, its true value will be demonstrated by how we use it in practice and make participation part of ‘business as usual’.
The Five Year Forward View sets out clear ambitions to improve engagement with people and communities, and make the most of what they can contribute to better health, care and wellbeing for all. This guidance supports us to make the ambitions a reality, enabling us to make the most of people’s experience, knowledge and passion for the NHS to transform our services and make them fit for the future.