I am continuing my adventures in trying to understand the NHS reforms as far as the public and patients are concerned.
As part of Andrew Lansley’s listening exercise on the Health and Social Care Bill, the idea was introduced of having “lay” members on the governing boards of Clinical Commissioning Groups (CCGs). These groups, who will hold the future of the NHS service in their hands as well as most of its budget, were originally made up almost entirely of GP’s. Now they are to have representation from outside of the world of local GP’s, with a consultant and a nursing representative as well as two lay members representing the local population.
So I thought that, as Public and Patient Engagement (PPE) and local accountability is part of the rationale for the reforms, I would enquire about how lay members would be appointed. I may well be interested in making a contribution myself.
My first port of call was the NHS Commissioning Board (NHS CB), which is intended to oversee PPE in the NHS and ensure that CCGs are operating to the required standard. When I enquired about lay members I was told: “The NHS Commissioning Board, a Special Health Authority, is not yet accountable for this. The guidance you describe is being worked on by the Department of Health and you will need to approach them to seek the clarification you require. “
Now I don’t want to be picky but pathfinder NHS CCGs have been in “shadow” operation for some time. Many have taken best practice from the GP community and have websites communicating what they do (an excellent move in my view). So it does amaze me that the NHS CB, a body that in a little over 12 months is supposed to be overseeing primary care, is not even out of the starting blocks on fundamentals like CCG board structure. (I did contact the Department of Health, via the link provided to me by the NHS CB. I await their response with interest).
Undeterred, I contacted my local CCG, via their website, to see what they could tell me about appointing lay members. Like most CCG’s they had no details on how these posts will be filled. They stated that there would not be any formal appointment of lay members locally until the national requirements and process are clear. This would presumably be some time after the Bill has been passed. In the meantime, I understand some CCG’s are using PCT Non-Executive Directors or existing PPI representatives.
My conclusion: the idea of Public and Patient Engagement in NHS CCG’s is just that – an idea. I have no problem with the concept. However someone needs to do a great deal of work in a very short space of time to make this a reality. During my investigations into PPE I have started to worry more about the NHS reforms generally. My major worry is that most of the organisations that will be responsible for the checks and balances in the new NHS system are nowhere near being fully established. It will be more by amazing luck than good judgement if each local CCG can deliver consistent standards come April 2013 when the PCTs are abolished. Local accountability is one thing, anarchy is something else.
By Jon Davies| Righttrack’s Digital Marketing Manager
PS All comments subject to the usual disclaimer of “assuming the Health and Social Care Bill is passed”