Patient and public participation in the context of the Big Society Public interest seminar 11 October 2010 The Coalition Government’s White Paper, Equity and Excellence: Liberating the NHS , sets forth radical proposals to restructure the organisation and financing of health care in England. As part of this, headlines about GP-led commissioning, reducing bureaucracy and securing greater patient choice are all stirring debate, while the White Paper reflects a fundamentally different philosophy about the role of the state in delivering public services. What the Big Society really means for us all is still unknown. However, we do know that engaging with local people and developing the capacity of the voluntary sector are at its heart and this, together with the structural changes, is likely to have a number of implications for the health sector. GPs now have the local responsibility for commissioning and engaging stakeholder groups. How this will be done alongside the local authority health and well-being board is unclear. In this seminar we will look at some of the emerging debates. For example, does the planned introduction of HealthWatch present a genuine opportunity, or will this simply be ‘more of the same’? What lessons can we draw from the mixed success of local involvement networks? What can be done differently to engage patient, communities and local citizens in their health and health services? The Big Society agenda brings public participation to the fore of public services. At present, however, there is no clarity about how this will work, where accountability will lie and where financial support will come from. This gives rise to questions about how the rights of patients and citizens – protected in the NHS constitution – will be exercised in reality. Patients have the right to be involved in and consulted about their care and citizens have the right to hold their NHS to account. This seminar, run jointly by OPM and Involve will be exploring some of these issues. The three levels of involvemen t First, questions are being raised about what is helpful at the individual level. Where are the sources of health advice? Where are the sources of information about illness and support organisations? A patient will be concerned about what they now need to know about the health service and how the changes will affect them. NHS Direct played a role in health advice and local information. Will this be taken on by the proposed 111 service? Whose responsibility will it be to provide this information in the future? The local authority? The new GP commissioning consortia? HealthWatch? Second, groups of people sharing a common interest may need support or advice, or to lobby on behalf of their group. The group might share a long-term health condition, such as heart disease or might simply live in a single geographical location and want better services. In the context of the Big Society, what opportunities will there be for these people to influence a service and what support might they need to do this? In theory, the Big Society approach should make this more straightforward because services can be ‘lobbied’ by any citizen, but page 1