NHS England has published updated guidance on patient and public participation in health and care for NHS commissioners. The guidance is intended for CCGs and NHS England and sets out the context for and principles of involvement in decisions about patient care and the commissioning of health services. This guidance supports commissioners to comply with their legal duties in these areas and to meet the objectives of the Five Year Forward View.
The refreshed guidance on involvement consists of two documents:
- Involving people in their own health and care: statutory guidance for clinical commissioning groups and NHS England
- Patient and public participation in commissioning health and care: statutory guidance for clinical commissioning groups and NHS England
CCGs and NHS England are under a legal duty to have regard to the refreshed statutory guidance.
Involving people in their own health and care
Involving people in their own health and care is aimed at ensuring CCGs and NHS England comply with their statutory duty to promote the involvement of patients in decisions about their own health and care (sections 14U and 13H NHS Act 2006 respectively) and it will primarily be of interest to those involved in commissioning patient care.
The guidance sets out ten key actions for NHS commissioners to follow, and includes advice on how to promote and publicise personal health budgets, as well as how to commission for involvement and how to ensure providers deliver care in a way that enables involvement.
Patient and public participation in commissioning health and care
Patient and public participation in commissioning health and care provides refreshed guidance on public engagement in the commissioning of services more broadly, and follows on from NHS England’s 2013 guidance: Transforming participation in health and care. It will be of particular interest to those involved in commissioning at service level.
There are ten key actions to assist CCGs and NHS England to meet their legal duties to involve the public in timely and meaningful participation throughout the commissioning cycle (sections 14Z2 and 13Q NHS Act 2006 respectively). The guidance also sets out ten “principles of participation”. Of particular interest are principles: (1) requiring commissioners to “reach out” to people proactively, (5) information must be “clear and easy to understand” and commissioners must “seek to facilitate involvement by all” and (7) which emphasises the need to be open, honest and transparent, about the evidence base for and motivations behind changes to services.
There is also a helpful three stage process for commissioners to work through to determine whether their legal duty is engaged.
The guidance also references the changing healthcare commissioning landscape and includes information on co-commissioning, joint arrangements including accountable care organisations.
What to take away
Commissioners will need to be cognisant of the guidance to ensure they have regard to it when commissioning health and care services – it is vitally important that patient and public engagement is properly understood by commissioners and providers. Unfortunately the prospect of a legal challenge is quite real and with a challenge will, at best, come a delay in implementation of plans and, at worst, the decision being sent back by the Administrative Court to be reconsulted on and taken again. By following the guidance you can minimise the risk of a claim being brought and /or stand a better chance of mounting a successful defence.
We support a number of commissioners and providers on reconfiguration and service change - so do get in touch if you have any questions or require advice on your organisation’s patient involvement or public engagement duties.
Samuel Lindsay, Associate