The NHS Confederation wants to see a framework for patient and public involvement that provides a stronger voice for patients and the public, clear responsibilities and local flexibility.

LINks

Local Involvement Networks (LINks) were established through the Local Government and Public Involvement in Health Act 2007. Every local authority area should have a LINk in place to give their community a say about how health and social services are planned and run by the end of 2008.

The NHS Confederation feels that, if developed appropriately, LINks have the potential to offer a more robust method for delivering effective engagement for patients and the public. However we recognise the need to ensure clarity around the responsibilities of the networks and to prevent unnecessary burdens being placed upon our members.

A period of stability in the operation of patient and public engagement would be welcome after two reorganisations of the system in the past five years. Therefore it is crucial that LINks are soon established as legitimate and effective bodies. The Confederation has a role to play in this process. Towards this end, we currently sit on both the LINks Project Board and the NHS Centre for Involvement's Strategic Advisory Group.

The Confederation would support any initiative aiming for a:

• stronger voice for patients, service users and the public at all levels in healthcare delivery
• more coherent vision and robust framework with specific roles and responsibilities
• more flexible structure across local areas that has clear levels of accountability and that focuses on the functions and duties as opposed to the form.

The duty to consult

One of the most significant sections of the Local Government and Public Involvement in Health Act enhanced Section 242 of the NHS Act 2006 relates to the duty to consult and involve users of health services. This specifies that service users should be involved, whether through formal consultation or merely by being provided with relevant information in the following:

• Service planning
• Both the formulation and evaluation of any proposals to alter service provision
• Any decisions by trusts or health authorities that would impact on service operation.

All NHS organisations fall within the scope of this guidance and non-NHS bodies can be brought under its auspices, depending upon the terms of their contracts. Primary care trusts will also have an obligation to produce an annual report outlining the ways in which they have engaged their local communities and the subsequent actions taken.

The NHS Constitution and Involvement

In June 2008, the Government launched a consultation on the proposed NHS Constitution, one of the most prominent elements of the NHS Next Stage Review. Among the 37 rights and pledges contained within the document are the following in relation to involvement:

• Patients have the right to be involved in discussions and decisions about their healthcare and to be given information to enable them to do this.
• Patients have the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided and in decisions to be made affecting the operation of those services.
• The NHS will strive to provide patients with the information they need to participate effectively to influence the planning and delivery of NHS services (pledge)
• The NHS will strive to work in partnership with patients, their family and their carers (pledge).

Patient survey programme

As part of its programme of patient surveys, the Healthcare Commission published its fifth survey of inpatients in May 2008. The 2007 results showed little change in average scores in many areas since the 2006 inpatient survey, although there are wide variations in the scores attained by different trusts. Jo Webber, deputy policy director at the NHS Confederation, said it was reassuring to see that more patients are satisfied with the quality of care they receive. Our summary for members outlines the key points of the survey results, with comparisons to those of previous years.