1.  The National Association for Patient Participation was formed in 1978 and is a registered charity. We are the umbrella organisation for Patient Participation Groups (PPGs) in primary care and currently have 280 affiliated groups (roughly 3% of English practices). Each of our members is unique with activities that respond to local need. Their functions include providing strategic advice to their practices, running health promotion events, providing advice and information, and delivering services such as volunteer transport, befriending, counselling and support to carers.

  2.  The National Association for Patient Participation welcomes the Health Committee's Inquiry into Patient and Public Involvement in the NHS. The future design of the statutory structures is clearly important. We hope, however, that the Committee will also be able to take a wider view that embraces alternative models, including the work of patient participation groups within primary care.

  3.  There has been considerable progress in recent years in improving the patient experience and in developing approaches that see patients as one of the resources that will drive up quality and promote safety. But the development of the machinery of patient and public involvement has come at a considerable price.

  4.  We would urge the Committee to aggregate and evaluate the money currently spent in supporting CPPIH and the PPI Forums in England, on the patient experience component of the Quality Outcomes Framework, on the PALS and PPI officers in each Trust, and on the national patient surveys.

  5.  Our concern is that resources have been sucked into the "provider" side of patient and public involvement, rather than being shared more evenly with those organisations who wish to influence the NHS. The current approach is unlikely to lead to the desired outcome identified by the Wanless report whereby our society is fully engaged with its health which is worth, in his view, £30 billion annually by 2022.

  6.  In our view, there needs to be greater emphasis on continuing to change the relationship between patients and professionals so that a philosophy of partnership is created. This must not be overwhelmed by investing in monitoring, scrutiny and inspection (important though those functions are) which can reinforce divisions and set patients against the services. Instead, our structures of patient and public involvement should also encourage healthy relationships based on mutual respect, professionalism, openness and a joint commitment to improving the quality of care.

  7.  In short, patient and public involvement can be seen as a mechanism which protects patients against poor care and poor service. But we believe that it should also be seen as a method by which patients can become more engaged in their own health and by which professionals learn to recognise just how much patients have to offer.

Graham Box and Danny Daniels

Chief Executive and Chairman, National Association for Patient Participation

January 2007