Patient and Public Involvement
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- Where are we going with Patient and Public Involvement?
Where are we going with Patient and Public Involvement?
With the Big Society the talk of politics at the moment you could
believe that Patient and Public Involvement, (PPI) is on the up.
However the debate around what actually makes a ‘big society’ is an
interesting and challenging one, and shares more ground with the ideas
of community development and co-production than PPI.
Community Development
Community development is the grass roots approach to strengthening
and empowering groups of people (geographical or common interest based)
to take action to improve their environment, health, education and/or
local services. It takes time and patience and is usually facilitated
by community development workers who are embedded in the community, or
local people who advocate for their community and might receive training
and support. It requires good relationship development and transparent
exchange of information. Fashionable many years ago for improved
public health, it faded, in favour of the ‘personal health’ agenda of
the 80’s and 90’s. It would seem that it is back in favour with the
Cabinet Office hosting a Community Development Exchange http://www.cdx.org.uk/
and a plethora of events and conferences discussing how the division of
power can be change in favour of communities and initiatives such as
the Neighbourhood Challenge http://www.nesta.org.uk/areas_of_work/public_services_lab/neighbourhood_challenge
Co production
Co production, a term coined in relation to community work with
police in Chicago in the 1970’s has been picked up in the UK by the
organisations such as the King’s Fund and the Institute for Policy
Research. Its central theme is relationships between service
providers/planners and service users – good relationships beget the co
production of services/policy that is more effective for both parties.
It assumes that service users are not passive recipients but
people with views, ideas and experiences that can contribute to the
development of a service. Professionals need to learn to accept user
expertise, and the emphasis is on real relationships and partnerships.
This investment in relationships suggests better outcomes and results,
neatly depicted by the diagram below:
http://www.kks.se/templates/StandardPage.aspx?id=5847
An interesting example of UK co production is “An exploration of
‘co-production’ – partnerships between public sector professionals and
community members, in particular those outside paid employment”.
Available on the Joseph Rowntree Foundation website:
http://www.jrf.org.uk/publications/co-production-people-outside-paid-employment
So, do we detect a shift back to working with groups rather than
individuals? Is the focus on developing sustainable relationships
rather than involvement on a project by project basis?
Is there room for PPI, community development and co production?
Yes of course! They are all a means to the same end – the
harnessing of a range of expertise on a problem, be it a research
project, developing a service to relocating a school. What they all
share are some founding principles of equality of relationship,
transparency of purpose and method, and respect for different experience
and expertise. So let’s not get hung up on definitions and models but
find what works best for your community, your project, your
relationships – variety is the spice of life!
