Support - NHS explained & glossary

Patient and Public Involvement (PPI) structures

The Commission for Patient & Public Involvement in Health (CPPIH) (external link)

The Commission for Patient and Public Involvement in Health (CPPIH) is the national body which was set up in 2003 as part of the new structure for PPI to

• oversee the whole system of patient and public involvement by carrying out reviews, collecting information from PPIFs
• report on how it is working to the Secretary of State for Health
• report concerns to other national bodies such as the Healthcare Commission, the National Care Standards Commission and the National Patient Safety Agency
• set standards, monitor and make recommendations about the performance of PPIFs

As a result of the Department of Health Review of Arms’ Length Bodies in July 2004 CPPIH will be abolished by 2008. A review is being undertaken to identify what structures will support PPI in the NHS. The Government has stated that Patient and Public Involvement Forums will remain “the cornerstone” of patient and public involvement.

Patient and Public Involvement Forums (external link)
There is a Patient and Public Involvement (PPI) Forum for every NHS Trust in England. They are made up of local people and have new powers. The Forums play an active role in health related decision making within their communities. PPI Forums are a key vehicle for raising awareness of the needs and views of patients and the public, and placing them at the centre of health services. They have a number of roles, which include

• obtaining views from local communities about health services and make recommendations and reports
• making reports and recommendations on the availability and delivery of health services
• influencing the design of and access to NHS services.

The CPPIH website has a Knowledge Management System section in which each PPI Forum has their own area where they store work plans, share experiences and report on their activities. They are listed alphabetically. (external link) The discussion forum (external link) is also a useful picture of the issues and debates generated by PPI Forums throughout the country, including their relationships with ICAS.

Under Statutory Instrument 2003 No 2124.The Patients' Forums (Functions) Regulations 2003 (external link) ICAS services are required to send anonymised data on complaints to PPI Forums. This data includes details of commitments that the Trust has made to complainants during the course of an ICAS supported complaint, in the hope that PPI Forums will check whether the Trust has honoured its commitments in order to support service improvement.

ICAS

The Independent Complaints Advocacy Service (ICAS) has been set up in each region to support patients and their carers who want to make a complaint about their NHS treatment or care. ICAS provides them with information, support and guidance helping them to articulate their concerns and navigate the complaints system.

The Department of Health has commissioned three providers to deliver the service on a regional basis:

• Carer’s Federation
• POhWER
• South East Advocacy Projects (SEAP).

The Department of Health manages these contracts. (external link)

PALS: Patient Advice and Liaison Service (external link)

All NHS Trusts now have Patient Advice and Liaison Services (PALS). PALS staff can explain the way the NHS Complaints Procedure works to a complainant, but should not be involved in the investigation or formulation of a response to a formal complaint.

PALS provide

• confidential assistance in resolving problems and concerns quickly
• explanations of complaints procedures and how to get in touch with someone who can help
• confidential advice and support to patients, families and their carers
• information on the NHS and health-related matters
• information on how patients can get more involved in their own healthcare and the NHS locally.

PALS staff can offer assistance in putting together a statement of complaint. If the complainant needs help with phoning or letter writing then the ICAS advocate should make a cross referral back to PALS.

ICAS should only provide that kind of support when the complaint moves into a formal stage. If the complainant has been referred early and there is room for early resolution, ICAS should only provide support with phoning or letter writing (at the request of the client)

• where there may be a conflict of interest for PALS staff
• where specialist advocacy would benefit the client.

In these circumstances, PALS should facilitate the handover to the ICAS staff, if the complainant wishes, by making first contact, helping summarise the complaint and copying relevant correspondence with the permission of the complainant.

4Ps briefing: Patient and public involvement structures (external link)

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