Last update 29nd. September 2004

PPIFO

CPPIH Consultation exercise future Forum organisation

There were about 40 or 50 people there, but only representatives from 5 forums.

Mostly, the attendants represented organizations involved in PPI work - and they seemed all rather cozy with each other (they had worked together on the initial discussions, legislation, consultation etc). Quite a few of them felt very angry and let down by the recent announcements about the abolition of the CPPIH - the overwhelming belief was that the system would have worked well had it been given more time to establish itself.

There were 4 working groups, focusing on: 1) forum support, 2) the proposed 'centre for excellence', 3) partnership working (with Healthcare Commission, other forums, OSC etc), 4) and recruitment and appointments.

I attend the working group on forum support, in which there was overwhelming agreement that

  1. we need clear national standards and more equity of support
  2. we need on the other hand more local (i.e. forum) control over this support
  3. the current set-up involves far too many boundaries that forums need to negotiate - too many players, too much 'liaison work' in order to get the system to work smoothly (PALS, FSOs, ICAS, Commissions, Forums, OSCs) and that
  4. the situation where support is 'contracted out' via short-term contracts to organizations with no experience in PPI work and with no real investment in and ownership of this work is probably unsustainable.

Quite a few members of the group felt that forum support should be provided by either employees of the new 'centre' or by employees of the NHS (however, not the NHS trust that the forum is 'paired' with). So that for example the forum support staff for London would be employed by the NHS in Surrey and Sussex. This would enable the establishment of a pool of people with expertise who could move in and out of NHS 'internal' and forum (external) jobs and who would already come with knowledge of healthcare and health issues.

However, some concerns about the perceived independence of forums were also voiced.

Regarding other types of support and resources, there was agreement that forums should have a physical, accessible presence in the community and that this shouldn't be based on where the FSO 'sits', but where the community is - which would mean more and more local premises. There was no agreement on whether premises 'on site' (i.e. on NHS premises) were acceptable. There is also a need for better access to computers and support for members or users with special needs.

When the other working groups reported back, the following issues were raised:

Concerns about the capacity of the NHS appointments commission to do the job. There was a discussion about whether there shouldn't be an element of democracy in choosing forum members (not necessary elections, but some form in which members can be chosen locally), which was mostly rejected by those people who make their living out of PPI work (since they know best who would make a good forum member, obviously...).

Concerns about whether the new 'Centre' wouldn't just be a mini CPPIH - whether it would be totally powerless, what would happen to a national voice for PPI work. Again, the 'PPI industry representatives' seemed little concerned about how forums themselves can have a degree of control over what goes on at national or regional level (it seems democracy is a concept that these professionals have fallen out of love with...)

Concerns about the current number of forums - there seems to be an overall agreement that there are too many forums at present.

There then ensued a short discussion about the need and plans for wider consultation.

There will be regional workshops and in-depth work with stakeholders (which we assumed would at least include forums) and the opportunity for every member or anyone else who is interested to also take part in a written consultation. The consultation is envisaged to last until early next year.

At this point, many attendants expressed doubts about the credibility of the process if it then just takes the orders of a 'bunch of bureaucrats' to do away with years of discussions (i.e. the abolition of the CPPIH).

Meredith Vivian seems to be in charge of this process and he tried to assure us that he is very committed to the consultation and that things have not all been decided yet. In know that some people might disagree with me here, but I do believe that he is genuinely committed to forum work, to PPI work more generally and to an open and inclusive consultation process (within very rigid constraints of timelines and budgets...) - but it is also clear that some things have already been decided:

This is already decided (according to Meredith)

This is apparently still up for grabs

The design of the consultation process - although there was very little room (and actually interest) to explore this further

One recurring theme of the meeting was that in order to find satisfactory answers for any of the above questions a greater degree of clarity was needed about what forums were actually there for. It just remains to be hoped that forums will get more of a say in defining their role and expectations (but the rather patronizing attitude of some of the PPI professionals, and the tight timeline for the consultation process don't necessarily fill me with much confidence...).

Dr Charlotte Augst


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