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This article provides insights into how the health scrutiny function has performed in its first year of operation in a unitary authority in the North of England, through a case study of an inquiry into health inequalities.

The purpose of this paper is to consider the possible implications for health scrutiny in England of changes being made/consulted upon resulting from the Health and Social Care Act 2012.

Analysis of the Health and Social Care Act 2012, associated secondary legislation and a review of the existing literature on health scrutiny over the last 10 years.

Health scrutiny legislation is in need of review, especially since the changes to the health care system introduced by the recent Health and Social Care Act 2012. The Department of Health has recently consulted on possible changes to be implemented from April 2013. If health scrutiny can become embedded in local commissioning processes, there is potential for health services appropriate to local populations to be more effectively provided within the current financially challenging environment.

Little has been written on health scrutiny in recent years. This article looks at the potential impacts on and opportunities for health scrutiny under the Health and Social Care Act 2012.

What difference is the operation of local authority health scrutiny making to the oversight and democratisation of decision making by health bodies? This article provides an insight into how a group of local authorities in England tackled the operation of a specific joint health scrutiny committee. This example highlights building relations with associated health bodies and other local authorities, choice of health scrutiny agenda, ways of working, capacity of committees, ambiguities within the policy itself, and the difficulties and challenges of adding meaningful democratic oversight to the decision‐making processes of NHS bodies. This review highlights some of the benefits of health scrutiny, but suggests that engaging more fully with patients and the public in such reviews could result in a more influential and inclusive process.

The Local Government Act (2000) introduced new Overview and Scrutiny Committees, composed of elected non‐executive councillors, that can respond to proposals from the NHS for changes in services and also set their own agendas for more detailed scrutiny, including of the NHS. Limited capacity has meant that the focus of scrutiny has often been on statutory consultations from the NHS, service provision, NHS organisations and only occasionally on wider issues. However, it is commissioning that is officially seen as the main vehicle for shaping NHS services, so health scrutiny ought logically to address itself more to commissioning than to investigating providers. Practice‐based Commissioning (PBC) was introduced in 2004 with the aim of engaging front‐line clinicians in commissioning health care, though most such commissioning is being undertaken by groups of practices joining together to form consortia, rather than by individual GPs. In principle, this makes it more practicable for health scrutiny to include PBC, but consortia are not statutory bodies and cannot be compelled to participate. We suggest ways in which this omission might be addressed.

The role of the councillor in health and social care is developing as part of the modernisation agenda and consequent legislative changes. This article explores some of the challenges facing local politicians in this transforming environment, providing examples of progress in one local authority.

As it is now some time since the publication of the Health White Paper, and there is currently a pause in the progress of the Health and Social Care Bill through Parliament, it seems timely to look at how the proposed changes to patient and public involvement (PPI) may develop. This paper seeks to address these issues.

The paper examines the proposals for PPI set out in the legislation and uses the findings of the authors' recent research to examine them.

The paper argues that the legislation, as currently written, contains nothing that will guarantee a more effective engagement with either patients or the public.

This is a fast moving field at present, and the eventual outcome of this major reorganisation is unclear. This paper uses evidence from previous studies to provide an overview of the issues relating to patient and public involvement in the National Health Service and highlights the potential problems in the proposals as they stand at present.

Exploring a brief history of patient and public involvement as a pathway to the present, the article considers whether we are close to achieving a system of public engagement in health and social care that can be truly held to account as enabling people to influence the decisions that affect their lives. Considering the most recent legislation and in particular local involvement networks the article looks more closely at ‘quality’ in public involvement and focuses on how we can work together through personal responsibility to achieve it.

With the recent publication of The Engagement Cycle (DH, 2009a), exploring the issues surrounding patient and public involvement (PPI) in World Class Commissioning, it seems timely to look at how this type of involvement/engagement has developed in recent years. Set against official rhetoric that emphasises the importance of PPI in the NHS, this paper is informed by evidence emerging from a three‐year research project into the development of practice‐based commissioning conducted at Manchester University. It is suggested that commissioners (primary care trusts and practice‐based commissioners) need to think deeply about the meaning of public involvement in their context, while at national level strategies should be flexible enough to allow a diversity of approaches which may ultimately allow PPI to flourish.

This article will examine the legal basis for joint working between health and social services and will look at some of the problem areas in the implementation of partnership arrangements.

A policy of surveillance which interferes with the fundamental right to a private life requires credible justification and a supportive evidence base. The authority for such interference should be clearly detailed in law, overseen by a transparent process and not left to the vagaries of administrative discretion. If a state surveils those it governs and claims the interference to be in the public interest, then the evidence base on which that claim stands and the operative conception of public interest should be subject to critical examination. Unfortunately, there is an inconsistency in the regulatory burden associated with access to confidential patient information for non-health-related surveillance purposes and access for health-related surveillance or research purposes. This inconsistency represents a systemic weakness to inform or challenge an evidence-based policy of non-health-related surveillance. This inconsistency is unjustified and undermines the qualities recognised to be necessary to maintain a trustworthy confidential public health service. Taking the withdrawn Memorandum of Understanding (MoU) between NHS Digital and the Home Office as a worked example, this chapter demonstrates how the capacity of the law to constrain the arbitrary or unwarranted exercise of power through judicial review is not sufficient to level the playing field. The authors recommend ‘levelling up’ in procedural oversight, and adopting independent mechanisms equivalent to those adopted for establishing the operative conceptions of public interest in the context of health research to non-health-related surveillance purposes.