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The first part of this briefing considers definitions of service user representation in health and social care services, sometimes known as patient and public involvement (PPI). Defining what constitutes PPI is difficult and the concept is contested. This has created problems with determining what effective patient involvement looks like. Despite this, the King’s Fund has observed that the idea of putting patients first and giving them a stronger voice in the operation of health and social care services had “become the favoured mantra of politicians and senior policy-makers in health”. However, the King’s Fund suggested that these kinds of policies had been undermined by a lack of clarity about what involving people in health meant and that the policy had not been prioritised.    

The second part of this briefing looks at Healthwatch England and its network of local Healthwatch organisations. Healthwatch was created by the Health and Social Care Act 2012 to be an “independent consumer champion for both health and social care”. Healthwatch replaced the previous system of Local Involvement Networks (LINks), which it was argued lacked power and were not representative. Healthwatch England and the local Healthwatch organisations have a number of statutory duties, such as promoting and supporting the involvement of local people in the commissioning, provision and scrutiny of local care services.

Healthwatch England was allocated £4.5 million in 2015/16 by the Government to fund core running costs and additional non-recurrent funding, while local Healthwatch received around £31.8 million in the same year. The organisation has recently conducted work into people’s experiences of the complaints system, and made a number of recommendations to improve the complaints process in the NHS and social care services. It has also been suggested that local Healthwatch organisations face a number of challenges, such as problems of capacity and resources, accountability, and representation.


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