18.04.18
A personal view of NAPP’s future strategy
Source: NHE March/April 2018
Dr Patricia Wilkie, president of the National Association for Patient Participation (N.A.P.P.), outlines her personal ambitions for the coming year as the organisation celebrates its 40th birthday.
N.A.P.P. was founded by visionary GP Dr Tim Paine in February 1978. The aim was to promote patient participation in general practice, to provide a link between patient participation groups (PPGs) first established in 1972 by another visionary GP Dr Peter Pritchard, and to represent PPG interests locally and nationally. What is implicit in these aims is the importance of the engagement of patients in their own care and in the wider organisation of healthcare as embodied in the 1978 WHO Alma-Ata Declaration.
In 2018, N.A.P.P. still pursues these aims. Health policymakers, politicians and professionals all now seem to acknowledge these aims with the use of concepts such as patient-centred care, ‘no decision without me’ and ‘put patients first.’ The reality, however, is not so rosy.
N.A.P.P. needs to be involved in working with policymakers at a national and local level to help them really understand that engagement means involving patients and the public from the outset. Far too frequently, statutory and professional organisations request involvement from patients and voluntary organisations representing them at the very last moment, suggesting that it was an afterthought to involve patients. This needs to change.
The involvement of knowledgeable patients in helping develop the content of undergraduate and postgraduate education programmes for all healthcare professionals is desirable, but still far from universal. Patients may now see different healthcare professionals in addition to doctors and nurses. It is important that there is relevant and sufficient input about the patient perspective in the training of all healthcare professionals, including those who have little direct contact with patients. This needs to change.
Patients, trained along with health professionals, are involved in some professional examinations including those of the Royal College of Anaesthetists and the Royal College of Surgeons. Such involvement brings different perspectives to other examiners, highlighting issues that professionals may not have recognised, as well as bringing credibility to the professional organisations. It is desirable that all professional examinations should include patient examiners. This needs to change.
We need to work closely with the regulators. The strapline of the General Medical Council (GMC) is ‘working with doctors working for patients,’ yet very many patients do not know the extent of the remit of the GMC, nor that it is responsible for setting the standards that patients can expect from their doctors. N.A.P.P. and other patient organisations can help the GMC raise awareness. We need to be working in partnership with the GMC to ensure that these standards reflect what patients now expect of doctors.
The CQC needs to assess the views of practice patients when it inspects a practice. Different methods are used, including a lay inspector speaking to patients in the waiting room and contacting the PPG. However, this latter point still does not always happen. Since April 2015 all GP practices in England are contractually required to have a PPG. They should be able to contribute to the inspection as they have intelligence about what works well and what could be improved.
Younger patients brought up using different forms of social media expect instant information on their phone. Older patients self-managing, with support from their GP, several lifelong conditions appreciate using different technologies as well as having ready access to their digital record. We need to be involved with NHS Digital and opt-out programmes to ensure that the concerns of patients are heard and that there is transparency about data-sharing.
In the early days of N.A.P.P. a system of regional representatives was developed. This should be renewed to enable better support for PPGs and easier collection of local intelligence. We need to work with GPs and practice managers and their organisations to emphasise how PPGs can support practices. Most patients want to be partners in their own care and have more to offer than their illnesses.
My personal strategy is achievable, but will require continued hard work from dedicated N.A.P.P. volunteers and an acknowledgement by policymakers and professionals of what we can achieve for the benefit of the NHS and patients.
FOR MORE INFORMATION
W: www.napp.org.uk