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Home > Involving you and your community > Guide to working with people and communities

We have produced a guide to outline our legal and moral obligations with regards to patient and public involvement. These obligations apply to any change to the provision of NHS services which involves a shift in the way frontline health services are delivered.

By service change we often mean a change to the range of services available or a change to the location from which services are delivered, but there is no single, generally accepted definition of service change and in particular no legal definition, so each case is assessed on its specific attributes.

This might apply to plans to reconfigure or transform services to improve health and well-being, changes to specific services, new models of care, new service specifications, or local improvement schemes.

We see the benefits of involving patients and members of the public as follows:

Improved health outcomes

This creates a much better chance of ensuring services meet people’s needs, improving their experience and outcomes.

Value for money

Services that are designed with people, will effectively meet their needs, improve health outcomes and reduce the need for further, additional care or treatment because a service did not meet people’s needs the first time.

Better decision-making

Decision-making is improved when insight from local people is used alongside financial and clinical information to inform the case for change. Their insight can add practical weight and context to statistical data, and fill gaps through local intelligence and knowledge.

Improved quality

Partnership approaches mean that services can be designed and delivered more appropriately, because they are personalised to meet the needs and preferences of local people. Without insight from people who use, or may not use, services, it is impossible to raise the overall quality of services. It also improves safety, by ensuring people have a voice to raise problems which can be addressed early and consistently.

Accountability and transparency

It is important that organisations are able to explain to people how decisions are made in relation to any proposal and how their views have been taken on board. Transparent decision-making, with people and communities involved in governance, helps make the organisations accountable to communities.

Participating for health

Being involved can reduce isolation, increase confidence and improve motivation towards wellbeing. Individuals’ involvement in their own care can lead to involvement at a service level and to more formal volunteering roles and employment in health and care sectors. It is well recognised that doing something for others and having a meaningful role in your local community supports wellbeing.

Meeting legal duties

Although this should not be the primary motivation, failure to meet the relevant legal duties risks legal challenge, with the substantial costs and delays that entails, and damage to relationships and trust and confidence between organisations, people and communities.

The guide has been developed to help decision makers (this includes NHS commissioners and providers, as well as Integrated Care System leads and partners), to both navigate the common legal and policy issues from the very start of a service change programme through to the final decision-making, but also to understand the importance of involving patients and members of the public in service change programmes.

It is accompanied by an Engagement Model which provides a flow diagram of the whole process here.


Last Updated: Monday 1st August 2022 - 12:17:pm

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