Public Involvement in Healthcare Decision-Making - Essay Example

Difficulty of Public Involvement in healthcare decision-making Introduction In this study, we are about to examine and comprehend the concept of public involvement or participation in the decision-making process of healthcare, with special focus on the National Health Service (NHS) by using a case study conducted by Anderson et al. (2005) that was published in 2006. The key focus of the study lay in two chief healthcare developments in underprivileged areas of Bristol and Weston-Super-Mare, together with a qualitative systematic review done by Crawford et al. (2002) on published literature and grey sources written in English between 1966 and October 2000, which was used to investigate how patients could be involved in Health Care Planning. Public involvement in healthcare A good amount of research has gone into exploring how patients can be incorporated into the Health Care Planning process. The underlying principle of shared decision-making is that professionals and patients exchange information about treatment options and preferences, and through negotiation find solutions to the existing problems. The involvement of patients in healthcare service planning and evaluation is thought to increase accountability to tax-payers, better identify and meet their needs, and broaden the value base underlying evaluation (Gagliardi et al. 2007). A recent government policy in the UK, issued in 1999 and reviewed in 2002, under the title of ‘Patient and Public Involvement in the new NHS’, has stressed the need “to involve patients, users, carers and the public in health and health services, highlighting the opportunities which the Government’s NHS reforms offer to develop effective patient and public partnership” (HSC 1999/210 p. 2). All over the world an awareness campaign has taken birth to understand the implications of public participation and their impacts. (Anderson et al. 2006). What is the purpose of pubic involvement in healthcare decision-making? Pollitt (2003) used a quotation from the Organization for Economic Cooperation and Development (OECD) to list some of the motives the governments are trying to employ to enhance the quality of services. It states, “…if service users participate, then surely they will know best what they want?” (Pollitt 2003: p. 100). It is also to escalate the credibility of policy decisions in trying to make the general public feel part of the process. It states, “This is not just our "political" decision making, it is yours too, because you participated in it” (Pollitt 2003: p. 100). The users may be consulted because of their specific experience of services, the public is consulted because of its status as citizens (Callaghan and Wistow 2006). As Farrell (2004) points out, the outcomes of public involvement increases the confidence, understanding and skills of the people who participate. It also influences the policies, plans and services of Primary Care Organizations. Partnerships enable learning about the available resources and expertise that could be shared across different health economies. What are the levels of public participation in decision-making? For the last thirty five years Arnsteins ladder of citizen engagement has been central to developing thinking, on the engagement between the general public and government organization. According to Arnstein’s views, citizen participation is a vital factor that balances the redistribution of power between the have’s and the have not’s, thus ensuring to include all citizens into the political and economic planning process. As Pollitt (2003) points out, involving the public in one way or another would help to foster healthy relationships between professionals and the general public. In fact, it is a two way process - Just giving information to the public about health issues would be more of a passive communication which is nothing but a one way relationship. On the other hand, involving or inducting people into the health planning process and decision making would be a two way relationship and would be considered as active communication. In genuine participation, power is shared or distributed between the public authority and the participating citizens. These distinctions are concerned with the level of interaction, and the distribution of power between the state and the citizens. Each step requires more from the citizen - from passive receiving of information, through the giving of opinions and suggestions, to active participation in agenda-setting, information gathering and decision-making. The Patient and Public Engagement Cycle According to NHS Centre for Involvement, patients and the public should be involved in a systematic way that is integrated into everyday practice, which would help to link members of the community by taking part in the planning process. This would help to make a great impact on the health of the community in general as well as show how the NHS organizes and delivers care. Building a system of engagement for evaluating and developing services is complicated and takes time. The cycle of patient and public engagement (see Figure 2) presents a way of thinking systematically about the different phases and processes that are involved and this in turn ensures that people’s views are given value. This cyclic process helps to ensure that you conduct engagement activities in a planned way that directs itself to changes in service organization and provision, and that people, staff, and clinicians all continually evaluate these changes (NHS Centre for Involvement 2008). According to authors (Crawford, M. et al 2002) the key factor behind the research was to make a through investigation of how patients could be involved in Health Care Planning and in doing so, what are the positive or negative outcomes of such a research? The study made use of published as well as other grey sources for collecting data and making an analysis. The literature used for the study was English written reports between 1966 and October 2000 in addition to qualitative reviews that involved the effects of planning and development of health care. The study resulted in 31 of the 42 papers describing the patient’s involvement in the health care process through information leaflets. It also resulted in the change in attitude of organizations, by involving patients in the on going process and accepting their positive responses. In conclusion we could say that there is evidence to prove that patient involvement has contributed to the implementation of a wide range of qualitative services that are not only satisfying but of immense value to the whole community. Through this study we come to understand it is not a bad idea to involve patients during the planning process. Therefore it is highly recommended that in order to procure a qualitative Health Care Service, it is necessary to have god and healthy patient involvement. Read More