Notes from the field of public involvement

Monday, 24 April 2006

Penalty Free Participation and Reward and Recognition

A new publication from the Department of Health "Reward and Recognition - the principles and practice of service users payment and reimbursement in health and social care".

A classic piece of NHS timing saw the publication of guidance for those involved in PPI only a few days after leaks in the papers foretold the shut down of the current set up (See our post RIP Patients' Forums)

However our hope must be that this advice survives the demise of CPPIH and does help those for whom it is intended - "service providers, service users and carers" because the issues raised in it are of great practical importance when working with the public.

As a consultancy training volunteers and recruits to Pilot Patients' Forums, we soon identified as a major issue, the complications around paying expenses especially to those in receipt of benefits. A report we wrote in November 2002 "Building Capacity for Pilot Patients' Forums" gathered the views of those involved in the early days of Pilot Patients' Forums. One of the questions was about money and as our report said "The number of responses prompted by financial support-related questions emphasises the importance of valuing lay time." We went on to say that resolving issues around reimbursement was "crucial that any payments in cash or kind are organised so as not to disrupt the lives of those individuals who receive a range of state benefits." We found that people were telling us that their benefits were being reduced "because their benefits office took the view that the role they fulfilled should be remunerated to reflect the time commitment and level of responsibility."

We also wrote at the time "Patient representatives are often uncomfortable with form filling and financially embarrassed by delays in payment which assume they have £20 to spare for a taxi in the first place." We advocated an approach that "makes a settlement in full 'at the time', 'on the spot' and in defined circumstances in advance using the means of payment preferred by the representative". Our conclusion was "the administrative principle must be penalty-free participation."

It is good to see that the new guidelines go a long way towards respecting this principle and grasping the benefits nettle. The arrangements dealing with benefits and the tax system are still blindingly complex and it is not surprising that the guidelines mention that some service providers have appointed a 'liaison co-ordinator' to take care of all this. It appears that such persons can end up by training Jobcentre staff to explain "how involvement is different to employment."

(However what chance such posts will survive the latest jobs blitz in the Health Service? Jobs with the words 'liaison' and 'co-ordination' in their title are in our experience the first to go in any jobs purge and it follows that a job with both words in the title has to be right at the top of the list.)

As we have said before about the recent spate of publications from the Department of Health, let us hope nonetheless that this work is not forgotten and unused. By the way, Foundation Trusts are not mentioned in it at all but if elected Governors are for example in receipt of benefit, presumably they should take a look at these guidelines as well. Or is there a special deal here?

Colin Adamson | Send feedback