Review

Get people together

NEW BEGINNINGS: towards patient and public involvement in primary health care
Stephen Gillam and Fiona Brooks (eds)
King’s Fund, 2001, £14.99

Health authorities, primary care providers, community health councils, charities and other agencies have been in the game of patient and public involvement for many years, so I hope that primary care trusts do not take the title of this book literally. They should not view this as a new beginning but an attempt to harness the expertise that has been built up in the field over the years.

This book offers a way into existing expertise. It is in two parts: putting patient and public involvement in context, and presenting case studies of successful projects. For me, the most thought-provoking aspect of the first part was the primacy of consultation – not the usual ‘consulting the public’, but the clinical encounter between health professional and patient.

If primary care wants to address patient involvement, then each and every health professional can contribute by facilitating patient involvement during consultations. If health professionals want to know why they should bother to do this, then some of the case studies illustrate powerfully the expertise and new understanding that patients can bring to situations that are often frustrating for both them and the professionals.

The most exciting aspect of the second part was a case study showing that seeking public and patient views of services does not have to be a sterile exercise. Clinicians and patients sat down together – after the patients had worked in groups – to clarify and set out their views, an exercise that actually brought about changes. This highlights the importance of bringing patients face-to-face with managers and clinicians, rather than producing endless reports no one acts on.

The editors clearly state that this is not a DIY book, but this did not stop me wanting a more explicit approach to how to move from having a lay member on the board to genuine patient and public involvement.

Everything the reader needs to know is in the book, but you have to work things out for yourself. Here are a couple of hints to start you off: first, try to facilitate direct communication between the parties that count and, second, be prepared to commit time, money and skills to the whole process. Read it if you have been given the job of facilitating patient and public involvement in primary care, and pay particular attention to the case studies.