An action research study of Patient and Public Involvement (PPI) in the NHS : how can PPI influence healthcare planning and decision making?

ABSTRACT Background: Patient and Public Involvement (PPI) has been in health policy for the NHS for the last 30 years and yet there is little evidence of their involvement influencing healthcare planning and decision making. PPI is a legislative duty for NHS bodies and yet there remains what is perceived as a ‘brick wall’ between the outputs of PPI and the outcomes in terms of influencing change (Commission for Health Improvement (CHI), 2004) . Aims: To explore how PPI can influence healthcare planning and decisionmaking in the NHS. The objective was to explore, interpret and obtain a deeper understanding of the views and perceptions of staff within an NHS organisation and identify the attributes and enablers that facilitate PPI to influence planning and decision-making. Method: This is an action research (AR) study, using semi-structured interviews and a critical document review as a pre-step, followed by the formation of an AR team following the cycle of steps. Results: The yardstick of success against which PCTs were measured nationally and against which my colleagues and I measured our own practice, was one that celebrated outputs not outcomes and policy did little to persuade that PPI should influence planning and decision making. Staff and organisational rhetoric placed high importance on PPI, but change as a result was peripheral; however, robust project management through the AR process is a critical enabler. Conclusions: New contributions to knowledge are provided by my proposal for an approach to enabling PPI in healthcare planning and decision-making using an AR project management methodology to ensure that measures of 4 success are set and repeatedly reassessed, and that follow through to change in healthcare service as a result takes place and the use of an AR methodology for this issue. The study has already directly contributed to national policy as findings were continually shared with the Department of Health.