Patient and Public Involvement (PPI)

17 Apr

Previously I had always overlooked PPI in favour of other more exciting things in healthcare, like the social determinants of disease and the importance of defining quality and measuring quality. Nevertheless, I can now see why patient public involvement is increasing in popularity and prominence in the world of public health and beyond.

There are the obvious things that you’d expect PPI to improve like patient empowerment and satisfaction, accountability of healthcare providers and appropriate treatment and care. In addition, PPI has been shown to improve quality of care which in turn can lead to increased compliance and better health outcomes. Nevertheless, with the above attributes, PPI remains a tool to improve the patient’s outlook on life with apparently very little benefit for the health professional or indeed, the health system itself.

Currently however, extensive patient public involvement is becoming a widely realised necessity to the health systems of the future. Okay that sounds grand but hear me out: we are seeing a massive epidemiological transition in the burden of disease globally, with increasing prominence in long term diseases such as diabetes, cardiovascular disease and mental health problems. Alongside this, ever-tightening budget restraints and a history of unsustainable spending is forcing many health systems along with the NHS to reconsider its action plan. We all know primary health care is the crux of a cost effective healthcare system but with PPI, it can be improved and enhanced even further.

Increasing PPI offers the opportunity to shift the focus from a reactive healthcare system dependent on specialised care in hospitals to a proactive healthcare system represented by extensive localised networks of community services. In doing so, PPI can help shape a much needed reform to fit the needs of the population. PPI can allow systems to be adapted to a population’s cultural or otherwise non-medical needs.

The Health Foundation’s scoping paper written by Angela Coulter (2009) gives many local examples in the UK that show the impact of various PPI projects. Of what I read (exam time dictates selective reading), it was really useful seeing how PPI was improving not only the patient experience but was also increasing efficiency of the health system.

The growth of ideas such as the Third Way and co-production is perhaps a reflection of the populist appeal they hold. PPI is a great way in which we can humanise the often bureaucratic and heartless health system, transforming its image for the public. Additionally, PPI holds great potential in accelerating the drive for efficiency within the healthcare sector without the need for introducing market principles or competition directly. PPI is a necessary companion to primary health care and it holds promise of salvaging the UK’s healthcare sector from its predicted trajectory.


One Response to “Patient and Public Involvement (PPI)”


  1. Commissioning: a rookie’s guide | Unhealthy Reflections - November 1, 2013

    […] low profile and lack of legitimacy meant that there was weak downwards accountabiltiy and little PPI, an important aspect in all strands of […]

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