Abstract

Over the past decade there has been mounting debate about the desirability of public and patient involvement in the commissioning of health services in the UK. This issue has arisen partially due to the National Health Service management moving from a system control by health practitioners to that of a devolved managerial approach with tight central financial control and an agenda for efficiency. Yet, it is often unclear within this debate about what constitutes as public and patient involvement. The aim of this study is to investigate what is meant by public and patient involvement, and to assess the effectiveness of public involvement initiatives associated with Practice Based Commissioning. In order to achieve this, the study has utilised quantitative and qualitative methods to analyse health inequalities and public involvement within the North-east of England. In order to measure patient and public involvement qualitative interviews were conducted with patients and health professionals in the Easington area of East-Durham. The conclusion of the research was that the public had little interest in the process of commissioning, but volunteers were keen to be involved in practical projects such as fitness promotion programmes, long term care initiatives and projects to encourage healthy activities in the community. The authors construct a model of involvement ranging from ‘passive’ involvement where volunteers simply discuss issues at meetings to ‘active’ involvement where they actually help organise activities. The study suggests that active involvement schemes could promote health and reduce health inequalities.