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© Nuffield Trust Local legitimacy: involving the public Ruth Thorlby Senior Fellow in Health Policy, Nuffield Trust May 2011
© Nuffield Trust Local legitimacy? “for the first time in forty years, there will be real local democratic accountability and legitimacy in the NHS” (Liberating the NHS: Local Democratic Legitimacy in Health, DH 2010) Proposed reforms aim at increased ‘legitimacy’ via: - Health and wellbeing boards - Expanded role for Healthwatch - Councillors and others on GP consortia boards? May 2011
© Nuffield Trust 25 April 2015 © Nuffield Trust A framework for public participation and decision making A route to legitimacy?
© Nuffield Trust Who will be involved? Expert Administrators Elected Representatives Professional Stakeholders Lay Stakeholders Random Selection Open, Targeted Recruiting Open, Self-Selection Diffuse Public Sphere May 2011 More Exclusive More Inclusive Fung, A. “Varieties of Participation in Complex Governance” Public Administration Review, vol 66 (2006):66-75
© Nuffield Trust How will people be involved? Listen as Spectator Express Preferences Develop Preferences Aggregate and Bargain Deliberate and Negotiate Deploy Expertise May 2011 Least intense Most intense Fung, A. “Varieties of Participation in Complex Governance” Public Administration Review, vol 66 (2006):66-75
© Nuffield Trust How much influence to give people? Individual Education Communicative Influence Advise and Consult Co-Governance Direct Authority May 2011 Least authority Most authority Fung, A. “Varieties of Participation in Complex Governance” Public Administration Review, vol 66 (2006):66-75
© Nuffield Trust The Democracy Cube May 2011 Fung, A. “Varieties of Participation in Complex Governance” Public Administration Review, vol 66 (2006):66-75 Technical expertise Communication & Decision Mode Listen as Spectator Participants Everyone Expert Administrators Individual education Direct authority Authority & Power
© Nuffield Trust Local legitimacy in reality? Public attitudes towards involvement: broad support for the idea of engagement but only a minority regularly volunteer Public attitudes: default setting is ‘national standards with no local variation’ NHS “will continue to be a national service, held to account by Parliament” (Liberating the NHS: Local Democratic Legitimacy in Health DH, 2010) May 2011
© Nuffield Trust May 2011 www.nuffieldtrust.org.uk Sign-up for our newsletter www.nuffieldtrust.org.uk/newsletter Follow us on Twitter (http://twitter.com/NuffieldTrust) © Nuffield Trust
© Nuffield Trust Predictive risk and health care: an overview Research summary Selected figures March 2011.
© Nuffield Trust Setting priorities in health: a study of English primary care trusts Authors: Suzanne Robinson, Helen Dickinson, Iestyn Williams, Tim.
PARTICIPATION IN FLOOD RISK MANAGEMENT AND THE POTENTIAL OF CITIZEN OBSERVATORIES: A GOVERNANCE ANALYSIS Uta Wehn, Maria Rusca, Jaap Evers (all UNESCO-IHE)
Health Overview Policy and Scrutiny Panel Update on Health Reform Proposals James Foster North Somerset Council.
Changes in healthcare commissioning Phil Ambler Operations and Information Manager UK Vision Strategy.
Building Local HealthWatch Eastern region parent carer forum 20 September 2011 Claire Ogley, Regional Project Lead, HealthWatch Transition.
© Nuffield Trust Review of aggregate assessment of providers of health and social care in England ('Rating Review‘)
© Nuffield Trust Inner North West London Integrated Care Pilot – year one evaluation 8 July 2013 Holly Holder Fellow in health policy Ian Blunt Senior.
© Nuffield Trust Social care and hospital use at the end of life Authors: Martin Bardsley and Theo Georghiou December 2010.
© Nuffield Trust Improving hospital efficiency Authors: Jeremy Hurst and Sally Williams Selected figures January 2012.
Welcome Health and Wellbeing Boards & Strategies Facilitated by Rachel Harris National Expert Advisor CfPS.
© Nuffield Trust 27 February 2012 A survey of GPs in England on the rationing of health care Survey results.
Snapshot survey of health leaders on NHS reform Survey results March 2013.
Local Healthwatch, health and wellbeing boards and council scrutiny: Roles, relationships and adding value Su Turner Principal Consultant Centre for Public.
Liberating the NHS HealthWatch DH GATEWAY REF
Community engagement Implementing NICE guidance 2008 NICE public health guidance 9.
Shaping Local HealthWatch Paula Murphy, K&C LINk Coordinator,
Supported by: Pay for performance Anita Charlesworth, Chief Economist, Nuffield Trust.
HealthMakers Join a community of patients making a real difference.
Supporting children and young people’s social, emotional and mental health in Leeds: the picture at April 2016 Dr Jane Mischenko, Leeds NHS CCGs Natalie.
© Nuffield Trust Priority setting in the reformed NHS Dr Judith Smith Head of Policy HSMC, University of Birmingham 30 September 2011.
© Nuffield Trust Transforming general practice: Setting the context Dr Rebecca Rosen Senior Fellow The Nuffield Trust May 15 th 2013.
Norfolk’s Shadow Health and Wellbeing Board & Clinical Commissioning Groups 25 April 2012.
Public Policy Conflict. PUBLIC PARTICIPATION PUBLICPUBLIC INTERESTINTEREST Attorney General Independent/Accountable Judges, Prosecutors, Police Constitutional.
Health and wellbeing boards and Police and Crime Commissioners.
Integrated care in Trafford: progress to date November 2011 © Nuffield Trust.
Pressure Groups Their role in a Democracy Aim of a Pressure Group Pressure Groups do not seek to govern the country. They seek to influence the government.
Equality and Excellence: Liberating the NHS Ian R Cumming 12th July 2010.
© Nuffield Trust 17 November 2015 Productivity across the NHS Anita Charlesworth.
Local HealthWatch: Information Event Monday 16 th July 2012, 2pm – 5pm NHS Gloucestershire, Sanger House, Brockworth, Gloucester.
BACKGROUND TO THE HEALTH AND WELLBEING STRATEGY Neil Revely.
Evaluating a whole systems approach to integrated care in North West London Nuffield Trust & London School of Economics 22 June 2015 Holly Holder
Healthwatch Gloucestershire Barbara Piranty Chief Executive April 2014.
SOWIT: Innovating for citizen deliberation in local government Dr. Clodagh Harris (UCC) Dr. Vanessa Liston (TCD) Mark O’Toole, Kilkenny County Council.
Overview of the new Health and Care Landscape Challenges and Opportunities Kathy Eastwood 10 July 2012.
Equity and Excellence: Liberating the NHS Health White Paper WHO Centre Imperial College London Elizabeth Dubois MSc FRSPH 11 August.
A Health and Wellbeing Board for Leicestershire Cheryl Davenport Programme Director.
© Nuffield Trust Commissioning for long-term conditions: what do commissioners actually do? Dr Judith Smith Director of Policy, Nuffield Trust The Commissioning.
What Democracy is... and is not n Ideas of Phillippe C. Schmitter and Terry Lynn Karl.
Healthy Lives, Healthy People Our strategy for public health in England Funding and commissioning routes Lucinda Cawley Consultant in Public Health | Associate.
© Nuffield Trust Authors: Sheelah Connolly, Gwyn Bevan and Nicholas Mays Selected figures January 2010 Funding and performance of healthcare systems in.
The Challenge of Representing Employers and Negotiating on their Behalf Gill Bellord Director of Pay, Pensions and Employment Relations NHS Employers.
Our plans for co-commissioning primary care in South Worcestershire Wednesday 21 January 2015.
Clinical Commissioning Group’s one year on: member engagement and primary care development Ruth Robertson Holly Holder Laura Bennett Shilpa Ross Jennifer.
Health and Social Care Select Committee Liberating the NHS proposals Penny Wakefield – Director, Partnerships, NCC Elaine Yardley – Director for Adult.
Click to edit Master title style Click to edit Master subtitle style The new public health system our role in improving and protecting health and wellbeing;
Political Leadership How to influence! And Current OH Issues Carol Bannister Royal College of Nursing of the United Kingdom.
Foundation Trust Status for UHL Foundation Trust Project Director.
Practice Leaders Programme Oxfordshire and Buckinghamshire Cohort Findings Practice Leaders Programme Oxfordshire and Buckinghamshire Cohort Findings Aim.
© Nuffield Trust Annual Health Strategy Summit Managing financial risk in the NHS March 2011 Twitter: #NTSummit Jennifer Dixon (with thanks to Sian Davies)
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