This article demonstrates the importance of the role of patient involvement in practice based commissioning within the NHS. It has produced some original and interesting findings, which show the importance of ivolving the patient in the complexities of local public health. It demonstrates how the North East is approximately 10 years behind the national average in England on a range of health inequalities. So, this papers points out that health is culturally specific to local regions and in order to tackle this we must include the voice of local  people andcommunities in order to overcome these health difficulties.  The NHS has started this process but this paper has attempted to develop a model on patient-public health involvement NHS commissioning of services. It is an interesting pilot study with a sound methodology, which can be expanded with futher research. In my opinion this article is worth publishing as it is original in that it adds new knowledege to the field of community public health.

Community health and health psychology.

The involvement of service users in the provision of publicly funded services has been an activity with considerably high profile in recent years.

This study provides a valuable insight into the rationale, fundamental principles and complexities of public involvement in the provision of health services. Whilst focusing on a specific locality (Easington district of East Durham), the findings will make interesting reading for those engaged in similar activities across the UK. It will also be useful to those involved in the provision of public services other than health as there are some key principles and concepts that those from other professions will find helpful. For those new to the rationale and significance of the role of the public the study offers clarity and a comprehensive overview of recent and current practice.

The study commences with a brief history and overview of both the rationale behind public involvement in services and raises issues in relation to the challenges that face those organisations and individuals who seek to ensure that such involvement is genuinely representative of the public/patients. Fundamental issues of representation and accountability power and financial responsibility are all explored using a quantitative and qualitative approach. Document analysis and qualitative interviews with various professionals and representative bodies combine to give a comprehensive account of both the context and specifics of public involvement. Using good illustrative examples from relevant documents and interviews the study draws upon feedback from those involved and this is particularly illuminating in relation to perceived areas of good and bad practice and the difficulties involved in achieving an effective public and patient contribution. In doing so it contributes effectively to our knowledge and understanding of the topic.

For those unfamiliar with the nature of public consultation developments in the NHS in recent years this is a helpful introduction bringing clarity to the topic and at the same time yet opening up further debate on the subject matter. It is thus a valuable contribution to our understanding. There are also wider issues here of community cohesion and the inherent problems for any large public sector organisation like the NHS and the organisational difficulties they face in trying to establish effective links with the community.  There is an interesting analysis for example of the workings of the various structures that operate between the NHS and the public/community and the implications for health strategy, financial control, devolution of decision making, quality of provision and the conflicts  that can arise.

Non – health professional professionals will find this very informative including the historical perspective including changes in funding, management, organisation, ideology (including issues of power and inequality) in the NHS. The study’s inclusion of issues around integrated services and the impact on professional working will also make interesting reading for both health and non health professionals alike (i.e. different demands of the organisation, patients, partner agencies/difficulties in dialogue/communication etc). These are clearly important and wider issues that this report addresses and which have implications for NHS provision.

Whilst the geographical area is quite small and there acknowledged difficulties in the collection of data nonetheless the data used is comprehensive and effectively used.

This study as well as being relevant to those involved in the health provision is also of relevance to those working in other publically funded services  and helps to open up to a wider audience questions and key messages about the nature of public involvement in service delivery. As such this study should have an appeal to a number of professionals outside the health service who may wish to draw upon some of the lessons and experiences explored here.

My experience is in public service management within the specific area of information advice and guidance.