A small island has appeared off the coast of Pakistan following the tragic earthquake there last week. The consensus of scientific opinion is that, before long, this island will disappear without trace. In the meantime it is an interesting curiosity, attracting quite a gaggle of geologists and geographers.
I wonder if that is how INVOLVE was viewed by the science establishment all those years ago when it first came together? Soon to disappear, I mean.
Well, we didn’t. In fact we are now in our seventeenth year. And we are not so small any more. So there!
Last week INVOLVE held its annual members’ symposium, an opportunity to re-group, share and think about the future. It is always telling what bubbles to the surface on these occasions. I even sketched a cartoon to help me think about the themes afterwards.
‘Integration’ was one of the most commons words used in our discussions over the two days. No, not the integration of health and social care.* But, the urgency with which patient and public involvement across health research needs to be integrated or connected at the very least; the dangers in terms of waste, duplication and missed opportunities, if they are not. Public involvement in research consists of many islands dotted across the system. Some are well-connected. Others less so. We must build bridges quickly between those that are not; even if means settling for pontoons rather than suspension bridges.
Changes in the NHS loom large. We were treated to two excellent presentations about ‘health and wealth’ and also the Academic Health Science Networks (AHSNs). AHSNs are the new kids on the block with the given task of helping to generate. But they are ending up with a different job description and less money than was originally hyped up two years. So be it. We’ve been there and done it many times as patients and the public. However, their emphasis on partnership and collaboration plays into our hands nicely if we can just get through that door marked ‘academia – do not disturb.’ And persuade those monsters from the deep to break the waters with some funding.
We are hesitant about the idea of patient leaders and/or patient leadership. Or rather, we are concerned about the speed with which patient-driven notions of leadership are fast becoming bastardised and commoditised by the NHS in its anxious search for accountability and legitimacy. Capsizing looks inevitable but not complete submersion if we can get a boson’s line to it fast enough. Should we succeed I think it could sail from port again but stronger just like INVOLVE did all those years ago.
As always there is he frustration that others in the NHS can not see what we can beyond the fog behind our island. Who knows what the charities are doing hanging on by the anchor chain and abandoning all hope of independent thought. Roll on the breath of fresh air that walks in the guise of future NHS leaders who truly understand involvement. They will come I feel sure.
Yes, we talked about language and definitions (c’mon, if we didn’t it would be like Christmas Island without its red crabs). We agreed that precision in our language can give confidence to others. That we shall seek to do, while avoiding those pincers of course!
We also talked at length about standards. What does good quality public involvement look like? Should we have a Chief Inspector of Patient and Public Involvement who can be CHiPPi with those who fall short? No. of course not. But we think there might be mileage in us producing some principles and a framework that helps people identify quality in different contexts. We can not instruct. We can, however, help others make sense of where they stand and surely that is far more empowering, Anyway, watch this space for an excellent paper summarising what we have discovered in terms of standards and values and principles.
I rather enjoyed the truncated session in which we were asked to identify the things we wished we had known before getting involved in public involvement. I said I wish I had known how much support and help was already out there ready to come to one’s aid. More simply, that a passion shared is change in the making.
So, give INVOLVE a call today. Look at the website. Or follow it on Twitter @NIHRINVOLVE
No PPI person is an island in our book.
*By the way does anyone else view health and social care integration as I do – like the merger of Lloyds and TSB. Resulting in a poorer service to consumers over many years before being split into two once again?