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Public and patient involvement in health service planning

Public and patient experience and involvement in health service planning


The acceptability of health and social care services is an important marker of quality, with patient feedback being a component in healthcare quality frameworks in most countries in the developed world[i]. Involving patients, their families and their carers in the design and improvement of services as well as in decisions about their individual care is a key way of improving public and patient experience, with evidence showing that patient involvement can lead to both improved health outcomes and more efficient resource allocation[ii].

In England, the NHS Constitution pledges that ‘the patient will be at the heart of everything the NHS does’,[iii] while the NHS Patient and Public Participation Policy sets out the vision that ‘by listening to people who use and care about services, [the NHS] can understand their diverse health needs better, and focus on and respond to what matters to them [in order to] improve patient safety, patient experience and health outcomes’.[iv]

The NHS in England has published guidance on public and patient involvement, based on the 10 principles set out in figure F below[v]. Potential sources of data on patient experience are shown in Figure G, with more information on NHS-specific resources available through the NHS Insights website[vi]. Methodology and toolkits for improving patient participation and experience have also been developed by the independent healthcare think-tank, The Kings Fund[vii],[viii].

Figure F: Principles of participation, adapted from Patient and public participation
in commissioning health and care (NHS England, 2017)

Principles of public and patient participation

  1. Reach out to people rather than expecting them to come to you
  2. Promote equality and diversity and encourage and respect different beliefs and opinions
  3. Proactively seek participation from people who experience health inequalities
  4. Value people’s lived experience and the strengths and talents that people bring to the table
  5. Provide clear and easy to understand information
  6. Take time to plan and budget for participation
  7. Be open, honest and transparent in the way you work
  8. Invest in partnerships, have an ongoing dialogue and avoid tokenism
  9. Review experience (positive and negative) and learn from it
  10. Recognise, record and celebrate people’s contributions


Figure G: Sources of data on patient experience, adapted from Patient and public participation in commissioning health and care (NHS England, 2017) 

Sources of data on patient experience

  • Surveys
  • Social media
  • Healthwatch reports
  • Care Quality Commission reviews
  • Research reports
  • Complaints
  • Patient Experience Library
  • Intelligence from health services, the voluntary, community and social enterprise sector and local government
  • Staff feedback including their own views, any ‘whistleblowing’ concerns and intelligence they have gained through their interactions with patients and the public
  • Previous public involvement exercises




© Flora Ogilvie 2017


[i] The Kings Fund. Patients’ experience of using hospital services: An analysis of trends in inpatient surveys in NHS acute trusts 2005-13. 2015

[ii] The Kings Fund. People in control of their own health and care: The state of involvement. 2014.

[iv] NHS England Patient and Public Participation Policy. 2017.

[v] NHS England. Patient and public participation in commissioning and healthcare. 2017.

[vii] The Kings Fund. Experienced-based co-design toolkit. 2013

[viii] The Kings Fund. Patient and family-centred care toolkit.