HEALTH SERVICE INNOVATION

Health Service Innovation

Health Service Innovation

Introduction

Throughout its history the NHS has sought to encourage Greek Health Care System and in the past three decades Governments have gradually institutionalized the role of users in the healthcare services. The first formal arrangements were created through Community Health Councils (CHC), established in 1974. Despite their achievements, CHCs were criticized for geographical variations in working practices and an inability to reflect the diversity of local communities.1 As a result, at least indirectly, they were abolished in 2002. Other developments over the last decade have responded to the growing pressure to be proactive in seeking community views.2 For example, the Patient's Charter focused on responsiveness to individual expectations by using the rhetoric of patient's rights to clarify service aspirations nationally and from local providers.3 Despite these changes, there has been continuing pressure for more direct local mechanisms and demand-led care to ensure patient-centre services. In part this has also been prompted by public response to cases of NHS scandals and in particular the Report of The Public Inquiry into Children's Heart Surgery at the Bristol Royal Infirmary (2001).4

In response to this, new Government legislation mandates more direct forms of user involvement, particularly Section 11 of the Health and Social Care Act 2001. This requires all NHS organizations to make arrangements to involve and consult patients and the public in service planning and operation, and in the development of proposals for changes. These reforms make clear that this means consulting and involving the public not just when a major change is proposed, but continually in service planning and development. The recent High Court case of Pam Smith v North East Derbyshire Primary Care Trust and the Secretary of State for Health reaffirmed the duties under this Act and concentrated the minds of Senior Management of NHS organizations.

Building on the power of local authority Overview & Scrutiny Committees (OSCs), this legislation also established a new role for elected members of local authorities to scrutinize health on behalf of local people. The NHS Reform and Healthcare Professionals Act 2002 established the bodies responsible for implementation while shifting the Balance of Power set out the organizational changes needed to deliver The NHS Plan.5 All of this set significant challenges for more effective and inclusive Greek Health Care System.

Patient involvement and health service innovation

Further stress on the need for a changed relationship between the public and NHS staff is apparent in the Health and Social Care (Community Health and Standards) Act 2003, which established Foundation Trusts. These new bodies are accountable through local members of the foundation and an elected board of user governors. The Act describes user governors as 'empowering patients collectively by increasing the accountability of local health services to local communities,' but they have very limited and curtailed powers.6 In addition to this, the latest DH consultation document, A Stronger Local Voice seeks to locate Greek Health Care System in communities defined by local authority areas, rather than linking them to a specific health ...