1. INDEPENDENT SCRUNITY
(LONDON PATIENT VOICE)
Paula Lloyd knight
Head of Patient and Public Voice
NHS England (London Region)
Scrutiny Paula Lloyd Knight June v4

2. Setting the scene
On 2nd December 2013, over 50 people, committed to improving patient
participation in London gathered to share their insight and recommendations for
how NHS England (London Region) commissioners can be held to account for their
engagement activities.
The co-production day was organised to gain insight into how the population of
London might hold NHS England (London Region) to account for its engagement
activity and outcomes.

4. Strong governance
Working at pace…without
leaving anyone behind
3. OUTCOMES
Describe what we want the Assembly to achieve in the future
2. DOING & BEING
What will the Assembly members be doing – what activities and work, what will
they be thinking, how will they be behaving?
1. HOW WILL IT FEEL?
Use words and pictures to express how we want it to feel to be a
member of the Assembly in the future
4. VALUES
4. VALUES
COLLABORATION
EMPATHY
COMPASSION
PERSON CENTERED TRUST
MUTUAL RESPECT
OPEN COMMUNICATION
HONESTY
TRANSPARENT
No fudge, thereare clear
objectives
Everyone’sviews
are respected
Listened to
Given enoughtimeto
be heard
No language
barriers
Aleap into the
unknown….but feel
supported
Barriers toovercomeare
part ofthe “challenge”
Part ofa team/
partnership
Understandhow
everything is
interlinked
Working towards acommon goal –
for the commongood
Rewarding
Working withthepublicas
people….not justaspatients
Thinking out ofthebox,
being creative
Dynamic
Feeling in touch
Positiveuseoftime
“You have soughtmeout,given meenoughtime,
listened to me, helpedme to participate”
Successfully juggling the
many topics, issuesand
needs
Light, relaxed, comfortable,
holistic environment
In control
Energised
Differences areaccepted
Travelling together on a journey
BELIEF
Endless possibilities
energy
Key values areknown,
lived, built in
Learn from others –local,
national,international
Active
Engaged
Resilientand
effective advocates
Acriticalfriend: reading,
listening,questioning,
challenging
Making decisionsand
agreeing
Accountable
Not leaving
things to chance
Visionary
Actively
listening
In meetings:useful
contributions, constructive,
productive
Outside meetings: Collecting
and absorbing opinionsand
events; onlinesharing and
collaboration
Working effectively
with commissioners
Unbiased focus –
representing everyone
fairly
Growing together
Accept whenthings
go wrong
Adaptable –leaving old
attitudes/processesbehind
Open to others
knowledge,
opinions, ideas
Questing
Bridging the gap
Magic when itworks
Totally inclusiveand representative
Good
communicators and
ambassadors –
feeding back to
Londoners
Shifting attitudesSetting thestandards/role modelling participation
Safeguarding quality/addressing inequality
Fulfil promiseto holdcommissionerstoaccount
An entity which truly representsthepopulation ofLondon
Better healthoutcomes asresultofcommissionersheld to accountfor PPI
Signposting
Everyone isequal
Everyone’sopinion isvalued
Empowered

5. Outcome of co production day
Develop - A stand alone patient and public
scrutiny function to hold the Region to
account for how it meets its statutory
participation obligations
Group to be called ‘London Patient Voice’
Scrutiny Paula Lloyd Knight June v4

6. Progress towards developing LPV
• Sept 2013- NHSE (LR) Transformation Group agreed to
setting up public arms length scrutiny Group
• Dec 2013 – Successful co production day held with 50
people agreed framework and concept
• Jan 2014 – Task & finish group developed operating
framework
• May 2014 – procurement process for independent
provider and support for LPV
• June 2014- Centre for Public Scrutiny appointed
• July 2014 – Recruitment commenced
Scrutiny Paula Lloyd Knight June v4

7. OUTCOME
METHOD
PRODUCTS
Public Scrutiny of Participation in the London Region
Scrutiny Paula Lloyd Knight June v4
Patients and the public have independently evaluated NHSEL’s
engagement against the two participation duties and made
recommendations for improvements.
Community Asset based Approach
Create London Patient Voice as a stand alone group which holds NHSE
(London Region) to account against the two participation duties across its
direct commissioning function
1. Annual independent evaluation of NHSE (London Region)
participation report
2. Independent assessment of the impact and experience London
citizens have had on NHSE (London Regions) commissioning activities
3. Public report making recommendations for improvement

8. London Patient Voice
London Patient Voice
independently
appointed citizen
scrutiny group
Assesses annual
participation &
engagement report
from London Region
Gathers experiences
of public involved in
the regions
commissoning
activities
Publishes
Independent report
and makes
recommendations
for improvement
Independent scrutiny of NHS England (London Region) participation and engagement activities

9. Role of London Patient Voice
• Assess NHSELRs annual participation and
engagement in commissioning report
• Prepare & publish an independent evaluation
of NHSELR participation and engagement
report making recommendations
• Collect evidence from NHSE (London Region)
patients & groups Involved in direct
commissioning activities and Boards to
support validation of NHSEL report
Scrutiny Paula Lloyd Knight June v4

10. Membership London Patient Voice
• Independent Chair (open recruitment)
• 11 members (open recruitment)
(Membership to be representative of London's
diversity – at application process)
Scrutiny Paula Lloyd Knight June v4

11. NHSE (London Region) PPI activities – Providing
evidence of impact of involvement
NHSE (London Region ) Public & Patient Involvement
structures are not part LPV but LPV will collect evidence
from those involved in NHSE (London Region)
engagement activities to explore their experience &
impact on the decision making process.
LPV members will collect the experiences/evidence from:
• Existing NHSE (LR) patient/ user groups who are active
participants in the commissioning process
• Groups who provide expert user experience /
knowledge to NHSE (LR)
Scrutiny Paula Lloyd Knight June v4

12. NHSE (London Region) Patient & Public Involvement
arrangements in Direct Commissioning Activities
LPV to
assess PPI
experiences
Patient & Public
Procurement
Group
Health & Justice
Stakeholder Sub
committee
Cancer Screening
programme
Board
3 sub committees
Primary Care
Transformation
Patient Board
Specialised
Commissioning
(Monitoring )
TBC
Cancer User
Involvement
Group
Youth Health
Network
London
Immunisation
Board
Strategic Clinical
Network
reference groups

13. LPV Relationship with NHSE
(London Region)
• LPV will be a stand alone arms length group
• NHSEL should have clear arrangements for
how it manages the LPV recommendations
• NHSEL SMT may be asked to give evidence to
support the annual report and
recommendations
Scrutiny Paula Lloyd Knight June v4

14. NHSE (London Region) Governance
arrangements for acting on LPV report &
recommendations
1. Report received by the Patient Experience &
Patient & Public Involvement Clinical
Governance Sub Group – to develop and agree an
action plan
2. Action plan presented to the Clinical
Governance Group for approval and in-year
monitoring
3. Formal response from The London Region
MD to LPV on how it plans to meet its
recommendations

15. Creating and developing London Patients
Voice
Su Turner
Head of Programmes
Centre for Public Scrutiny

16. Who are CfPS?
Founded in 2003 to:
• promote accountable public services
• influence policy and practice
Now a charity, we are a national leader in ideas about
accountability and scrutiny in public services:
• on-line (library, exchange, bulletins and news, blog, twitter)
• training and improvement support services
• publications and events

17. what is scrutiny?
Fundamentally, we believe that:
scrutiny is based on the principle that
someone who makes a decision…
…shouldn’t be the only one to review or
challenge it

18. what is good scrutiny?
CfPS “four principles” of good scrutiny:
• Provides ‘critical friend’ challenge to executive policy-
makers and decision-makers
• Enables the voice and concerns of the public and its
communities
• Is carried out by ‘independent minded governors’ who
lead and own the scrutiny process
• Drives improvement in public services

19. Creating London Patient Voice -
Recruiting and developing its members
• Recruitment – by end of July
• 3 training and development sessions in August covering:
• Getting to know each other, NHS England and the
London Area Team.
• Independent scrutiny, questioning and listening skills.
• Working with others and work programming.
• Coaching and support – particularly for the Chair
• Support for panel members at meetings

20. Thank you
Any questions?

21. To find out more
www.cfps.org.uk - register on-line or sign up for:
- e-newsletters, e-digests & scrutiny exchange
- reviews library, on-line forum, latest news
- new Policy and Skills Briefings
Twitter: @CfPScrutiny
info@cfps.org.uk or 020 7187 7362 for helpdesk