ABSTRACT
The frequency and scale of the ‘redisorganisation’ of the National Health Service has often been the subject of comment, and in no area is it more evident than patient, public, citizen and consumer involvement in health and social care decision-making. Broadly speaking, the evolution of patient and public involvement in healthcare in England maps neatly onto wider political and policy developments that took place over the same period. It is perfectly possible to address the individual needs of patients, carers and consumers and at the same time offer collective input into decision-making. More significantly, Healthwatch are expected to scrutinise services, such as social care and public health that are provided or commissioned by the local authorities that themselves commission Healthwatch. A common preoccupation for all participants was the tension created by a broad set of expectations, including statutory requirements, with a limited resource base, often including annual reductions in funding and relatively short contracts which hampered long-term planning.
