Editor—Contrary to the findings of the King's Fund that lay members of primary care groups are finding it difficult to ensure that patients' views are heard,1,2 a study of lay members conducted by the University of Bristol indicates that they are increasingly confident in their ability to influence decision making.
In a postal survey of all primary care groups in the South West region (response rate 76%), 69% of lay members reported that they had either moderate or a lot of influence over decision making. They reported that their influence has increased with time as a result of their contribution to the work of the group and that they have gained credibility and earned the board's respect for their skills and experience. Their main contribution lies in fulfilling their responsibilities as a corporate board member, although many have taken the lead in public engagement.
The remaining 31% of lay members reported either limited or very limited influence; this was not associated with age, sex, prior knowledge of the NHS, or extent of previous board experience. Rather, isolation as the lone lay voice, lack of time, and general practitioners' dominance of the primary care group's agenda and decision making were reported as key constraints.
Such self reports can always be criticised as lacking objectivity, but they do reflect the level of confidence that lay members have in their ability to influence decisions, which is likely to be reflected in their participation in decision making.
The survey highlights that lay members have a dynamic and evolving role, their influence increasing with knowledge and experience and through successful interaction with other board members. Where lay members have been able to contribute their skills, this has caused other board members to revise their views on the benefits of lay participation, which in time may foster a culture that supports wider public involvement in the work of primary care groups and trusts.
Don't write lay members off too soon.
References
- 1.Richard T. Patients need a real say in the NHS, not just to be “muppets,” says report. Abridged version: BMJ. 2001;322:754. www.bmj.com/cgi/content/full/322/7289/754/b . Full version [news extra]: www.bmj.com/cgi/content/full/322/7289/754/b. (31 March.) . (31 March.) [Google Scholar]
- 2.King's Fund. Gillam S, Brooks F, eds. London: Kings Fund; 2001. New beginnings: towards patient and public involvement in primary care. [Google Scholar]