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Title: Patient and public involvement in primary care groups : a case study
Author: Fee, Verna
ISNI:       0000 0001 3458 7338
Awarding Body: Durham University
Current Institution: Durham University
Date of Award: 2007
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The focus of this thesis is patient and public involvement in the UK National Health Service (NHS) following the White Paper, The New NHS: Modern, Oependable (DoH 1997). It offers a critical analysis of the delivery of the promises made in the White Paper, with particular reference to a detailed case study of one Primary Care Group (PCG) during the period 1999 - 2002. The study is set in the policy context of profound organisational and structural change in the UK NHS, which has included an increasing emphasis on developing mechanisms for involving patients and the wider public. The case study is based on observation of several key structures and processes within the PCG and in-depth interviews with key stakeholders - medical and nursing practitioners, PCG managers, members of partner organisations, the lay member of the Board and community representatives. Using a theoretical framework that draws on Lukes' analysis of power, the study explores how the roles of patients and members of the public were perceived and constructed, the effectiveness of involvement and some of the main issues and challenges. The study revealed immature structures and processes, confusion over the why, how and when of involvement activities, tensions between centrally driven targets and local control and relatively little understanding of how acknowledging and addressing existing power relationships is fundamental to developing meaningful involvement. The thesis concludes that attempts to develop patient and public involvement in isolation from theoretical and philosophical issues undermine the impact that traditional and historical patterns of power and control can have on current and future developments in respect of policy and practice. In particular, creating the conditions necessary to enable all stakeholders to identify, articulate, negotiate and argue for their perceived needs will require ideological as well as structural and organisational change.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available