3. LHB Board appointments and Citizen Engagement (CE)
A question was raised about the vagueness of the remit of the two (of five) LHB non-executive directors contributing community knowledge and understanding. To help drive the process of continuously renewing NHS democracy and public confidence in the new NHS Wales, the view was expressed that there should be a new focus at the LHB Board level on (a) patient safety/public protection and (b) CE strategy. The two NEDs should be specifically appointed to focus upon this agenda and to support the specific role of the LHB vice chairperson's public health remit.
It is noted that the role of championing 'patient safety' extends well beyond the 'cleaning' role indicated in the NHS II consultation paper. For example, medicine management, to prevent overdosing of very old patients, which may cause them to become unsteady and fall in hospital leading to fractures and death; adequate nutrition and hydration resulting in improved recovery and reduced possibility that frail patients will return to hospital; or those Health support workers who have little or no adequate training in infection control.
For public accountability to become meaningful, particular significance is attached to ensuring that the public appointments criteria clearly explain the essential and desirable qualities and experience required of these two specific NEDs. We can offer specimen details to the Public Appointments Unit or the NHS Reform Team, if required.
In addition, at the minimum, the Minister should review guidelines for carrying out competence linked appraisals for these two NEDs and the chair and vice chair organisational roles at (NHS) national, regional and 'local' levels so that the framework of rules which govern the way the organisation deals with key issues and objectives is reflected in the performance criteria across all competency units.
We assume that the NHS reform team will be working with the National Advisory Board to prepare a higher-level guidance for Citizen Engagement guidance for all, including the new LHBs, local authorities, and the new Public Health system. This will be far more effective in ensuring a meaningful CE framework, with a new system enabling an iterative process between patients, carers, service user and other interests. Such a system, including the annual presentation by the chair of the Board of CHCs to the National Advisory Board and the Public Health Service NHS Trust, should be supported through new "web 2.0" approaches.
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