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Involvement and accountability in the English health and social care system

16 October 2014
Short briefing on the current arrangements for patient and public involvement, and public oversight and accountability, in the English health and social care system.

Involvement and accountability structures in the English health and social care system are a complex but vibrant web. Across the country a range of organisations each have different responsibilities and arrangements, for engaging patients and the public in the planning and decision making for health and social care services, and for holding themselves and each other to account.

The most important and direct route for public involvement is provided by Local HealthWatch Organisations (LHOs) which operate at borough, city, or county levels. These 153 organisations are supported by HealthWatch England (HWE), a national consumer body, and together they create the "HealthWatch Network", which has been given the responsibility of championing the needs and concerns of citizens in provision of health and social care services.

Across the country the numerous organisations with responsibility for organising or providing health services each have some responsibility to support involvement. NHS England and Clinical Commissioning Groups (CCGs) have duties to involve and consult on local services, and Foundation Trusts have to have members and governors.

In tune with the government's desire to better connect health and social care, Local Authorities (LAs) have responsibility for supporting new "grand committees", Health and Well-being Boards (HWBs), which are responsible for engaging with local communities to identify and address local health priorities. In addition to this co-ordination role, LAs are also charged with system oversight, having a legal duty to scrutinise their local health and social care services.

If you have any comments or wish to contribute further, please email policy.international@rcn.org.uk