International Journal of Integrated Care, 16 March 2005 - ISSN 1568-4156
Book review
Involving patients and the public: how to do it better. Second edition
Edited by Ruth Chambers, Chris Drinkwater, Elizabeth Boath
Radcliffe Medical Press, 2003, pp 168,
ISBN 1 85775 994 X
Pierre De Paepe, Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium
Jean-Pierre Unger, Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium

There is a renewed interest, from ministers of health to health professionals, in achieving a meaningful dialogue with patients and the general public, to improve quality of care and patient satisfaction. Patient and public involvement has become a key element of UK government policy. Those with experience in developing countries, in particular in primary health care, know that this is not an easy issue, as real participation implies a power shift from providers to users, and from professionals to the public. Patients refrain from participating if they perceive hidden agendas or closed decision-making.

In fact, quality of care cannot be tackled without patient participation, and that is what this book is all about. The authors have considerable experience: from general practice to methods for information gathering, and from educational techniques to community care policy and practice.

After a general introduction, the second chapter examines how patient and public involvement has emerged as a key issue in the UK following the 2001 Bristol inquiry into poor standards of surgery. The third chapter describes questionnaires and interview surveys. The fourth relates a variety of qualitative methods to gather information and views from patients, professionals and the general public, ranging from standing panels and the Delphi technique to consensus development conferences. The fifth chapter tells the reader how to do it right: sampling techniques, validity and reliability of questionnaires, ethical approval, informed consent, best practice in planning, executing and writing up a survey or consultation exercise, and templates to evaluate best practice. The final chapter helps to select the best methods for the task in hand.

The reader will also find a list of useful information for patients, managers and health professionals about relevant websites, patient support groups, media contacts and relevant reading. For UK readers in particular, the book explains the new structures and processes implemented to support patient and public involvement in the NHS. Particularly innovative is the attempt to estimate the costs of different methods of stakeholder involvement. Although written primarily for a UK audience, the book's detailed description of the methods of involvement will be useful to readers from other countries. The latter may find the multiple cryptic abbreviations a bit exasperating (PF, ICAS, CPPIH, OSCs etc.), although so might some UK readers and this is not the fault of the authors! Finally, constant and ongoing NHS reform may serve to limit future public involvement, and could soon make the information about useful addresses, websites and contacts out-of-date. Perhaps a third edition will be needed soon.

This is not the first book about methods for involving patients and the public, and the reader may find more in-depth descriptions of particular methods elsewhere. However, it is thoughtfully written and is a good general introduction for health professionals and managers, particularly for those living in the UK.