Patient and public engagement in healthcare system policy: An integrative review




Harper, Caryl

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The need for greater patient and public engagement (PPE) in policy-making in the healthcare system has garnered significant attention from governments (Lewin, Lavis & Fretheim, 2009). Patient and public involvement (PPI) has been at the core of the United Kingdom’s (UK) British National Health Service (NHS) and was accelerated by the Health and Social Care Act 2001 (Tritter & Koivusalo, 2013). In the UK PPI is implemented to create a national mechanism for holding policy-makers in governments and health-care provider organizations accountable for planning and delivering health services. One of the ongoing challenges of engaging the public or patients is how best to involve patients and the public in health policy and decision-making (Thurston, et al., 2005). In this paper, I explore the findings from my review on PPE policy to understand if PPE policy makes a difference within the healthcare system. I have included qualitative and secondary sources, grey literature, and mixed methodology literature published between 2002 and 2015 (January to March). I conducted an integrative review and organised the findings using the Services Management (SM) and Service-Dominant (SD) Theory (Osborne, Radnor & Nasi, 2012). The following three themes were identified in the findings benefits of PPE policy, challenges for policymakers, and governments’ role in PPE policy. An analysis of the key themes revealed a number of policy challenges and recommendations for policy makers, healthcare and nursing leaders specific to PPE. The Advanced Practice Leadership (APL), Master of Nursing, University of Victoria program includes policy competencies. I developed an Integrated PPE Framework for Public Service and Nurse Leaders that includes APL competencies, theoretical concepts and the findings in this review. Future efforts in PPE should include research on how PPE is linked to accountability, translated into policy and practice, and evaluated using standardized, valid, reliable, and appropriate measurement systems.



patient and public engagement, healthcare system policy, governance, nursing competencies