Major health service transformation and the public voice: conflict, challenge or complicity?:

ObjectivesCalls for major reconfigurations of health services have been accompanied by recommendations that wide ranging stakeholders be involved. In particular, patients and the wider public are seen as critical contributors as both funders and beneficiaries of public health care. But public involvement is fraught with challenges, and little research has focused on involvement in the health service transformation initiatives. This paper examines the design and function of public involvement in reconfiguration of health services within the English NHS.MethodsQualitative data including interviews, observation and documents were collected in two health service ‘transformation’ programmes; interviews include involved public and professional participants. Data were analysed using parallel deductive and inductive approaches.ResultsPublic involvement in the programmes was extensive but its terms of reference, and the individuals involved, were restricted by policy pressures and programme objectives. The degree ...