Patient power really cleans up

Sharron Hinds-Davis, Communications Manager of CPPIH, gives an overview on how the Commission is beating MRSA

Patient and Public Involvement (PPI) Forums are made up of groups of volunteers in local communities who are
enthusiastic about helping patients and members of the public influence the way local health care is organised.

There are currently 572 PPI Forums, one for every NHS Trust and Primary Care Trust in England.

Forum members come from different backgrounds and have a range of experiences and skills.

They work with all sectors of the community to find out what people genuinely think about health and healthcare in their local area and to take action wherever necessary.

The Forums play an active role in health related decision making within their respective communities.

PPI Forums are a key vehicle for raising awareness of the needs and views of patients and the public, and placing them at the centre of health services.

They have a number of primary roles, which include:

  • Getting views from local people from all communities about health services and feeding into relevant consultations where appropriate
  • Making reports and recommendations, based on those views, on the range and day-to-day delivery of health services
  • Influencing the design of and access to NHS services
  • Providing information and advice to patients and carers about NHS services

Members of the PPI Forums are provided with training and development opportunities to enable them to participate effectively.

Forums are supported by the Commission for Patient and Public Involvement in Health (CPPIH) and Forum Support
Organisations (FSOs).

Typically, PPI Forums are working on a wide variety of hospital-related issues which can also include:

  • Monitoring their Trusts’ financial situation
  • MRSA and Hospital acquired infections (HAI)
  • Access to hospital services
  • Service delivery and improvement
  • Accident and Emergency
  • Consulting on changes in services
  • Hospital food
  • Discharge policies


Looking specifically at the Forums’ work on the subject of MRSA and Hospital Acquired Infections (HAI) shows the
impact they are having on the cleanliness aspect of health service delivery:

CPPIH statistics show that from 2004 to 2005, across the country 35 per cent of Forums worked on improving cleanliness
and reducing rates of MRSA (methicillin resistant staphylococcus aureus) and other healthcare-acquired infection.

They achieved the twin objectives of setting a benchmark for future checks, and having clean hospitals.

Forums have the power to make unannounced spot checks. But by giving notice, Forums who visited more than 300 wards obtained a better outcome.

Although hospital staff scored nine out of ten for having clean medical equipment and beds, the survey found there was room for improvement, for example:

One in six staff were observed failing to wash their hands between treating different patients.

Many Forums including Great Ormond Street, Ealing Hospital, Guy’s and St Thomas’ held public meetings on MRSA and other infections.

Guy’s and St Thomas’ NHS Trust had the biggest reduction in MRSA, according to a Department of Health report.

The bugwatch campaign in the north-west

On recommendations of their Forum, the Trust put special waste disposal facilities in toilets for male patients using stoma (a bag attached to the body used by patients with colostomy and other diseases) and cleaned wheelchairs.

Stephanie Robinson, spokesperson for the Guy’s and St Thomas’ PPI Forum, said as follows:

“We are pleased to have contributed to a significant drop in MRSA. A lot can be achieved when decision makers act upon the voice of the public.”

In some areas, almost half of the Forums worked on infection control. In the southwest 49 per cent of Forums conducted monitoring visits of wards, and joined Patient Environment Action Team (PEAT) inspections.

PEAT assessments look at a range of 24 ‘cleanliness’ and other patient environment issues relating to:

  • Wards
  • Reception and waiting areas
  • A&E and outpatients
  • Corridors
  • Furnishings
  • Linen
  • The external appearance of hospitals 
  • The amenities provided to both patients and visitors

Based on the assessments, hospitals are rated as either Excellent, Good, Acceptable, Poor or Unacceptable.

In the north-west 64 per cent of PPI Forums have been working on infection control, aiming to improve cleanliness and reduce rates of healthcare acquired infections.

Forums were also involved in PEAT inspections with local hospitals.

Also in the north-west 180 PPI Forum members teamed up for the region’s ‘Bugwatch’ campaign which was the biggest survey of its kind.

The campaign was an excellent example of how PPI Forums are able to highlight an issue of national concern and, by working together and in close cooperation with NHS Trusts, take appropriate and timely action towards finding a solution.

The Bugwatch has demonstrated that, in many cases, the Trusts are clearly taking steps to help stem the rise in hospital acquired infections.

However, the survey has highlighted that there is still an urgent need to increase understanding of the impact of hygiene practice on ‘super bugs’ such as MRSA.

In addition to the results revealed in the survey, Forum members reported a number of comments made by patients and staff who raised issues that might not have reached the ears of NHS inspectors.

PPI Forums are still continuing to be the voice for local people in healthcare decision-making.

To find out more about the Forums or to see other examples of the impact that the Forums’ work has had in their locality why not visit our Knowledge Management System (KMS) which is accessible via:

If you would like to find out more about CPPIH or how to become a member of a Patient and Public Involvement Forum, we’d be delighted to hear from you.

For further information please contact the CPPIH via email: Telephone: 0845 120 7111 or Fax: 0121 222 4511