The rationale and design of public involvement in health-funding decision making: focus groups with the Canadian public

2020 ◽  
Vol 36 (6) ◽  
pp. 592-598
Author(s):  
Edilene Lopes ◽  
Jackie Street ◽  
Tania Stafinski ◽  
Tracy Merlin ◽  
Drew Carter
Keyword(s):  
Decision Making ◽  
Focus Groups ◽  
Policy Development ◽  
Public Involvement ◽  
Public Understanding ◽  
Funding Decision ◽  
The Public ◽  
Health Technologies ◽  
Advantages And Disadvantages ◽  
Health Funding

BackgroundWorldwide, governments employ health technology assessment (HTA) in healthcare funding decision making. Requests to include public perspectives in this are increasing, with the idea being that the public can identify social values to guide policy development, increasing the transparency and accountability of government decision making.ObjectiveTo understand the perspectives of the Canadian public on the rationale and design of public involvement in HTA.DesignA demographically representative sample of residents of a Canadian province was selected to take part in two sets of two focus groups (sixteen people for the first set and twenty for the second set).ResultsParticipants were suspicious of the interests driving various stakeholders involved in HTA. They saw the public as uniquely impartial though also lacking knowledge about health technologies. Participants were also suspicious of personal biases and commended mechanisms to reduce their impact. Participants suggested various involvement methods, such as focus groups, citizens' juries and surveys, noting advantages and disadvantages belonging to each and commending a combination.Discussion and conclusionsWe identified a lack of public understanding of how decisions are made and distrust concerning whose interests and values are being considered. Public involvement was seen as a way of providing information to the public and ascertaining their views and values. Participants suggested that public involvement should employ a mixed-methods strategy to support informed debate and participation of a large number of people.

Public Involvement in the Design of Public Projects

2019 ◽  
Vol 44 (4) ◽  
pp. 73-79
Author(s):  
Emad S. Mushtaha ◽  
Omar Hassan Omar ◽  
Dua S. Barakat ◽  
Hessa Al-Jarwan ◽  
Dima Abdulrahman ◽  
...  
Keyword(s):  
Decision Making ◽  
Design Process ◽  
Public Involvement ◽  
Decision Making Process ◽  
Quantitative Methodology ◽  
Public Project ◽  
The Public ◽  
Public Projects ◽  
Novel Approach ◽  
Building Program

The involvement of the public in the decision-making process is essential, especially in the early stages of a design process. This study aims to achieve the development of an architectural program for a memorial public project, using the outcomes of the Analytical Hierarchy Process (AHP) based on public opinion. It employs a novel approach that sharply focuses on public involvement in the design process, using a quantitative methodology for the development of a suitable building program and selecting a memorial form that meets the public's needs in a practical way. The study drew on data from various memorial projects to identify possible spaces and their selection criteria. A written questionnaire was distributed to a sample of 105 members of the public, to narrow down the number of spaces according to public response. Then, a hearing (spoken) questionnaire was conducted on a sample of 20 to produce the program for development by generating the most strongly preferred form of memorial. The results contradicted the existing norm for a memorial as a sculpture; it was revealed that most of the public preferred memorial landscapes to buildings and great structures. The study concluded that AHP could be used to further involve the relevant stakeholders in the decision-making process of the design of a public project.

scholarly journals Involving citizens in disinvestment decisions: what do health professionals think? Findings from a multi-method study in the English NHS

2017 ◽  
Vol 13 (2) ◽  
pp. 162-188 ◽  
Author(s):  
Tom Daniels ◽  
Iestyn Williams ◽  
Stirling Bryan ◽  
Craig Mitton ◽  
Suzanne Robinson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Public Involvement ◽  
Health Care Systems ◽  
Future Research ◽  
Local Health ◽  
The Public ◽  
Health Care Leaders ◽  
Local Health Care ◽  
Care Systems

AbstractPublic involvement in disinvestment decision making in health care is widely advocated, and in some cases legally mandated. However, attempts to involve the public in other areas of health policy have been accused of tokenism and manipulation. This paper presents research into the views of local health care leaders in the English National Health Service (NHS) with regards to the involvement of citizens and local communities in disinvestment decision making. The research includes a Q study and follow-up interviews with a sample of health care clinicians and managers in senior roles in the English NHS. It finds that whilst initial responses suggest high levels of support for public involvement, further probing of attitudes and experiences shows higher levels of ambivalence and risk aversion and a far more cautious overall stance. This study has implications for the future of disinvestment activities and public involvement in health care systems faced with increased resource constraint. Recommendations are made for future research and practice.

scholarly journals Key stakeholders’ views, experiences and expectations of patient and public involvement in healthcare professions’ education: a qualitative study

2021 ◽  
Author(s):  
Megan Cullen ◽  
Cathal Cadogan ◽  
Susmi George ◽  
Siobhan Murphy ◽  
Siobhan Freeney ◽  
...  
Keyword(s):  
Focus Groups ◽  
Public Involvement ◽  
Health Professions ◽  
Patient And Public Involvement ◽  
Health Professions Education ◽  
Multiple Perspectives ◽  
Group Setting ◽  
The Public ◽  
Training Requirements ◽  
Key Stakeholders

Abstract Background Patients and the public have an integral role in educating healthcare professionals. Authentic partnerships between higher education institutions and patients and the public are essential. This study examined key stakeholders’ views, experiences and expectations of patient and public involvement (PPI) including the nature of the involvement and requirements for partnership. Methods Purposive and snowball sampling was used to recruit key stakeholders, including patients and members of the public involved in health professions education, and academics interested in PPI. Focus groups were held with patient and public participants, providing the opportunity to gain multiple perspectives in an interactive group setting. Academics with an interest in PPI were interviewed using a semi-structured approach. Topic guides were derived from the literature and piloted prior to data collection. Focus groups and interviews were conducted until data saturation was achieved. All data was audio-recorded, transcribed, anonymised and thematically analysed. Results Four focus groups were conducted involving 23 patient and public participants (median number of participants per focus group of 6). Nine interviews were conducted with academics (face-to-face [n=8] or by telephone [n=1]). Five themes were developed: previous experiences of PPI, training requirements, challenges/barriers to PPI, facilitators of PPI and future ideas for PPI. All participants held positive views of the value of PPI. Participants had mixed views in terms of training, which depended on the level of involvement, but similar views on the challenges and facilitators for PPI in education. There was agreement that PPI requires institutional vision and investment to build strong relationships and a culture of PPI best practice. Conclusion There is a need for more strategic and formal involvement of patients and the public to ensure that that PPI becomes sustainably embedded in health professions education.

Community views and perspectives on public engagement in health technology assessment decision making

2017 ◽  
Vol 41 (1) ◽  
pp. 68 ◽  
Author(s):  
Sally Wortley ◽  
Allison Tong ◽  
Kirsten Howard
Keyword(s):  
Decision Making ◽  
Focus Groups ◽  
Health Technology Assessment ◽  
Public Participation ◽  
Healthcare System ◽  
Public Engagement ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Making Process ◽  
The Public

Objectives The aim of the present study was to describe community views and perspectives on public engagement processes in Australian health technology assessment (HTA) decision making. Methods Six focus groups were held in Sydney (NSW, Australia) as part of a broad program of work on public engagement and HTA. Eligible participants were aged ≥18 years and spoke English. Participants were asked about their views and perspectives of public engagement in the HTA decision-making process, with responses analysed using a public participation framework. Results Fifty-eight participants aged 19–71 years attended the focus groups. Responses from the public indicated that they wanted public engagement in HTA to include a diversity of individuals, be independent and transparent, involve individuals early in the process and ensure that public input is meaningful and useful to the process. This was consistent with the public participation framework. Perceived shortcomings of the current public engagement process were also identified, namely the lack of awareness of the HTA system in the general population and the need to acknowledge the role different groups of stakeholders or ‘publics’ can have in the process. Conclusions The public do see a role for themselves in the HTA decision-making process. This is distinct to the involvement of patients and carers. It is important that any future public engagement strategy in this field distinguishes between stakeholder groups and outline approaches that will involve members of the public in the decision-making process, especially if public expectations of involvement in healthcare decision-making continue to increase. What is known about this topic? The views and perspectives of patients and consumers are important in the HTA decision-making process. There is a move to involve the broader community, particularly as decisions become increasingly complex and resources more scarce. What does this paper add? It not been known to what extent, or at what points, the community would like to be engaged with the HTA decision-making process. The present study adds to the evidence base on this topic by identifying features of engagement that may be important in determining the extent of wider public involvement. It is clear that the community expects the system to be transparent, for patients to be involved early in specific processes and the wider community to be able to contribute to the broader vision of the healthcare system. What are the implications for practitioners? A formalised strategy is needed to include the public voice into health technology decisions. With the current level of reform in the healthcare sector and the focus on creating a sustainable healthcare system, there is a real opportunity to implement an approach that not only informs patients and the community of the challenges, but includes and incorporates their views into these decisions. This will assist in developing and adapting policy that is relevant and meets the needs of the population.

What the Public Thinks and Knows About Science—and Why It Matters

2017 ◽  
Author(s):  
William K. Hallman
Keyword(s):  
Decision Making ◽  
Science Literacy ◽  
Public Understanding Of Science ◽  
Public Understanding ◽  
Scientific Methods ◽  
The Public ◽  
Civic Discourse ◽  
Scientific Institutions ◽  
Understanding Of Science ◽  
Over Time

Modern conceptions of science literacy include knowledge of science facts; a grasp of scientific methods, norms, and practices; awareness of current discoveries and controversies involving science and refinement of the ability to comprehend and evaluate their implications; the capability to assess the priorities and actions of scientific institutions; and the capacity to engage in civic discourse and decision-making with regard to specific issues involving science. Advocates of increased science literacy maintain that widespread public understanding of science benefits individuals, culture, society, the economy, the nation, democracy, and science itself. This chapter argues that the relatively crude measures currently employed to assess science literacy are insufficient to demonstrate these outcomes. It is difficult to know whether these benefits are real and are independent of greater levels of education. Existing measures should be supplanted by multidimensional scales that are parsimonious, easy to administer, reliable, and valid over time and across cultures.

PP124 Smart Capability Building For Effective Patient Involvement

2019 ◽  
Vol 35 (S1) ◽  
pp. 59-60
Author(s):  
Claire Davis ◽  
Sophie Hughes ◽  
Susan Myles
Keyword(s):  
Best Practice ◽  
Patient Involvement ◽  
Public Involvement ◽  
Health Technology ◽  
Patient And Public Involvement ◽  
The Public ◽  
Health Technologies ◽  
Capability Building ◽  
Working Together ◽  
Strategy Building

IntroductionA new Health Technology Assessment (HTA) agency, Health Technology Wales (HTW), has been established to consider the identification, appraisal, and adoption of non-medicine health technologies. This includes, for example, medical devices, surgical procedures and diagnostics. HTW recognizes the importance of effective patient and public involvement (PPI) and is building smart capabilities.MethodsHTW consulted with external organizations to identify the first steps toward effective PPI. Public partners were recruited as a priority before working together on a PPI strategy. Building smart capabilities is key to establishing effective PPI and future-proofing. HTW established a PPI Standing Group to inform HTW throughout its work, including the development of processes and procedures.ResultsKnowledge and resources have been shared and future collaborations identified, including events to encourage new topics from patients and the public. The HTW PPI lead has become a member of key PPI groups, locally and internationally. HTW has recruited public partners who are actively contributing as full members of the Assessment Group and the Appraisal Panel; two members on each Committee. The PPI Standing Group has been established. They have provided advice and co-produced PPI tools for piloting.ConclusionsThe PPI Standing Group concluded that PPI methods and approaches should be tailored for each project based on best practice, and should be piloted to allow them to evolve based on impact evaluation. A PPI strategy or framework would be more useful at a later stage. HTW is committed to identifying and following best practice. Future-proofing and building smart capability will be key to ensuring that HTW develops effective PPI that can be dynamic and responsive to the evolving PPI and HTA landscapes.

‘The public is too subjective’: public involvement at different levels of health-care decision making

2002 ◽  
Vol 54 (12) ◽  
pp. 1825-1837 ◽  
Author(s):  
Andrea Litva ◽  
Joanna Coast ◽  
Jenny Donovan ◽  
John Eyles ◽  
Michael Shepherd ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Public Involvement ◽  
Health Care Decision ◽  
The Public ◽  
Care Decision ◽  
Different Levels

Administrative Flexibility and Knowledge in Policy Delivery

2013 ◽  
pp. 260-276
Author(s):  
Nick Letch
Keyword(s):  
Public Policy ◽  
Decision Making ◽  
Public Sector ◽  
Policy Development ◽  
Critical Role ◽  
Information And Communications Technologies ◽  
The Public ◽  
Communications Technologies

Information and communications technologies are emerging as important drivers of reform in the public sector. This chapter explores both enabling and constraining aspects of the role that ICTs can play in transforming the development and delivery of public policy. Two issues are explored: the reduction in flexibility of decision making that frequently accompanies ICT-based initiatives, and the critical role of knowledge embedded in networks of stakeholders in policy development and delivery. A case study, which traces the knowledge embedded in networks of relationships of actors involved in developing and implementing operational policy in an Australian public sector agency, is presented to illustrate the unintended constraints on knowledge activities. A framework for analyzing socio-technical networks involved in integrating ICTs into the cycle of public policy is presented.

The Public and Decision-making Process: Who and Why Needs Citizen Participation?

2014 ◽  
pp. 63-80
Author(s):  
O. Bychkova
Keyword(s):  
Public Policy ◽  
Decision Making ◽  
Citizen Participation ◽  
Public Involvement ◽  
Empirical Studies ◽  
Point Of View ◽  
Work Time ◽  
Alternative Mode ◽  
The Public ◽  
Time And Energy

The participation of the public in the decision-making and policy discussion is expected to allow the officials to re-valuate the proposed decisions, save money on their implementation and restore public trust in government. However, from the point of view of bureaucrats, direct participation is often unproductive: you are required to spend work time and energy on discussions with non-experts and have no means to predict the effectiveness and efficiency of these debates. The article considers theories and empirical studies that can explain a new fashion trend of openness and transparency in world’s public policy and problems with its implementation. The article also evaluates the applicability of republican tradition to modern policy-making and analyzes alternative mode of public involvement. Keywords : public policy, rule-making, open government, transparency, public participation.

Factors Affecting Public and Political Acceptance for the Implementation of Geological Disposal

2007 ◽  
Author(s):  
Bernard Neerdael
Keyword(s):  
Decision Making ◽  
Policy Development ◽  
Implementation Process ◽  
Social Dimension ◽  
Added Value ◽  
Acceptable Solution ◽  
Factors Affecting ◽  
The Public ◽  
Value Judgements ◽  
Decision Making Processes

The main objective of this paper is to identify conditions which affect public concern (either increase or decrease) and political acceptance for developing and implementing programmes for geologic disposal of long-lived radioactive waste. It also looks how citizens and relevant actors can be associated in the decision making process in such a way that their input is enriching the outcome towards a more socially robust and sustainable solution. Finally, it aims at learning from the interaction how to optimise risk management addressing needs and expectations of the public and of other relevant stakeholders. In order to meet these objectives, factors of relevance for societal acceptance conditions are identified, described and analysed. Subsequently these factors are looked for in the real world of nuclear waste management through cases in several countries. The analysis is conducted for six stages of a repository programme and implementation process, from policy development to the realisation of the repository itself. The diversity of characteristics of such contexts increases insight in the way society and values of reference are influencing technological decision making. These interrelated factors need to be integrated in step by step decision making processes as emerging the last years in HLW disposal management. In the conclusions, the effect of each factor on acceptance is derived from the empirical record. In the course of carrying out this analysis, it became clear that acceptance had a different meaning in the first three stages of the process, more generic and therefore mainly discussed at policy level and the other stages, by nature more site-specific, and therefore requesting both public and political acceptance. Experience as clearly addressed in this report has shown that a feasible solution has its technical dimension but that “an acceptable solution” always will have a combined technical and social dimension. If the paper provides tentative answers to the central question how factors affect public and political acceptance, it also aims at illustrating the added value of broadening the technical dimension with social dialogue and insight in value judgements.

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