Commentary on Sections Patient and public involvement Section 20: The Commission for Patient and Public Involvement in Health
103.Section 20,, subsection (1) establishes an independent body corporate, to be known as CPPIH.
104.Subsections (2)(a) and (2)(b) provide for CPPIH to advise the Secretary of State, and such other bodies as the Secretary of State may prescribe in regulations, about the arrangements that are in place for the involvement and consultation of patients and the public in matters relating to the health service in England; and on arrangements for the provision of independent advocacy services (to be provided under section 19A of the 1977 Act).
105.Subsection 2(c) provides for CPPIH to report to and advise the Secretary of State, and such other bodies as the Secretary of State may prescribe in regulations, on the views of organisations representing patients and their carers, including Patients’ Forums, on such arrangements (for example, how effectively they are operating).
106.Subsection (2)(d) provides for CPPIH to facilitate the co-ordination of Patients’ Forums activities and to provide advice and assistance to Patients’ Forums including staff for PCT Patients’ Forums.  It is intended that CPPIH will, through the staff provided to PCT Patients’ Forums, provide administrative support to NHS trust Patients’ Forums.
107.Subsection (2)(e) provides for CPPIH to give advice and assistance to providers of independent advocacy services.  This could be, for example, in the form of guidance or training.
108.Subsection (2)(f) specifies that CPPIH will set quality standards for (i) the activities of Patients’ Forums and (ii) the provision of independent advocacy services. It will also monitor how effectively these standards are met and make recommendations to them about how to improve their performance against those standards.
109.Subsection (2)(g) enables the Secretary of State in regulations to prescribe other functions for CPPIH.
110.Subsection (3) specifies CPPIH’s function to promote public involvement in decisions and consultations on matters affecting the health of the population.  It will do this at a national level whilst PCT Patients’ Forums will do so at a local level.  The bodies making decisions and carrying out consultations to which subsection (3) relates are described in subsection (4), namely health service bodies but also other public bodies and others providing services to the public.  Subsection (5) also confers on CPPIH a function of reviewing the annual reports of Patients’ Forums and making any recommendations or reports to the Secretary of State and others that it thinks are necessary on matters arising from the annual reports.
111.Subsections (6) and (7) place a duty on CPPIH to report to those it considers appropriate matters of concern about patient safety and welfare, where these are not being dealt with satisfactorily.  An example might be that if it were made aware, as a result of the monitoring of a trust by a Patients’ Forum, of a unit within a trust with a particularly high mortality rate, it might then report its concerns to, for example, a body such as CHI, the National Patients Safety Agency, the National Care Standards Commission or the police.
112.Subsection (8) allows CPPIH to make charges as it sees fit for the provision of its advice or other services.  It is envisaged that in practice CPPIH will want to use this power to recover reasonable costs incurred in providing its services, but there may also be opportunities for CPPIH to supplement its income in this way, for example by charging for advice provided to private hospitals. Regulations may be made to set limits on this - for example, it is not intended that CPPIH would charge for the advice it provides to the Secretary of State or for the routine guidance and training materials it provides to Patients’ Forums and providers of independent advocacy services.
113.Subsection (9) gives the Secretary of State power by regulations to make further provision about CPPIH andsubsection (10) provides by way of example that those regulations may make provision about the information that should be made available to CPPIH by Strategic Health Authorities, Special Health Authorities, NHS trusts, PCTs, Patients’ Forums or providers of independent advocacy services.
114.Subsection (11) gives effect to Schedule 6.  Schedule 6 makes provision about constitution, membership, the payment of allowances, appointment of staff, the delegation of functions, arrangements for assistance with functions, payments and loans, accounting and auditing arrangements, reporting and the miscellaneous amendments needed in relation to other legislation.  It also provides for the Secretary of State to delegate his function of appointing the chair of CPPIH to a Special Health Authority.  In practice, this will be the NHS Appointments Commission.