The first years findings were published in September 2005 and are available for download.  The final report is available for download.

Background - A team of researchers from Manchester University are evaluating the impact of local authority health scrutiny (September 2004 to September 2007). The team includes input from The Centre for Public Policy and Management (CPPM), The Institute for Political and Economic Governance (IPEG) and The National Primary Care Research and Development Centre (NPCRDC). The Centre for Public Scrutiny (CfPS) made this award as part of their three-year national Health Scrutiny Support Programme (HSSP). 

Aim - This project focused on local authority health scrutiny and aimed to:

• Describe and understand the impact of health scrutiny on organisations, on communities and to understand the relationship between context, process and impact.
• Describe and understand the range of methods, processes and approaches being used in health scrutiny, and to examine their effectiveness.

Method - The research built on work already undertaken at NPCRDC, CPPM and IPEG over the last few years on both broader local authority scrutiny and the more specific area of health scrutiny. This research consisted of two main phases: Baseline study (postal surveys) and development of analytical framework (09/04 - 08/05); 18 month in-depth case study fieldwork with 8 anonymous sites using interviews, observations and documentary analysis (09/05 - 02/07).

Results

Structures

• HOSCs relate to multiple Primary Care Trusts (PCTs) and general acute and mental health care trusts;
• HOSCs have been involved in at least one joint committee;
• Officer support is generally good and organised in specialist scrutiny units, but resources are constrained for this activity;
• Chairs tend to be experienced individuals, often including experience of working in or with the health sector in some capacity;

HOSC Processes

• Committees have used a variety of approaches and methods. The use of working groups is common. A few cases have adopted the 'new' style of scrutiny, which includes innovative methods of scrutiny in particular a more collaborative approach with stakeholders and the public.
• The 'new' style has been used mainly for review work, and in cases where collaborative work has been pursued, reviews have involved key stakeholder groups including user groups;
• HOSCs have generally both conducted reviews and scrutinised statutory consultations, but the latter activity has limited the former in many of the cases.
• Relationships with NHS bodies have been developed and are considered productive;
• Relationships with Patient and Public Involvement Forums (PPIFs) have not always worked so well, with the main barrier here being resource constraints within the PPIFs.
• Involvement of the general public has in general been low with few instances of the public attending meetings or contacting the HOSCs.

Impacts

• Process impacts and substantive impacts have been identified, but attributing these outcomes to scrutiny is ultimately difficult;
• Changes to plans and services have been the impacts most readily identified, and whilst they have been small they are valued; and
• Where collaborative approaches have been taken by HOSCs this has supported the further development of relationships with service providers.

Publications