The impact of patient and public involvement on UK NHS health care: a systematic review

Purpose. Patient and public involvement (PPI) has become an integral part of health care with its emphasis on including and empowering individuals and communities in the shaping of health and social care services. The aims of this study were to identify the impact of PPI on UK National Health Service (NHS) healthcare services and to identify the economic cost. It also examined how PPI is being defined, theorhed and conceptualized, and how the impact of PPI is captured or measured. Data sources. Seventeen key online databases and websites were searched, e.g. Medline and the King's Fund. Study selection. UK studies from 1997 to 2009 which included service user involvement in NHS healthcare services. Date extraction. Key themes were identified and a narrative analysis was undertaken. Results of data synthesis. The review indicates that PPI has a range of impacts on healthcare services. There is little evidence of any economic analysis of the costs involved. A key limitation of the PPI evidence base is the poor quality of reporting impact. Few studies define PPI, there is little theoretical underpinning or conceptualization reported, there is an absence of robust measurement of impact and descriptive evidence lacked detail. Conclusion. There is a need for significant development of the PPI evidence base particularly around guidance for the reporting of user activity and impact. The evidence base needs to be significantly strengthened to ensure the full impact of involving service users in NHS healthcare services is fully understood.