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The College of Health

Marianne Rigge, Director of the College of Health

The College of Health was the brainchild of Michael Young (Lord Young of Dartington), founder of the Consumers Association and the Social Science Research Council, and the moving spirit behind the Open University. Back in 1983 he explained why we were setting it up, in the first issue of the journal Self Health:

"The reason for establishing the College of Health lies in the present imbalance between medical professions and their patients. The former have power, the latter do not. It is also owing to the large gap between the knowledge and information of the two parties. Information, as always, is power."

The College of Health is dedicated to promoting patient-centred care. It does this in six main ways, as described below.

Information services

The College of Health is a major provider of information to patients:

• Through its Healthline service which gives 24-hour access to information on more than 500 medical and health-related subjects over the telephone and the internet (through NHS Direct Online).
• Through its National Waiting List Helpline which has the only national database of outpatient waiting times by consultant and helps patients negotiate their way through the complexities of the NHS.
• Through its database of more than 2000 national self-help groups, voluntary and other organisations, which offer support to people alongside the NHS.
• Until it was subsumed by NHS Direct, the College's Health Information Service took 80000 calls a year.

Research

Besides giving information to patients, the College has pioneered a range of qualitative research techniques to glean information from patients and their carers about their experiences of the health service.

Consumer audit uses the techniques of observation, focus groups, meta-plan and in-depth interviews, as well as the more commonly used quantitative techniques such as patient satisfaction questionnaires.¹

Over the years, our research has spanned most areas of health and social care, including primary,^2,3 acute, mental health and community care, and publications resulting from these help to promote best practice.

Clinical audit and guideline development

The College of Health has been at the forefront in promoting ways in which the NHS can involve patients and carers in both clinical audit⁴ and clinical guideline development.⁵

For the past 2 years the College has provided advice to the National Institute for Clinical Excellence (NICE) on developing more systematic methods for involving patients in its own national clinical guideline development programme.

NICE has now commissioned the College of Health to set up and run the NICE Guidelines Patient/Carer Involvement Support Unit. NICE does not produce its clinical guidelines in house, but commissions one of six national collaborating centres (NCCs) to develop individual guidelines.

The Patient/Carer Involvement Support Unit is working with both NICE and its NCCs to develop a range of opportunities for patient/carer input to NICE guideline development:

• National patient or carer organisations can register as stakeholders in an individual guideline and comment on the scope, submit evidence to the guideline developers and comment on the draft guideline.
• Individual patient or carer representatives may participate as members of a guideline development group.

Some collaborating centres are also exploring other ways of engaging patient and carer views to inform the guideline development process, e.g. focus groups to identify issues of key concern to current users of services, which are then employed to guide the search strategy used to identify the relevant research literature.

The Patient/Carer Involvement Support Unit can also provide advice, support and training (if needed) to patient/carer organisations and representatives involved in the development of NICE guidelines.

Training and consultancy

The College of Health runs a range of off-the-peg and bespoke training courses for health service professionals in the range of research techniques needed to elicit patients' and carers' views of health services.

One of its most recent publications and training courses, Voices in Action, is aimed at lay members of primary care groups and trusts and other health service committees and bodies.⁶

Consultancy services include carrying out evaluations, e.g. of pathfinder Patient Advocacy and Liaison Services (PALS), and helping trusts to implement the findings of patient satisfaction surveys.

Campaigning

The College of Health has long campaigned for patients to be given much more information to enable them to make informed decisions about their own healthcare.

It pioneered the provision of comparative information about hospital waiting lists with the publication of an Annual Guide to Hospital Waiting Lists from 1984 to 1991, before setting up the National Waiting List Helpline.

The College has consistently urged trusts to give fuller information to GPs as well as patients about consultants and their subspecialty interests. At present, only around half the acute trusts in the country do so and this can only hamper appropriate referrals.

Direct services

As primary care trusts move towards setting up their own PALS, the College of Health is working towards the provision of a range of online services to enable them to meet the information needs of patients. These include access to the national database of self-help groups and the National Waiting List Helpline database.

Another key information service is the Healthline audiotext library of 500 tapes which can be accessed by telephone 24 hours a day.

These could complement the PALS service, especially out of hours, by giving information about what patients can do to help themselves, especially when they feel they should not bother the doctor or want to prepare for a consultation.

Research has shown that patients particularly welcome the opportunity to listen to information in the anonymity and privacy of their own home, especially when they are feeling nervous or embarrassed.

For further information, visit the College of Health website at (Figure 1, below).

Figure 1: Front page of the college of Health website

College of health
Set up	1983
Objectives	To help people keep themselves healthy and look after themselves and their families during minor illness To give people the information they need to make the most effective use of the NHS To campaign on behalf of people who are vulnerable in their dealings with the health service To promote patient-centred care
Status/funding	Independent national health charity
Key personnel	Chair:	Dr Graham Lister
	Director:	Marianne Rigge
	Senior Research Fellow and Director of Patient/Carer Involvement Support Unit:	Dr Marcia Kelson
	Business Manager:	Ian Flack
	Head of Training and Consultancy:	Jessica Bush
Contact details	Address:
	Tel:
	Fax:
	E-mail:
	Website:

References

1. Consumer Audit Guidelines. College of Health, 1994.
2. 'Ask the Patient' pack an action pack for GPs to get feedback from patients. College of Health, 1991.
3. Stowmarket Health Centre Patient Satisfaction Survey. College of Health, 1999.
4. Kelson M. Promoting Patient Involvement in Clinical Audit: practical guidance on achieving effective involvement. London: College of Health, 1998.
5. Kelson M. Patient involvement in clinical governance. In: Lugon M, SeckerWalker J (Eds). Advancing Clinical Governance. London: Royal Society of Medicine Press, 2000: Chapter 2.
6. Fletcher G, Bradburn J. Voices in Action Resource Book. Training and support for user representatives in the health service. College of Health, 2001.

Guidelines in Practice, August 2001, Volume 4(8) © 2001 further information |