Influencing the NHS in Scotland

Sadly, HIV and other sexually transmitted infections still suffer from high levels of prejudice which can make people less likely to be open about their condition. This has a negative knock-on effect when it comes to sexual health services, as people are less likely to campaign for improvements or complain when they receive a poor standard of care. We would encourage all our supporters to get involved in your local NHS structures to raise our voice and make sure sexual health makes it onto the agenda. Patient power is growing in importance and you can now have a greater influence than ever before.

If you have problems dealing with any aspect of your local NHS or receive a poor service it's important to feed this back to the NHS to ensure that the service improves for you and other people that use that service after you. Again, people can often be too embarrassed to make a fuss if they encounter poor sexual health services so bad practice often goes unchallenged.

Making a complaint

You have the right to complain about any aspect of NHS treatment using the NHS complaints procedure. In the first instance, this will usually involve complaining to the person or organisation providing your service. However, if you are uncomfortable doing this you have a number of other options to consider.

Most NHS organisations will have a dedicated complaints officer who you may be able to deal with directly with your concerns. Alternatively, the Scottish Citizens Advice Bureau provides an Independent Advice and Support Service (IASS) which helps people access the NHS complaints procedure. It may also be possible to secure the support of an independent advocate or conciliator to progress the complaint on your behalf or help you resolve your concerns with the NHS.

More details on NHS complaints procedures are available on the Health Rights Information Scotland website.

Scottish Health Council

The Scottish Health Council (SHC) has been set up to ensure that all NHS Boards in Scotland take account of the views of patients and the public when designing and delivering services for local communities. Each Board is accountable to the SHC and is subject to an annual review to assess how well they are doing in terms of listening to and working with local people.

The SHC is comprised of Local Advisory Councils situated in each Health Board area. These Councils are made up of voluntary members of the public with local knowledge and an interest in health care services. There are no specific qualifications needed to become a Council member and the SHC actively encourage people from a wide range of backgrounds and with different experiences of the NHS to get involved. This will usually entail 2 or 3 days of work a month.

If you feel passionately about improving your local NHS for the benefit of people living with HIV and the wider community, or if you feel that your experiences of the NHS have given you a valuable insight into how things could be changed for the better, you might want to consider contacting your Local Advisory Council. To find one in your area, visit the Scottish Health Council website.

Health Boards and their Membership

Each NHS Board has a decision-making body that is responsible for overseeing and directing all of the organisation's performance and operations. Boards are made up of a mix of Executive (members of the senior management team) and Non-Executive Directors.

If you have specific skills and a bit more time to spare you can stand to become a Non-Executive Director on your local Board, which is a formal role with a fixed term of office. NHS Boards generally look for people with specific skills in areas such as finance or law to become Non-Execs, and there is an appointment process much like a regular job interview. Non-Executive Directors will be expected to devote a few days a month and will be paid in return. When you become a Non-Exec you will take on some legal responsibilities but will usually have significant influence over local services. You should be able to find more information and contact details online through the website of your local NHS Board.

Board meetings are often open to the public and all papers and minutes made available. These are usually published online but can also be obtained through a Freedom of Information request (usually subject to a small charge). There will also be a member of your local council on your NHS Board. If, for example, there is a particular issue coming up for consideration at the Board, you may be able to contact your local councillor to ask them to communicate your concerns to their representative on the Board.

Health Boards (Memberships and Elections) (Scotland) Bill

The Health Boards (Memberships and Elections) (Scotland) Bill was introduced to the Scottish Parliament on June 25th 2008. The bill proposes making a proportion of NHS Board positions in Scotland elected posts, voted on by members of the public. This would mark a significant change in the way that the public engages with the NHS in Scotland and is expected to increase accountability. To keep up to date on the progress of the Bill and whether it becomes law, go to the Bill's page on the Scottish Parliament's website.

Community Health Partnerships - Public Partnership Forums

Community Health Partnerships (CHPs) have been introduced to bring together the different organisations which provide health care to local communities. They are intended to provide a link between primary care, specialist services and social care; bringing together GP and acute services as well as the voluntary sector, community groups and patient representatives.

There are usually a number of CHPs in every health board area and each CHP has a Public Partnership Forum. These forums inform the work of the CHPs in how they communicate with patients and how they design and improve services. These are relatively new organisations so there could be potential opportunities for fresh public involvement and new participants. If this is something you may be interested in, you can find contact details for your local CHP on the Scottish Government's website.

Ad-hoc feedback

If you don't have much time on your hands you can still get involved. Even giving constructive feedback after you've used a service helps: most services will have comment cards or suggestion boxes you can use. There may also be local one-off activities that you can get involved with. These could include surveys, focus and user groups and even mystery shopping exercises. Health services are frequently providing more services like newsletters and email alerts that keep you up to date on these kinds of opportunities. Check out your Health Board or Community Health Partnership website for more details or speak to your local service providers who should be happy to help you find out more.

Your MSP

MSPs usually have close links with NHS providers and you can write to ask them to encourage your NHS Board to make improvements in sexual health or HIV services, such as providing more prevention services for gay men. You can also raise specific service problems you have encountered with them.

You might like to take a look at the campaigners pack on our website for information on how best to influence your elected representatives.