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dc.contributor.authorStewart, Ellen
dc.contributor.authorErcia, Angelo
dc.contributor.authorGreer, Scott L
dc.contributor.authorDonnelly, Peter D
dc.identifier.citationStewart , E , Ercia , A , Greer , S L & Donnelly , P D 2020 , ' Between a rock and a hard place : comparing arms' length bodies for public involvement in healthcare across the UK ' , Health Policy , vol. 124 , no. 4 , pp. 454-461 .
dc.identifier.otherPURE: 273495512
dc.identifier.otherPURE UUID: de125e0e-3cc2-4d94-bf84-7085ad4fe52f
dc.identifier.otherPubMed: 32139172
dc.identifier.otherScopus: 85080854200
dc.descriptionThis study was funded by the Health Foundation under the Policy Challenge Fund. Thanks to all our research participants for sharing their time and views.en
dc.description.abstractArms' length bodies are often seen as a tool of technocratic governance, designed to insulate decision-making from the politicizing pressures of populist influence. This article examines a subset of arms' length bodies in the UK which challenge this convention: agencies which exist to 'champion' the voice of patients and the public in the four NHS systems (England, Northern Ireland, Scotland and Wales). We compare the functions of these agencies on paper and through qualitative interviews in each system which focused on public involvement in major service change (such as closing hospitals). We found that agencies in all four systems had struggled to demonstrate their legitimacy, squeezed between the demands of the elected Governments they answer to, the NHS organisations they are meant to support and challenge, and the publics whose voices they are meant to amplify. We argue that the evolving solutions found in each system demonstrate a foundational tension between locally-legitimate actors and nationally-capable political savvy.
dc.relation.ispartofHealth Policyen
dc.rightsCopyright © 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (
dc.subjectPublic and patient involvementen
dc.subjectHealth system reformen
dc.subjectPublic administrationen
dc.subjectHV Social pathology. Social and public welfareen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.titleBetween a rock and a hard place : comparing arms' length bodies for public involvement in healthcare across the UKen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. WHO Collaborating Centre for International Child & Adolescent Health Policyen
dc.description.statusPeer revieweden

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