Creating a membership organisation has helped one primary care trust increase public involvement in decision-making

My local hospital is aiming to become a foundation trust. They have been recruiting members and they managed to attract more than 300 people to their last annual general meeting, most of them members who had been personally invited.

Primary care trusts are charged, as we know, with creating dialogue with citizens and engaging in serious debate about health issues such as resource allocations. They must involve citizens in serious and difficult choices. But hardly anybody knows what PCTs are for, or indeed cares. When the best explanation you can come up with is, "they are a bit like a health authority used to be", then you know you are in trouble.

Reaching out

At our PCT's annual general meeting, we had nearer to three than 300 members of the public. And this is despite an intensive campaign over the last few years to extend our patient and public engagement. It feels as though we only communicate with the small group with whom we have always communicated. And these folks are decreasingly representative of our local demography, which includes a rapidly growing black and minority ethnic population.

To overcome this problem, we have come up with an approach that we believe will help us reach our local population. We have decided to take some of the elements of the membership approach used by FTs and apply them to our PCT. Are we stealing their clothes? No, only borrowing them. And in any case, FTs borrowed their model from the co-operative movement.

So on New Year's Day, we launched MyNHS Walsall. It is a membership organisation and is free to join. Any resident of Walsall, anyone registered with a Walsall GP or anyone who works in the Walsall NHS can join.

Members can join online or by post, or they can text their details and we will ring them back. There is a members' website with closed areas for those who have signed up. We hope members will use this website to discuss and vote on health issues.

Early engagement

We will ensure members are informed as early as possible of strategy discussions and potential changes to services. This will be in addition to the usual consultation process but should give us a real chance to debate issues early on.

Members can be involved in forming issues and not just responding to them. For instance, 18 months ago we launched a consultation on changes to older people's services. By the time we had polished our formal proposals and prepared a consultation document, there were already 8,000 signatures on a petition opposing the unpublished proposals. We believe earlier engagement can avoid this happening again.

All members of MyNHS Walsall will be able to vote for representatives from among their number to sit in an "NHS parliament". This will meet four times a year to debate and can put issues directly onto the PCT board's agenda. At least once a year, all members will be invited to the annual general meeting, which will be much less of a process occasion and more an opportunity to reach out into the community and engage their views.

We are aiming for 1,000 members in the first year and many more in the years ahead. Whether it will work remains to be seen, but membership is growing and it does seem to be capturing people's imagination.