Published: 24/02/2005, Volume II5, No. 5944 Page 22

Blair McPherson, head of organisation development, Lancashire social services

I represent social services on the professional executive committees of two primary care trusts. I have often questioned if this is the best use of my time. The agenda is dominated by reports on waiting lists, GP prescribing habits, the financial crisis in the acute trust and GPs' dissatisfaction with some consultants and mental health services in general.

But things have changed recently in Wyre PCT's PEC through the adoption of a thematic approach. The majority of the meeting is now dedicated to a theme or topic from a list agreed by members.

Topics include mental health services, dementia in old age, chronic health conditions and services to children with disabilities. Papers and presentations are provided by a range of professionals, including social services. Everyone feels engaged and contributes, in contrast to when the GPs dominated and PCT directors presented volumes of monitoring reports.

A good example of how this works was the recent public health meeting.

The director of public health - who has previously struggled to get issues on the agenda - produced background papers on the public health white paper and identified a range of issues to be discussed.

Social services presented a paper arguing for a broader definition of public health to include health inequality by addressing issues of poverty, poor housing, unemployment and pollution.

As the meeting progressed, people began to see the bigger picture and to make links with what they and their staff do and what people in other services and organisations do. Rather than discussing the effectiveness and funding for treating alcoholism, we started talking about alcohol abuse and its links to crime, domestic violence and child protection.

Gradually the discussion moved away from specifics about reducing teenage pregnancies, smoking cessation targets and 'exercise on prescription' to the lessons for integrating services and planning.

The discussion became both strategic and tactical. Ideas started to emerge - ie a public health plan as an umbrella covering a range of plans, including social inclusion, community cohesion and community safety.

Attendance at PEC meetings is no longer symbolic - but instead influence the way people think.