Throughout the North-East, Patient and Public Involvement forums are making waves in the NHS, as Barry Nelson finds out.

WHEN North-East teenagers were asked how their local health centre could be improved, the NHS questioners didn't get the answer they bargained for. "They asked for Playstations and better looking staff," says Karen Leech, trying to keep a straight face.

Karen is the assistant regional manager with the Commission for Patient and Public Involvement in Health. Her job for the last three years has been to oversee the development of a network of patient and public forums across the region's NHS.

Created by the Government in December 2003, the PPI forums were intended to fill the vacuum caused by the abolition of Community Health Councils, or CHCs. That move, ordered by the then Health Secretary, Darlington MP Alan Milburn, was criticised at the time by a number of independent organisation.

The sudden removal of CHCs meant that local NHS services suddenly lost a body of experienced volunteers who knew the workings of the health service back to front

It is to the considerable credit of the hundreds of volunteers who have joined PPI forums in the region since the CHC 'night of the long knives' that regular inspections of hospitals, health centres and other NHS institutions have continued throughout the hand-over.

Remarkably, the North-East was the first NHS region in England to declare that all local forums were up and running (the Government decreed that each 15 strong forum should have a minimum of at least seven members).

However, it wasn't easy in the early days.

"The first year was a steep learning curve. A typical first meeting had eight complete strangers sitting around a table who didn't even know each other's names," says Karen.

About one third of all new forum members have had experience with CHCs but the rest are newcomers, including a significant number of younger people and an increased number of people from ethnic minorities.

Since 'ground zero', the forums have set about their tasks with commendable zeal.

Apart from inspections, the forums also have the job of finding out the views of patients and the public about their health and health services through meetings, surveys and other events.

Forums also have the right to demand access to any health-related information they need to do their job and to make recommendations about improving health services.

If any sceptics pull a face and suggest the forums are just toothless poodles, Karen can produce a dossier giving examples of how the forums have made a difference.

One case hit the headlines when the Newcastle Hospitals PPI forum blew the whistle over a threat to the region's specialist paediatric plastic surgery unit posed by a clinical review.

By drawing the attention of the media to the review, a major debate has been generated about the future of plastic surgery in the region.

Less dramatic but still invaluable to users of the NHS, the South Tees Hospitals PPI forum raised the issue of delays in issuing digital hearing aids, which made the trust adopt a new policy of giving priority to certain categories of patients.

More nitty-gritty issues were raised by Darlington PPI forum, which resulted in improvements to the new Walk-In Centre.

Forums in Easington and Sedgefield both surveyed young people in their areas to find out their views about health issues. Both forums collected valuable information, including the crack about Playstations and better looking staff.

"The Sedgefield survey showed that confidentiality was important to young people. Girls in particular identified stress counselling as a key issue and young smokers wanted to know whether smoking cessation services are available to under 16s," says Karen. "Incidentally, the answer is yes."

Doreen Sadler, 61, from Shildon, County Durham, says she "loves" being part of Sedgefield Primary Care Trust's PPI forum.

"I used to work in the NHS on the clerical side but now I can help people find out what local health services are available," says Doreen, who has three grown-up children and seven grandchildren. "This job means I can also find out how local people would like to be treated and pass that on to the powers that be."

* Anyone interested in serving on their local PPI forum can ring 0191-448 4303 (North-East England) or 0113-2272400 (Yorkshire).