How patient centric is health policy development? The case of the Parliamentary Inquiry into Sleep Health Awareness in Australia.

Objective: Parliamentary inquiries into health-related issues empower everyday Australians to contribute to the development and reform of health policy. We explored how patient and family/carers concerns are translated by this process, using a less well-known disease, narcolepsy, as an example. Methods: Written submissions made to the Parliamentary Inquiry into Sleep Health Awareness in Australia 2018 by self-identified patients or family/carers with narcolepsy (n = 13) were extracted and thematically analysed using the Framework Approach. Each submission was systematically coded and abstracted into emergent themes before being evaluated against the final policy recommendations. Results: Although patients and their family/carers prioritised issues that affected their daily lives (i.e. mental health sequela, workplace accommodations), the policy recommendations in the report focused mainly on issues of healthcare infrastructure, funding and engagement. Our analysis highlighted several barriers that patients and their family/carers face when contributing to this part of healthcare policy formation. Conclusions: Our findings suggest that the parliamentary inquiry process in its current form is not an ideal vehicle by which patients and family/carers can contribute or influence healthcare policy. Despite calling for submissions from patients and their family/carers, the final report and subsequent health policy recommendations made by the inquiry do not appear to be patient-centric or reflective of the submissions written by these stakeholders. Increased transparency, development of processes to balance stakeholder priorities and improved accessibility for stakeholders to participate are needed if health-related parliamentary inquiries are to produce healthcare policy that ultimately meets the needs of patients and family/carers. What is known about the topic? Parliamentary inquiries are rare instances where patients and their families/carers can contribute to high-level health policy development. What does this paper add? While healthcare and health policy development have become increasingly patient-centric, stakeholder engagement is often driven by other, more powerful stakeholder groups (e.g doctors, non-government organisations etc.). A parliamentary inquiry represents a unique approach towards engaging stakeholders, allowing for direct contribution and empowerment of everyday Australians. This is the first study that explores the translation of patient and family/carer concerns by the parliamentary inquiry process and the extent these concerns are addressed by policy reform. What are the implications for practitioners? Parliamentary inquiries have the potential to develop and reform high-level healthcare policy, yet lack transparency and processes for balancing stakeholder perspectives. This may lead to misaligned stakeholder priorities and inefficient healthcare policy, programs and services that do not adequately meet the needs of patients or family/carers. [ABSTRACT FROM AUTHOR]