Why do we need a National NHS Public Voice?

The public are not being listened to by NHS England who are responsible for the NHS in England. They don’t ask us about services only talking to the few people they select themselves. The wider public now has no voice in service changes. We should be heard.

NHS England has a legal duty to involve the public in:

  • decisions about services they commission on our behalf
  • possible changes how services are delivered to us
  • proposed changes to the range of health services available to us

But this is not happening.

NHS England pretends that it’s involving us, the patients and the public (p&p), but what is actually going on is:

  • NHS England is selecting, and paying, their own choice of individuals to ‘represent’ OUR interests and they are also inviting voluntary organisation employees to speak for US.

How can these people speak for us?  They:

  • Were not chosen by us
  • Don’t talk to us
  • Have no accountability to us

That must change.

Together we will make that change.

JOIN Our campaign for a democratic NATIONAL NHS PUBLIC VOICE (N-NHS-PV) to bring about that change.  (Please click onto our Contact Us page and give your contact details).

Regardless of this hoax, about NHS England saying they are involving us all but only actually involving a select few, NHS England has many documents and a few policies that talk about their commitment to:

“…putting patients at the heart of everything we do, promoting transparency and accountability of our work to citizens, and ensuring the most efficient, fair and inclusive use of finite taxpayer resources.”  (Malcolm Grant, Chair NHS England – the  NHS England Annual Review 2013-2014)

In October 2014 NHS England published the Five Year Forward View, which outlined proposals to change how services were delivered.  This would involve the integration of services as ‘New Models of Care‘ which would be tested out in ‘Vanguard sites‘, which are collaborations of service providers across an area covering a number of local boroughs.

In December 2015, fifteen months later, NHS England published a new Planning Guidance 2016/17-2020/21 that required all parts of England to form a ‘transformation footprint’. These were to be created by Clinical Commissioning Groups (CCGs) coming together across an area covering a number of local boroughs and based on what NHS England describes as ‘natural communities’.

There would be a maximum of 44 of these ‘footprints’ across England and each would be decided locally by the end of January 2016, that’s within a month of their announcement.  Each ‘footprint’ was required to create a ‘Transformation and Sustainability Plan’ (STP) for the population in their area, by June 2016, within six months of their announcement, and have an STP budget ready for October 2016.  Each STP would show how services for their population would be developed over the next five years, 2016 until 2021, but it was made clear in the Planning Guidance that the plans should be in line with the new models of care outlined in the Five Year Forward View proposals.

So let’s go through that schedule again:

The Five Year Forward View (FYFV) was published in October 2014, with its delivery plan published fifteen months later, but gave less than a year for the ‘footprints’ to create and submit the STPs, as a fully costed plan.

This meant NHS bodies working together, a new thing, to plan priorities and service delivery for the next few years and for a larger population, a new thing, but in a matter of months, a new thing.

The  STPs and ‘footprints’ were not mentioned in the FYFV, which, together with the increased pace of change may be connected to the change of government in mid 2015.

Where is this legally binding duty on NHS England to involve the public in how it runs Our=NHS on our behalf?

  • Were the public asked about New Models of Care?        NO.
  • Were the public asked about the new Footprints?         NO.
  • Were the public asked about Vanguards & STPs?           NO.
  • Were we asked to select our own representatives?        NO.

It is interesting to note that the only existing NHS England public voice system, the NHS Citizen website’s ‘Gather’ discussion forum, was closed at the end of May 2016 and the website made ‘read only’.  This happened overnight and without any warning and effectively took the public voice in the NHS away from the public.


Some of those who contributed regularly to the Gather discussion forum tried to meet with NHS England’s Patient and Public Participation Involvement Team to talk about the future of the public voice.  This was immediately following the unilateral closing of Gather -during the spring and summer months of 2016.  Our aim was to check that the team’s work included making sure that NHS England actually carried out its legal duty to involve the public, and did so in an open, transparent and inclusive way.

We were eventually invited to a workshop in September 2016, to discuss the future of NHS Citizen with the team and with other NHS Citizen contributors. However this plan was changed by the team later on and the invitation was then opened up to anyone who wanted to attend, without the usual restriction of ‘invitees only’, which had been implied to us earlier.


This meant the workshop included staff from any NHS or health organisation and wasn’t just involving patients and the public.  Bookings closed within hours of the event being posted on the NHS England website event pages, and many former contributors to NHS Citizen Gather and members of the public were unable to book a place.

We have to ask – Was there any connection between the following timings and actions?

  • the closure of the NHS Citizen website at the end of May 2016
  • the tight timetable for the STP submissions by June and October 2016
  • the public voice workshop being delayed until September 2016
  • the open invitation that restricted bookings from the public for this workshop

Watch out for later posts to see what happened at the September workshop.

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