New Public NHS national Board members will be accountable to an NHS England manager – and NOT to Patients or the Public.

The Expert Patient Adviser Board Members on the new NHS Citizen Programme Board will have no contact with, or accountability to, patients or the public. They will have to report to a Senior NHS England Officer instead.



The September NHS England Board approved the recruitment of members of the public as Expert Patient Advisors to sit on the new NHS Citizen Programme Board.  They are to bring public voices to the Board and to have an advisory role in the future of public involvement in the NHS in England.

On 19th October 2016 applications were invited for these roles via the NHS England website with a closing date on 10th November 2016.  The invites were on a page on NHS England’s website.  The intended ‘audience’ lists ‘patients’, ‘carers’ and ‘service users’. But the list doesn’t include members of the public.

The invitation says:

“The NHS Citizen Programme Board is looking for three Patient and Public Participation Expert Advisers. One of the candidates will serve as the Programme Board Chair and will be responsible for the administration of the Board and ensuring an objective and impartial approach.”

It goes on to describe the people they want to apply:

“The ideal candidates will bring significant board level experience, with a strategic healthcare focus, strong intellect, commercial and political astuteness, and a willingness to challenge.”

And also says that: “There will be payments of £150 per day (for those people not representing or supported by an organisation) for an estimated time commitment of 10 days per year. This is in line with the NHS England Patient and Public Voice Expenses policy. Membership of the group is for 12 months initially, at which point membership will be reviewed.”

It ends with saying – “NHS England wants to ensure that its Patient and Public Participation Expert Advisers are representative of the population and that a wide range of people are appointed to these roles.

What this webpage does NOT say is that all representatives or ‘patient and public expert advisors’ are SELECTED by NHS England managers and REPORT to THEM – NOT to patients or the public as they are given no contact with the wider public.

So how can these Board members be representative of the population?

Why are they excluding the public in a Programme that it says is intended “to meet the requirements of the duty to involve”.

(This refers to the legal duty to involve the public – as in Section 13Q of the Health & Social Care Act 2012 !)

How can we trust that NHS England  – when they say one thing and do another?


The role description and the Terms of Reference of the new NHS Citizen Programme Board are described in the NHS Citizen Programme Board Expert Patient Advisor information pack and it becomes clear that:

  • “Patient and Public Participation Expert Advisers are appointed by NHS England’s Senior Responsible Officer (SRO) for the NHS Citizen programme, and will be accountable to the SRO for carrying out their duties and for their performance.” **
  • “All lay members of the NHS Citizen Programme Board must undergo mandatory induction training approved by NHS England in order to undertake the role.”
  • They willManage the public’s expectation around where their feedback will lead;”
  • “The NHSC-PB will be jointly chaired by the National Director for Patient, Public Participation and Insight and a member of the public who will be recruited in an open and transparent fashion*** for an initial period of 12 months.” ***

Did you remember that the webpage inviting people to apply told us that “One of the candidates will serve as the Programme Board Chair” ?  

Well that’s not really the case is it?

This person will be appointed by her and accountable to her, as it says in the Terms of Reference.(**above).  So much for an “open and transparent fashion”, as it also says in the Terms of Reference (*** above)

This is not acceptable!  It is not honest – and it is disrespectful to the public.

  • The invitation to apply to be an NHS Citizen Programme Board member misleads.
  • The members of the public on the Board are not accountable to the wider public.
  • They are not required to be experienced in patient and public involvement.
  • These public Board members are not able to act independently in their roles.
  • The Director of Patient & Public Voice & Insight (PPV&I) selects  them and manages their performance and how they carry out their duties.
  • The Director of PPPV&I has total control over patient and public involvement.
  • There is no collective, independent, inclusive and representative NHS Public Voice.

We have no say in the future of our Public Voice.

We have no Voice in the future of OUR NHS.



PLEASE share this information – and tell us what you think about it.

The last NHS England Board agreed a new ‘NHS Citizen plan’- to involve the public – that didn’t involve us in deciding what was in it!

September’s NHS England Board agreed a new public involvement plan without telling the public what was in it


On September 29th 2016 the NHS England Board discussed and approved a ‘paper’ proposing a new NHS Citizen plan for the future involvement of patients and the public in the work of NHS England.

This Board Paper ‘Improving the quality of customer insight through NHS Citizen’ was presented by Jane Cummings, the Chief Nursing Officer, one of the six National Directors at NHS England. She leads the Nursing Directorate which includes all the work around patient and public participation.

The document describes the brief history of NHS Citizen, an involvement service designed jointly, during 2013 and 2014, by staff and ‘citizens’ – an Amercian term the NHS establishment uses to describe ‘people’.  It was facilitated by four agencies one of which described it’s purpose as:

“NHS Citizen aimed to bring voices from diverse communities into decision-making processes and to hold the Board of NHS England to account.”

However the joint approach was soon discarded with new people taking charge of NHS Citizen at NHS England during 2015, and rather than working together it became ‘managed’ and controlled.  The participation became arranged ‘for us – not with us,’ and just a way of gathering individual ‘feedback’ with no transparency about which ideas in this ‘feedback’ were accepted and which were rejected – or why.

The ‘paper’, in describing its purpose, includes the following words that make it clear it is not about working together anymore, or about public involvement, but about ‘efficiency’ and ‘customer insight’:

“This paper provides a summary of the changes to NHS Citizen since the November 2015 Citizens Assembly, and the proposed new approach for delivery. The programme objective is to improve the quality of customer insight within our business plan priority areas. The new approach will ensure we use a much more comprehensive picture of citizen insight than previously. In line with meeting the triple aim set up in the Five Year Forward View, this will support efficient and effective business planning and policy development.”

How can a manager improve the ‘quality of customer insight’ – within ‘business plan priority areas’?  Are they implying that they know best whether our views are important or relevant?  Or – are they implying that they intend to just ‘note’ those views that agree with their ‘business plan priority areas’?  Or is it both?

The four agencies contracted to deliver the NHS Citizen programme between 2013 and 2016 were asked to write a ‘learning report’ describing the ‘feedback’ from some of the people involved in NHS Citizen and drawing their own conclusions about what worked, what didn’t and how it could work better.  ‘Citizens’ were NOT involved at all in the analysis, nor the writing, of the NHS Citizen Learning Report.

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The Board paper also describes the NHS Citizen Workshop held two weeks before the Board meeting and implies that the new plans were discussed and supported by saying:

“On 12 September 2016 an event was held to present the proposed new approach to a group of c80 citizens, organisations, partners, and NHS England staff to ensure that it meets both the engagement needs of NHS England, and the requirements of citizens. Many more also engaged with the event through a live webcast and twitter feed. There was a lot of support for the refresh of NHS Citizen and for working with system partner stakeholders. Linking in with existing insight and activity was also strongly supported.”

This was NOT the case.  See the recent post  describing what really happened. Also two people who attended the workshop, and one webcast watcher, wrote to Lord Victor Adebowale before the Board meeting to tell him so.  He, Lord VA, is the NHS England Director who will be overseeing the changes to NHS Citizen, and the emails were from members of our campaign the N-NHS-PV (National NHS Public Voice campaign).

He reported our correspondence at the Board meeting suggesting that people needed to be listened to, even if what they say is not comfortable listening.  You can watch the board’s discussion and hear Lord Adebowale’s contribution here – see the video for Item 7 . (He speaks towards the end of the discussion).

The new plan also included a new NHS Citizen Programme Board. We will be discussing this in a new post shortly.  It will include three Patient representatives that will be selected by NHS England to ‘act’ in our interest, but with no way of hearing what we think or of reporting back to us what they say and do on our behalf.

Please – tell us what you think about all this – by adding a comment or contacting us – and share this information with your friends.


We look forward to hearing from you and starting some good discussions.