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.
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.