Guest blog by Kate Ansell (Chairman – West Midlands PV&I Group)
As a keen ambassador for Public Voice from people who are actually using our health services – rather than their representatives from various charities and societies – I have been giving some thought to how it might be possible to link the local voice with the national voice and vice-versa. And, how the national Discovery, Gather and Assembly model would also work at Local & Regional level.
If NHS Citizen has a responsibility to bring national and local issues to the attention of the NHS England Board, then its composition has to be carefully considered. Too often in the past the “inclusion” of patient voices has been from CEOs or Directors of National Charities, to the exclusion of the real patient voice. This makes the decision of what/who to ‘involve’ in order to achieve genuine insight a little difficult. How might this be resolved?
The 12 Regional Senates could well provide the answer in respect of Public Voice membership. If each has a Citizens’ Senate – in the manner of the East of England model, then they could nominate two of their Patient Voice members to join NHS Citizen – 24 people who would bring with them local issues, local concerns, best practice, failing practice – the very topics that NHS England “needs to know”. This is where the local Discovery, Gather and Assembly model could be used very successfully.
It is important to note here that the EoE Citizens’ Senate is made up of genuine patient voices gathered from a broad and transparent recruitment process that was overseen by the patients and carers themselves.
Equally the NHS England Board needs to disseminate information about national issues, service changes, new initiatives and responses when needed. Again how much simpler it would be to use these Regional Citizens’ Senate voices to take the decisions back “home” and cascade the information out to their communities. When either party wishes to discuss, for example, major changes to service provision, the Regional Citizens’ Senates could be asked to nominate an additional Patient Voice who has more detailed knowledge and experience of that topic. They would just attend for that particular meeting.
By having a basic 24 people on NHS Citizen this allows for the “must haves” of Healthwatch, Public Health, etc., whilst always trying to keep the composition to “essentials”. For a change it could mean that the Patient Voices would be in the majority!
I have also been giving thought to the practicalities of the current NHS Citizen proposal. The role of NHS Citizen is to monitor/scrutinise the NHS England Board. However, they will be hard put to do so if they only meet every six months. For instance our West Midlands Voices find it hard enough to keep up and on top of the work programme of our Council with their quarterly meetings. Inevitably “things” happen in between. Similarly, so do the patient voices who monitor the CCGs. Perhaps the timescale for meetings might need to be looked at. Is there some way of “between meeting” contact which is meaningful, or should patient voices be included in work/discussions which comes out of the meetings, and which are not necessarily projects?