I was asked to observe and report on my reflections on the live prototype of the Citizens Assembly at the NHS Expo 14 – the layer of the NHS Citizen project which involves direct discussion and challenge for the NHS England board.
Ideas were gathered during the offline contacts on day one of the expo and online too. There was also a system of voting ideas up and down. There were criteria by which one idea would be discussed during this testing of the assembly model. The idea that was selected was “how do we make NHS information more accessible”. This was a very common theme during discussions the day before and covered issues raised on inaccessibility by the following communities in society-
1. People with learning disabilities
2. Trans people
3. People for whom English isn’t their first language
4. Asylum seekers – people who may have experienced trauma and have no idea how to access our health system at all
5. Gypsies and travellers
These points were mostly mentioned very eloquently during the session by people who had agreed on this accessibility issue.
Other people joined the conversation, in fact it was packed out with people standing all around the edge of the discussion. The board members reflected points back well, gave information and agreed that the key challenge was-
1. There is a difference between information and communication and the support to access information is necessary and having said that,
2. The information that is provided should be designed with the people who are most excluded up front perhaps, this way benefiting everyone with clearer more accessible information
The format seemed to appeal, enabling people to attend a pop-up meeting and engage online seemed to work well.
Possibly having the board members that did attend in the front makes sense for a first meeting but it is retaining a “them and us” format and also, possibly enforces a hierarchy. Having said that their behaviour didn’t enforce any negative culture.
The facilitation was good and tricky to achieve in a large group in a confined space with such a fast pace of discussion. We need to think about who facilitates and what approach is taken in the future. This was quite a formal approach and was led by the project team. At what point and how does that move to the group to design? Especially as the “group” can be so flexible and drop in etc.
Lots of unanswered questions but I had the impression that there is plenty of will of all participants including NHS England’s most senior leaders to make this work.