NHS Citizen assembly prototype

4 Mar

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.

NHS Citizen – The Launch Event

3 Mar

Today at the NHS Expo 2014 the exciting NHS Citizen model was launched. Interestingly, before the model is finished. The team working with NHS England are working very much in public and in live time. The purpose of the model is to increase accountability to citizens of the NHS England Board and, to enable big changes to develop in the NHS, fit for the future, with citizens.

I took a photo of the basic model, which is constantly being re-refined with groups of interested citizens…either live during events and workshops or via digital participation.




The event was packed with people standing around the edges and at the back. Clearly, delegates were really interested in how citizen voice could be heard effectively enabling the NHS England board to engage in better way and use that voice to inform priorities and decision making.




NHS England board member, Lord Victor Adebowale said:

“NHS Citizens is mission critical fro the NHS – it is thing we go to and get to done to.  And it must be a place we go with and get done with”

There were many questions from the floor and I couldn’t do them justice in a blog post. But there were themes:

1. Ensure that the louder voices don’t drown out the most marginalised – This was raised in particular in relation to trans issues and the prejudice faced in accessing health services

2. How reflective is the assembly? – Here both older and younger voices were felt to be important (There are sessions tomorrow to explore how the assembly should work)

3. How accessible is the model? – This was raised in particular in relation to people with learning disabilities being able to participate and be heard

4. Why will this work? – There was some cynicism in the room, though very constructive. The project team welcomed this and Board Members said that people would really only know when change because of citizen voice had clearly happened.

Explaining that this launch didn’t mean the model was finished, and to emphasis the difference in this approach as opposed to approaches people have found less satisfying, NHS England Patient and Public chief, Olivia Butterworth said:

“It is not a thing – we have not created aboard and the voices that are part of this are the voices of the people we have been talking to. Mostly digitally but in other ways as well. So many voices and opinions  – these voices come though in a genuine way that people can connect with and we can  have that conversation – people from learning difficulties have a route and a way to have their say in this process. As to  where are the teeth of NHS Citizen–Tomorrow we are going to try and model what the Assembly space will look like? This is a test and a work in progress. No one of us has all the answers.”




Shout! Let it all out – Getting better democracy

24 Feb

Just a quick post on the kind of interactions that campaigning politicians and activists can expect on social media inspired by a tweet this afternoon by Alex Andreou @sturdyalex – his blog is at sturdyblog.wordpress.com – here is his excellent (left-wing focus ) list which had me crying with laughter because it IS true!

By @sturdyalex

Shout out and get a shout back

Political debates on social media tend to be shouty and can descend fast; a bit like a drunk leaving a pub slurring “…and another thing” as they stumble out. (Especially during a campaign period as I learned hence my post on dealing with negative interactions Sticks and Stones - people generally react to the context they see you in but you do have control over your tone and your interactions.)

Also, you can set context by listening and joining other discussions rather than just broadcasting your views. Broadcasting rather than interacting definitely increases the broadcasting shouty replies. However, in fact, DEBATE is fine and disagreement is inevitable and I think we have to relax and accept that. Even, as Alex has, have a sense of humour about it.

Is debate or party politics the cause of our democratic deficit?

But, shouty debate between politicians is perceived to be a problem and is often cited a reason why people aren’t voting or engaging in formal democratic structures. I, often, see pleas for a more consensus based approach and actually the reality is that consensus is an important part of democracy but we can’t lose debate and disagreement because actually winning elections should be about winning the argument. The challenge for online politicians is choosing the right argument to engage in and win. I believe that actually the main democratic issue was the shift towards seeing local authorities and other bodies like corporations and building a consumer – provider relationship. If we can shift this relationship, and move from transactions to relationships this is a bigger key to unlocking better democratic engagement than stopping the shouty debates on or offline!

Any more lists?

Plea – I would love to see a list that Conservative councillors and activists made to go with this one and if I find one I will amend this post to incorporate. You can submit in the comments or via twitter if you like.

Police & Crime Scrutiny – the right to remain silent?

24 Feb

BBC research published 21 February 2014 was pretty damning on the performance of the accountability and scrutiny frameworks around Police and Crime Commissioners in particular the effectiveness of the Police and Crime Panels. With notable exceptions of the Sussex and Surrey PCCs mentioned and quoted who webcast and engage using technology to help involve the public more in formal and informal scrutiny many are performing poorly. With 8 of 37 Police and Crime Panels not even accepting public questions there are some serious questions to be asked.

The recent report from CfPS Police and Crime Panels- The First Year cites some really interesting challenges for the scrutineers and PCCs. The report suggests that whilst they have been hampered by timings of budget processes, officer support, unclear guidance around role and teething pain generally they should be ready to make a difference now. Aside from tackling some of these issues the report focuses on three areas and ideas for improvement that I am interested in and all could be seen independently or as inter-related areas:

Public involvement

  • Use issues raised at neighbourhood levels as information to drive scrutiny projects
  • Joint engagement projects between the police, PCC and Police and Crime Panel
  • Digital presence  including webcasting would help more people to get involved
  • Proactive scrutiny which seeks active public involvement should be timetabled


Digital tools

The report mentions the lack of digital presence for most PCPs as a key concern, especially given the very large geographical areas they cover.

  • Use webcasting
  • Use social media
  • Allow filming, photos and social reporting during public events and meetings especially if PCPs are not providing this themselves

“The majority of meetings are not webcast. Given that many Panels cover wide geographical areas, the presumption in favour of webcasting might be seen as higher than with standard council meetings…We are aware of instances where members of the public have sought to record and broadcast footage of the Panel in session, something that ought to be encouraged in the absence of official facilities to do this.”


  • PCCs should publish a forward plan of decisions
  • PCCs should public data on operational performance as this is vital context to show decision making in and to help the public and PCPs to understand the outcome of a decision making process
  • OPCCs should operate under the principle that you should publish information by default rather than by exception or as prescribed

Why is it important that the Police and Crime Panels have a higher profile and engage directly with the public? Well the report says this:

“It is vital that Panels are visible to those in the local community. The Panel must have a relatively high profile in order to provide local people with the information they will need in order to make an informed choice at the ballot box – quite apart from the role in assuring the public that the PCC is being effectively held to account between elections”

UK Gov Camp 2 – imagining the council of 2030

26 Jan

There was a session at the conference I went to yesterday on what the future council might look like. The conversation whilst I was in the session described a change paralysis, funding crisis, and issues with councillors. There are many debates on local council funding and powers and in this post I am not going to touch on those. Not because I don’t have views on those matters but because they tend to get in the way of this conversation which is worth having in its own right.

However where I feel a good place to start on imagining the council of the future is understanding the expectations of 2030 citizens. I believe their expectations will be driven in part by the technological revolution of the social web. So I will focus on those features.

- content creators – I think citizens will expect to create their own answers to issues and be supported by the council. This develops the behaviour in social enterprise and the voluntary sector already there to an extent but which is being driven out or squashed by intense commissioning discussions. More peer to peer support networks, more pop up projects like riots clean up, coats for kids etc will emerge and the future council needs to support and create an environment where these flourish.

- feedback – the culture of trip advisor, eBay, “liking” etc will be important in any service delivery and democratic participation..I think this will drive decision making and conversations and enabling this instantaneous feedback rather than surveys etc will be the new normal.

- direct relationships – I think citizens will have a direct conversation with staff and councillors via digital tools and have a blurred on and offline relationship with them. This challenges the culture of the “invisible” officer working behind the scenes and I can see already an appetite to engage with local councillors.

- wearable and environmental tech – I think that all services will begin to use tech in people’s homes and on their persons to respond to needs or to prevent more expensive crisis prevention. I also think that tech might address environmental issues such as waste management massively, ideas like food waste disposal from sinks, perhaps waste as a asset to be used to 3d print are coming up and I am optimistic that we will have some action by 2030 which has addressed this problem. Already in social care – tech is important in maintaining people in their own homes rather than institutional care.

There is no doubt that like the industrial revolution, the digital revolution is changing our lives and expectations very fast. How do you think the council of 2030 will change to meet the expectations of its citizens by 2030?

UK gov camp 2014

25 Jan

This is just a quick reflections post on my day at this event. It was my first time at the event and I *really* wanted to go. My first two sessions we on increasing voting and getting more young people to vote. I found the sessions really fascinating although I was struck by the overwhelming message that both politics and politicians are the thing that is broken. Obviously, I wanted to know more, sadly the sessions were a little short and very popular to completely develop these conversations today.

Delving deeper, many felt that they should work more openly, more collaboratively, more digitally and in a more networked manner. Good news for the Networked Councillor project I am involved with for Public-I developed with EELGA.

Here are some of the ideas I heard today -

1. More independent councillors at local level – some felt party politics wasn’t relevant at a local level
2. Proportional representation – so all votes count rather than going for the least worst option or spoiling paper
3. That councillors should blog
4. That councillors should work along a community activist method.
5. That councils should work with schools to teach kids about local democracy

I would have liked to see some experimental ideas come out of the sessions and be sketched out that don’t require a constitutional change or “permission” from a statutory sector body to be trialled.

Also, I wonder what we can learn from methods like rock the vote, Speakers Corner projects, City Camps or any projects that have made an effort to increase voter registration and turnout from anywhere.

There wasn’t time to develop some prototype projects today but I look forward to this conversation continuing at UK Vote Camp later in the year.

I also took a UK gov camp selfie with Christine Townsend from Musterpoint because … Why not?



Get every new post delivered to your Inbox.

Join 32 other followers