Archive | March, 2014

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.”