Your NHS needs you! The NHS is under pressure – it is one of our nation’s treasures and yet it is under threat and something needs to change. Sir Robert Francis, chair of Healthwatch, suggests that it’s time for a shift in our relationship with our national health service and suggests how everyone of us can help support our NHS
Politicians often talk about the health service as being ‘our NHS’ but, if it truly belongs to us, then it’s time for a shift in the relationship. Whilst I am probably best known in health circles for my work on the Mid-Staffs inquiry, I have actually spent much of my legal career on cases about the NHS. I have seen first hand the terrible consequences that can follow an innocent medical mistake and the frustration at the effects of an injury which was avoidable. I have also felt the anger at the denial that all too often followed the incident and the stress experienced by families and staff who struggle to get answers.
The value of transparency
But it was Mid-Staffs that gave me a valuable overview of the weaknesses in the health and care sector as a whole. I saw how performance measures and financial targets were consistently put first, with the quality of care and experiences of those the hospital was looking after coming a distant second. Most importantly I have seen the dangers that arise when patients and their families are not listened to, and where questions and complaints are dismissed and the truth covered up.
Whilst other scandals have come to light in the five years since I do think Mid-Staffs was an important victory for transparency in the NHS. Things like the Duty of Candour and better support for whistleblowers have fundamentally altered expectations. The culture of covering things up and closing ranks is simply not acceptable anymore and is being rooted out.
A broader culture shift
But it’s not only attitudes to serious incidents which have changed. There is a broader cultural shift going on, one where patients and the public are being increasingly involved in shaping their own treatment and how services should be run.
You see this starting to happen at an individual level, where patients are being increasingly seen as partners – working with clinicians to come to decisions together. No longer are we expected to listen to a well-meaning doctor dictate what they think is best for us and to automatically accept it.
We also see this at a system level, with an increasing expectation that user feedback and involvement is used to ensure services are designed around what people want and need. Healthwatch, with its 152 local teams and more than 5,000 volunteers, has been at the very heart of this. Crucially, the way the Healthwatch network was set up means it has brought a real professionalism to public involvement in health and care, with local leaders using their expertise and their statutory powers to make health and social care organisations sit up and take notice.
The NHS long-term Plan
The NHS Long Term Plan is a good example. Healthwatch has brought its analysis of the views and experiences of over 85,000 people into the development process to ensure NHS England can build the plan around what matters to those they care for. As I take up my new role as chair of Healthwatch I want to take this further. I want Healthwatch to help start a social movement of citizens who really want to make a difference in our NHS. I want Healthwatch to be the banner under which they can help our NHS social services be the best they can possibly be.
I want to ensure Healthwatch is hearing from more and more people. I want to generate more and better insight to help health and social care services know where and how to improve. I want to create a platform that harnesses and amplifies the collective contribution of the millions of people already out there helping the NHS and social care services to do their job by acting as carers, as volunteers or just by providing feedback.
Politicians often talk about it being ‘our NHS’. Well, if it truly is ‘our NHS’ and ‘our’ social care service then our relationship with it needs to change. We need to stop seeing ourselves as passive recipients of a service and start seeing ourselves as joint owners. It is, of course, true that hospitals, GPs and social care services will need continued financial investment, but wouldn’t it work so much better if we all played our part in improving it too?