Published on March 6, 2014

Some more reflections on NHS Citizen in Manchester

NHS Citizen

By Clive Mitchell

Clive Mitchell is Programme Manager at Involve. He is based in the West Midlands and has 30 years experience of working in and with local authorities.

The Community Space at NHS Expo 2014

I’m back in my usual place, perched over my laptop, following two fascinating, exciting, challenging and tiring days at the NHS Expo in Manchester. The NHS Citizen team undertook to capture and blog their immediate reflections of the event. Here are mine.

1. It was such a pleasure to see, and meet, so many interesting and different people over the two days. The venue buzzed, helped along by a pretty fab location in the Community Space (see the picture): a mix of graffiti wall, cafe seating, allotment gardens and speakers’ corner.

2. As nice as the Community Space was, it would be good if the world of NHS Expo didn’t need a Community Space. It would be good if a citizen-centred health system was something that the NHS (and its suppliers) just took for granted. Despite some great conversations with, and participation by, other exhibitors in Manchester, it felt a little bit like two worlds looking at each other over the garden fence.

3. There were some themes to the conversations I had with other people, one being: how does NHS Citizen fit with all the other participation initiatives and activity across the health and care system – of which there are loads! This is something that’s already been chewed over in the design work to date, and will continue to be. And I need to work at getting my head around the fit.

4. Something else that came up in conversation, and which I need to better understand, is how (and how much) NHS Citizen will exercise influence in a dispersed health and care system. The aim is to design a mechanism for bringing citizen voice into the heart of decision making within NHS England. Central though it is, there is more to the system than NHS England.

5. We had a fairly diverse population at Expo, and heard from some voices that are often marginalised in wider society. But there were gaps, and this will be something that we are going to work hard at in NHS Citizen design. Class and poverty are going to barriers – Expo was, to my middle class eyes, mostly a middle class affair.

6. I was struck by the bravery and passion of some of the patient leaders and carers who were at Manchester, and how clearly they articulated their concerns. But some folk, I felt, were in campaigning mode and I, perhaps naively, expected more reflective participation. Reflecting on this further myself, I am sure that the system plays a big part in driving people’s behaviours – if you get ignored then no wonder you start battering away at the walls. But we are all more than just campaigners. Simon Burall talks in his post-Expo post about looking forward to seeing people bring their other identities to NHS Citizen.

7. One comment that really hit home – and caused a pause in the pop-up seminar – was that the NHS England Board, having kick-started and funded the project, has lost control of NHS Citizen. There was a pause because this sounded damaging. But a moment’s thought revealed the fantastic power behind this idea. This isn’t going to work and is not going to be sustainable unless it is a genuine co-production between Board and Citizens.

8. I came away from Manchester a little bit emotional. Working with a great team accounts for some of this. But also seeing citizen participation in action has a power and an impact that can humanise organisations.

Now that I’ve dried my eyes, I’m really looking forward to seeing how NHS Citizen grows.

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