Published on September 17, 2014

NHS Citizen: A Continuous Learning Cycle

NHS Citizen

By Sonia Bussu

Dr Sonia Bussu is a researcher at Involve. She is passionate about increasing citizen voice in public policy (so much so that she did a PhD on the topic) and over the past few years she has been involved in several research projects on citizen participation in policy-making.

IMG_1377After months of preparation the NHS Citizen project is facing its first big test: the Assembly Meeting test on Thursday 18th September.  The Assembly Meeting is an essential part of the NHS Citizen architecture with both symbolic meaning and pragmatic objectives. It’s the opportunity for citizens to be on the centre stage (a stage that with time we hope will get more and more visibility and clout) and to meet face to face with the NHS England Board, getting them to focus on national-level issues raised by the citizens themselves.

This test will be a daytime event, finishing shortly before the formal NHS England AGM which takes place in the same venue, The Queen Elizabeth the Second Conference Centre, in Central London. Over 250 hundred self-selected participants will discuss five issues chosen from among over 100 proposals submitted by citizens online, through our Gather space. Different groups of citizens will talk about how the NHS can improve:

These are very broad and complex issues, but the discussion will be facilitated, based on a deliberative and collaborative process. The objective is to identify areas of agreement/ disagreement as a first step towards co-designing solutions to these problems with NHS England’s Board members, who will take part in the conversation in the second half of the day. A webcast of the event starting at 10.30 am on the daywill be available on this page. You can also join the online conversation – via Twitter – using the #nhscitizen hashtag and the specific hashtags for each issue discussion. You can find out more about this here.

This will be an important test of how citizens can work together and cooperate with the Board to help the NHS respond effectively to people’s needs. I can predict the learning curve here will be at its highest: as it has happened before with our design workshops, we might have to rethink some approaches and even make drastic changes. But the beauty of this process is that there is nothing set in stone and we’ll continue to learn in a self-reflective way, trialling out and developing new methods and new ideas, in a collective fashion.

For tomorrow’s test we opted for self-selection of participants, because NHS Citizen is still a relatively unfamiliar process to most people and it seemed natural to involve those stakeholders that have followed and contributed to the design process from the start. NHS England knows them and trusts them and this process is already something radically new which will require time for people to familiarise themselves with.

As we learn more about NHS Citizen and start trusting it, I think we could be braver and use the Assembly Meeting as the channel to draw the rest of the country into the process. Inevitably the agenda-setting work will involve a minority of the population – either participating directly at the local level or through the NHS Citizen online spaces.  Purposeful selection (specifically targeting the marginalised and those groups that tend to engage the least) or random sampling (to ensure representation of the socio-demographics of the country, with quota for minorities and marginalised groups) could be a way of reaching out a bit further. A randomly selected Assembly Meeting, for example, would provide NHS England with a fairly reliable gauge of what the public would think on a given issue if it had access to information and the space to deliberate together in a level playing field.

In the meantime, we approach this first big test with an open mind and humility, well aware that once again participants will question, challenge, and help us learn and make it better.




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