What’s changing in how people’s voices are heard in health and care
The government plans to change how people’s experiences of health and social care are gathered and used. This includes proposals to close Healthwatch nationally and locally, with responsibilities expected to move into other parts of the NHS for healthcare and local councils for social care.
These changes will require new legislation, expected to be brought forward through Parliament, and are not likely to take effect before April 2027. This means Healthwatch will continue in the meantime.
The proposals form part of wider changes to health and social care, including the government’s 10 Year Health Plan, which aims to change how care is organised and how people access support.
A new report from The King’s Fund helps explain what can be learnt from Healthwatch and what these changes could mean for the future.
The King’s Fund is an independent health and care charity that works to improve how care is organised and delivered.
Read the report
The future of patient voice: learning from the Healthwatch model
What the report tells us
The report highlights some important lessons about what works when it comes to listening to people.
It shows that:
- people need an independent organisation to listen to them and speak up on their behalf
- building relationships and trust with communities over time gives people the confidence to speak up and know that their voice will make a difference
- what people say locally helps to shape improvements in health and social care so people know they have been listened to
The report also highlights some challenges for Healthwatch, including reduced funding over time, differences between areas, and limits in how consistently people’s experiences lead to change. This highlights the need for stronger support in future.
Overall, the report suggests that Healthwatch has made a real difference in bringing people’s experiences into decisions.
It also reflects wider challenges in how decisions are made, including how easy it is for people’s voices to influence change in practice.
What Healthwatch hear
People tell us they value having somewhere independent to go when they want to share their experiences. Being separate from the NHS and local councils helps people feel able to speak openly and honestly.
Some people also tell us they worry that raising concerns directly could affect the care they receive, which can make it harder to speak openly. Having an independent place to share experiences can help people feel more confident coming forward.
This shows why having an independent place to share experiences matters, alongside the ways people can already give feedback directly.
We also know that people’s experiences are not always captured through formal routes. Whether it is accessing GP appointments, navigating different types of care, or understanding what support is available, people often share things that might not otherwise be picked up.
Healthwatch also goes out into communities to hear from people directly, including those who may not usually come forward or take part in surveys. Being independent helps us reach people who might not feel comfortable sharing their experiences elsewhere, so we can understand a wider range of views.
In North Yorkshire, what we hear through this work often reflects these kinds of challenges. People tell us about:
- travelling longer distances to appointments
- limited public transport
- long waits for care
- difficulties getting clear information and advice about the support available
Healthwatch does more than gather feedback. Alongside hearing about these issues, we also help people find clear information and advice so they can understand their options and know what to do next.
People often come to us when they do not know where else to turn, want to raise a concern, or need support to understand their rights.
There are also questions about how many different ways people are asked to share their views. People tell Healthwatch this can sometimes feel confusing or like they are repeating themselves.
These are not new issues, but they show why it is important that people have a clear and trusted way to share their experiences.
Over time, these conversations help build a clearer picture of what is working well and where improvements are needed, including issues that may not always be visible at a national level.
Healthwatch also reports back on what we hear and the changes that happen as a result, working with the NHS and local councils so people can see how their experiences have led to improvements in care. This is a key part of how Healthwatch works locally.
Looking ahead
The report is clear that any future approach to listening to people about their care must build on what has worked.
This includes people feeling confident sharing their experiences, keeping strong, trusted relationships, and continuing to hear from a wide range of people.
It also highlights the need to join things up more effectively, so that what people tell us locally helps shape decisions at a wider level.
Any future approach will need to bring together the different ways people currently share feedback, from surveys and complaints to community conversations, while making sure people still have access to an independent place to speak openly.
There are also questions about how this work will be led in future, including whether new national roles will have enough independence and authority to challenge where needed.
Chris McCann, acting chief executive of Healthwatch England, said:
"We welcome the King’s Fund review as a balanced assessment of both the strengths of the Healthwatch model and the challenges it has faced since its launch in 2013.
As highlighted in the Public’s Perspective report published by Healthwatch earlier this week, the public has entrusted Healthwatch with nearly 400,000 pieces of feedback over the past two years. This helps inform those in charge of care to make improvements across a wide range of health and social care issues.
With the government now preparing to replace Healthwatch at both local and national levels, the King’s Fund report offers an important guide to the principles that must be upheld."
Ashley Green, Chief Executive of Healthwatch North Yorkshire, added:
“People in North Yorkshire tell us they value having somewhere independent to go when they want to share their experiences. It helps them feel confident they can speak openly and be listened to.
As changes are considered, it is important that this independence is not lost, and that people continue to have a clear and trusted way to be heard.”
Why all of this matters
Listening to people is not an optional extra. Care works best when it reflects what it is actually like to use.
It remains important that people have a clear and trusted way to share their experiences, ask questions and understand their rights.
The report highlights that this is a key moment to rethink how feedback works across the NHS and social care, and to make sure it is simpler, clearer and more effective for the public.
It is an opportunity to look at how health and care listens to people and how different feedback routes work together.
Whatever changes come next, it is vital that people continue to have a clear, trusted and independent way to be heard.
