A citizens’ assembly will put people at the heart of everything the NHS does

Since the publication of this blog Tim Kelsey has left NHS England.

Tim Kelsey, NHS England’s National Director for Patients and Information, explains the next step towards empowering people

Since being established NHS England has been seeking and developing ways to put patient participation at the heart of its decision-making.

Over the last few months we have been working with colleagues throughout the health and care sectors, and beyond, to try to describe what that really means in the context of a 21st Century NHS. We heard and learnt a lot from a day we spent with colleagues in June to test out our early ideas about a national assembly to really put peoples voice at our core.

On October 22 and 23 we are hosting two further development days to towards this concept of establishing a Citizens’ Assembly.

We have a real and genuine commitment to building this new approach to participation with our communities – which means that we have to be open to change and amend our ideas as we listen to, hear and respond to feedback.

This will need a transparent and open process which is one of the reasons why the event is going to be live streamed and why we will be including comments and ideas from our digital participants as well as the people in the room – in the 21st Century we are going to need to be ‘digital by default’ at the same time as making sure everyone has the chance to participate and contribute.

At present we see the Citizens’ Assembly as having three main purposes:

  • To give citizens and organisations a direct transparent route for their voices to reach the heart of the NHS England decision making process, in a way that cannot be ignored.
  • To give the NHS England board and others a new source of evidence and opinion on the NHS now and future.
  •  To give the public an open and robust accountability mechanism for the work of NHS England, and opportunities to participate in every aspect of the organisation’s work.

We intend it to be much more than simply a consultation or reporting mechanism and it will play a central role in the way in which NHS England operates.

It is intended to describe the new kind of relationship between stakeholders and NHS England that was discussed in the July workshop that was attended by a wide audience.

This purpose and the design behind it will undoubtedly be refined following our design event and we hope it will be stronger for it – if we are committed to doing things differently then we have to open to change.

I look forward to seeing the next stages of this work and even more to seeing it develop into a living system that brings the voice of the citizen into the heart of what we do at NHS England.

Tim Kelsey was previously National Director for Patients and Information, since the publication of these blogs he has left NHS England.


  1. Anne Milstead says:

    It seems that some citizens are more equal than others. Yes, how are you going to interact with PPGs? Are they citizens? or are the citizens only going to be those who have already been around the block a few times? Healthwatch seems to be populated by semi professional politicians who serve on numerous bodies and once you get one post, you are likely to get more and more. Us plebs stand little chance of being heard. How many people could afford to go to NHS EXPO? You only had to look at the cost of entry to see who it was aimed at. £400 plus VAT if you weren’t explicitly NHS but employees got paid for! How many Patients knew about NHS EXPO? and could afford the cost? If I had not been guested, it would have cost me near enough £800. Sadly, I’m not a politician,CCG Commissioner, GP, Consultant. Sorry, but the NHS belongs to the Patient is just words

  2. Darshna Rughani says:

    This sort of forum has been used by Local Authorities. Is there any shared learning from them on the effectivness of this type of engagement.

  3. Sara Siloko says:

    Thanks very much for letting us know about your ‘consultation’ on 22 and 23 Oct on 24 Oct. That really is the way to encourage involvement, engagement, participation etc. Very empowering.

  4. Nicola Kingston says:

    Please can you explain how this will link with
    1. Healthwatch – where there arle already many conversations which need responses locally from NHSE
    2. Health and Wellbeing boards – where the NHSE rep is stretched trying to attend many boards, and recognises that local engagement in local primary care or prison health issues is poor
    3. CCG where there are many issues around primary care, eg quality of shared decision making, where we need a triangulated discussion
    4 Complaints in primary care – where NHSE will not accept complaints if they have already been responded to I from the surgery, so how will this be fed back into quality control?
    5 PPGs – how is NHSE going to work with the vast numbers contributing to PPG work, often poorly appreciated by their surgeries
    6 Clinical Senates – who have different recruitment processes for patient reps.
    7 how will these new proposals fit with lLay Members in CCGs, who have had proper investment and pay, whereas patient reps have not?
    8 Will there be formal training and development and pay for any patients prepared to make major time investment?

  5. Oluwafemi Faniku. says:

    Patients experiences are true reflection on quality of service. The retail industry got this long before the NHS.