Browse the corpus

Third is how to strengthen rather than diminish patient and public voice. The requirement for NHS foundation trusts to have councils of governors—a policy originally intended to boost accountability to communities—will be removed. And Healthwatch—the independent organisation that operates nationally and locally to gather patient and public views—will be abolished. The experience of Healthwatch has been varied and its impact hampered by budget cuts and a power imbalance with the NHS.12 13 14 But scrapping it entirely and bringing its functions “in house”15 means patients are losing an institutionally independent voice. The NHS has a mixed record of listening to patients,16 as repeated inquiries into patient safety failings show.17 18 Government could choose to do more to listen to their views without reorganising anything. An independent body with sufficient infrastructure to gather local data and influence national decisions is needed. Last is how the government’s plans for sharing patient data will work. The bill includes powers to establish a single patient record—bringing together existing information on people’s health and social care use into one place. The aim of joining up data to improve patient care is good. Patients and staff are frustrated with the current system, with clinicians navigating multiple and incomplete information systems.19 20

ablish a single patient record—bringing together existing information on people’s health and social care use into one place. The aim of joining up data to improve patient care is good. Patients and staff are frustrated with the current system, with clinicians navigating multiple and incomplete information systems.19 20 But whether the plans can avoid the fate of past national NHS IT programmes21 is unclear. Detail on how the new record will work is thin. Questions include how it will combine existing fragmented systems and how the data will be accessed and governed, given concerns about NHS data sharing and privacy.22 Measures elsewhere in the bill to bring digital and data responsibilities into the Department of Health and Social Care may undermine the trust needed to deliver. Recent data suggest the public trusts the NHS more than the government with health data.23 The NHS is in the middle of yet another restructure. The bill brings the legislation needed to finish the job, but local NHS organisations are already in flux.24 The costs are clear: reorganisations eat up time and resources and can distract leaders from improving services.25 Potential benefits are harder to find—and the legacy of a more politicised NHS may prove poisonous.