The NHS Modernisation Bill aims to strengthen patient involvement in healthcare in the NHS in England.
However, proposals to abolish Healthwatch England, Local Healthwatch organisations and Councils of Governors at NHS Foundation Trusts raise important questions about how independent patient voice will be protected.
The Bill introduces major changes to NHS governance and patient representation. While the Government has pledged to put patients at the centre of decision-making, several long-standing bodies for independent patient representation would be removed.
Key changes
Patient voice in national decision-making
Responsibility for patient involvement would move from NHS England to the Secretary of State, supported by a new Directorate of Patient Experience within the Department of Health and Social Care.
Foundation Trust governance
The requirement for Foundation Trusts to maintain Councils of Governors would be removed, with some powers transferred to the Secretary of State.
Healthwatch reforms
Healthwatch England and Local Healthwatch organisations would be abolished, with responsibilities redistributed across Integrated Care Boards (ICBs), local authorities and the Department of Health and Social Care.
Picker’s view
The NHS is at a pivotal moment for patient voice.
While we welcome greater focus on patient experience, the Bill concentrates significant powers within government while removing independent routes for patient and public representation. This risks weakening accountability, transparency and the independence of patient voice.
Our recommendations
Picker is calling for:
- A statutory duty to report regularly on patient experience across health and social care.
- Independent oversight and advice on patient experience and representation.
- Stronger safeguards for patient voice within ICBs and local authorities.
- Clear arrangements for incorporating patient perspectives into regulation, safeguarding and local decision-making.
- Greater clarity on how current Healthwatch functions will be protected and strengthened.