One of the biggest pieces of work when delivering an NHS major service change programme is to formally consult members of the public. From pre-consultation engagement to extensive media and stakeholder planning, to independent analysis, the process of public consultation can seem mountainous.

So why do we carry out public consultations in the first place?

A large part of the reason is so that NHS organisations can meet their duty to involve the public, as set out in the NHS Act 2006 (as amended).

NHS organisations have a duty to involve patients and the public (by means of providing information, consultation, or in other ways) in:

a) planning commissioning arrangements

b) the development and consideration of proposals for changing services

c) decisions they make.

But, as the legislation itself says, your organisation can meet this requirement “whether by being consulted or provided with information in other ways.” So why is it so common to decide to formally consult the public on NHS service changes?

This is where the local authority health scrutiny regulations come into play. Regulation 23 requires NHS organisations that are considering a proposal for substantial development (sometimes referred to as substantial variation) of the local health service to consult the relevant local authority or authorities. As part of the duty of local authority Health Overview Scrutiny Committees to effectively scrutinise health services, it is typical for NHS organisations to also consult the public to seek their views on proposals.

So that’s the legal bit. But here’s the perennial question: do we consult because it’s the law, or is it the law because it’s good to consult?

Public consultation can provide health and social care commissioners with information about a service they commission that they may not already know themselves.

The clinical quality of a service is paramount, but so too is its accessibility, its sustainability, and its effectiveness in reducing inequalities. These aspects of a service are less easy to define without engagement with the people who are affected by them: patients, the public, staff, seldom-heard communities, and other stakeholders that have experience with this service.

Moreover, the NHS is a much-loved institution. Its services are cherished; it’s embedded into the life and spirit of communities across the country. From cradle to grave, a single NHS building can feature in the lives of entire families. They may be born there, have their own children there, and say goodbye to loved ones. This can go on generation after generation. Thousands of people will do the same. Changing these institutions can be emotional for everyone impacted.

By formally consulting the public on NHS service change proposals, it becomes much easier to hear the voices of everyone that has a role to play in that service, from the clinicians that deliver them to the community that receives them.

Public consultation is more than just an opportunity to discharge legal duties: it is an expression of the value that patients and members of the public can bring to the future of NHS services. This is an invaluable resource for any commissioner or provider that wants to make meaningful, long-term change to improve services for communities.

The Stand team are recognised experts in planning and delivering public consultations. Our clients come to us to help them understand the issues, involve their stakeholders, and develop proposals for changes to services. We love to talk about all things service change, so if you have a challenge you want some insight on get in touch.

Blog by: Jonny Williams