Healthwatch Norfolk has joined with local Healthwatch across the country to issue a warning about the Government’s Equality Impact Assessment (EQIA) for the NHS 10-Year Health Plan.
An EQIA is a process carried out to make sure that a policy does not unlawfully discriminate against certain people, as outlined in the Equality Act 2010. The Act defines nine protected characteristics, including race, religion or belief, disability and age.
Why the concern?
The Government’s EQIA for the 10-Year Plan, published on 17 December, refers extensively to “patient voice” and “patient feedback”. However, this is largely framed through digital tools such as the NHS App, surveys and experience metrics. Healthwatch leaders says this risks confusing data collection with meaningful, independent patient voice and engagement.
As such, the plans fail to fully consider the impact of losing independent patient voice and scrutiny, as required under the Public Sector Equality Duty – a legal obligation requiring public authorities to consider how their policies affect people protected under the Equality Act.
Healthwatch England’s most recent complaints research shows that while almost a quarter of people experience poor NHS care, fewer than one in ten go on to make a formal complaint, and more than half of those are dissatisfied with the process or outcome. This points to deep-rooted issues of trust and confidence. Local Healthwatch leaders argue these issues cannot be addressed simply by expanding feedback mechanisms controlled by the NHS, such as the NHS App.
Emphasis on NHS App
Proposals within the NHS 10-Year Health plan suggest that the functions of local Healthwatch could be absorbed into Integrated Care Boards and local authorities. This includes an emphasis on the NHS App as a feedback route, despite longstanding concerns about digital exclusion.
Healthwatch Norfolk has carried out extensive work looking into the patient experience of using digital tools, such as the NHS App, in primary care. The findings reveal that a number of barriers exist that are preventing people from engaging fully with the app, including limited access to technical devices and struggles with registration and navigation.
Importance of independence
Alex Stewart, Chief Executive of Healthwatch Norfolk, said: “Patient voice cannot be independent if it is owned and controlled by the system it is meant to scrutinise.
“When people’s trust has been damaged by poor care, they often do not turn back to the same system to report it.
“Local Healthwatch are embedded in their communities and work directly with people whose voices are most easily lost. That role cannot simply be replaced by an app and our findings show there are still significant numbers of people who are currently not able, or willing, to use the app to manage their healthcare.”
Healthwatch is urging the Government to meet its legal duties under the Public Sector Equality Duty by fully considering the implications of losing independent patient voice as reforms within the NHS progress.