John Kell, Head of Policy at the Patients Association

This is the first in a short series of blog posts looking at the policy challenges in health and social care as we press ahead into 2018. So, while I will be using it to introduce my area of work in the Patients Association, as Rachel, Heather and Sarah already have, I also want to highlight some key themes for future exploration.

The Patients Association is, uniquely, a patient-facing campaigning charity with an over-arching remit. Any and every policy issue of interest to people with health and social care needs is, in principle, within our scope. Most patient charities, by contrast, are condition or organ-specific, giving them an obvious and self-explanatory focus. So what is the role for a patient charity as far as cross-cutting health and care issues are concerned – and for the Patients Association in particular? And as a small organisation working in a policy arena with arguably unprecedented headwinds, what can we achieve?

The charity sector and the national policy debate

In the national policy debate about healthcare issues, patient representation is massively outweighed by employee and organisational voices. This should be no surprise on reflection: health and social care involves a great many institutions and a workforce numbering in the millions, so the organisations that represent these interests should be, and are, substantial and well resourced. The people involved are overwhelmingly motivated by a strong ethic of concern for patients and service users, and the way they frame the debate is therefore often positive from a patient point of view. As an organisation we have good relationships with many of these bodies, and work with them whenever we can. But the views of professionals and institutions ultimately cannot substitute entirely for the views of patients, however closely aligned they may be for much of the time.

The patient voice in the national debate, by comparison, is smaller and more fragmented. Although the phalanx of patient charities is large, top-level questions of funding, structures, workforce and so on will be out of scope for the typical condition or organ-specific charity, whose remit will not formally extend beyond their own patient group. Indeed, for those charities it is important to resist the temptation to make calls for increased resource levels in their area, implicitly at the expense of some other patient group. Happily, most charities are adept at avoiding such a ‘beggar my neighbour’ approach, but the implicit competition between different patient groups for a fixed and ever more stretched pot of resources can be an impediment to most patient charities addressing the big picture.

The remaining part of the sector, with an over-arching remit across all care issues, amounts to a headcount smaller than any of the more substantial condition-specific charities, if one were to count us all up together. In this corner of the sector, the Patients Association has traditionally been a somewhat punchy campaigning voice, willing to present messages that are not always comfortable for decision-makers to hear. This is a tradition we wouldn’t want to abandon, though at what is surely a critical time for patients, service users and carers, it’s more important than ever that we align this with strong evidence, and offer not only a compelling account of patients’ views and concerns, but also well developed, useful commentary that is built firmly on them.

The year ahead

So, what will this look like in the year ahead? Firstly, our trustees have identified five priority policy areas: patient safety, patient experience, complaints handling, funding and sustainability, and digital technology in care. We are developing our programme of work around these issues, which will include both our traditional approach of national action, including reports and media work, and more opportunities for our supporters to tell us their views and get involved in campaigning actions and events. Members will get information about these as they are launched - you can also sign up for our Weekly News here. In addition to that, we will continue to engage with the Government and the NHS nationally, including both responding to consultations and some exciting collaborative work tying in with the NHS’s seventieth anniversary celebrations.

Of course, we will not redress the imbalance in the public debate in one fell swoop, and the existence of very serious headwinds to any positive impact is undeniable. These include the long term struggles at a political level to provide adequate resources and planning for health and social care, whose results are now alarmingly apparent; and the challenges of Brexit, in terms of both the ‘bandwidth challenge’ it creates for Parliament and the Government in addressing any other major challenge at the same time, and the complexities of whatever its policy implications for health and care turn out to be. I will pick up some of these issues in more detail on this blog next week.