Our current & future position
Introduction
The purpose of this paper is to provide background and context to the North Yorkshire Scrutiny of Health Committee about the future and current position of Healthwatch North Yorkshire and the value of an independent voice organisation.
Background
Healthwatch North Yorkshire is a core partner within the health and care system, playing a vital role in ensuring that the voices of local people are heard in the planning, design and evaluation of services, with a particular focus on the voice of those people experiencing exclusion and inequalities.
We have established and maintain strong relationships with individual health and care organisations within the NHS, primary care, North Yorkshire Council and community voluntary sector and help facilitate organisational and system integration, paying particular attention to the public voice. Established under the Health and Social Care Act 2012, Healthwatch North Yorkshire has been operating since 2013.
Review of patient safety bodies
In July 2025 a report was published by Dr Penny Dash entitled a ‘Review of patient safety across the health and care landscape’, which recommenced the abolition of Healthwatch England and all 153 local Healthwatch across England. The review also looked into the future of organisations such as the National Guardian’s Office, the Health Services Safety Investigations Body, the Patient Safety Commissioner, and NHS Resolution.
The Secretary of State for Health and Social Care accepted the recommendations of the report, which for local Healthwatch mean:
· The statutory functions of local Healthwatch relating to healthcare should be combined with the involvement and engagement functions of integrated care boards to listen to and promote the needs of service users.
· The statutory functions of local Healthwatch relating to social care should be transferred to local authorities to improve the commissioning of social care.
This transfer of local Healthwatch functions will take place once new health and care legislation has been passed by Parliament and will require Royal Assent. The timeframe provided by the Department of Health and Social Care, is that a Kings Speech will happen in spring 2026 when a new Health & Care Bill [entitled Health Reform Bill] will be announced, following this the Bill will require scrutiny and approval by the House of Commons and House of Lords, which is expected to take approximately twelve months, so possibly taking us to spring/summer 2027.
Transition and Healthwatch action
Healthwatch England is currently supporting the Department of Health and Social Care with the establishment of a new Directorate of Patient Experience (which will replace Healthwatch England), which is expected to be established by April 2026 (in limited form). Healthwatch England will remain, with a reduced capacity during 2026/2027 to continue to support the local Healthwatch network.
The Department of Health and Social Care has confirmed that funding for local Healthwatch will be provided to local authorities, as per usual, for 2026/2027.
Healthwatch England and the Kings Fund are working together to see how health and care systems can continue to hear from and involve the public in decision making without a local Healthwatch model in place. This review will look into:
· The strengths of the current Healthwatch model & its impact
· Understand the challenges for local Healthwatch
· How a new model might look if it were to be designed
· What this learning would mean for the future of public experience and involvement
A report is expected around February 2026, which will include recommendations to help support integrated care boards and local authorities when they consider how they will take over the functions of local Healthwatch.
The Department of Health and Social Care will provide guidance to integrated care boards and local authorities on what functions of local Healthwatch they will be expected to deliver once an Act has been passed. No date has been given for when this guidance will be completed or issued.
The Department of Health and Social Care has said that integrated care boards can commission external third parties to deliver their Healthwatch function, if they so wish. But, there has been no clarity on whether ringfenced funding will be provided to local authorities, as it currently is, for their Healthwatch function to be delivered.
In response to the news about the abolition of local Healthwatch the network of Healthwatch organisations across England have come together to both support each other alongside challenging the decision. This challenge has not been based around desires to save individual local Healthwatch but instead has been based on genuine concerns that this decision will remove the independence and legitimacy of people’s concerns and experiences. Locally Healthwatch have set up a national petition, written to and met with MPs, elected Mayors, councillors, and met with and spoken with their local health and care partners.
Healthwatch North Yorkshire current actions
Despite the current situation and uncertainty Healthwatch North Yorkshire is continuing with business as usual across our core activities and priority areas including:
· Farming & rurality
· Women’s alcohol consumption
· Care home enter & views
· Reasonable adjustments
· Hearing from people affected by health inequalities
· Health promotion
Alongside this we continue with our partnership working including representation at:
· the North Yorkshire Health & Wellbeing Board
· Local Care Partnerships
· North Yorkshire Safeguarding Adults Board
· Humber & North Yorkshire Integrated Care Board Quality Committee
· Humber & North Yorkshire Integrated Care Partnership Board
Our concerns for the abolition of an ‘independent voice’
We fully believe that an independent organisation is best placed to serve and represent the concerns of the public and to champion the views of those people and communities who do not or who are unable to speak up for themselves.
In this turbulent time of change within our NHS, local authorities and with the introduction of local Mayors and Combined Authorities – the need for an independent organisation to represent and guide local communities has never been greater. Our belief is also based on the appreciation that health and social care partners do not have the capacity or resource to fully deliver a Healthwatch function.
The Mid Staffordshire NHS Foundation Trust scandal stands as a stark reminder of the consequences of failing to listen to peoples views and experiences. The Francis Inquiry made clear that independent scrutiny and public advocacy are essential. It also exposed the failure of local democratic scrutiny mechanisms, which lacked the expertise to detect serious failings.
We feel that the loss of an independent voice organisation such as Healthwatch North Yorkshire may negatively impact on:
People & communities
There is a risk that there will be substantially less engagement with members of the public to understand their experiences of care. Healthwatch North Yorkshire undertake proactive engagement each month at events, going to established groups from diverse communities and communities of interest.
Quality & safety
There is a risk that with less public feedback and less qualitative people’s stories that important concerns about people’s treatment, care and access will be missed resulting in significant issues affecting quality, safety and safeguarding.
Equality, Diversity & inclusion
There is a risk that the proposed plans to centralise public engagement at an Integrated Care Board (ICB) level may result in only involving or hearing from those people and communities who are already well represented and further ignore those people who do not engage or who are digitally excluded.
Decisions & policy making
There is a risk that people’s voice will be left out of decision making forums that Healthwatch North Yorkshire both contribute to and facilitate locally. Resulting in services and care not always meeting the needs of our diverse communities.
Healthwatch North Yorkshire feels that if less people are heard, engaged with and involved in their care, that this will contribute to a widening of health inequalities across our communities.
The new NHS Strategic Commission Framework published in November requires all integrated care boards to work in partnership with their local authority and have a comprehensive understanding of the people they provide services and care for. Additionally, that they involve and co-produce those services with local people. The Framework encourages integrated care boards to actively involve people and communities and use the Care Quality Commission’s Framework for engaging with people and communities to address health inequalities (2025).
Healthwatch North Yorkshire believes that it can continue to play a pivotal role in helping to shape how this new health and care landscape can look and function. By acting as a catalyst to help bring meaningful public, carer, and community insight to the forefront of discussions, we would support system partners to work with people as partners in the design, delivery and evaluation of services.
Opportunities to support system partners
We have identified six core areas based on our organisational strengths and how these could support health and care system partners across North Yorkshire.
North Yorkshire Ambitions for Health – through the North Yorkshire People’s Voice Network, we would work with NHS, council and voluntary, community organisations and social enterprises to help identify and support communities to participate in co-production.
Core20PLUS5 – using our established community networks which we have formed via our conversations and engagement projects - for example in accessibility, mental health, younger people, social care and mothers we would help to facilitate and provide insight from those people affected by health inequalities and support shared decision making.
Equality, Diversity & Inclusion – using our established contacts we will continue to develop relationships with different communities, such as Asian, Afghan, Nepalese, Pakistani and Bengali and ensure that their experiences feed into putting together healthcare services tailored to the needs of all communities.
Neighbourhood health – support system partners to ensure that neighbourhood health is led by people and communities (neighbourhood led as opposed to neighbourhood based) by helping to facilitate and provide views and experiences from local communities in partnership with the voluntary, community and social enterprise sector.
Health & Adult Services involvement framework – through our extensive community connections across the county (urban, coastal and rural) we will support Health & Adult Services in North Yorkshire to deliver their ambitious plan to involve the public in how they work with people and communities to develop and deliver their services and support.
Public voice – using our infrastructure and mechanisms for hearing from the public (volunteers, digital communication, asking and listening to people, focused research and methodology) we will continue to collect diverse public intelligence that will help to shape service improvements.
Each of these six areas provide opportunities for us to build on and develop our collaborative working with system partners and to explore our priorities for our current work now and into next year (2026/2027,) as well as looking into the future, post any legislative changes.
Ashley Green, CEO
November 2025