Report

The future of patient voice

This report from UK think tank The King’s Fund examines the future of patient and public voice in England.

This report examines the future of patient and public voice in England in light of the government’s decision to abolish Healthwatch England and the network of local Healthwatch organisations.

It sets out what can be learned from the Healthwatch model, which since 2013 has gathered and amplified people’s experiences of health and social care, and considers how these lessons should inform future arrangements. Drawing on an evidence review, interviews and workshops with national and local stakeholders, the report highlights the significance of the moment, given wider reforms to health and care system structures and ongoing concerns about how effectively patient experience influences decision-making.

The research finds that Healthwatch’s independence from government and service providers has been central to its credibility, allowing it to build trust with communities and surface issues that might otherwise be overlooked. The ‘hub and spoke’ structure, combining strong local relationships with a national voice, helped connect community insight to policy debates, while the collection of large volumes of qualitative and quantitative feedback enabled emerging problems to be identified. However, the report also identifies persistent challenges, including limited statutory powers to drive change, tensions between national and local bodies, variation in capacity across areas, and long-term funding pressures that constrained impact.

Looking ahead, the report argues that any future model must preserve the conditions that enabled Healthwatch to add value, particularly independence, meaningful engagement with diverse communities and the ability to link local insight to system-level action. The King’s Fund emphasises the need for clarity about transitional arrangements, safeguards against conflicts of interest and stronger links between insight, accountability and improvement. Without this, there is a risk that patient and public voice becomes more fragmented or marginalised, rather than central to shaping better health and care services.