NHS Wales and care patients given new 'citizen voice' body

Community health councils - which currently speak up for patients - will be replaced

A new "citizen voice" body to represent patients in the NHS and social care is to be set up, in new legislation proposed by the Welsh Government.

Health Minister Vaughan Gething said it would be "more than just a complaints body" and would bring improvements.

But there have been concerns from existing patient watchdogs about a lack of detail about what will replace them.

The proposals also set out a "duty of candour" on health providers when things go wrong.

The network of community councils have been operating in Wales for 45 years - now down to seven from an original 19.

But there have been issues around whether the public know who they are and what they do.

The proposals are:

• The Citizen Voice Body would replace the existing community health councils and act as a national body but also work at regional and local levels, ensuring patient views are heard, to help in making complaints and also to drive improvements

• The Duty of Candour would make it a legal obligation for NHS providers to promote a "culture of openness, transparency and candour" - they will also have to report annually about what went wrong, how often the duty was triggered, describe the circumstances leading up to it and the steps taken afterwards. It is seen as making it safer for patients and a better environment for staff to work in

• A legal Duty of Quality means that health boards and ministers will have to ensure quality improvements are "front and centre" whenever decisions on health services are made

Mr Gething said: "It should mean when you engage with the health service it's even more honest and open about what it does and what it can't do.

"When something goes wrong it will be open about that as well and it should mean there's a greater and more visible drive to improve the quality of care that you and I should expect."

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Community health councils have cast doubt that the new "citizen's voice" body will truly represent the public or be able to hold health providers to account. There has also been criticism of a lack of detail.

Along with speaking up for patients, currently CHCs have the power to inspect hospital wards and can refer big decisions on service changes to the minister if they disagree with them.

But the new body will not undertake the latter two roles.

Cwm Taf CHC - which complained recently that it struggled to be heard expressing concerns about maternity services - had said the proposals "have the potential to significantly weaken" the citizen's voice rather than strengthen it.

The Board of Community Health Councils broadly welcomed the plans but Huw Jones, one of its independent members, said it was important that the new body builds on the work of the existing CHCs - and was able to act quickly on issues raised.

"Visiting hospitals on a daily basis and talking to patients about their concerns has been hugely important - so it's essential that we keep that and that it's safeguarded," he said.

The Welsh NHS Confederation - which represents health boards - previously said the current CHC model was "not fit for purpose" and patients using social care needed more of a voice.

Nesta Lloyd-Jones, interim director, said the duty of quality reaffirmed NHS Wales' commitment to continuous quality improvement.

"We believe the duty of candour and a new citizen's voice body, which strengthens patient involvement across health and social care, will add momentum to changes in organisational culture and behaviour," she said.

But Conservative health spokeswoman Angela Burns AM said she had serious concerns over the plans for the patient voice.

"We know that across Wales there are huge disparities in standard of care, and to take away the boots on the ground in the most vulnerable corners of Wales is sending the wrong message to health service users," she said.

"Welsh Conservatives recently announced that we would fight to protect the independence of Wales' Community Health Councils, and we will continue to do this by speaking out against this proposal."