Introduction

Whilst browsing the BBC website late on June 27th, I learnt that the organisation, (with all of its attendant concepts and values) to which I had dedicated 13 years of my life was to be abolished. There had been no prior warning, no time to prepare myself. Worse that that (from my perspective) was that there had been no time to prepare our staff, volunteers and Directors, people who are still giving so much to Healthwatch Warwickshire, for the shock they were about to experience.

I deliberated long and hard before putting my feelings on the termination of Healthwatch on paper. I wanted to allow my shock and anger at the way this has been done to abate before responding.

The views I express in this paper are entirely my own and in no way represent the official views of Healthwatch Warwickshire CIC, it’s Board of Directors, staff or volunteers.

What Healthwatch does

Healthwatch Warwickshire, was established in 2013, acting as a bridge between the patients and public, and those who commission and provide services. For over a decade, we have provided an accessible channel for patients, families, and carers to share their experiences,  collecting feedback, investigating concerns, and influencing improvements across the NHS and social care sectors.

It has taken many years to accomplish, but Healthwatch is now uniquely placed within the complicated machinery of the health and care system. Our remit is broad but clear: listen, reflect, and challenge. We didn’t just gather complaints or praise; we look for patterns, highlight inequalities, and champion the voices of those who are most frequently ignored.

Our approach was equally clear: we do not give opinions; we simply articulate what the evidence is saying. We had no interest in catching anyone out; our objectives are all about service improvement. We took our role as critical friend very seriously; we took pains to ensure our reports were robust and balanced. We did not flinch in standing up for the rights of patients and the public when it was needed.

We have also been unashamed advocates of the idea of permanent engagement. This is a process where service providers and commissioners engage with communities on a continuous basis, most likely through community or voluntary groups, to build up trust and make it more likely that we will hear the authentic voices of local people. This seems a much more powerful concept than the  idea of engaging with local communities only when significant service change is being proposed.

The Symbolism of Abolition

The decision to abolish Healthwatch is symbolically potent. It raises questions about the direction of health policy—are efficiency and structural reform to be prioritised over engagement and inclusion?

Having personally witnessed the transformative power of Healthwatch’s dialogues, I would be deeply saddened by this loss. Not just for my specific organisation, but for a principle: that the people who use services must be at the heart of how they are designed and delivered. Nothing about us without us.

The abolition conjures mixed emotions—disappointment, anxiety, but also a lingering hope that the spirit of Healthwatch will survive elsewhere. I worry that without a dedicated, independent champion, the system may become more insular, less attuned to the real life, often subtle nuances of patient’s lived experiences. The risk that concerns once surfaced through Healthwatch may now go unheard or unaddressed.

Personal Encounters and Stories

I am also fearful that the voices and lived experiences of patients and carers will become little more than one source of data feeding into the commissioning process. Healthwatch is, above all else, about stories—real accounts from real people. I recall speaking with individuals whose voices had been amplified by Healthwatch: the older resident whose care home was transformed after a Healthwatch report; the parent whose concerns about paediatric services were finally acknowledged; the nurse who found validation and support through patient feedback. These were not isolated tales but recurring themes that illustrated the compelling power of collective advocacy.

On a personal level, I have attended public engagement events where Healthwatch representatives brought clarity, calm, and compassion to often heated debates about local service changes. The ability to calmly sift through conflicting perspectives and present clear, evidence-based perspectives was often invaluable. The absence of Healthwatch may leave a vacuum—how will we now collect and synthesise the fragmented voices of patients and carers? How will we ensure those voices are not just heard, but acted upon?

The Significance for Frequently Ignored Communities

A particular strength of Healthwatch Warwickshire has been our commitment to engaging with communities often marginalised in mainstream consultations. These people have been variously described as hard to reach or seldom heard, we have characterised them as Frequently Ignored. They are most assuredly not hard to reach if you take the time and trouble to find out how best to communicate and engage with people on their own terms.

I like to think that people with disabilities, minority ethnic groups, LGBTQ+, travellers, boating community and many others have all found in Healthwatch an ally. By proactively seeking out these voices, Healthwatch challenged assumptions and ensured that service design reflected the true diversity of need.

The abolition raises concerns about widening inequalities. Without a dedicated platform, those frequently ignored may become even more isolated. The risk is not merely theoretical—it is a lived reality for many who already struggle to access care or make themselves understood within complex bureaucracies.

Accountability and Transparency

One of Healthwatch’s greatest contributions in debate across the system is to transparency. Our reports are public, the processes open, and our remit clear. By publishing findings and conclusions, Healthwatch Warwickshire has held a mirror up to the powerful, often prompting action and, occasionally, uncomfortable conversations. This has always been done in an evidenced, respectful, and balanced but firm way. One of my concerns is that the abolition could easily feel like a step away from openness—will any alternative mechanisms be as rigorous and as public-facing? I hope so.

If the abolition of Healthwatch Warwickshire does proceed, I believe that any replacement or alternative provision must not lose sight of the need for properly informed scrutiny. The patients and public deserve a window into how decisions are made, how complaints are handled, and how improvements are implemented. Without this, trust in the system may erode, and cynicism may become entrenched.

The Challenge of Replacing Healthwatch

I am not naïve enough to imagine that Healthwatch was perfect; like any public body, it faced challenges such as underfunding and limited reach. Yet its abolition presents challenges of its own. What will replace it? Will new models of engagement emerge, or will patient involvement become a box-ticking exercise?

In reflecting on its absence, I am struck by the need for innovation. Perhaps continuous engagement, new technologies and grassroots movements will fill the void, allowing for more direct and immediate feedback. Maybe the lessons learned from Healthwatch—about listening deeply and acting transparently—will inspire new forms of advocacy. But this transition is not guaranteed, and the journey will not be easy.

What Should Be Preserved?

It must be the principle that the voices and lived experiences of patients, carers and residents must be at the heart of the design, delivery and evaluation of all health and care services. Health systems are at their best when designed with, not for, those who use them. The courage to listen, the humility to change, and the commitment to serve must inform every future initiative.

Where Healthwatch is best placed to uphold those principles and to serve the interests of patients, carers and residents then thought could be given to exploring ways to enable the service to continue.

In any event preserving the ethos of Healthwatch, our dedication to inclusivity, openness, and responsiveness, should surely be a priority for policymakers, commissioners, practitioners, and communities. Those values are not inevitably bound to any single institution; but they can, and must, survive any changes that are made.

Conclusion

The potential abolition of Healthwatch could be a watershed moment in the history of patient and public involvement and engagement in health and social care. If/when it happens it demands both mourning and resolve: mourning for what is lost, but a real resolve to sustain and renew the values that Healthwatch represented. My personal reflections are, inevitably, tinged with sadness; after all I have given much of my life to Healthwatch. But I also have hope—a hope that new forms of advocacy could emerge, and that the voices of patients, carers, and communities will never again be relegated to the margins.

In the end, the greatest tribute we can pay to Healthwatch is action: we must collectively demand that our health and social care system remains, always, attentive to the needs and aspirations of those it serves. The challenge is daunting but vital—one that we, as a society, cannot afford to ignore.