Equality assessment for NHS 10-Year Plan overlooks loss of independent patient voice, Local Healthwatch leaders warn

Local Healthwatch leaders have warned that the Government’s Equality Impact Assessment (EQIA) for the NHS 10-Year Health Plan fails to properly consider the loss of independent patient voice and scrutiny.

While the EQIA frequently refers to “patient voice” and “feedback,” it largely relies on NHS-owned digital tools such as the NHS App, surveys and metrics. Healthwatch argues this risks replacing meaningful, independent engagement with system-controlled data collection — particularly excluding people who already face barriers to care.

“Patient voice cannot be independent if it is owned and controlled by the system it is meant to scrutinise,” said Sabrina Taylor, CEO of Healthwatch Nottingham & Nottinghamshire.

For over a decade, local Healthwatch organisations have provided independent oversight of health and care services, supporting people from marginalised communities, those who have experienced poor care, and those unable or unwilling to use digital systems. National research shows that although many people experience poor NHS care, very few complain, and many who do are dissatisfied — highlighting deep issues of trust.

The EQIA does not address the risk that protected or marginalised groups may disengage from NHS-owned feedback routes, nor does it consider the importance of independence in rebuilding trust and accountability. Proposals to absorb Healthwatch functions into NHS or local authority structures offer no clear safeguards for independence.

Healthwatch is urging the Government to meet its legal duties under the Public Sector Equality Duty and fully assess the equality impact of removing independent patient voice — warning that failure to do so could widen health inequalities rather than reduce them.