Message from Healthwatch Camden Director – Frances Hasler

Sustainability is high on my concerns just now. It is one of the NHS buzzwords of the year – we are asked to take part in shaping “Sustainability and Transformation Plans”.

To be sustainable is to have an ability to keep going and to thrive in the longer term. Environmentalists look at problems such as decline in the number of bees, and look for ways to change the environment to make it more bee friendly. When the concept is applied to public services, it usually means looking at the pressures that services face – increasing demand and fixed or smaller income – and working out what they can change: doing more with less. It rarely feels as if it is focused on the sustainability of us, as thriving humans.

But, the pressures on services are undeniable, so if we want to thrive as local residents and citizens it is a good idea to think about the future of the services we rely on. The drive for sustainability can offer opportunity, because it is forcing services to think radically. Citizens have as much wisdom as anyone else when it comes to finding the answer.

The necessity to do things differently means that all aspects of the way a service is provided can be challenged and changed. Unhelpful aspects of bureaucracy or out of date aspects of clinical practice can be identified and stopped. Already, the need for some visits to clinics is being removed by giving patients their own monitoring equipment, where they can just e mail or text results to the clinic staff. Online access to our own records means we can check our own test results – and a doctor can still monitor them to follow up if there is any concern. People using social care have been able to choose to take a direct payment rather than a standard service for many years now. It gives them the power to use the budget to meet their needs in the way they find best. The same opportunity is being offered for health care.

One of the roles of Healthwatch Camden is to make sure that these opportunities are offered in a way that is genuinely helpful. For direct payments, the money on the table must be a realistic sum. For all self-care methods, advice and support must be freely available. Pretending you are “empowering” people by simply passing the problem of doing more with less on to them is not acceptable.

Our ambition is to work with local citizens to agree the innovations that will work best for all of us. We know that there are some aspects of service that no-one wants to lose: prompt, compassionate, professional care when you are acutely ill; systematic and supportive monitoring of long term conditions; dignified and reliable support at home. There are some aspects of service that could be better: now is the time to design them into the new system.

Share your ideas for what could be better if it was done differently – e mail us at or comment below.