Listening exercise: how to get involved

You can get involved with the NHS listening exercise in a number of different ways.

There are four themes to the exercise and you can read more about them at the links below and leave comments publicly:

If you want to submit comments privately, please use our online form.

You can also download a form and return it by email or post: download NHS Listening Exercise

Email to:
Send to: NHS Modernisation Listening Exercise, Room 605, Richmond House, 79 Whitehall, London SW1A 2NS.

You can also request alternative versions of any of these documents by contacting us using the above details.

All responses and views should be submitted by 31 May 2011 to inform the Government’s response to the listening exercise.  However, we would be grateful to receive responses as early as possible so that they these can help shape the NHS Future Forum’s initial advice to the Prime Minister, Deputy Prime Minister and the Secretary of State for Health, which is due to be submitted by the end of May.

There will also be events running in every part of the country during the next two months. This will give people a chance to share their views in person – from specific events for NHS staff, to others involved with the NHS, and those already involved in making change.

You can keep up to date with the latest coverage and announcements on this website or by following us on Twitter.

In Conversations, Listening exercise: Get involved, NHS Future Forum: Pausing, listening, reflecting, improving, Pathfinder Learning Network, Working together for a stronger NHS

47 Responses to Listening exercise: how to get involved

  1. Frank Roberts says:

    I have just heard on BBC News 24 the most compelling reason for abolishing PCTs. 50% of them adhere to NICE guidelines whilst the rest either pay lip service or disregard them altogether. No wonder there is no standard NHS across the country.
    Perhaps the Nhs suited brigade are not the best people to carry out root and branch changes, they are not going to vote themselves out of a job.

    • timothy doust says:

      a comment from my local mp east worthing

      ” so we can get services to as many people as possible with limited resources ”

      not everyone then ….
      i expect the suits will be ok in bupa

  2. Liam Holloway says:

    These reforms should not be introduced due to the basic fact that the Minister has no democratic mandate from the British public to introduce these changes.

    Neither party in the coalition government included these reforms in their election manifestos, so the British electorate have been denied the opportunity to vote on these proposals.

    Most experts agree that the nature of the reforms will change the way the NHS works significantly, the majority of opinion being that it will seriously undermine the principles of the NHS. This is why it is important that the electorate should be allowed the opportunity to vote on these proposals.

    It is clear, the next step in the process should be for the reforms to be suspended until the issue is put to the country, in an election. To do otherwise is totally undemocratic and fuels the suspicion that the Government is reluctant to put the matter to the country for fear of the negative result.

    • John Harvey says:


    • Ian K. Iles says:

      ‘Reforms’? Shome mishtake, shurely. These are changes, and they are deforms as much as they are ever reforms.

      When government is reduced to dodgy data, misrepresentation & lies to justify its actions, then we should be very doubtful of what underpins the proposed changes. When the plans now revealed were clearly established pre-election, we should rightfully question why they were kept so very quiet.

      No mandate for change from the British people, no evidential basis for the proposed changes, but plenty of blind assertion, misrepresentation & lies.

    • Jennifer Martin says:


      The government responds to all criticism of this bill by saying that we must do something and that keeping the status quo isn’t an option.

      It’s like the classic Yes Minister quote, “Something must be done. This is something. Therefore we must do it.”

      But I don’t think anyone believes that the NHS is perfect and no change is needed, but where is the evidence that this change is the way to go? In fact the evidence shows that over the last 10 years we’ve had massive improvements in the NHS in terms of outcomes and satisfaction. Surely what we should be doing is building on what has been shown to be successful? And from what I understand, improvements have been largely down to clinicians / providers working together, not competing with each other. Oh, and of course – using the best evidence available to make decisions – where is the evidence that the proposed changes will lead to improvements.

    • Sam (Nurse) says:

      Absolutely! Not only was this not in the manifesto, but it was stated that no ‘top down reorganisation’ would happen. This is complete hypocrisy. Patients and staff are being hoodwinked.

    • Tanya Watson says:

      Agreed – they led us down the garden path and when we weren’t looking concreted it over behind us! Put it to the election and let the people decide.

    • NHS Manager says:

      There’s no way that these reforms would make it into a manifesto!!!

  3. Francesco Palma says:

    I would be grateful to receive details about applying to join the National Reform Forum in open competition as a patient representative unless of course a ‘Top down’ approach has been taken. Whatever the case please response.

  4. Robert Irving says:

    The Secretary of State should remain responsible for providing a comprehensive health service, as at present, not just for promoting one, as the Bill proposes.

    His Bill leaves each Consortium free to decide what services we should have, in light of what competing providers will offer at a given price. The universal right to a comprehensive service would disappear.

    2) The Secretary of State alone should be able to impose new or higher charges for health services, whereas the Bill allows Consortia to impose them. No more elements of care should be subject to payment via ‘top-ups’ – i.e. fees. The government should be responsible for maintaining the principle of free comprehensive care, instead leaving it to decisions of Consortia.

    Consortia should be responsible for providing services to everyone in a given area, and funded to cover everyone who lives in that area, whereas under the Bill they will only be responsible for people registered with one of the practices in the Consortium. This is essential to the preservation of a universal comprehensive service.

  5. Lucy Smith says:

    One of the issues I think that hasn’t been debated is the size of commissioning bodies. For example, a PCT that covers an Inner London borough surrounded by big acute foundation trusts has, in my experience, little clout. It is like David and Goliath. If we are continuing down the market route and concept of purchasing health services then only by having larger commissioning bodies can we improve quality and be more cost effective. GP consortia look like they are by and large mirroring PCTs in Inner London, so I don’t see any difference in purchasing power. Worst of all the decision making will come from people from the same profession rather than a diverse mix of stakeholders eg. those that sat on PCT Boards. I really don’t see how these changes are going to improve commissioning of healthcare or result in equitable decision making for our communities.

    • Brian Stewart says:

      I agree. Derbyshire’s proposed consortia will have populations ranging from 600,000 down to 60,000. How can the relatively tiny budget allocated for a population of 60,000 be expected to cope with the unexpected or unusually expensive treatments. Post-codery is going to be more prevalent and marked than ever.

  6. felix greaves says:

    Where is the best place to make comments about public health?

  7. Mark Loftus says:

    It’s a shame that this ‘listening exercise’ is designed with such painfully leading questions. If you are genuinely interested in listening then the questions should be phrased using neutral language and not assuming that there is support for increased choice when there is not.

    There is no evidence that increasing choice is the most efficient intervention to improve quality. Increasing choice decreases efficient delivery and effective use of funds.

    It appears that this listening exercise is a hollow PR sham.

    • Murmur says:


      I’ve responded anyway, but it does look like yet another one of those sham NHS “consultations” in which a decision has already been made and this is a PR fig leaf.

      Anyone else remember the “consultation” in 2000 over the NHS Plan? I attended one of the last staff “consultation” events and the damn` thing was published a week later: since when did the Department ever do anything that quickly?

    • margaret reeve says:

      I agree with your comments 100% this is an exercise to tick a box that says we have listned and consulted NO goverment has not listened in this instance.Continueous changes are expensive and unneccesary particularly at such a time where budgets cuts to frontline services have been so severe.By all means fix the bits that need it but lets stop the never ending saga of throwing the baby out with the bath water syndrome.Also to identify what could be improved we dont need a high powered expensive quango just ask patients WHAT THEY FEEL.

    • Tanya Watson says:

      agreed – the ‘pause’ at Westminster to undertake this listening exercise is just that a pause at Westminster. Everywhere in the country seems to be plowing on with changes even though the Health Bill is not through and shouldn’t be passed. What a load of rubbish – increasing choice – I don’t want to have more choice, some decisions are really hard to make as it is – I just want the best care, locally that I can get without having to travel miles and go somewhere I don’t want to just because it is cheaper – it should be a standardised charge across the country for each type of service so there is no ‘competition’. Cheaper doesn’t mean better.

  8. Iain says:

    I am wondering ig the British government has ever looked at other European systems.
    The Dutch model at the present moment considered the best in Europe. It is a private/public operation having the private insurance companies at its centre. The governemnt has a very strict inspectorate will keeps control of the whole system.

  9. Rachel R says:

    As a parent of a disabled child, I am terrified by the proposals. My child needs comprehensive, multi-agency, co-ordinated care. He is extremely expensive in terms of therapy, medication, equipment and time. No GP consortia, with its eyes on the finances, is going to want my child on its patient list. He simply does not make financial sense. Handing over the budget to the GPs will mean that children like him will be less likely to receive the care that they need because decisions will be made at a micro level rather than at the level of a district or a city where there is an understanding of just how many people like my child there are and the burden is spread more easily. All feels a bit like eugenics by health insurance to me.

  10. Isla Dowds says:

    I have tried patiently and through various routes to get some information re’ There will also be events running in every part of the country during the next two months. ‘ No reply to my queries about how you are making this exercise accessible and inclusive. No information about events.
    Poor, poor show DH, how on earth do you expect people to engage and to have any belief at all in this process if you cannot even provide answers to specific questions about engagement opportunities, and the ways in which you will seek to make these equitably accessible.
    One more question – how are you going to demonstrate the impact of the contributions of those taking part in this process, by various means, on the proposals in the bill? How will these be fedback to the public?

    • web editor says:

      Hello Isla

      Thanks for your comments. We were not ignoring your previous questions, but are waiting for details of events to be finalised. When we have this information, we will publish it on this website.

      Regarding your last question, the Future Forum’s report to the Prime Minister, Deputy Prime Minister and Health Secretary will be made public. The Prime Minister has said that where there are good suggestions to improve the legislation, those changes will be made. Any changes will be publicised.


  11. Murmur says:

    Another example of how much of a sham this “listening exercise” is:

    my partner works for another trust in our area and is unable to complete the online response linked to above at work as access is denied.

    How many other trusts are blocking their staff from commenting on-line? How will this distort the findings? Why is such censorship being tolerated by the Department?

    A copy was printed off and will be sent in the post.

    • ecp says:

      Murmur – thanks for taking the time to respond by post. Sorry to hear that your partner couldn’t access the site. We’ve done our best to ensure the site is made available to as many web users as possible, but we are not able to influence restrictions on website access that are in place at a local level. Tim@DH

  12. Tom says:

    These reforms are ill-considered, are being rushed through too quickly and seem to be miss-representing the truth, for what to my mind are ideological purposes: some of the facts and figures used in the health reform leaflet seem to have been taken out of context and misrepresent the true picture (e.g. the Cancer survival rates on page 7, have been taken from a study looking at data from 1985 to 1999 – over ten years ago – much has happened since then!)

  13. Emily says:

    So far this government has succeeded in performing miracles!

    My disabled mother has now been officially declared cured and downgraded her care package! A miracle!

    Along with herself and other friends in wheelchairs she no longer needs the care that was essential up to a month previous and mow without it there’s no chance at a march in opposition.

  14. Mike Dalley says:

    A tobin tax would probably preclude the need for any cuts.

  15. C Roberts says:

    How does the consultation propose to reach those without internert access, and who are not in position to find out that there are alternative means of contributing, e.g. some pensioners for example may have not heard of consultation form and therefore wlll not have a say. Is there a media campaign, television and radio etc?

    • Kate@DH says:

      We are keen to reach as many people as possible and those without internet access can request a hard copy of the questionnaire if they contact the Department’s Call Centre. Details of how to write in or call the Department are available through this link:

    • Lucy says:


      For those of people without internet access, please follow this this link on how to contact us?!?!

      1. how on earth will they know about this campaign without internet access.

      2. they don’t have internet access so couldn’t possibly follow a link.

  16. Helen Le Bretton says:

    I have read through quite a lot of the replys and I could’ent of expressed my feelings about the changes any more clearer than the replys, I quite agree with all opinions.Our NHS is a caring profesion so lets keep it that way, we are not a bussiness.

  17. D Ward says:

    The Guardian printed an interesting analysis by Ben Goldacre of the claims contained in the Listening Exercise leaflet on 16 April. Its in the ‘Bad Science’ column and concludes that “many of the figures [the leaflet] contains are misleading, out of date or flatly incorrect.” See

    • Ashley says:

      I was also shocked to see the crude use of black and white images to illustrate bad black managers and good white doctors! Together with the poor use of data and so-called facts, it should never have passed initial checks. Who edited this document and authorised it as fit for publication?

  18. D Ward says:

    The Guardian printed an interesting analysis by Ben Goldacre of the claims contained in the Listening Exercise leaflet on 16 April. Its in the ‘Bad Science’ column and concludes that “many of the figures [the leaflet] contains are misleading, out of date or flatly incorrect.” See

  19. Kate in Ringwood, Hampshire says:

    Let’s try to be a bit more positive.
    First, improve the working conditions of High Street healthcare staff so they stay in their jobs long enough to complete their training, then drip feed the changes one at a time.

  20. Christopher Smith says:

    “We are keen to reach as many people as possible and those without internet access can request a hard copy of the questionnaire if they contact the Department’s Call Centre. Details of how to write in or call the Department are available through this link:

    This shows that the mandarins at the DH may be listening, but they are not hearing, I do hope that they will hear what is being said during this “listening exercise” and not merely be “listening”.

    The Rt Hon SoS for Health has no mandate for
    these changes and very little support from the staff at the front line. We hear that most of England is signed up to pathfinders but this is a misleading statistic which includes many practices who may not support the reforms, but who don’t want to be left behind, should they go ahead.

    Pause and listen, but also hear what is being said. Start by writing to every health user in the country, using snail mail, so that everyone is given a chance to comment during this “not listening exercise”. This will ensure that the sickest and most vulnerable in this
    big society, who may nor have access to a computer, are given the opportunity to raise their concerns.

  21. Pete says:

    I see changes all around, monies need to be saved, that I am aware. The thing that totally annoys me is that at this moment in time our Directorate is going through a consulation to reduce staffing levels but at the same time, the same Directorate is going out to tender for a Private company to take over. With the threat of “UP TO” 40 redundencies BEFORE the move away from the N.H.S surely NOT losing the jobs would save the N.H.S. so much more by letting the New company sort out the staffing levels when all have been moved over?

  22. Ernie says:

    Excessive use of commercial providers will destroy the NHS. When they provide say 40% of services they can dictate to the government. If there is another need to trim costs in future, they will decline to bid for contracts if they deem them not to be in the interests of their shareholders. The NHS provision will have been reduced to 60%, and will not be able to replace the withdrawn commercial provision. What will the government do? They will cave in, just as they did with the banks, just as they are about to do with the North Sea Oil Tax.

  23. Dr Tom Yates says:

    It is difficult to know what to do with this. I have elected to submit responses to the questions to prevent Lansley claiming support. However, I feel the consultation is deeply flawed and imagine many self-respecting people will boycott this exercise.

    As BigSocietyNHS have pointed out, the leading nature of the questions is outrageous. For example, on the question ‘Are we doing enough to make sure the NHS at a local level has the freedom it needs to take locally-based decisions?’, they point out ‘There are two possible answers to this question. Either you say the DoH are doing enough, and then they can write a press release saying “Our reforms supporting local decision making are supported by the population”. The second option is to say that the DoH are not doing enough, and then the poor DoH interns can write a press release saying “The public want us to do more to remove centralised planning in the NHS”. Either way, Lansley is leading you to the answer that he wants to hear.’
    The public, the BMA and the RCN have already roundly rejected the proposals. If Lansley had been listening, he would have heard. As Laurence Buckman has already pointed out “Having a large number of GPs signed up to consortiums doesn’t prove they are in favour of the reforms. Just because someone gets into a lifeboat doesn’t mean they support the sinking of the ship.”

    I have worked in the NHS in various capacities for almost a decade – currently as a junior doctor. I can think of numerous ways in which the service could be improved. None are in Lansley’s proposals. Whatever the conclusions of his hand picked panel or this rigged listening exercise, I urge the coalition to reject these hugely damaging proposals.

  24. Peter Grand says:

    I worked in the NHS up to last month – now we are a “Community Interest Company”.

    I thought that I worked for, and was accountable to, the people of this borough.

    Now, I find that I am working for a set of performance management targets, and the managers pull my strings in the name of Finance.

    Any “expertise” that I had developed is worth nothing when all is worked out on paper up there.

    I used to have a vocation – now I have a job.

    • NHS Manager says:

      1. CIC’s are accountable to the local community.

      2. Without performance management the services provided cannot be held accountable to anyone

      3. With respect to targets….remember the 2 week referral for cancer….was that such a bad thing?

  25. Ann Whyte says:

    I have not read one comment supporting these changes so far – does that not speak volumes and if the Government is truly listening to the public should they not seriously reconsider this Bill?

    I am a nurse working within the NHS for 32 years and certainly cannot support these changes.

  26. Jo says:

    Could we have an update on dates and how to attend the national listening events. We really need to give members of the public as much notice as possible.

    Many thanks

  27. Fi says:

    I see above that in response to a query the DH web editor says
    “.. the Future Forum’s report to the Prime Minister, Deputy Prime Minister and Health Secretary will be made public. The Prime Minister has said that where there are good suggestions to improve the legislation, those changes will be made. Any changes will be publicised.”

    This suggests that only alternative suggestions will be listened to and factored in any amendments as a result of the “Pause”. What about the many comments that have been made about how undemocratic the reforms are in the first place as the coalition does not have a mandate – That neither party in the coalition government included these reforms in their election manifestos, so the British electorate have been denied the opportunity to vote on these proposals. Will this be listened to so that a referendum can be held and we the taxpayer – whose healthservice this is – get to make a democratic choice about what we want to happen to our NHS.

  28. Kath Horner says:

    I work on the basis of using upto date evidence to support interventions in health service delivery. Everything to date that this Conservative led Coalition has done is not based upon evidence to support effectiveness of Lansley’s proposed interventions. It is ‘ideology led’. Privatise the NHS and we will get markets competing on price and the quality of care will not go up for patients.

  29. Dave O'Carroll says:

    I am incredibly proud to live in a country which provides healthcare free at the point of delivery. In this respect, we are quite rightly the envy of many many other countries in the world. I am very happy to look at the difference between my gross pay and my net pay each month and think, some of those taxes are being used to fund the NHS. However, I don’t live in a fantasy world, and as such, I know that every organisation has good points and bad points: in that respect, the NHS is no different to any other organisation throughout the world. It should strive to improve its good points, and reduce its bad points. But let me tell you, I’m also not arrogant enough to think that I personally know more than those people working in the NHS and healthcare sectors on how to get this balance right, and quite frankly, nor should Andrew Lansley assume that he personally knows more than those people working in the NHS and healthcare sectors. What is it with perfectly reasonable people, who suddenly find themselves in a position of authority, and then go power crazed?

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