2023 PhD Project
About The Project
The Health and Social Care Act 2012 requires NHS organisations to involve patients and the public in decisions about how services are planned and delivered. However, the legislation does not specify how this should be done, and research (e.g. Heath 2018) has highlighted the need for the NHS to become more democratic and accountable to the people it serves. The Darzi Review (2024) echoed this, concluding that ‘the patient and public voice is not loud enough’ and that there is greater potential for people to shape how services are designed and delivered.
In May 2025, NHS England published an update to the Model ICB Blueprint, providing guidance for Integrated Care Boards (ICBs) during a period of rapid transformation. Although it does not outline new legal requirements, the update places greater emphasis on the importance of working with people and communities. It describes co-design, co-production, and deliberative dialogue as core elements of service planning, highlighting the requirement for commissioners to collaborate closely with service users and the wider public to shape strategy. Further detail is expected in the 10-Year Health Plan, due in June 2025.
This shift reflects a broader movement known as New Public Governance (NPG), an approach that moves away from centralised, top-down models of decision-making and instead prioritises collaborative, networked ways of working. NPG emphasises partnerships between the NHS, local authorities, voluntary sector organisations, and people and communities. It positions the NHS not just as a service provider, but as part of a wider system that responds to local needs, includes diverse voices, and shares responsibility for improving health outcomes. This ethos underpins the work of Integrated Care Systems (ICSs), which aim to embed more participatory, place-based approaches in health and care planning.
Nottingham University Business School has been working with the Nottingham and Nottinghamshire Integrated Care Board (NNICB) to explore and strengthen participatory approaches to local health planning. NNICB is committed to a more inclusive and engaged way of working with citizens than has historically been the norm in the NHS, presenting a valuable opportunity to study how an NHS organisation makes this transition. Feedback from this research will continue to shape NNICB’s approach to local engagement, strengthen our existing collaboration, and contribute to the development of NHS services in the region.
This project has been co-created and is supported by researchers from Nottingham Trent University, the University of Nottingham, and partners at the Nottingham and Nottinghamshire NHS Integrated Care Board.
Project Aims
The project aims to answer the following research questions:
- How does the NNICB gather, understand, and use the views and experiences of people and communities to inform service provision and development?
- What do local NHS stakeholders think about the citizen engagement strategy currently used by the NNICB?
The Project Team
- PhD Candidate: Julia Cons
- Lead Supervisor: Professor Stephen Timmons, UoN
- Co-Supervisor: Dr Ana Isabel Nunes, NTU
- Community Supervisor: Prema Nirgude, Nottingham and Nottinghamshire NHS Integrated Care Board