Why are services changing?

Health and social care services are changing to become more efficient and better at providing the support that people want. If services are to get these changes right, it is important that they work with local people to give them a say in decisions.
Health services are changing. Make sure you have your say

Here we explain more about why services are changing, the work the Healthwatch network is doing to ensure people's views are sought and listened to, and how the public can get involved. 

We face big health and care challenges

Our society faces big challenges when it comes to people’s health and the services that support them.

More people are living longer with health conditions, such as dementia, which means they need ongoing care. Lifestyle factors, like a poor diet, are contributing to growing problems such as obesity.

The growing demand for support from services comes at a time when the cost of care is increasing.

However, factors like advances in technology and the way services work also mean there are opportunities for services to better meet public expectations and for individuals to take greater control of their health, care and wellbeing.

A changing world

Rising demand:

  • 1,000,000 people are projected to have dementia in the UK by 2021. People are living longer, which means more individuals with long-term conditions need support.
  • We are 20% less active than in 1961. Lifestyle factors, such as smoking and a lack of exercise, have a negative impact on our health.

Rising costs

  • NHS faces a £30 billion funding gap by 2020. The rising demand for help, technological innovation that needs investment and other factors are increasing the cost of care.


  • 73% of adults access the internet every day in the UK. The public are increasingly using technology to manage their own care and interact with health services.
  • 11,000 people now have hearing devices implanted under their skin. Medical innovations and technological breakthroughs have the potential to improve treatment outcomes.

Response from Government

In 2014, the NHS published the Five Year Forward View which aims to make health and social care services more efficient, effective and centred on the needs of individuals.

The strategy set out plans to break down the barriers between family doctors and hospitals, between physical and mental health support, and between NHS and social care systems. As well as reforming services so they work together to support all the health conditions we face, the Five Year Forward View also aims to give people more control of their own care.

Our role

The Five Year Forward View is now being delivered through a range of initiatives involving the NHS and local Government. We want to make sure that people's views across the country are taken into consideration by these initiatives.

Putting people at the heart of service change

In November 2016, and March 2017, we brought together local Healthwatch and NHS leaders at two conferences to review the extent to which local communities have been involved in shaping STPs to date and the opportunities that exist for making sure this happens in the future.

What needs to happen next?

Several clear themes emerged from debate and discussion at the conferences on what should happen next. These included:

  • The need for the NHS to clearly explain STP proposals to their communities in clear, accessible language.
  • STP proposals taking into account the needs of, and ensure equality of access for, disadvantaged groups. Local Healthwatch can play a specific role in helping the NHS talk to seldom heard communities.
  • The importance of involving the wider voluntary, charitable and social enterprise sectors in local conversations about STPs.
  • The need for NHS England and Healthwatch England to promote good practice and successful examples of when the public have been involved in health reforms.
  • The need for both the NHS and local Healthwatch to make clear to people how their views have been used.

Find out more

Share your thoughts

You can help make a health and care services better by sharing your experiences and ideas. Find your local Healthwatch.

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