NHS Citizen, UK

Planning to improve or reinvent an existing high-impact policy? Want to include citizens in this debate to receive their feedback? See, how they did it at NHS Citizen.

Client Introduction

NHS Citizen (National Health Service Citizen) is a national program to give the public a say on healthcare matters and influence NHS England decision making.


NHS Citizen was commissioned by the board of England's National Health Service and designed to bring the views of patients, service users, and the general public into the policymaking process.

Together with Democratic Society, they created an innovative space for deliberation, where anyone in the country could propose policy and debate ideas, then vote on which proposals should go to an in-person assembly of citizens and referred directly to the national board of the NHS. In order to increase the level of consensus and facilitate an efficient dialogue, a mechanism for real-time feedback and consensus-building was required.

D21 solution

In September 2015, D21 joined with Democratic Society and offered NHS Citizen the ability to use D21 voting to choose among the proposals they wanted the board of NHS England to discuss with them.


The D21 style vote during the assemblies helped to produce a greater level of flexibility and consensus. Democratic Society's Director, Anthony Zacharzewski, noted that “D21 were a committed and responsive partner, providing a smooth and efficient voting system that smoothed the process of selecting between highly sensitive and difficult issues.

Talking about health care should be inclusive. D21 makes sure it is along with being efficient and consensus-oriented!


Citizens' Assembly

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