Local Healthwatch outcomes and impact development tool · 2019-06-05 · Local Healthwatch outcomes and impact development tool 3 Introduction This outcome and impact development

Health, adult social care and ageing

Local Healthwatch outcomes and impact development toolVersion 2 March 2014

2 Local Healthwatch outcomes and impact development tool

Introduction 3 How the Tool can be used 4 How the Tool is organised 4 Thefirstfoursections–thegrid 5 BlankgridforlocalHealthwatchtoaddoutcomesbasedonlocalpriorities 5 Resources 5 Wickedissues 5 Methods 6

Section 1: governance Visionandmission 7 Accountabilityandtransparency 10 Form,systemsandmanagementarrangements 13 Culture,skillsandlearning 15

Section 2: finance Financialmanagement 20 Accountingandreporting 22 Effectiveuseofresources 23 Financial sustainability 24

Section 3: operations Accessibility 26 Influencing 28 Informationandsignposting 31 Beingacommunityvoiceandconsumerchampion 34

Section 4: relationships Relationshipswithcommunityandconsumers 40 Relationshipswithkeylocalpartners 47 Relationshipswithproviders 58

Section 5: blank grid for local Healthwatch to add outcomes based on local priorities 67

Section 6: resources 68

Section 7: wicked issues 74

Section 8: methods 77

Contents

Local Healthwatch outcomes and impact development tool 3

Introduction

ThisoutcomeandimpactdevelopmenttoolhasbeendesignedtopromotethedevelopmentoflocalHealthwatchasanindependentorganisationthatcaneffectivelyandefficientlydeliveritsfunctions.

It is intended to assist local Healthwatch identifywhatoutcomesandimpactsa‘Good’localHealthwatchcouldachievethroughthedeliveryofitsfunctions.Thetooldoesnotstate‘whatgoodlookslike’-thatiscontainedintheresource‘DeliveringLocalHealthwatch’.

‘DeliveringEffectiveLocalHealthwatch’updatesandrefreshestheresource.‘DevelopingEffectiveLocalHealthwatch’publishedbeforetheofficiallaunchofHealthwatch.

SowhenyouaresettingyouroutcomesandimpactsforlocalHealthwatchitiswisetopayattentiontothecontentof‘DeliveringLocalHealthwatch’,asitwillhelpcouncilstounderstandbetterthecommissioningoflocalHealthwatchandreviewhowwelltheirlocalHealthwatchdeliversitsrolesandresponsibilities.ItcanalsohelplocalHealthwatchorganisationsdeveloptheirunderstandingofwhatisexpectedofthemandhowtheycandeliverbestpractice.

‘DeliveringLocalHealthwatch’seekstosupportsector-ledimprovementatacouncil

levelbyhelpingtoshapetheoutcomescouncilswanttoachieveintheirlocalHealthwatchcommissioningrole.Itisimportanttoemphasisethatthedocumentdoesnotcoverthecommissioningprocessitself,nordoesitcommentonorganisationalmodelsforlocalHealthwatch.

HavingalocalHealthwatchthatunderstandswhatisexpectedofitandhowitcandeliverbestpractice,isthefirststepinbeingabletodemonstrateoutcomesandimpactstheorganisationisachieving.

ThistoolprovidesarangeofoptionstohelplocalHealthwatchachievethis.Itsetsoutsuggestionsforgoodpracticeanddiscussesopportunities,dilemmasandsolutionstoassistlocalHealthwatchtonavigatethecomplexitiesinvolvedindevelopinganeworganisationwithachallengingrole.

ItpresentsamenuofoutcomesandimpactsthatcanbeadoptedandadaptedbylocalHealthwatchandcouncilcommissioners.

ThetoolisjointlyproducedbytheLGAandHealthwatchEngland,andhasbeenshapedandtestedinarangeoflocalHealthwatchareas.WearegratefultothecouncilsandlocalHealthwatchorganisationsthathavecontributedtothetoolandcommentedondrafts.Thanksalsotothosewhohavesentcopiesoftheirownprotocols,outcomes,performanceframeworksandsuccessmeasuresfromwhichwehavedrawn.

Local HealthwatchOutcomesandImpactDevelopmentTool

The Tool recognises that:

• localHealthwatchareatdifferentstages ofdevelopmentsoneedtomoveattheirownpacewhilealwaystryingtolearnfromthe best

• local,regionalandnationalsystems,relationshipsandconceptsarestillbeingdeveloped,andtheviewsofpeopleusingtheToolaresoughtsothatitcanbefurthershapedandformedtomeetneeds.

How the Tool can be usedThisisaflexibleToolwhichcanbeadoptedandadaptedbylocalHealthwatchandbycouncilcommissionersoflocalHealthwatchandusedinarangeofdifferentwaysdependentonlocalcircumstances,forinstance:

• topromptdiscussionbetweencommissionersandlocalHealthwatch

• toinformkeystakeholdersandpartnerswith local knowledge about what Healthwatch is there to do

• todevelopalocaloutcomesandperformanceframework

• asawayofassessingprogressincomparisonwithlocalHealthwatchinotherareasandthroughpeerreview.

How the Tool is organisedLocalHealthwatch’sremitistoengagewithpeoplesothattheirviewsinform,shapeandimprovehealthandcareservices.TheToolisbasedondeliveringthoseoutcomesandlongerterm,widerimpacts.ItaimstoassistlocalHealthwatchandcommissionerstomovebeyondafocusonoutputssuchas

numberofmeetingsheldorattended,totheoutcomesthatlocalHealthwatchseekstoachieve-forinstancespecificimprovementstohealthorcareservicesbasedontheviewsofpeoplewhouseservices.InthelongertermitsuggestswaysofassessingtheoverallimpactoflocalHealthwatch’sworkonthewidercommunity,stakeholders,healthimprovementandhealthinequalities.

Aspubliclyfundedbodies,localHealthwatchmustbeabletodemonstratethattheyareachievingtheirobjectivesandthattheirorganisationisfitforpurpose.TheTooloffersasystematicwayforlocalHealthwatch,theircouncilcommissionersandthepeopletheyservetomovefromdecidingwhichoutcomeswillmeettheirobjectives,“Whatdowewanttheoutcomestobe?”,totakingaction,“Whatcouldwedotoachievethem?,tofindingwaystoassesstheirprogress,“Howwouldweknowwehavesucceeded?”

Thetoolispresentedinsixseparatelooseleafsections:

• Governance

• Finance

• Operations

• Relationships

• Resources

• Wicked Issues

Althoughthesectionsarepresentedseparatelythereareanumberof crosscuttingthemes.

Thefirstfoursections –thegridTobecomeorganisationsthatconsistentlydeliveronoutcomesandimpact,localHealthwatchneedtogetthefundamentalsofgovernance,financeandrelationshipsrightandtodevelopaneffectiveoperationalapproachasastablebasisfortheworktheydo.Thereforethegridbelowisdividedintofoursectionseachwithanumberofoutcomes:

• Governance

• Finance

• Relationships

• Operations

Eachoutcomewithinasectionisnumbered,egG1andG2aregovernanceoutcomes,F1andF2arefinanceoutcomesetc.Inevitably,therewillbesomecross-referencingandoverlappingbetweenthesections,aseachtopicconnectswiththeothersandtheactivitiesneededtoachieveoutcomesareinterdependent.Incross-referringoutcomesinthedifferentsections,itishopedthataricherpicturewillemergeofthepotentialandoverallaspirationsoflocalHealthwatch.

The grid should be seen as a guide only, notasaprescriptivelistof“mustdos”.Itisintendedtobeflexibleenoughtobeadaptedtolocalcircumstancesandwaysofworking.AblankgridispresentedattheendtosuggestthatlocalHealthwatchmaywishtousethegridtodeveloptheirownoutcomesandactionsbasedonlocalpriorities.

LocalHealthwatchwillneedtosetshort,mediumandlonger-termobjectivesandoutcomes.Theywillneedtothinknotonlyaboutwhattheywanttoachievein

theirfirstyear,butalsostrategicallyabouttheiraspirationsforthenextseveralyearstoenablethemtobecomeaneffectivecommunityvoice,consumerchampionandsustainablebusinessforthefuture.Eachsectionofthegridisthereforedividedaccordingly.AslocalHealthwatcharedevelopingdifferentlyacrossthecountry,nospecifictimescaleshavebeengiven.Thesearetobedeterminedlocally,basedonarealisticassessmentofwhatcanbeachievedwiththeresourcesandsupportavailable.

BlankgridforlocalHealthwatchtoaddoutcomesbasedonlocalprioritiesThissectioncontainsablankgridforcouncilsand local Healthwatch to record their locally developedoutcomesandimpacts.Toassistcouncils and local Healthwatch in their furtherdevelopmentandimplementationwe would encourage you to share any local outcomesandimpactswithcolleagues.

ResourcesThissectioncontainsalistofresourcesthatlocalHealthwatchmayfindhelpfulindevelopingtheirthinkingandplanningundertherelevantheading.LHWwillcertainlybeabletoaddtothissectionthemselves.

Wicked issuesInthissectionanumberofissuesarepresentedthatlocalHealthwatcharelikelytofaceinthecourseoftheirdevelopment.Therearenoprescriptivesolutionstothedilemmasdescribed–solutionswilldifferfromareatoarea.ThereforetheyareposedasquestionsforeachLHWtoconsiderindevelopingitsvision,objectivesandworkingpractices.Thedescriptionsof‘wicked

issues’mayalsobeusefulasthestartingpointfordevelopmentsessions,board,stafforvolunteerseminars.Again,localHealthwatch will be able to add to these as theyconfronttherealitiesofdevelopinganeworganisation.

Methods

Methods to provide evidence of outcomes and impactsThissectiondiscussesarangeofmethodsthatcanbeusedtoprovideevidenceof

agreedoutcomesandimpactsforalocalHealthwatch.Examplesaregivenofthekindofinformationeachtypeofmethodmightdeliver.LocalHealthwatchareencouragedtobeflexibleandcreativeintheuseofthem.

ContactingLGAHealthwatchImplementationTeamandHealthwatch EnglandIfyouhaveanyqueries,comments,orwouldliketospeakwithamemberoftheLGAHealthwatchImplementationTeampleaseemail:healthwatch@local.gov.uk. HealthwatchEnglandmaybecontactedatenquiries@healthwatch.co.uk.

Local HealthwatchOutcomesandImpactDevelopmentToolSection1:governance Vision and mission

What do we want the OUTCOMES to be? What could we do to achieve them? How would we know we have succeeded?

Short termG.1: MissionSee also R.1.LocalHealthwatchunderstandsitspurposeastheindependentconsumerchampionforhealthandsocialcare.

Developavision/missionstatementorequivalentinconsultationwithawiderangeofstakeholdersparticularlypeoplewhousehealthandcareservicesandlocalcommunities.

Staffandboardmemberscanexplain thevision.

VisionclearlyavailableonthelocalHealthwatchwebsite.

Medium termLocalHealthwatchunderstandsitspurposeandcommunicatesthiswidely;externalstakeholdersunderstandthepurposeoflocalHealthwatch.

Reviewmissionstatementwithdeepenedinvolvement-e.g.stakeholdershelp developproposals.

Undertakeawareness-raisingexercisewithlocalcommunities.

WidercommunitiescanexplainthepurposeoflocalHealthwatchandknowhowtocontactit(identifiedthroughsurveyor similarexercise).

MorepeoplewhocontactlocalHealthwatchshowunderstandingofitsrole.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchistrustedbypeoplewhousehealthandsocialcareservicesandbythepublic.

lFundamentalreviewofthevision/ missionstatement.

ConsultationonexternalperceptionoflocalHealthwatchamongstcommunities,users,carersandpatients.

ResultsofconsultationshowmajoritytrustandvaluelocalHealthwatchandbelieveitoperatesindependently.

Short termG.2: Outcome-based planningSee also O.4, R.1.LocalHealthwatchknowswhatoutcomesitistryingtoachieveoverthenextthreeyears.

Developanoutcome-basedthreeyearstrategy/workplan.

Consult on the strategy with local communities

Developaframeworkformeasuring whetheroutcomesandlongertermimpactarebeingachieved.

Boardconsiderstheresultsoflocalconsultation and agrees the strategy in light ofthis.

Strategyisonwebsite.

Boardagreesaframeworkformeasuringoutcomes.

Medium termLocalHealthwatchknowswhetherithasmetitsinitialoutcomesandtakesanyactionnecessarytoimproveitsperformance.

Boardreceivesregularreportsonprogress(e.g.quarterly).

Undertakeanannualreviewofprogressandrefreshthestrategywithgreatercommunityinvolvement.

AsfaraspossiblealignstrategywithprioritiesidentifiedinJSNAandJHWS.

AnnualreportmeetsrequirementsinHealthwatchDirections,andreflectstheissuesandprioritiesraisedbylocalpeople.

Annualreportiswidelypublicisedinanaccessibleformat.

Longer term IMPACT How could we measure IMPACT?Serviceschangeandimprovetomeet needsidentifiedthroughJSNAandalign withJHWS.

LocalHealthwatchvolunteersandboardmembersactivelyengagedindevelopmentofcommissioningplansanddesign ofservices.

CommissioningplansshowinfluenceoflocalHealthwatch.

Short term

G.3: Focus on priorities and clear communicationLocalHealthwatchisfocusedonachievingitsoutcomes,butmaintainscapacitytorespondtourgentissues.

LocalHealthwatchknowswhocanspeakonbehalfoftheorganisation.

Boardstructuresitsagendatofocusonoutcomesandperformancewithspaceforurgentissues.

LocalHealthwatchdevelopsacommunicationandmediapolicy.

Agendas,reportsandminutesarepostedpromptlyonthewebsite.

Relevantpoliciesandproceduresareagreedbyboardandplacedonwebsite.

Medium termLocalHealthwatchknowshowitisperformingontheaboveoutcomes.

LocalHealthwatchreviewsanydifficultdecisions/issuesithasfaced,identifieswhetheranythingcouldhavebeendonedifferentlyandamendspolicies.

Refreshedpoliciesindicatingwherechangesaremadeareplacedonthewebsite.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisseenasacredibleandeffectiveorganisationbypartnersinlocalauthorities,theNHSandotherstatutoryandvoluntaryorganisations.

Undertakeexercisesuchassurveyor360degreefeedbacktofindouthowlocalHealthwatchisviewedbypartnerorganisations.

LocalHealthwatchisworkingtowardsan organisational accreditation such as InvestorsinPeople.

Resultsofexercisearepositive.

Actionistakentolearnfromfeedback.

Accreditationisachieved.

Short term

G.4: Board skills and knowledgeLocalHealthwatchboardmembershipprofileincludesarangeofessentialknowledge andskills.

Auditmake-upofboardtoensuremembershiphasappropriateknowledgeandskills.

Considerco-optiontoincreaseskills.

Maintainsizeofboardtoreflectgovernance.

Identifyskillsneededonboardegfinance,leadership,involvement,localperspective,governance,businessdevelopment.

Boardmembersreflecttherangeofnecessaryknowledgeandskills.

Arrangementsareinplacetoaugmentskillsandperspectivesthrough,forinstance, co-option.

Medium termLaypeopleandvolunteerssuchaspeoplewhouseservices,carersandpatientsaredirectlyinvolvedinlocalHealthwatchgovernance.

Considerdedicatedrolesforconsumers.

Helppeopletodevelopskillsandconfidencetotakeanactiveroleingovernance.

Identifyothermeasurestoincreaseroleofcommunitiesinworkofboardsuchasadvisorygroup.

LocalHealthwatchincludestheperspectiveofpeoplewhouseservices/patients/carers.

Diversityofopportunitiesforinvolvement has increased while continuing to include therangeofnecessaryskillsandasizefit forpurpose.

BoardmembershipchangesovertimetoreflectlocalHealthwatchdirectionandfuturevision.

ResultsofconsultationshowmajoritytrustandvaluelocalHealthwatchandbelievesitoperatesindependently.

Accountability and transparency

Short term

G.5: Decision makingLocalHealthwatchisabletomakerobustdecisions,includingonhigh-profileissues.

LocalHealthwatchoperatestobestpracticein relation to:• enterandview

• useoftrademark.

LocalHealthwatchhasoperatingproceduresforhowdecisionsarereachedinlinewithRegulationsbasedonprinciplessuchas:

• reflectingtherangeofviewsnotjusttheloudestvoices

• independentdecisionsbasedonevidence

• reportswrittentoahighstandardofclarity,accessibilityandmethodology.

ConsidermessagesfromtheFrancisInquiryaboutmaintainingindependenceandfocusingonpriorities.

Enterandviewrepresentativesaretrained.

Proceduresareconsultedonwithstakeholders,amendedinlightofcomments,agreedbytheboardandpubliclyavailableonwebsite.

Medium termLocalHealthwatchdemonstratesthehigheststandardsoftransparency,involvementanduseofevidenceinitsdecision-making.

LocalHealthwatchreviewsitsoperatingproceduresinlightofexperienceandinvolvescommunitiesandpartnersin thereview.

LocalHealthwatchdevelopsstandardsforitsoperatingprocedures.

Proceduresredraftedinlightofexperienceandconsumer/partnerfeedback.

Standardsagreedandpubliclyavailable onwebsite.

LocalHealthwatchisseenasacredibleandeffectiveorganisationbypartnersinlocalauthorities,theNHSandotherstatutoryandvoluntaryorganisations.

What do we want the OUTCOMES to be? What could we do to achieve it? How would we know we have succeeded?

Short term

G.6: Involving local communitiesSee also O.2, O.3, R.1.LocalHealthwatchdemonstratestransparencyinallitsactivity.

Allreports,papers,minutes,policiesandproceduresarepubliclyavailableonlocalHealthwatchwebsite.

Anindividualisresponsiblefor updatingwebsite.

Websiteupdatedregularly.

Culture, skills and learning

Medium termLocalHealthwatchcandemonstratehowlocalpeoplehaveinfluenceddecision-making,prioritisationandrecommendations.

AlocalHealthwatchstakeholderadvisorygroupestablishedtoadvisetheboardonsignificantissues.

Mechanismsareinplacetofeedbacktopeopleconsultedhowtheirviewshavebeentakenintoaccount.

Influenceoflocalpeoplerecordedin relevantreports.

Influenceisrecordedinnewsletter/ newmedia.

LocalHealthwatchhasmechanismsfordiscussionswiththepublic.

Form, systems and management arrangements

Short term

G.7: Role and formLocalHealthwatchhasaformandstructurethatmeansitoperateseffectively.

LocalHealthwatchunderstandsitsdutiesandpowers.

LocalHealthwatchisclearabouttherespectiverolesofboardandseniorstaff.

Buildingonitsvision,localHealthwatchhasdevelopedaconstitution/operatingprinciples,inconsultationwithstakeholdersandlocalcommunities.

LocalHealthwatchworkstotheNolanPrinciplesofstandardsinpubliclife.

LocalHealthwatchhasasystemtoalloweffectivecommunicationbetweenboardandstaffegregularsupervision.

Boardamendsdraftconstitutioninlight offeedback.

Constitutionisavailableonwebsite.

Medium termTheaboveoutcomesareembeddedin theorganisation.

LocalHealthwatchreviewsandlearnsfromanygovernanceproblems.

Feedbackexercisebetweenboardandseniorstaff.

Refreshedconstitutionifneeded.

Resultsofstaff/boardfeedbackarepositive.

Longer term IMPACT How could we measure IMPACT?

LocalHealthwatchisseenasacredibleandeffectiveorganisationbypartnersinlocalauthorities,theNHS,otherstatutoryandthevoluntaryandcommunitysectors(VCS).

LocalHealthwatchisworkingtowardsanorganisationalaccreditation/qualitystandardssuchasInvestorsinPeople.

Short term

G.8: CompetenceLocalHealthwatchoperatesasaneffective,competentorganisation.

LocalHealthwatchdevelopsasetoforganisationalandgovernancepolicies andproceduresegHR,complaints,finance,data-seeresourcesectionpolicies andprocedures.

Policiesandproceduresagreedbyboardandpubliclyavailableonwebsite.

Medium termStaffandvolunteersareclearabouttheirroles, actions, boundaries and who to go to forhelp.

Undertakeprogrammeofreviewsofpoliciesincludingtestingwhetherstaffareimplementingtheseeffectively.

Staffandvolunteersdemonstratetheyunderstandrelevantpoliciesandprocedures

LocalHealthwatchisavaluedmemberofthe VCS and contributes to raising their reputationandinfluence.

LocalHealthwatchtakesactiveroleinvoluntary/communitynetworksanddevelopments.

Culture, skills and learning

Short term

G.9: Skills and knowledgeLocalHealthwatchboard,staffandvolunteersenableittooperateeffectivelyandcompetently.

Recruitmentandselectionofstaffincludesunderstandingthediverseneedsoflocalcommunitiesandasfaraspossibleincludesdifferentgroups.

ArangeofskillsarepresentinlocalHealthwatchincluding:strategic,influencing,politicalandreport-writingskills.AlsoIT,communications,engagement,advice andinformation.

LocalHealthwatchmakesarrangementstofillskillsgaps(egsharingstaff/skillswithotherorganisationsorsubcontracting).

HRpoliciesinplaceandoperating.

LocalHealthwatchhasidentifiedinitialskillsgapsandtrainingneedsforstaff,boardmembersandvolunteers.

HRpoliciesinplaceandoperating.

LocalHealthwatchhasidentifiedinitialskillsgapsandtrainingneedsforstaff,boardmembersandvolunteers.

LocalHealthwatchhasacomprehensivesystemofsupervisionandappraisalforstaff.

Medium termLocalHealthwatchboard,staffandvolunteersenableittooperateeffectivelyandcompetently.

LocalHealthwatchhasatraininganddevelopmentprogrammeforboardmembers,staffandvolunteers.

LocalHealthwatchundertakesgroupdevelopmentalactivityegboardawayday.

Annualappraisalshavetakenplace.

Staffsicknessabsencelevelsarelow.

Traininganddevelopmentprogrammesinplaceanddeliveringoutcomes.

Accreditationisunderway.

LocalHealthwatchistrustedbypeoplewhousehealthandsocialcareservicesandbythepublic.

LocalHealthwatchlinkswithlocalVCStraininganddevelopmentprogrammes.

LocalHealthwatchisworkingtowardsaccreditationforadviceservices.

Consultationonexternalperceptionof localHealthwatchamongstusers,carersandpatients.

Undertakeexercisesuchassurveyor 360degreefeedbacktofindouthow localHealthwatchisviewedby partnerorganisations.

Adviceaccreditationisachieved.

Short term

G.10: Role of volunteersVolunteershaveaclearroleinlocalHealthwatchandaresupportedby theorganisation.

Developvolunteerpolicywhichdescribesrole,induction,expenses/remuneration,oversightanddevelopmentalopportunities.

Proactivevolunteerrecruitmentfromacrosslocalcommunities.

Volunteerpolicyinplaceandonwebsite.

Volunteersstarttoreflectthediversityofthecommunityandincludepeoplewhouseservices,carersandpatients.

Medium termVolunteersbringawiderangeofperspectivesandskillstolocalHealthwatch.Volunteersfeelvaluedbytheorganisation.

Regularoversight,supportandcelebrationofvolunteerstakesplace.

Volunteersinvolvedintrainingsessions withstaff.

Retentionofvolunteers

Rangeofvolunteers.

Volunteersatisfaction.

Short term

G.11: Continuous improvementLocalHealthwatchstatesitscommitmenttocontinuousimprovementandacting onfeedback.

Establishapolicyforcomplaints,commentsandcomplimentsaboutlocalHealthwatchwhichdescribeshowlearningfromthesewillinfluencelocalHealthwatch.

Boardagreedpolicies/procedures.

Documentsonwebsite.

Medium termLocalHealthwatchcandemonstratehowithaslearntandimproved.

LearningfromcomplaintsconsideredbylocalHealthwatchboard.

LocalHealthwatchdiscussesperformancewithcommissioners.

LocalHealthwatchlooksintoorganisationalqualityassurancestandardsuchasInvestorsinPeopleorPQASSO(PracticalQualityAssuranceforSmallOrganisations).

LocalHealthwatchfeedsbackhowithasusedcomplaintsandcommentstoimproveperformanceonitswebsite.

Positiveresultsfromcouncilannualmonitoring.

LocalHealthwatchundertakesa‘yousay, wedid’collationofcomments.

Consultationonexternalperceptionoflocal Healthwatchamongstusers,carersandpatients.

Asabove,plusresultsofconsultationshowmajoritytrustandvaluelocalHealthwatchandbelieveitoperatesindependently.

Local HealthwatchOutcomesandImpactDevelopmentToolSection2:finance Financial management

Short termF.1: Responsible financialmanagement LocalHealthwatchmanagespublic fundsresponsibly.

Establishrobustfinancialmanagementpolicies,proceduresandsystemsthatenable local Healthwatch to:

• setabudgetandkeeptrackofit

• dealwithmoneycominginandout

• keepaccuratefinancialrecords

• forecastandplanfutureexpenditure.

UnderstandthelegalandfinancialrequirementsoftheformofsocialenterpriseadoptedbylocalHealthwatch.

Theboardincludesexperienceandexpertiseinfinancialmanagement.

LocalHealthwatchhasarrangementstoreinvestatleast50percentofdistributableprofitperyearinitslocalHealthwatchactivitiesandforcommunitybenefit.

Boardconsidersandagreesfinancialpoliciesandproceduresthatareinlinewithrequirementsoftherelevantregulator,HWlegislationandcouncilcontract.

Boardapprovesyearonebudget.

DocumentsarepubliclyavailableonthelocalHealthwatchwebsite.

LocalHealthwatchhasarrangementsfordistributionofassetsintheeventoftheorganisationbeingwoundupordissolvedinaccordancewiththerulesofitsregulator.

Medium termLocalHealthwatchmanagespublic fundsresponsibly.

Boardreceivesregularfinancialreportswhichareopentopublicscrutiny.

Anysignificantvariation,over-spendorunder-spendisraisedwiththeboardas soonaspossible.

LocalHealthwatchreviewsfinancialallocationstoitsfunctionsandservicesto check whether the balance is right (eg issufficientfundingallocatedtoinvolvingchildren)andthatallocationfavours front-lineservices.

LocalHealthwatchhasrobustfinancialinformationtodemonstratetocommissionerswhatfundingisneededtorunaneffectivelocalHealthwatch.

EndofyearaccountsshowlocalHealthwatchhasabalancedbudget.Endofyearfinancialactivityandclosingpositionarepublishedaspartoftheannualreport.

LocalHealthwatchmeetsallfinancialrequirementsinitscouncilcontract.

LocalHealthwatchmeetsallfinancialrequirementsofitsregulatorandinHealthwatchregulations.

Followingreview,adjustmentsmadeifnecessarytofinancialallocationsinlocalHealthwatchplans.

Ifinprofit,localHealthwatchcandemonstratewhichofitsactivitiesbenefitfromadditionalinvestment.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisseenasanefficient,competentandopenorganisationwhichdemonstratesgoodfinancialmanagement..

See medium term success factors in F.1. and F.2.

LocalHealthwatchachievesF.1andF.2successfactorsyearonyear.

Short term

F.2: Transparency and honestyLocalHealthwatchputsarrangementsinplacetoshowthatithasanaccountable,openandtransparentapproachtotheuseofpublicfunds.

Buildacommitmenttoachievingvalueformoneyintorelevantdocumentationegconstitution,articlesofassociation.

Relevantdocumentationisagreedbytheboardandavailableonthewebsite.

Medium termLocalHealthwatchfinancialinformation isaccessibletothepublicandother interestedparties.

AboardmemberorseniorofficerisresponsibleforaccountingforlocalHealthwatchfinances,reportingtolocalHealthwatchboard.

Boardpapersrelatingtofinanceare publiclyavailable.

AnnualaccountsareapprovedinlinewithregulationscoveringthelocalHealthwatchorganisation.

Annualaccountsarepubliclyavailableonthewebsitewhenapprovedbytheboard.

ThelocalHealthwatchannualreportincludesinformationabouttheamountsspentbytheorganisationinitslocalHealthwatchcapacityandwhatthesewerespenton;appliesalsotoanylocalHealthwatchsubcontractor.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisseenasanefficient,competentandopenorganisationwhichdemonstratesgoodfinancialmanagement.

See medium term success factors in F.1. and F.2.

LocalHealthwatchachievesF.1andF.2.successfactorseachyear.

IndependentorpeerreviewconfirmsthatlocalHealthwatchisanefficient,competentandopenorganisationwhichdemonstratesvalueformoney.

Accounting and reporting

Short term

F.3: Value for moneyLocalHealthwatchunderstandswhatconstitutesvalueformoneyinthecontext ofitswork.

IncollaborationwithstakeholdersdevelopadefinitionofvalueformoneyinthecontextoftheworkoflocalHealthwatch.

Buildacommitmenttoachievingvalueformoneyintorelevantdocumentationegconstitution,articlesofassociation.

BoardmembersandstaffcanexplainhowtheyareseekingtoachievevalueformoneyinlocalHealthwatch.

Medium termLocalHealthwatchmakesefficiency savingstoreinvestinfrontlineserviceswherepossible.

Undertakeprogrammeofreviewsofactivityandexpendituretoidentifypotentialefficiencysavings.

Considermechanismsthatmayproduceefficienciesandgreatervalueformoney such as:• sharingback-officefunctions

• sub-contractingfunctions

• local,regionalorsub-regionalpartnershipseglocalHealthwatchobservatory.

Amountgainedfromefficiencysavings/betterorganisationandhowitisreinvested.

ExamplesofeffectiveuseofresourcessuchassubcontractingwiththelocalVCSforactivitiessuchasresearchorengagement.

Effective use of resources

Short term

F.4: Income generationLocalHealthwatchagreestoconsideritspotentialforincomegenerationatatimewhenitisoperatingeffectivelyinallitsactivities(asdemonstratedbymeetingoutcomesingovernance,finance,operationsandrelationshipgrids).

Buildthepotentialforextendingactivityintorelevantdocumentationegconstitution,articlesofassociation.

Financial sustainability

Longer term IMPACT How could we measure IMPACT?Commissionersandthelocalpopulationunderstand/feelthatlocalHealthwatchisavalueformoneyorganisation

See medium term success factors in F.1, F.2 and F.3.

Organisationisre-commissionedtolocalHealthwatchatfuturetendering.

Possiblynewservicescommissioned fromorganisation.

IndependentorpeerreviewconfirmsthatlocalHealthwatchisanefficient,competentandopenorganisationwhichdemonstratesvalueformoney.

Longer term IMPACT How could we measure impact?

LocalHealthwatchisoperatingsuccessfullyintheaboveareasandcanconsiderwideningitsactivity.

LocalHealthwatchhasdevelopedandimplementedasustainableincomestrategy.

LocalHealthwatchhasreservesthatwouldallowittooperateforayear.

LocalHealthwatchhasaprojectedsecureincomeoverathree-yearperiod.

Medium termLocalHealthwatchisoperatingsuccessfullyintheaboveareasandcanconsiderwideningitsactivity.

• Ifcharity,developfund-raisingpotential.

• Considerviabilityof,andoptionsfor,providingadditionalservices.

• Discussextendedrangeofserviceswithcouncilcommissioner-wouldthisbenefitlocal Healthwatch users and local serviceprovision?DiscusswithCCGs-egpotentialforsupportingpatientparticipationgroups.

• Discusswithcouncilegpotentialfortakingonotherpublicengagementactivity.

• Investigatethepotentialforprovidingcustomerinsight/engagementactivitiesinthewiderwellbeingcommunitye.g.housing,communitysafetyorganisations,universities.

Incomegeneratedthroughfundingandhowthishasbeeninvestedinfront-lineservices.

Tenders/applicationstoprovideawiderrangeofservices.

Tenders/applicationssuccessfulegcommissionedtocarryoutserviceevaluationfocusedonserviceuserexperience.

Incomegeneratedthroughfundingandhowthishasbeeninvestedinfront-lineservices.

Tenders/applicationstoprovideawiderrangeofservices.

Tenders/applicationssuccessfulegcommissionedtocarryoutserviceevaluationfocusedonserviceuserexperience.

Local HealthwatchOutcomesandImpactDevelopmentToolSection3:operations Accessibility

Short termO.1: Ease of accessSee also R.1.Anyone who wishes can contact local Healthwatchforhelpandsupport.

Accessiblewebsiteandphonelineup andrunning.

Systemformonitoringandrecordingcontactsandinquiriesonwebsiteandphone.

Agreementwithrelevantpublicsectorandvoluntarysectorbodiesformutuallinks onwebsites.

Ensurerelevantdocumentsareavailable inaccessibleformatsandlanguages.

Recordofwebsitecontactsandqueries.

Recordofphonecallsandqueries.Qualitativeanalysisoffollow-uptoqueriesandresultingoutcomes.

Medium termLocalHealthwatchunderstandsitspurposeandcommunicatesthiswidely;externalstakeholdersunderstandthepurposeoflocalHealthwatch.

DevelopoutreachprogrammeincollaborationwithVCS.

Supplementwebsite,phonelineandshopfrontwithsessionsinaccessiblecommunityvenues(egschools,GPsurgeries,daycentres,churches/temples/mosques,libraries,pharmacies,supermarkets).

Recordandevaluationofcontactsincommunityvenues.

Surveytoestablishcommunityknowledgeoflocal Healthwatch, how it can be contacted andhowaccessibleandwelcomingitis.

Surveyofvenues’perceptionofaccessibility.

Longer term IMPACT How could we measure IMPACT?EventhemostisolatedandseldomheardindividualsknowaboutandareabletocontactlocalHealthwatchforassistance andinformation.

LocalHealthwatchhasacase-findingandreferralsystemandagreedprotocolswithCCG(s),council,VCSandotherpartnerorganisations about how and when toreferandhowtorecordlocal Healthwatchreferrals.

AbletoshowawiderangeofroutesthroughwhichindividualsandgroupscancontactlocalHealthwatchandbereferredtosourcesofadviceandsupport.Recordofnewcontactsandreferralstokeycommissionersandproviders.Casestudiesillustratingcontactwithisolatedindividualsandcarersandinformationandsupporttheyhavereceived.EvidencefromhealthandsocialcareserviceprovidersthatdifferentgroupsandnewindividualsareusingservicesbecauseofcontactwithlocalHealthwatch.

Short term

O.2: Understanding the community See also G.6.LocalHealthwatchhasanunderstandingofthecommunitiesitservesandhowtoincludeallelementsinitswork.

Developanoutreachandcommunicationsstrategywithexplicitreferencetoreachingouttoallpartsofthecommunityandamonitoringsystemandcontactsdatabasetorecord and disaggregate contacts (see O.1 above)

Informationfromcontactsdatabaseandcontactsmonitoringshowscontactsin allcommunities.

Medium termLocalHealthwatchincludesthosewhosevoicesareseldomheardthrough proactiveengagement.

Ensureworkprogrammeincludesactivitiesandstrategytoinvolvemembersofseldomheardgroupswhichtakeplaceinfamiliarandeasy-to-reachlocations.

AnnualreportlistsawiderangeoflocationsforlocalHealthwatchactivitywithstatisticsandcasestudiesaboutinvolvementofseldomheardvoices.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisaccessibleandinclusiveinallitdoes.Itunderstandsthedifferenttechniquesforgatheringviewsandinvolvingpeopleinthedesignanddeliveryofservicesandchoosesthemostappropriatemethod,includingunderstandinghowqualitativeinformationcanbearichsourceofevidenceaboutthelivedexperienceofserviceusersandthequalityofservices.

Satisfactionsurveysofstakeholdersincludingcommunitygroupsandindividualmembersofseldomheardgroups.

InvolvementofwiderangeofgroupsandindividualsinservicedesignfacilitatedbylocalHealthwatch.

Developmethodologyforgathering andpresentingqualitativeaswellasquantitativeinformation.

Developcasestudiesandindividual storiesincollaborationwithserviceusersandcarers.

Positiveresultsofsatisfactionsurveys

Examplesofservicedesignandre-designthataddressneedsidentifiedbydifferentcommunitygroups(inJSNA,JHWSandindividualcommissioningplans).

Andsee‘influencing’tablebelow.

Short term

O.3: Collecting views See also G.6, R.1.LocalHealthwatchhasaplanforsystematicallycollectingtheviewsofadiverserangeofserviceusers,thosenotyetusingservicesandthegeneralpublic.

Decidewhichtechniques(egfocusgroups,onlinesurveys,workwithVCOs)tousetocollectviewsfromdifferentcommunitygroupsandindividualsandtofeedbackonhowtheirviewsarebeingheard.

ThisperspectiveandvoicebeginstoappearinJSNAandJHWSdocuments.

Thehealthandwellbeingboard,individualcommissionersandprovidersbegintofindspaceatstrategicmeetingstolistenandrespondtocommunityvoices.

Influencing

LocalHealthwatchworkswithVCOstosupportgroupsinputtingforwardtheirownviews,(egatHWBmeetings,NHS.

FoundationTrustmeetingswith publicgovernors).

Medium termLaypeopleandvolunteerssuchaspeoplewhouseservices,carersandpatientsaredirectlyinvolvedinlocalHealthwatchgovernance.

Considerdedicatedrolesforconsumers.

Helppeopletodevelopskillsandconfidencetotakeanactiveroleingovernance.

Identifyothermeasurestoincreaseroleofcommunitiesinworkofboardsuchasadvisorygroup.

LocalHealthwatchincludestheperspectiveofpeoplewhouseservices/patients/carers.

Diversityofopportunitiesforinvolvement has increased while continuing to include therangeofnecessaryskillsandasizefit forpurpose.

BoardmembershipchangesovertimetoreflectlocalHealthwatchdirectionandfuturevision.

Longer term IMPACT How could we measure IMPACT?Awiderangeofhealthandsocialcareforums(bothcommissionersandproviders)regularlymakespacetoheartheviewsofandfeedbacktoserviceusersandthepublic.

Servicesdescribethemselvesinthelanguageandfromtheperspectiveofservice-users(seetheMakingitReal‘Istatements’asanexample,referencedbelow)andaredifferentbecauseofthis.

Developamethodtorecordandpublicisehowdifferenthealthandsocialcareprovidersareengagingwithconsumers.

Compareandcontrastthewayinwhichhealthandcareservicesdescribethemselvesbeforeandaftertheworkof localHealthwatch.

Evidenceofgreaterandmorevariedpublicandservice-userengagementbycommissionersandproviders.

AdemonstrableshifttowardsthelanguageandperspectiveofserviceusersandpatientsinHWB,commissioners’andproviders’strategicdocumentsandevidencethatserviceshavechangedasaresult.

Short term

O.4: Influencing health and wellbeing board See also G.2, R.5.LocalHealthwatchisarespectedvoiceonHWBandHWBmembershaveagreaterunderstandingofconsumers’/serviceusers’experiencesoflocalhealthandsocial careservices.

DevelopclearproceduresforfeedingintoandbackfromtheHWBandmeetingswithhealthandsocialcarecommissioners.

Begintocollect,record,analyseandpresentrobustdataaboutusers’experiencesofhealthandsocialcare,identifyinggapsinintelligenceandinfluencingthesystemto fillthem.

Increasedpatient,service-userandpublicinvolvementinworkofHWB,advisedandsupportedbylocalHealthwatch.HWBhasanengagementstrategyinvolvinglocalHealthwatchrepresentatives.

LocalHealthwatchserviceuseranalysesroutinely discussed and drawn on in HWB deliberations.EvidenceofraisedawarenessamongHWBmembersabouttheimportanceofengagingwithcommunitiesandtheexpertiseandvaluethatVCOscanbringtodiscussionanddecisionmaking.

Medium termJSNAandJHWSdevelopedincollaborationwithandstronglyinfluencedbycommunityviewsandpriorities.

Localpeopleareenabledtomonitorandreviewthequalityofservicesandfeedbacktheirfindingstocommissioners andproviders.

ProposenewwaystodevelopJSNAandJHWSwithgreaterinvolvementofcommunityvoice.

Make local Healthwatch data, analysis and reportsavailableonwebsiteand othermedia.

LocalHealthwatchleadsonJSNAandJHWSworkinggroupswithacommunityinput.

JSNAandJHWSreflectgreaterevidenceofcommunityvoice.

VCOsdrawonlocalHealthwatch’sinformation,analysisandevidenceaboutneedsandservicestomaketheircaseforimprovedservices.

HealthandsocialcarecommissionersinvitelocalHealthwatchinputintotheirindividualcommissioningplans.

Longer term IMPACT How could we measure IMPACT?ServiceschangeandimprovetomeetneedsidentifiedthroughJSNAandalignwithJHWS.

LocalHealthwatchvolunteersandboardmembersactivelyengagedindevelopmentofcommissioningplansanddesign ofservices.

MinutesofHWBmeetings.

MinutesofCCGandsocialservicescommissioninggroups.

Patientandserviceusersatisfactionsurveys.

CasestudiesandstoriesshowingevidenceoflocalHealthwatchinfluenceimprovingtheconsumerexperienceofservicedelivery.

Short term

O.5: Information and signposting service See also G.6, R.1.BasicinformationaboutlocalhealthandcareservicescollectedandsystematisedbylocalHealthwatchand/orinformationandsignpostingconsortiumpartners.

RecruitmentofinformationandITprofessionalstolocalHealthwatchorsubcontractingITcapacitytospecialist.

Stafftrainingandregularupdatingonrelevantlocalservices.

Establishlinkswithotherinformationandadviceproviders.

Uptodateinformationdatabasesonwebsiteandincommunityvenues.

Contactsfromhealthandcareprofessionalsaskingforinformationonlocalservices.

Information and signposting

Medium termAfit-for-purposecomprehensivelocalinformationandsignpostingsystemonhealthandsocialcareservicesthatgivespeopletheinformationtheyneedat firstcontact.

Workwithcommissioners,providersandestablishedvoluntaryandthirdsector

organisationsthatalreadyperformadviceandinformationsignposting

functionstoshareinformationdatabasesandsystems.Workwithotherstakeholderstosupportarea-widedevelopmentofuserfriendlyITsystems,incorporatingfeedbackfromusers.

Jointtrainingwithotherinformationproviders,egCAB.

LocalHealthwatchstafforconsortiumpartnerstaffaccreditedwithqualificationininformationandsignposting.Theyhavethenecessaryskillstosynthesise,interpretandunderstanddifferentkindsofinformationanduseinformationappropriatelytoprovidetheevidencebaseforreportsandrecommendationstocommissionersandprovidersandHWB.

Satisfactionsurveysofserviceusersandcarers,healthandsocialcareproviders.

BenchmarkingwithotherlocalHealthwatchandinformationproviders.

LocalHealthwatchhasanetworkof“communitysignposters”fromdiversebackgrounds,ietrainedvolunteersworkingincommunityvenuestosupplementonlineservicesandreachouttoseldomheard,resultinginincreasingnumbersfromdiversegroupsaccessingservices.

Longer term IMPACT How could we measure IMPACT?Localpeopleareenabledeasilytoaccessinformationaboutthestandardofprovisionoflocalcareservices.

Thereisanarea-widesingleentry“goto”virtuallocationforserviceusersandthepublic.EntrythroughthelocalHealthwatchvirtual‘frontdoor’ispartofanarea-wideinformationsystemarangeoflocalservicesandbenefits.Asystem-wide‘nowrongdoor’policymeansthattherearenumerousroutesandformatsforpeopletofindtheconsistent,up-to-dateinformationtheyneedtoaccessandinfluenceservices.

HealthandsocialcarecommissionersandproviderscontributetofundingoflocalHealthwatchinformationandsignpostingservicebecausehighqualityservicehasreducedinformationinquiriestocommissionersandincreasedeaseofaccesstoinformationforproviders.

LocalHealthwatchispartofaconsortiumorothercollaborativeefforttoprovidethearea’ssingleentrylocationforinformationonsupportandservices.

ExtensivepartnershipbetweenhealthandsocialcarecommissionersandproviderssystematicallyfeedingintolocalHealthwatchinformationandsignpostingportal.

Increasingcross-referralbetweenservicesasfrontlinestaff(egGPs,healthvisitors,homecareassistants)morefamiliarwithandhaveeasieraccesstoinfoonthefullrangeofservices.

Additionalfundingfromcommissionersandproviderstoruninfoandsignpostingportal.

Satisfactionsurveysofusersofself-directedhealthandcareservices.

Casestudiesofinfoandsignpostingservicesbringingpeople(commissioners,providersaswellasserviceusersandcarers)intocontactwithservicestheypreviouslydidnotknowabout.

Graphicrepresentationofthearea’spublicinformationandsignpostingservices,showing‘nowrongdoor’routestoinformation.

Short term

O.6: Consumer rightsPeopleunderstandthatascitizensandusers/consumersofhealthandcareservices,theyhavecertainrightsinterms ofqualityandaccesstoservices.

PromotetheNHSConstitution,theMandatetotheNHS,theMakingitRealframeworkforsocialcareandotherrelevantdocumentsthroughlocalHealthwatch’scommunicationschannelsandthroughpartners.

Evidencethatpeopleareincreasinglyinquiringabouttheirentitlementstoservices.

Medium termPeopleunderstandtheoptionsthatareavailabletothemandtheirrighttomakechoices,iftheywantto,abouthowtheyreceivecareandsupport.

Produceeasy-to-understanddocumentsexplainingoptions(andconstraintsonthem)andhowtoexercisechoices.

Supportorsignpostindividualstosupportinunderstandingoptionsandmakingchoices.

Linksonwebsitetoqualitativeinformationaboutprovidersofhealthandsocialcareservices(egtoCQCreports,surveys andreviews).

Increasingevidence(egfromGPs/socialservices)thatpeopleareexercisingtheirrightstoaccessandchoosebetweenserviceprovidersandthattheyareusingsignpostingandsupportservicestohelpthemmakeinformedchoices.

Monitorinquiriesandadviceonaccess andchoicetoensurethemostdisadvantagedarereceivinginformation tomakeinformedchoices.

Being a community voice and consumer champion

Medium term How could we measure IMPACT

Patternsofserviceprovisionbegintoalignmorecloselywiththeprioritiesofserviceusersandpatientsasreflectedinthechoicestheyhavemade.

The Health and Wellbeing Board and health andsocialcarecommissionersdevelopcommissioningstrategiesandplansbasedonpatientandservice-userchoices,followingpresentationsandpromotionofoptionsbylocalHealthwatch.Providersshowtheyaredevelopingservicesinresponsetochoicesmadebypatientsandserviceusers.

Analysisofinformationandsignpostingserviceprovidinginformationaboutoptionstoserviceusersandpublic.

InformedbylocalHealthwatchfeedback,referencestotheexerciseofchoiceanditsinfluencewithincommissioningstrategiesandplansandinthedevelopmentofservicesbyproviders.

Surveysofconsumers/serviceusersaskingabouttheirexerciseofchoiceandhowtheybecameawareofoptions.

Short term

O.7: RepresentationLocalHealthwatchispositionedtogather,understandandrepresenttheviewsoflocalindividualsandcommunities.

Establish good relations with local VCOs, especiallythosethatworkwithcommunitiesandindividualsthatdon’taccess traditionalservices.

Establish good relations with other communitygroups(egfaithgroups).

PromotelocalHealthwatch,itsremitandvisionincommunitysettings.

VCOsexpressinterestinworkingwith localHealthwatch.

LocalHealthwatchreceivesinvitationstopresentitsworkincommunitylocations.

Individualsexpressinterestinvolunteering.

Medium termLocalHealthwatchhasaworkprogrammeforsystematicallyseekingviewsofdiversecommunitiesandindividualsonkeyhealthandsocialcareissuesandservicesandpresentingthesetocommissionersandserviceproviderstoinfluencetheirapproach.

LocalHealthwatchshowspeoplethatitvaluestheirviewsandfeedsbackonhowitusestheinformationtheyprovideandwhatimpactithashad.

WorkwithVCOstoproduceeffective androbustcommunity-basedand actionresearch.

Developmethodologyfor“virtuouscircle”ofgatheringviews,presentingtheminforumswheretheywillhavemostinfluenceandfeedingbacktoconsumersandcommunitiesontheirimpact.

HWBandcommissionersrespondtoviewspresentedbylocalHealthwatchindevelopingJSNA,JHWSandcommissioningplans.

HWBandcommissionersseekadviceoflocalHealthwatchandVCSpartnersonimprovingtheirowncommunityengagement.

Longer term IMPACT How could we measure IMPACT

Consumerandcommunityviewsareevidentincommissioningdecisionsanddirection ofservices.

Specificservicesdevelopedtorespondtogapsandinequalitiesidentifiedthroughcommunityengagement.

Reportsofcommissionersandproviders,optionsforservicereconfigurationsandhealthandsocialcaregovernancepointtotheinfluenceofconsumers’andcommunities’viewsaspresentedby localHealthwatch.

VCOscommittolong-termworkingrelationshipswithlocalHealthwatch.

MinutesofHWBandcommissioningboards.Annualreportsofcommissioners,NHStrustsandothersocialcareandhealthproviders.

JointprojectswithVCOsand communitygroups.

Short term

O.8: Research, intelligence gathering and information feedback CommissionersandprovidersrespondpositivelytolocalHealthwatchevidence-basedassessments,intelligenceandresearchbasedonuserexperiencesofservicequalityincludingreportsofenterandviewvisits.

Planinformationandintelligence-gatheringandengagementstrategiesandselectionandauthorisationofEnterandViewauthorisedrepresentativesanddeveloptemplatestoproducetimely,evidence-basedreports.

DecidewhetherandhowtoinputintoNHSQualityAccounts.

Reporttocommissioners,providers,health(andsocialcare)scrutiny,HealthwatchEngland/CQCasappropriate.

MakerecommendationstoHealthwatchEnglandtoundertakespecialreviewsorinvestigationsandpublishreportonparticularmattersarisingfromlocalHealthwatchfindings.

MinorchangesmadeinresponsetolocalHealthwatchreportsandrecommendationsonserviceusers’experiences.

Medium term

CommissionersandproviderstransferlearningtodifferentserviceareasfromlocalHealthwatchreportsonengagementactivitiesandserviceusers’experience.

Makerecommendationsthatarespecific,measurable,achievable,realisticandtimely(SMART)andtransferabletootherservices.

Referissuestohealth(andsocialcare)scrutinyforin-depthinvestigation.

MakerecommendationstoHealthwatchEngland/CQCaboutspecialreviewsorinvestigationstoconduct.

Assist Healthwatch England in its work asappropriate.

MajorchangesmadeinresponsetolocalHealthwatchreportsandevidence-basedrecommendationsandassociated scrutinyreviews.

ThequalityofcareimprovesoverallandissuesofdignityandrespectareprioritisedinresponsetohighlightingandevidencefromlocalHealthwatch.

SatisfactionsurveysCQCandHealthwatchEnglandreports.

Morepositiveresultsfromsurveysand CQCassessments.

Findingsofimprovementsbydignitychampions,youngpeople’schampions.SurveysofVCOsrepresentingparticulargroupsandconditions,askingwhetherconsumers’/serviceusers’viewshavebeenrespectedanddignityaddressed.

Short term

O.9: Concerns and complaints Peopleknowhowtoraiseconcernsandmakecomplaintsaboutservices.

Clearsignpostingtoinformationonlocalcomplaintsadvocacyservice(s)forhealthandsocialcare.

Monitorandanalyseinquiriesaboutconcernsandcomplaintsandsignpostingtocomplaintsadvocacyservice.

Medium termPeoplearesupportedinraisingconcernsandmakingcomplaints.

Agreean(anonymised)information-sharingprotocolwithcomplaintsadvocacyservice(s).Workwithcomplaintsadvocacyservice(s)toanalysepatternsofcomplaintsandraisecomplaintsandconcernsappropriately(egwithHWB,CQC,QualitySurveillanceGroups,localsafeguardingboards,healthscrutiny).

Stafftrainingonthelocalcomplaintsadvocacyandsafeguardingsystems.

Feedbackfromcomplaintsadvocacyservice.

PositiveresponsesbyHWB,CQCetc.Issuestakenupbyhealthscrutiny.

Patternsofcomplaintsandissuesraisedbyindividualsinfluenceservicesforthebetter.

AnalysetheusemadeofstatisticscollectedbylocalHealthwatchandcomplaintsadvocacyservice.

Servicesde-commissioned/recommissionedinresponsetoconcerns/complaints,healthscrutinyreviewsarisingfromlocalHealthwatchreferrals,actiontakenbyCQC.

Local HealthwatchOutcomesandImpactDevelopmentToolSection4:relationships Relationships with community and consumers

Short termR.1: Consumers and community See also G.1, G.2, G.4, G.10, O.1. LocalHealthwatchisknowntobeopenforbusinessandopenandreceptivetoinputfromconsumersandthecommunity.

LocalHealthwatchunderstandsthekeygroupswithwhichitneedstoengageintermsoflocalcommunitiesandconsumers.

LocalHealthwatchissystematicallynetworkedwithallsectionsofthecommunity.

Undertakeauditofkeygroupsinlocalcommunitiesintermsofcharacteristics/geographyetc-tappingintoJSNAswhererelevant.

Identifydifferentwaysofbestinvolvingandcommunicatingwithkeygroups,particularlythosewhosevoicesarelessheardinrelationtohealthandsocialcareorwhoaremajorusersofservicessuchaschildrenandyoungpeopleandolderpeople.

Developanengagementstrategythatincludesengagementwithsignificantlocalcommunitiesofidentityandinterest.

InvolveVCOs,keygroupsandindividualsindevelopingengagementstrategy.

Websitedesignedwithinputfromkeygroups.

Rangeofpeoplebeginningtousephonelineandwebsitecontact.

Engagementandcommunicationstrategyproducedwiththeinvolvementofkeygroups.

Volunteers beginning to be recruited, inductedandtrainedfromrangeofcommunitiesforappropriatelocalHealthwatchactivities.

Medium termPeoplewhousehealthandcareservicesknowthepurposeoflocalHealthwatch,areengagedwithitanduseitasasourceofinformationandsupport.

LocalHealthwatchisknowntobeanindependentvoicespeakingonbehalfofusersofhealthandsocialcareservices.

ReviewtheengagementandcommunicationstrategytoensurethatitdovetailswiththoseofotherkeypartnersinthestatutoryandVCStoavoidduplication.

Workwiththecouncilcommissioneroflocal Healthwatch and the health scrutiny committeetoaddresstheproblemsidentifiedbytheFrancisinquirysuchasunduedeferencetowardspowerfulNHStrusts.

PeoplefromarangeofbackgroundsareinvolvedinlocalHealthwatchengagementactivities,involvedindraftingreportsandrecommendationsandauthorisedforEnterandViewvisits.

Specificprojectsondifferentservicesinvolvearangeofvolunteersfromacrossthecommunity.

VolunteersinvolvedinoutreachandsignpostingworkoflocalHealthwatch.

LocalHealthwatchhaswelldevelopedwebsiteandproactivelyusessocialmediatoadvise,inform,engageandconsultwithconsumers.

Inputofvolunteersisrecognisedandrewardedappropriately.

InformationaboutlocalHealthwatchreachespeoplefromarangeofchannelssuchasfromthelocalVCS.

DiverseprofileofvolunteersinvolvedinlocalHealthwatchengagementandreportingactivities,includingoutreachtoseldomheardgroups.

Evidencethatsignpostingandinformationserviceissupportedandusedbydiverserangeofusers.

Evidencefromuseofwebsiteandsocialmediabyconsumers/serviceusers.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisfullyembeddedinthecommunity,isrecognisedasakeyelementinthevoluntaryandcommunitysectorinfrastructureandistrustedbyandengagedwithadiverserangeofpeople.

ThepublicandVCSuselocalHealthwatchasameanstoputforwardtheirexperiences,views,concernsandideasinrelationtoimprovinghealthandwellbeinginthe localcommunity.

DiversegroupsinvolvedatdifferentlevelsofengagementinworkoflocalHealthwatchacrossthefullrangeofitsactivities.

Prioritiesandworkprogrammedrivenbyinputfromserviceusersandcommunities.

LocalHealthwatchinputtodevelopmentofJSNA,JHWS,commissioninganddelivery ofservices.

Asabove.

Annualreportshowsawiderangeofengagementacrossallusergroups.

StoriesfromindividualsandgroupsabouthowtheyhavemadeadifferencethroughengagementwithlocalHealthwatch.

AnalysechangesinJSNA,JHWS,commissioninganddeliveryandabletopointtospecificexampleswherelocalHealthwatchhasmadeadifferencethroughgatheringandpresentingserviceusers’experiencesandcommunityviews.

Short termR.2: Children and young people See also R.6. ChildrenandyoungpeopleareactivelyinvolvedinthedevelopmentoflocalHealthwatchprioritiesandvision.

Ensure local Healthwatch skills and experienceenableittounderstandtheprioritiesofchildrenandyoungpeopleandto engage with local organisations already engagedwithchildrenandyoungpeople.

FormworkingpartnershipswithVCOsworkingwithchildrenandyoungpeople.

Abletopointtoinfluenceofchildrenandyoungpeopleonvision,prioritiesand workplan.

Profileofvolunteersincludeschildrenandyoungpeople.

Setupasub-groupofBoard,workinggrouportaskgroupofchildrenandyoungpeopletoadviseBoardonpriorities.

Recruit, induct and train children and young peopleasvolunteers(egtodevelopuseofsocialmedia,signposting).

Medium termLocalHealthwatchhaschannelsofcommunicationwithcommissionersandserviceprovidersofchildren’sandyoungpeople’sservicesandissupportingincreasedengagementofyoungpeopleincommissioninganddesignofservices.

Innovativeuseofsocialmediaandsignpostingfortwo-waycommunicationwithchildrenandyoungpeople.

SupportcommunicationbetweenVCOsrepresentingandengagingwithchildrenandyoungpeopleandhealthandcareservicesandcommissioners.

CoregroupofchildrenandyoungpeopledevelopinglocalHealthwatchprojectstoimprovehealthandsocialcareservicesforchildrenandyoungpeople.

IncreasingnumbersofVCOsworkingwithchildrenandyoungpeopleincontactwith/engagementwithlocalHealthwatch.

SpecificprojectswithVCOsengagingchildrenandyoungpeople.

Demonstrateinfluenceofcoregroup andwiderengagementofchildrenand youngpeopleinlocalHealthwatch workprogramme.

Longer term IMPACT How could we measure IMPACT?LocalhealthandsocialcareservicesmoreresponsivetotheneedsandwishesofchildrenandyoungpeoplebecauseoflocalHealthwatch’sinvolvement.

DemonstratetheinfluenceonservicesoflocalHealthwatch’sengagementwithVCOsworkingwithchildrenandyoungpeople.

Surveysofchildrenandyoungpeopleandtheirparentsabouttheirperceptionof localHealthwatch.

Smoothertransitionfromchildren’stoadults’servicesbecauseoflocalHealthwatch’sinvolvement.

Greaterintegrationacrosshealth,careandotherservices(egeducation,leisure)forchildrenandyoungpeoplebecauseoflocalHealthwatch’sinvolvement.

Greaterawarenessofcommissioners andprovidersofneedsandwishesofchildrenandyoungpeoplearisingfrom local Healthwatch collaboration with VCOprojects.

Surveysofchildrenandyoungpeopleandtheirparentsabouttheirperceptionof localHealthwatch.

Surveysofcommissionersandprovidersshowingincreasedunderstandingofexperiences,needsandwishesofchildrenandyoungpeopleusingservices,throughrepresentationbylocalHealthwatch.

CasestudiesofchangesinservicesinfluencedbyinputoflocalHealthwatch.

IndividualstoriestoldbychildrenandyoungpeopleabouttheirengagementthroughlocalHealthwatchinchangingservicesfor thebetter.

Short termR.3: Older people See also R.6. OlderpeopleareactivelyinvolvedinthedevelopmentoflocalHealthwatchprioritiesandvision.Dignityandrespectarekeycomponentsofthevision.

Ensure local Healthwatch has the skills and experienceforeffectiveengagementwitholderpeopleandcapacitytorepresenttheirviewsandtoengagewithlocalorganisationsalreadyengagedwitholderpeople.

Forgelinkswithdignitychampionsamongkeypartnersandstakeholders.

Abletopointtoinfluenceofolderpeopleonvision,prioritiesandworkplan.

Profileofvolunteersincludesolderpeople.

Dignitychampions’networkorlocaldignityworkinggroupsetuporjoined.

Dependingonexistingprovision,considerdevelopingorjoiningadignitychampionsnetworkorlocaldignityworkinggroup.

FormworkingpartnershipswithVCOsworkingwitholderpeople,especiallythosewhoaremoreisolatedandseldomheard.

Recruit,inductandtrainolderpeopleasvolunteers(egforengagementactivitiesincludingEnterandViewvisits).

Longer term IMPACT How could we measure IMPACT?LocalhealthandsocialcareservicesmoreresponsivetotheneedsandwishesofolderpeoplebecauseoflocalHealthwatch’sinvolvement.

Greaterintegrationacrosshealth,careandotherservices(egeducation,leisure)forolderpeoplebecauseoflocalHealthwatch’sinvolvement.

DemonstratetheinfluenceoflocalHealthwatch’sengagementwitholder peopleonservices.

Greaterawarenessamongcommissionersandprovidersofexperiences,needsandwishesofolderpeople.

Surveysofolderserviceusers/consumersandoldercarersabouttheirperceptionoflocalHealthwatch.

Surveysofcommissionersandprovidersabouttheirunderstandingofneedsandwishesofolderpeople,issuesofdignity andrespectandtherolelocalHealthwatchhasplayed.

Medium term

LocalHealthwatchhaschannelsofcommunicationwithcommissionersandserviceprovidersofolderpeople’sservicesandissupportingincreasedengagementofolderpeople(includingoldercarers)incommissioninganddesignofservices,includingageproofingofuniversalservicesandissuesofdignityandrespect.

StronginvolvementofolderpeopleinEnterandViewandotherformsoflocalHealthwatchvolunteering,includingdevelopmentofspecificworkprojects, taskgroupsetc.

ActaschannelofcommunicationbetweenVCOsrepresentingandengagingwitholderpeopleandhealthandcareservices andcommissioners.

Supportdignitychampionsnetworkandhelpdevelopitsworkprogramme.

Increasingnumbersofolderpeopleincontactwith/engagementwith localHealthwatch.

Dignitychampionsareworkingona commonagenda.

SpecificprojectswithVCOsengaging olderpeople.

DemonstrateinfluenceofengagementwitholderonlocalHealthwatchworkprogramme.

MoreageproofingofuniversalservicesandspecialistservicesnottargetedspecificallyatolderpeoplebecauseoflocalHealthwatch’sinvolvement.

Moresupportforoldercarersandco-carersbecauseoflocalHealthwatch’sinvolvement.

InvolvementoflocalHealthwatcholdervolunteersincross-sectoralageproofingprojectsanddignitychampionsnetwork.

LocalHealthwatchinvolvementinworkaroundoldercarersandco-carers.

Crosssectoralprioritisationofdignity andrespect.

CasestudiesofchangesinservicesinfluencedbyinputoflocalHealthwatch.

Individualstoriesgatheredfromandpresentedbyolderpeopleabouttheirengagementinchangingservicesforthebetterthroughtheirinvolvementwith localHealthwatch.

Outcomesfromdignitychampions’networkorworkinggroup.

Short termR.4: Adults of working age

LocalHealthwatchunderstandsthemaingroupsthatfallunderthecategoryofadultsofworkingageandwhattheirneedsaree.g.

• workingpeoplewhowantflexibleaccesstohealthandcareservices(maybe ‘time-poor’)

• adultswithlong-termconditions

• adultswithshort/medium-termhealthconditions

• adultsatriskofhealthinequalities

• adultswhoarecarers.

BefamiliarwiththeprofileofthearearelatingtoadultsofworkingageasidentifiedinJSNAandtheJHWS.

Theoutreachandcommunicationsstrategyincludesthesegroups,andcontactsaremonitored.

Medium term

LocalHealthwatchgathers,understandsandrepresentstheviewsofadultsofworkingage.

AdultsofworkingageareinvolvedacrossallthefunctionsoflocalHealthwatch.

Identifyarangewaysofinvolvingadultsofworkingageandusethemostappropriatemethod:

• withVCOsandpeer-ledgroupsforlongtermconditions

• withgroupsrepresentingpeoplewithshort/medium-termillnesse.g.cancersurvivors

AbletopointtotheinfluenceofadultsofworkingageonlocalHealthwatchvision,prioritiesandworkplan.

Peopleaged18-65includingthoseinworkareinvolvedinlocalHealthwatchgovernance.

• throughlocalmediaandsocialmedia

• throughdevelopingrelationshipswithmajorlocalemployersandtradeassociations.

Utilise Healthwatch England guidance on engagement;e.g.forthcominginformationoninvolvingpeoplewithlearningdisabilities.

Makeservicesandengagementactivityaccessibletopeoplewhoworkduringthedaye.g.someeveningandweekendavailability.

Profileofvolunteersincludespeopleaged 18to65.

TheneedsandprioritiesofadultsofworkingageareincludedinJSNA,JHWSandanylocalcommunitydevelopmentplans.

Long term IMPACT HealthandsocialcarecommissionersandservicesaremoreresponsivetothewishesofadultsofworkingagebecauseoflocalHealthwatchinvolvement.

Reviewworkprogrammetoensurethattheprioritiesofadultsofworkingageareincluded.

Satisfactionsurveysshowpositivefeedbackfrompeopleofworkingage.

LocalHealthwatchactivitiesshowinvolvementofmajorlocalemployers.

HealthandsocialcareannualreportsshowimprovementsinprovisionbecauseoftheinputoflocalHealthwatch.

Short termR.5: People with characteristics protected by the Equality Act

LocalHealthwatchunderstandshowequalitylawappliesto:

• itselfasanorganisation

• healthandsocialcareservices.

LocalHealthwatchhasagoodunderstandingofthediversityandmake-upofthepopulationinitsareaandtheneedsofdifferentgroups,includingthosewithprotectedcharacteristics.

Produceanequalitypolicyandmonitorthisthroughthecommentsandcomplaintsprocedure.

Provideequalitytrainingforallstaff,volunteersandboardmembers.

Befamiliarwiththeequalitypoliciesandtrainingoflocalhealthandcarecommissionersandproviders

Developearlyworkingrelationshipswithdiversecommunityandvoluntarysectorgroupsaswellashealthandsocialcarestaffworkingonequalitiesissues.

DeveloplocalHealthwatch’sownprofileofthediversecommunitiesitistryingtoreachand what their needs are in relation its activities.

DataaboutequalityissuesinlocalHealthwatcharecollectedandmonitored.

Complaintsrelatingtoequalityanddiscriminationaremonitored.

Feedbackfromcommunityandvoluntarysectorgroups;invitationstospeakatandparticipateincommunityevents.LinkstolocalHealthwatchbegintoappearoncommunitywebsites.

Medium term

Promotingequalityforpeoplewithprotectedcharacteristics(disability,genderreassignment,pregnancyandmaternity,race,religionorbelief,sexandsexualorientation)iscentraltotheworkoflocalHealthwatch.

ReviewlocalHealthwatchphysicalenvironmentandhowitcommunicateswiththepublicsothatallreasonableadjustmentsforpeoplewithadisabilitycanbemadee.g.websitesuitableforpeoplewhousetexttospeechsoftware.

NumberofcomplaintstolocalHealthwatchabouthowitimplementstheEqualityActarelow.

Commentsandcomplaintsresultinmeasurableimprovements.

InvolvepeopledescribedbyprotectedcharacteristicsacrosstherangeoflocalHealthwatchactivitiese.g.asvolunteers.

PeoplewithprotectedcharacteristicsactivelyseektobecomeinvolvedinlocalHealthwatch.

IfnecessaryinfluenceJSNAtoincludeinformation(whereverpossible)onpopulationswithprotectedcharacteristics.

Understandthecommonwaysinwhichpeoplewithprotectedcharacteristicsmaybediscriminatedagainstinhealthandsocialcare(e.g.peoplewithlearningdisabilitiesfindingdifficultiesaccessinghealthcare)andidentifywhetherthesearehappeninglocally.

Providepublicinformationaboutpeople’sequalityrightsinhealthandsocialcareandprovideadviceand/orsupporttopeoplewhosaytheyhavebeendiscriminatedagainst.Collectanonymiseddatawhichallowstrendstobeidentified.

Lookoutforanytrendsrelatingtodiscriminationinlocalservicesarisingfromcontacts with local Healthwatch and raise withcommissionersandproviders.

Profileofvolunteersismonitoredandincludespeoplewithprotectedcharacteristics.

JSNAincludeslocalprofilesofgroupswithprotectedcharacteristicswhereverpossible.

JHWSincludesactiontoaddressspecificneedsofthesepopulations.

Makeavailabledataonanytrendsrelatingtoequalityissuesinlocalcommissionersandproviders.

Commissionersandprovidersmakeimprovementsoninformationreceived.

Long term IMPACT Peopleusinghealthandsocialcareserviceshaveanincreasedawarenessoftheirequalityrights.

Healthandsocialcarecommissionersandservicesshowincreasedsensitivitytothehealthandsocialcareneedsofdifferentgroups.

Undertakeworkthatpromotesequalityandtacklesdiscriminationinhealthandsocialcare(dependentonlocalpriorities).

Specificprojectsonsupportingparticulargroupsinhavingtheirvoiceheardandneedsidentifiedinrelationtohealthandsocialcare.

Complaintsrelatingtoequalitylawagainstlocalhealthandcarecommissionersandprovidershavereduced.

SpecificimprovementshavebeenmadeinrelationtopeoplewithprotectedcharacteristicsfollowinglocalHealthwatchinterventions,andarerecordedattheHealthandWellbeingboard.

Relationships with key local partners

Short term

R.6: Safeguarding See also R.2. and R.3.ThelocalHealthwatchboard,staffandvolunteersunderstandsafeguardingissues,bothforchildrenandyoungpeopleand forolder‘vulnerable’adultsandareaware oflocalarrangementsandhowto reportconcerns.

LocalChildren’sandAdultSafeguardingBoardsunderstandtheroleandremitof local Healthwatch and how it can contribute tosafeguarding.

CollaboratewithlocalChildren’sandAdultSafeguardingBoards,andQualitySurveillanceGroupsinprovidingtraining,includinghowtoreportconcernsandtherolesofthecouncil,thepolice,thelocalsafeguardingboardboards,Ofsted,CQCandVCOs.

Understandingofsafeguardingissues andprocedureswrittenintothe appraisalprocess.

LocalHealthwatchvolunteersandstaffbegintoraiseandreportsafeguardingissuestoappropriatepartnerorganisations.

LocalHealthwatchaskedtoassistinconsultation/engagementexercisesonsafeguardingissues.

Medium termUnderstandingofsafeguardingissuesinfluenceslocalHealthwatch’sworkprogrammeandindividualprojects.SafeguardingBoardsandotherrelevantstakeholdersarepartnersinaspectsoflocalHealthwatch’sworkprogrammethatrelatetosafeguarding.

Referralswithasafeguardingcomponentaremadeinanappropriateandtimelywaytorelevantorganisations,includingcomplaintsadvocacyservices.

Ensurelearningfrominductiontraining iscarriedintoworkprogrammeand projectdevelopment.

Developgoodrelationswithkeypartnersinvolvedinsafeguardingactivity,includinglocalSafeguardingBoardsandQualitySurveillanceGroups.

LocalHealthwatchworkprogrammeisalignedwithprioritiesofsafeguardingboardsandQualitySurveillanceGroupsandsafeguardingaspectsofotherpartners’ workprogrammes.

LocalHealthwatchmakespresentationsaboutitssafeguardingworktoSafeguardingBoards,HWB,QualitySurveillanceGroupsandotherrelevantpartnersandviceversa.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisseenaskeychampionandcommunityvoiceonsafeguardingissues.localHealthwatch’sassistanceissoughtbypartnersinengagingwithdifferentgroupswithinthecommunityonsafeguardingissues.Dignityandrespectareseenaskeycomponentsofsafeguardingandofengagement.

Withrelevantpartners,followuplocalHealthwatchenterandviewvisits,reportsandrecommendationswithasafeguardingcomponent.

AssessimpactoflocalHealthwatchreferralswithasafeguardingcomponent.

Overalllocalprioritisationofdignity andrespect.

AnalysisoflocalHealthwatchreportsandrecommendationsshowstheyhaveinfluencedpartnerstomakeimprovementsinrelationtosafeguardingissues.

Analysisofreferralsshowstheyhavedrawnattentionofpartnerstoissuesandcasestheymightotherwisehavemissed.

Increasingdignityandrespectbyengagingandempoweringserviceusersincreasinglyrecognisedinpartners’visionstatementsandworkprogrammes.

Short termR.7: Health and wellbeing board See also O.4. LocalHealthwatchistreatedasanequalpartneronthehealthandwellbeingboard.

PresentationstoHealthandWellbeingBoard(HWB)onvision,purposeandremitoflocalHealthwatchandhowitisdevelopingitsprioritiesandworkprogramme.

DevelopbriefingpapersonhowlocalHealthwatch could collaborate with HWB onissuesofengagementinrelationtoJointStrategicNeedsAssessment(JSNA),andJointHealthandWellbeingStrategy(JHWS),tothemutualbenefitofeach.

LocalHealthwatchissupportedbyHWBmembersinplayingkeyroleindevelopmentofJSNAandJHWS.

StructureandcontentofHWBmeetingsreflectprioritygiventoconsumerandcommunityengagement.

Medium termLocalHealthwatchiscentraltodevelopingthecommunityengagementstrategyoftheHWBandadvisestheHWBoninnovativeformsofengagementinitswork.

WorkwithHWBcolleaguestodevelopcommunityengagementstrategy.

Makeevidence-basedpresentationstoHWBonneedsandwishesofconsumers/communitiesandSMARTrecommendationsabouthowtheycanbemet.

ContributetodevelopmentofJSNAandJHWS.

Makeproposalsoninnovativeforms ofengagement.

Communityengagementstrategyiswelcomedbythewiderpublicandserviceusersandresultsinactiveengagementamongdiversegroups.

SurveysofHWBmembersand/or360degreeappraisalprocessindicatehighopinionoflocalHealthwatchcontributions.

Longer term IMPACT How could we measure IMPACT?LHWBseeslocalHealthwatchasaneffective,authoritative,credibleandinfluentialvoiceforserviceusers,thegeneralpublicandthecommunityandvoluntarysector.

LocalHealthwatch’sadviceissoughtbyHWBonpublicengagementandHWBmeetingsallowforconsumer/serviceuserviewsandconcernstobeexpressedthroughlocalHealthwatchanddirectly.Positiveactionistakeninresponsetotheseviewsandconcerns.TheHWBandlocalHealthwatchfeedbackthroughavarietyofroutestoconsumers,VCOsandcommunitiesaboutHWBactivities.

EvolutionoftheJSNA,JHWSandcommissioningstrategiestowardsacommunityandconsumerperspective, morepersonalisedservicesandmorecommunity-ledinitiatives.

Evidenceofinfluenceofchangingperspectiveontypesofservicescommissioned,locationsand serviceproviders.

EvidenceoflocalHealthwatchinfluenceoncloserintegrationofservices.

Evidenceofincreasedsupportforcommunity-ledinitiatives.

Short term

R.8: Council – different roles

Local Healthwatch has a good mutual understanding with its council about the different roles in which they relate.

Seebelowunderdifferentroles. Seebelowunderdifferentroles.

Council as commissioner of local Healthwatch

LocalHealthwatchworkstospecificationdrawnupbycouncil,reportsregularly onprogress.

LocalHealthwatchreceivesimprovementanddevelopmentsupportfromcouncil.

CouncilsatisfiedwithlocalHealthwatchprogress.

LocalHealthwatchsatisfiedwithsupportfromCouncil.

Councilstaffandcouncillorshappytoengage with local Healthwatch training and discussmutualbenefitsofworkingtogether.

Council as commissioner of public health and social care services

MakepresentationstocouncilExecutiveandothermeetings.

LocalHealthwatchdemonstratesitcancontributetoimprovingcouncil’sownobjectiveofmeaningfulengagementwithserviceusers,carersandcommunities.

CouncilsocialcarerepresentativesinvolvedinlocalHealthwatchtrainingforboard,staffandvolunteers.

CouncilsocialservicesandotherdepartmentsaskforlocalHealthwatchassistanceindevelopinganddeepeningtheirpublicengagementactivities.

Council as health scrutiny body Drawupaprotocolormemorandumofunderstandingonco-operationwith healthscrutiny.

Successfulprotocoldrawnupandagreed.

Council as community leader LocalHealthwatchdevelopsrelationshipswithwardcouncillorsfordisadvantagedareas and areas in which local Healthwatch wantstomakecontactwithspecificgroups.

WardcouncillorsassistinmakingcontactwithlocalVCOsandcommunitygroups.

Medium term

Local Healthwatch works collaboratively on projects with council.

Seebelowunderdifferentroles. Seebelowunderdifferentroles.

LocalHealthwatchcontinuestofulfilcontract/grantconditionswithsupport fromcouncil.

Councilrenewscontract/grant.

LocalHealthwatchcarriesoutsomeengagementworkaroundspecificsocialcare/publichealthservicesandbeginsprogrammeofresearch,intelligence-gatheringaboutservice-userexperiencesincludingEnterandViewvisitstosocial careservices.

Council seeks local Healthwatch assistance inengagingwithnewserviceusers,seldomheardgroupsandongoingusergroups.

CouncilrespondspositivelyintermsofservicedesigntolocalHealthwatchreportsofuserexperience.

Council as health scrutiny body LocalHealthwatchrefersseveralissuestohealthscrutinycommittee.

HealthscrutinycarriesoutreviewsofoneormoreissuesreferredbylocalHealthwatch.

Council as community leader LocalHealthwatchprovidestrainingforwardcouncillorsinusinginformationandsignpostingsystemonbehalfofresidentsandfortheirownresearch.

Increasinguseofinformationandsignpostingsystembywardcouncillorsonbehalfofresidents.

Longer term IMPACT How could we measure IMPACT?Local Healthwatch and the council in all its roles have supported each other in developing an integrated and inclusive approach to citizen engagement across all services.

AlloftheaboveandmutualtrustbetweenlocalHealthwatchandcouncil.

360degreereviewoflocalHealthwatch/LArelationship.

ThecouncilissatisfiedthatitsspecificationforlocalHealthwatchhasbeenfulfilled.

LocalHealthwatchhasdevelopedcapacityandextendeditsskills,servicesandengagementactivitieswithsupportfrom thecouncil.

Council/localHealthwatchcontinuedcontract/grantrenewal.

ThecouncilhasextensivelyrevieweditsengagementactivitiesandformulatedamorecomprehensiveengagementstrategywithsupportfromlocalHealthwatch.

ThereisanestablishedagreedmethodologyforthecounciltorespondtofeedbackfromlocalHealthwatchonuserexperience.Thereisevidenceofusers’experiencesinfluencingtheshapeofservices.

Council as health scrutiny body Thereisacloseongoing,mutuallysupportiveworkingrelationshipbetweenhealth and social care scrutiny and localHealthwatch.

IssuesreferredbylocalHealthwatchandtakenupbyscrutinyresultinginimprovementstoservices.

RequestsbyscrutinytolocalHealthwatchforintelligenceaboutuserexperience–this intelligence is drawn on in scrutiny reportstoprovideevidenceforscrutinyrecommendationstoimproveservices.

Council as community leader WardcouncillorsareveryfamiliarwiththeworkoflocalHealthwatchintheirareaandmakeproactiveproposalsforlocalHealthwatchengagementwithparticulargroups.CouncillorsdrawonlocalHealthwatchintelligencetomakethecaseforimprovedservicesintheirarea.

OngoinginvolvementoflocalHealthwatchinward/neighbourhood/area-basedstructures.

InvolvementofwardcouncillorsinlocalHealthwatchengagementactivities.

Short term

R.9: Clinical Commissioning Groups LocalHealthwatchhasgoodmutualunderstandingwithCCG(s)

MakepresentationsatCCGBoardand othermeetings.

DemonstratethatlocalHealthwatchcancontributetoimprovingCCG’sownobjectiveofmeaningfulengagementwithpatients,carersandcommunities.

InvolveCCGrepresentativesinlocalHealthwatchtrainingforBoard,staffandvolunteers.

DevelopsupportiverelationshipswithGPpatientparticipationgroups.

CCGasksforlocalHealthwatchassistanceindevelopinganddeepeningitspublicengagementactivities.

Medium termCCG(s)’publicandpatientengagementstrategyisdevelopedandimplemented.

AssistCCG(s)todeveloppublic engagementstrategy.

WorkwithCCG(s)todevelopinnovativeformsofengagement.

LocalHealthwatchinvitedtoparticipateindevelopmentofCCGcommissioningstrategies.

Longer term IMPACT How could we measure IMPACT?ThereisanoticeabledifferenceinthewayCCG(s)setaboutdevelopingtheircommissioningstrategies,withearlierandmoreextensivepatientandpublicengagement.

CCGcommissioningplanreflectsexperiencesofconsumersthroughlocalHealthwatchengagement.

Collectindividualstoriesandcasestudiesofengagementandhowitcanresultinimprovedcommissioningandultimately,betterservices.

Evidenceofincreasingengagement,casestudiesandpersonalstoriesdemonstratetheinvolvementoflocalHealthwatch.

Short term

R.10: Voluntary and community sector LocalHealthwatchisseenasapartnerandpotentialsourceofsupportbyvoluntaryandcommunitysectororganisations.

TalktoVCOsaboutsupportlocalHealthwatchcouldgive.

Show willingness to listen and take on boardVCOs’ideasandexperiencesofengagement.

SupportVCOonHWB.

LocalHealthwatchinvolvedinVCOnetworksandmakepresentationsonitswork.

Mutuallinksonrelevantwebsites.

Medium termLocalHealthwatchisrecognisedasakeyelementinthevoluntaryandcommunitysectorinfrastructure.

LocalHealthwatcheffectivelyutilisesVCSresourcestoobtaintheviewsofthecommunity,especiallyhardtoreachgroups;andinfluenceslocalservicestobeinclusiveofthesegroups.

Demonstratebestpracticeinthepromotion,developmentandcelebrationofvolunteering.

DeveloplocalHealthwatchroleastwo-wayconduit between VCS and health and social carecommissionersandservices.

LocalHealthwatchadvicesoughtbyVCOsonhowtobringaboutgreaterengagementofserviceusersinhealthandsocialcare.

InvitationstospeakatVCOmeetingsandVCOtospeakatlocalHealthwatch.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchisworkingwithpartnersinotherorganisationstobuildthecapabilityofexistingserviceusers,volunteersandpaidstafftohelpthemchampionhighqualityhealthandsocialcareservices–understandingtheirresponsibilityandhowtheycanbringinfluenceandchallengetobearinanappropriateway.

Cumulativeevidenceofeffectivevoluntarysectoractivityonhealthandsocialcare.Increasing collaboration across the sector, egininformationandsignpostingservicesandmutualreferrals.

Evidenceshowshealthandcareserviceshaveimprovedasaresultofvoluntarysectorintervention,activelysupportedbylocalHealthwatch.

The VCS as a whole, including local Healthwatch,isworkingcollaborativelyresultingingreatervalueformoneyand costeffectiveness.

Short term

R.11: Advocacy and complaints services

LocalHealthwatchhasagoodknowledgeoflocaladvocacyandcomplaintsservicesandhowpeoplecanaccessthem.

Co-trainingwithcomplaintsadvocacystaff.

Developasystemforfeedingbacktocomplainantsonprogressoftheirissues.

Successfulfirst-timereferralandusefulanalysisofcomplaintsreferrals.

Medium term

Commissionersandprovidersreceivecomprehensivereportsofcomplaintsandconcernsandacttomakechangewherecomplaintsandconcernsshowsystemandmanagementproblems.

LocalHealthwatchworkswithcomplaintsadvocacyservicetodevelopsystematicanalysisandstatisticalpresentationofcomplaintsandconcerns.

Reportsofimprovementinsystemasaresultofcomplaintsandconcernsreporting.

Longer term IMPACT Longer term IMPACT

Commissionersandproviderslearnfromcomplaintsreportingandareabletodesignoutsomeoftheinitialcausesofcomplaints.

Theneedforseriouscasereviewsandthenumberofseriousuntowardincidentsisreduced,ascomplaintsareresolvedatanearlierstage.

BenchmarkingwithotherlocalHealthwatchandcomplaintsadvocacysystems.

ImprovedCQCandlocalHealthwatchinspectionandvisitreports.

Benchmarkingshowspositiveresults.

EnterandViewreportsincreasinglypositive.

Short term

R.12: Healthwatch England and Care Quality Commission

LocalHealthwatchhasaclearunderstandingofHWEandCQC’srolenationallyandlocally.

LocalHealthwatchandCQClocalrepresentativesshareinformationabouthealthandsocialcareservicesandtheirrespectiveworkprogrammes.

LocalHealthwatchsharetheirinformationwith Healthwatch England through the HealthwatchInformationHub.

CQCrepresentativesparticipateintrainingforlocalHealthwatchvolunteersonEnterandViewvisits.

Successfulsharingofinformation.

InformationsuccessfullyuploadedonHealthwatchInformationHub.

Successfultrainingaccomplished.

Medium term

ThereismutualtrustbetweenlocalHealthwatchandCQCrepresentatives.

ThroughinformationbroughttogetherontheHealthwatchInformationHub,localHealthwatch are enabled to network together,sharingeachothersinformation.

LocalHealthwatchandCQCworkcollaborativelyontheirrespectiveactivities.

Developworkingrelationshipwithneighbouring local Healthwatch to aggregate andshareinformation.

EnsureinformationisregularlyuploadedtoHealthwatchInformationHub.

CQC’swillingnesstoworkcollaboratively.Effective,evidence-basedreportswithevidentcontributionfromlocalHealthwatch.

Longer term IMPACT How could we measure IMPACT?Workingtogetherandapart,CQCandlocalHealthwatchbringaddedvaluetoeachother’sroles.

Byprovidinggoodqualityinformationto Healthwatch England through the Healthwatch Hub local Healthwatch enable HealthwatchEnglandtobeinfluentialonthenationalstage.

ChangesresultingfromCQCandlocalHealthwatchcollaboration.

AnnualreportsofHealthwatchEngland.

CQCinspectionandEnterandViewfollow-upreportsresultinaction.

HWEannualreportsdescribeexamples ofinfluencebasedoncollaborationwith localHealthwatch.

Relationships with providers

Short term

R.13: Health and social care providers.

LocalprovidersofNHSandsocialcareservicesunderstandtheremitandroleoflocalHealthwatchandexpresswillingnesstoco-operatewithitswork.

PresentationstoNHSTrustandFoundationTrustBoards,meetingsofFTpublicgovernorsetc.

PresentationsonlocalHealthwatchto otherkeyprovidersoflocalNHSandsocialcareservices.

Drawupaprotocolormemorandumofunderstandingonco-operationwith keyproviders.

Invitationstospeakatproviders’forums.

RequeststoattendNHSboardmeetings.

Protocolormemorandumof understandingsigned.

Medium termConcernsaboutserviceshighlightedthroughengagementactivities,intelligenceonusers’experiences,EnterandViewvisitsandlocalHealthwatchservicemonitoringareaddressedbyproviders.

Well-planned,evidence-basedengagementactivities,intelligencegathering,EnterandViewvisits,reportsandrecommendationsonservicesusers’experiencesbysuitablytrained and skilled local Healthwatch representativesandvolunteers.

TimelyandpositiveresponsebyproviderstoreportsandimplementationofasignificantnumberoflocalHealthwatchrecommendations.

Longer term IMPACT How could we measure IMPACT?Learningfromearlierreportsonproviders’servicesissharedacrossservices.Providersproactivelyinitiategreaterpatient,serviceuserandpublicengagementatanearlierstageindevelopingservices.

EffectivesystemstoanalyseresponsesbyproviderstolocalHealthwatchreports andrecommendations.

ProvidersimplementasignificantnumberoflocalHealthwatchrecommendations.ProvidersseekadvicefromlocalHealthwatchforproactiveengagementactivities.

Short term

R.14: Carer, patient and service-user representatives and advocates

LocalHealthwatchunderstandshowtocommunicatewithlocalrepresentativesofcarers,patientsandserviceusersandthoseadvocatingforpatientsandserviceusers.

CompilecontactinformationthroughVCS,commissionersandproviders.

Comprehensive,up-to-date contactdatabase.

Medium termLocalHealthwatchispartofanetworkofcarer,patientandserviceuserrepresentativesandadvocateswithregularcommunication.

Developonlinetwo-waycommunications,chatrooms,webinarsetc.InvolvethesegroupsandVCOsbringingthemtogether,indevelopmentofworkplanandenlisttheirsupportforwiderengagementactivities.

Evidenceofgoodtwo-waycommunications.

Longer term IMPACT How could we measure IMPACT?LocalHealthwatchhasfacilitatedtwo-waycommunicationbetweencommissionersandprovidersofservices,andcarer,patientandservice-userrepresentativesandadvocates.

Reportsofthesegroups(egmeetingminutes,annualreports)andrelevantVCOs.

MinutesofHWB,CCGandcouncilmeetings,includingscrutinymeetings.

Reports,minutesetcshowactiveengagementofservicecommissioners andproviderswithcarer,patientand service-userrepresentativesandadvocates,andevidencethishasbeenfacilitatedbylocalHealthwatch.

Local HealthwatchOutcomesandImpactDevelopmentTool Blank grid for local Healthwatch to add outcomes based on local priorities

Short term

Medium term

Resourcesforgoodgovernance

Policies and proceduresLocalHealthwatchwillneedafullrangeofpoliciesandproceduresrelevanttotheformandsizeoftheorganisation.Theseinclude:

• HRpolices(ModelHRpoliciesavailableonNCVOwebsite)

• Financepolicies(seesectiononFinance)

• Volunteerpolicies

• Healthandsafety

• Equalopportunities

• Safeguardingchildrenandvulnerableadults

• Complaints

• Whistleblowing

• Dataprotection

• IT

• Governancepoliciessuchasboardmemberroledescriptions,expenses/remuneration,codeofconduct,andconflictofinterest.

LocalHealthwatchwillalsorequirepoliciesandproceduresrelatingtolocalHealthwatchactivitiesthatmeetlocalHealthwatchRegulations:

• Campaigningprocedures

• Mediaandcommunications

• Operationalprocedures

• Sub-contracting

TheNHSBodiesandLocalAuthorities(PartnershipArrangements,CareTrusts,PublicHealthandLocalHealthwatch)Regulations 2012

Sourcesofinformation andsupport

The Charity CommissionProvidesarangeofusefuladviceandresourcesincluding‘startingacharity’‘trustees,staffandvolunteers’and‘runningacharity’.

Yourlocal/regionalvoluntaryandcommunityorganisationumbrellagroup/network/CVS

Willprovidelocalopportunitiesforadvice,support,traininganddevelopmentandnetworking.

NCVO – National Council for Voluntary Organisations NCVOhasover10,000membersfromthevoluntarysectorrangingfromthelargestcharitiestothesmallestcommunityorganisations.Itchampionsandsupportsthesectorandpromotescivilsocietyatthenationallevel.Itswebsitehasawiderangeofadviceandsupporttopicswithpopulartopicsbeing:fundingandfinance,governanceandleadershipandpeople,andHRandemployment.Itprovidesinformationon

Local Healthwatch–resourcestosupportoutcomesandimpactdevelopmentTool

qualitystandardsinthevoluntary/communitysector.Italsorunsanonlineadviceline.

NAVCA – National Association for Voluntary and Community ActionAnationalcharitythatchampionsandstrengthensvoluntaryandcommunityactionbysupportingitsmembersintheirworkwithover160,000localcharitiesandcommunitygroups.Providesitsmemberswithnetworkingopportunities,specialistadvice,support,policyinformationandtraining.NAVCAisabridgebetweenlocalgroupsandnationalgovernment.

Civil Society MediaAnindependentcompanyfocusedentirelyonsupportingcharitiesandcivilsocietyorganisationstodeliverysustainablepublicbenefit.Itproduceseventsandmagazinesrelatingto:governance,financeandfundraising.

Social Enterprise UKThenationalbodyforsocialenterpriserepresentsitsmemberstosupportandhelpgrowthesocialenterprisemovement.SEUKcampaigns,carriesoutresearch,buildsnetworksandraisestheprofileofthesector.Itrunseventsandaconsultancyservice.

LGA & HWE TheLGAandpartnershaveputtogetheranumberofbriefingscoveringthedevelopmentoflocalHealthwatch;afulllistofpublicationsisavailableatHealthwatch:Briefings-LocalGovernmentAssociation.

Publicationsrelatingtogovernanceinclude:

The Tool recognises that:

• Establishing local Healthwatch: governance

• LocalHealthwatchRegulationsExplained

–layandvolunteerinvolvementandrestrictionsonactivitiesofapoliticalnature

• LocalHealthwatch:Governanceandinvolvementofcouncillors

• Knowledge,skillsandcompetenciesforaneffectivelocalHealthwatch

• EstablishingLocalHealthwatch–Dignity,qualityandsafeguardingadults

• InvolvingLocalHealthwatch–Theroleofchairsandmembersofhealthandwellbeing

• LocalHealthwatchandcommunityleadership–Theroleofnon-executiveelectedmembers

• LINklegacy

LGA Healthwatch Implementation TeamIfyouhaveanyqueries,comments,orwouldliketospeakwithamemberoftheLGAHealthwatchImplementationTeampleaseemail:healthwatch@local.gov.uk.

‘Wicked’issuesinfinance–questionstoconsider

Extending the services offered by the local Healthwatch organisation Associalenterprises,localHealthwatchhavetheoptionofgeneratingadditionalincomethroughprovidingotherfundedservicesin addition to statutory local Healthwatch functions.ItislikelythatarangeoftypesoflocalHealthwatchwillemerge:somewillfocusonlocalHealthwatchservices;somewillprovidealargerangeofadditionalservices-forinstancethelocalhubforadviceandinformationandforinvolvingcommunities;somewillundertakeamorelimitedrangeofadditionalactivity.TheformlocalHealthwatchtakesovertimewill

dependonanumberoflocalfactorssuchashowitwasinitiallysetup,existingprovisionofrelevantservicesbyotherproviders,gapsinthelocalmarket,andtheaspirationsofthoseinvolvedinlocalHealthwatch.Localauthoritycommissionerswillwishtobeassured that statutory local Healthwatch functionswillnotbenegativelyaffectedbyanyextensionofactivity;localHealthwatchwill wish to be assured that local authority commissionerswillcontinuetosupportitfinanciallythroughcentralgovernmentfunding.Thebenefitsofwideningactivityarethattheorganisationwillhavemorecertaintyoveraseveralincomestreams,thereforeamoresustainablefuture.Questiontoconsider:DoesthelocalHealthwatchhaveaviewonwhetheritwillseektoextenditsrangeofservices?Whatfactorswouldneedtobetakenintoaccountwhenmakingthatdecision?

Resourcesforgoodmanagementoffinance

Regulatory bodiesDifferentfinancialrulesapplytodifferentformsandsizesoforganisation;regulatorsprovidegoodinformationabouttheirspecificrequirements.

For local Healthwatch with charitable status

TheCharityCommission www.charitycommission.gov.uk/running-a-charity/money-and-accounts/handling-money-safely/

ForlocalHealthwatchthatarecompaniese.g.limitedbyguarantee

CompaniesHouse www.companieshouse.gov.uk

ForlocalHealthwatchthatarecommunityinterestcompanies

CommunityInterestCompaniesRegulator https://www.gov.uk/government/organisations/office-of-the-regulator-of-community-interest-companies

For local Healthwatch that are industrial and providentsocieties

The Financial Conduct Authority http://fca.org.uk

Local Healthwatch legislation with information about financeTheLocalGovernmentandPublicInvolvementinHealthAct2007 http://www.legislation.gov.uk/ukpga/2012/7 section/187/enacted

14:227(3)onannualreportsasamendedbyHealthandSocialCareAct20125:2:187www.legislation.gov.uk/ukpga/2012/7 contents/enacted

TheNHSBodiesandLocalAuthorities(PartnershipArrangements,CareTrusts,PublicHealthandLocalHealthwatch)Regulations 2012 http://www.legislation.gov.uk/uksi/2012/3094 regulation/41/made

Information, advice and support on managing financeTheCharityCommissionhasextensiveadviceonfinancialmanagementincludingannualreturns,accounts,handlingmoneysafety,investing,financialresources,fundraising.Italsohasaninteractiveguidetofindoutwhatappliestodifferentforms ofcharity. http://www.charitycommission.gov.uk running-a-charity/money-and-accounts handling-money-safely/

NCVOprovidesarangeofadviceonfundingandfinanceincludingfinancialmanagement,incomesources,planningandsustainablefunding.Itrunsanonlinemembers’helpdeskandaconsultancyservice. http://www.ncvo.org.uk/practical-support/

CompaniesHousepublishesThelifeofacompany:annualrequirements–guidetomeetingrequirementsoftheCompanies Act2006. www.companieshouse.gov.uk/about/pdf/ gp2.pdf

Audit,accountingandreporting:guideforUKcompanies-helpfulguidefromtheDepartmentforBusiness,Innovation andSkills. www.gov.uk/audit-accounting-and-reporting guidance-for-uk-companies

LGA Healthwatch Implementation Team Ifyouhaveanyqueries,comments,orwouldliketospeakwithamemberoftheLGAHealthwatchImplementationTeampleaseemail:healthwatch@local.gov.uk.

Resources to supportoperations

Legislation and policyHealthwatch England, Understanding theLegislation:AnoverviewofthelegalrequirementsforlocalHealthwatch: http://www.healthwatch.co.uk/sites/default files/20130822_a_guide_to_the_legislation affecting_local_healthwatch_final.pdf

LGAandDH,LocalHealthwatch RegulationsExplained–layandvolunteerinvolvementandrestrictionsonactivities ofapoliticalnature: www.local.gov.uk/c/document_libraryget file?uuid=0a4e69a3-2d07-41d2-896d 0477fde029dc&groupId=10180

DepartmentofHealth(2013),TheNHSConstitution:theNHSbelongtousall: http://www.england.nhs.uk/2013/03/26/nhs constitution/

DepartmentofHealth(2012),TheMandate:AmandatefromtheGovernmenttotheNHSCommissioningBoard:April2013toMarch2015:www.gov.uk/government uploads/system/uploads/attachment_data file/213131/mandate.pdf

DH,LGAandmanyVCOs(2012),MakingitReal:Markingprogresstowardspersonalised,communitybasedsupport:www.thinklocalactpersonal.org.uk/_library Resources/Personalisation/TLAP MakingItReal.pdf–aframeworkdevelopedbyover30nationaladultsocialcareorganisations,developedfroma‘citizen-focusedagenda’andbasedaround‘I’statementsexpressingwhatserviceusersandcarerswanttoexperiencefromservices.

Other useful readingLGA(2013),LINkLegacy:Howdowe makesuretheorganisationalmemory ofLINksiscarriedforward?: www.local.gov.uk/web/guest/publications/-/journal_content/56/10171/3846724/PUBLICATION-TEMPLATE

LGA(2013),KnowledgeandskillsandcompetenciesforaneffectivelocalHealthwatch: www.local.gov uk/web/guest/publications/-/journal content/56/10171/3845882/PUBLICATION TEMPLATE

LGA(2012),MakinganimpactwithHealthwatch: www.local.gov.uk web/guest/publications/-/journal content/56/10171/3734142/PUBLICATION TEMPLATE

LGA(2012),EstablishinglocalHealthwatch:advice,informationandsignposting: www.local.gov.uk/web/guest/ publications/-/journal_content/56/10171/3738712/ PUBLICATION-TEMPLATE

Resources to supportrelationships

DepartmentofHealthetal(2013,‘HowtoEstablishaQualitySurveillanceGroup–Guidancetothenewhealthsystem’: www.gov.uk/government/uploads/system uploads/attachment_data/file/216996 Establishing-Quality-Surveillance-Groups.pdf

HealthwatchEngland(2013),HealthwatchChildrenToolkitandResourcesGuide: www.healthwatch.co.uk/resource healthwatch-children-toolkit-and-resources guide

LGA(2012),EstablishingLocalHealthwatch: engagingwiththewidestrangeoflocalpeople:www.local.gov.uk/ web/guest/publications/-/journal_ content/56/10171/3776878/PUBLICATION- TEMPLATE

HealthwatchEngland(2013),HealthwatchChildrenToolkitandResourcesGuide: www.healthwatch.co.uk/resource/ healthwatch-children-toolkit-and-resources- guide

LGA(2012),EstablishinglocalHealthwatch:workingwithclinicalcommissioninggroupsandGPpractices:www.local. gov.uk/web/guest/publications/-/journal_ content/56/10171/3776652/PUBLICATION- TEMPLATE

LGA(2012),EstablishingLocalHealthwatch–Dignity,qualityandsafeguardingadults:www.local.gov.uk/web/guest/publications/-/ journal_content/56/10171/3818090/ PUBLICATION-TEMPLATE

HealthwatchEngland(2013),Healthwatchescalationpolicy:www.healthwatch.co.uk/ resource/healthwatch-engalnd-escalation- policy–setsouthowtheHealthwatchnetworkisexpectedtoworktogetherwiththeCQCtoensurethatacomprehensivepictureofthestateofcarecanbedeveloped.

LGA(2012),Engagingserviceusersandthepublic:theroleofcouncilexecutivemembers:www.local.gov. uk/web/guest/publications/-/journal_ content/56/10171/3818079/PUBLICATION- TEMPLATE

CentreforPublicScrutiny(2012):LocalHealthwatch, health and wellbeing boards andhealthscrutiny:roles,relationshipsandaddingvalue:http://cfps.org.uk/domains/ cfps.org.uk/local/media/downloads/L12_693_ CFPS_Healthwatch_and_Scrutiny_final_for_web.pdf

RegionalVoicesandLGA,TheVoluntarySector:akeypartnerinlocalHealthwatch: http://www.regionalvoices.org/sites/default/ files/library/VCSapartnerinlocalHW_0.pdf

The‘questionstoconsider’belowarebasedon‘wickedissues’–problemsthatarehardtosolve,partlybecausethereisnoclearrightorwronganswer,partlybecausetheissuemaybecomplexandmany-sided,partlybecauseitmayjustbereallydifficulttofindasolution.Issueslikethisdonotfitreadilyintoatemplateorgrid.Nevertheless,theymayraisequestionsthatlocalHealthwatchwillwantorneedtothinkaboutindevelopingtheirvisionandapproachtotheircoreactivities.Twoheadsarebetterthanone(andthreearebetterthantwo)whenitcomestothrashingoutsolutionstowickedissues.ThebriefexplanationsandquestionsbelowmayprovideausefulstartingpointforBoard,stafforvolunteerseminarsortraininganddevelopmentsessions.

1.Beingrepresentative

LocalHealthwatchhasthepotentialtoberepresentativeintwoways.

• Byreflectingtheprofileofthelocalcommunity,forexampleitsagerange,itsethnicandfaithdiversity,thetypeoflong-termconditionsexperiencedinthecommunity–thistypeofrepresentativenesscanbeanindicationthatanorganisationiswellembeddedinacommunityandgiveitcredibilityamongcommunitymembers

• Byspeakingupeffectivelyonbehalfofthecommunity,reflectingitsviewsand

actingasitsvoice(forexampleonthehealthandwellbeingboard)–thistypeofrepresentativenessmaydependonalevelofprofessionalexpertiseandexperience,forexampleaboutmethodsofcommunityengagement,andknowledge,forexampleaboutthelocalhealthandcarelandscape.

ThefirstelementisimportantsothatLocalHealthwatchbringsavarietyofperspectivestoitsgovernanceandoperations,howeverindividualsdonotrepresenttheviewsoftheircommunities(withoutsomeformofselection/electionprocess);thesecondelementisessentialfortheworkoflocalHealthwatchasitseekstoaccuratelymeasureandreflecttherangeofviewsoflocalpeople.

Question to consider: How will you ensure thatyourlocalHealthwatchisrepresentativebothinawaythatgivesitcredibilitywithinthecommunityandinawaythatgivesitanauthoritativeandknowledgeablevoiceamongprofessionalsandexperts?

2.Gettingengagementright

Inengagingwiththecommunitiesitrepresents,localHealthwatchwillneedtomakeprovision,ontheonehand,forsupportingandlisteningtoarelativelysmallnumberofvolunteerswhowanttobeactivelyengagedlong-terminitsworkand,ontheotherhand,forreachingouttothosewhomaywanttobeinvolvedinaparticularissueandthosewhosevoicesareseldomheardattheseatofpower.

Wicked issues

Question to consider: How will you maintainabalanceindevelopingyourengagementstrategiesbetweenthesetwoformsofengagement?

3.Learningfromthe Francisinquiry

The Francis InquiryintoMidStaffordshireFoundationNHSTrustwascriticalofmostelementsinthesystemforoversightofhealthandsocialcareincludingformalpatientandpublicinvolvementmechanisms.PoorpracticeidentifiedinthePatientandPublicInvolvementForumincluded‘mutualacrimony’betweenmembers,andbetweenmembersandthehost,apreoccupationwithconstitutionalandproceduralmattersanda‘degreeofdiffidencetowardstheTrust’.TheLocalInvolvementNetworkwasdescribedas‘anevengreaterfailure’.‘ThealbeitunrealisedpotentialforconsistencyrepresentedbytheCommissionforPatientandPublicInvolvementwasremoved,leavingeachcounciltodeviseitsownworkingarrangements.Notsurprisingly,inStaffordthesquabblingthathadbeensuchafeatureoftheprevioussystemcontinuedandnoconstructiveworkwasachievedatall’(ExecutiveSummary1.22).

ThefindingsoftheFrancisInquiryhavebeenasalutarylessonforbothlocalHealthwatchandcouncilcommissioners;workingthroughthelocalHealthwatchoutcomesandimpactdevelopmentToolshouldenableorganisationstoavoidthesepitfallsandswiftlyaddressanyearlyproblems.

Question to consider:WhatmeasuresisthelocalHealthwatchtakingtoavoidproblemsidentifiedintheFrancisInquiry?

How is local Healthwatch working with the councilcommissioneronthis?

4.ExtendingtheservicesofferedbythelocalHealthwatch organisation

Associalenterprises,localHealthwatchhavetheoptionofgeneratingadditionalincomethroughprovidingotherfundedservicesin addition to statutory local Healthwatch functions.ItislikelythatarangeoftypesoflocalHealthwatchwillemerge:somewillfocusonlocalHealthwatchservices;somewillprovidealargerangeofadditionalservices-forinstancethelocalhubforadviceandinformationandforinvolvingcommunities;somewillundertakeamorelimitedrangeofadditionalactivity.TheformlocalHealthwatchtakesovertimewilldependonanumberoflocalfactorssuchashowitwasinitiallysetup,existingprovisionofrelevantservicesbyotherproviders,gapsinthelocalmarket,andtheaspirationsofthoseinvolvedinlocalHealthwatch.Localauthoritycommissionerswillwishtobeassured that statutory local Healthwatch functionswillnotbenegativelyaffectedbyanyextensionofactivity;localHealthwatchwill wish to be assured that council commissionerswillcontinuetosupportitfinanciallythroughcentralgovernmentfunding.Thebenefitsofwideningactivityarethattheorganisationwillhavemorecertaintyoveraseveralincomestreams,thereforeamoresustainablefuture.

Question to consider:DoesthelocalHealthwatchhaveaviewonwhetheritwillseektoextenditsrangeofservices?Whatfactorswouldneedtobetakenintoaccountwhenmakingthatdecision?

5.Clearcommunications

LocalHealthwatchhasanumberofdifferentrolestoperforminrelationtocommunication:asacommunityvoice,aconsumerchampion,arepresentativeinstrategicforumsandasaproviderofinformationandsignposter.Someofthesecommunicationsrolesarecommunity-facing,somefacetowardspartnersandotherstakeholders,somemaybecriticalofcommissionersandproviders.Thereisadangerofimbalanceandofconfusionbetweenthedifferentroles.

Question to consider: How will you ensureyoufulfilallthecommunicationsrolesrequiredoflocalHealthwatchandthat you are clear about which role you are undertakingindifferentforumsandwithdifferentaudiences?Howwillyouensurethatyourlocalitypartnersunderstandyourdiverseroles?

6.Championingissues

Manypublic,privateandvoluntarysectororganisationshaveappointedorinvitedvolunteersas‘champions’forparticulargroupsorissues–peoplewhoseremitistotakeaparticularinterestandspeakupformembersofagroup.Forexample,manycouncilshaveolderpeople’schampionsandhealthandsocialcareorganisationshavedignitychampions.Appointingchampionstoadvocateforacertaingrouporissueensuresthattheywillnotbeforgottenandwillgetspecialattentionforparticularneeds.Sometimes,also,advocatesorchampionshavesomeexpertiseorrelevantexperiencetheycanbringtotheirremit.Ontheotherhand, there is a danger that all those who arenotchampionsforthatgroupwillseeitas‘someoneelse’sbusiness’toadvocate

forthegroupandwillnotdeveloptheirknowledgeorunderstandingofthegroup’sperspective.localHealthwatchwillneedtodecidewhethertogodowntherouteofhavingadvocatesorchampionsforcertainconsumergroups/identitiesofinterest/issues.

Question to consider: How will you championoradvocateforparticulargroupsor issues

(a) ontheBoard?

(b) amongststaff?

(c) amongstvolunteers?

RegionalVoicesandLGA,TheVoluntarySector:akeypartnerinlocalHealthwatch:www.regionalvoices.org/sites/default/files/library/VCSapartnerinlocalocalHealthwatch_0.pdf

Local Healthwatch outcomes and impact development tool 77

Introduction

ThisappendixdiscussesarangeofmethodsthatcanbeusedtoprovideevidenceofagreedoutcomesandimpactsforalocalHealthwatch.Examplesaregivenofthekindofinformationeachtypeofmethodmightdeliver.Somemethodsoverlapthesethree categories and local Healthwatch are encouragedtobeflexibleandcreativeintheuseofthem.

MethodsMethodstoprovideevidence ofoutcomesandimpacts

Section1:Checklistfordecidingmethod(s)

Thechecklistbelowsummarisesthefactorsthatmaybehelpfulindecidinginasystematicway,whichmethod(s)touseingatheringevidenceofoutcomes.

FACTORS INFLUENCING METHOD DETAILS OF SPECIFIC CASEWhichoutcome(s)dowewanttoevaluate?

Whoistheintendedaudiencefortheevidence?Forexample;

• communityfeedback

• council(localHealthwatchcommissioner)

• Health and Wellbeing Board

• CCG

• NHSEngland

• serviceprovider(s)

• other?

(Theremaybemorethanonepotentialaudienceandeachshould be considered inthenextcolumn.)

Whatinformationwillcountasgoodevidenceoftherelevantoutcome(s)?Forexample:

• quantitative/statisticalinformation

• personalstories/qualitativeinformation

• both

Whoarethetargetrespondents?Whatfactorsneedtobetakenintoaccountindecidingmethod(s)?

• age

• specialneeds(eglearningdisabilities)

• access(egphysicaldisabilities)

• language/culturalissues

• anyother(s)

Howcanweinvolveserviceusersandothersindecidingonmethod(s)?

Willthemethod(s)wehaveinmindreallytestoutcomes(ratherthaninputsoroutputs)?(Relatethisbacktothefirstquestioninthechecklist.)

Section 2: Issues to consider

Differentfactorscanhelpindecidingwhichmethod(s)tochooseforaparticularoutcome.Thissectiondiscussestheseinmoredetail.LocalHealthwatchmaywishtousethechecklistabove,basedonthediscussionbelow,inhelpingdecidewhichmethodologytousetoevaluateaparticularimpactoroutcome.

1. Test outcomes not inputs or outputs where possible, eg:• howmanypeoplehavereceivedtheadvicetheywereseeking,ratherthanhowmanysoughtadvice

• didpeoplefeeltheirviewswerelistenedtoatameeting,ratherthanhowmanyattended

• howhaveissuesraisedbyserviceusersimpactedoncommissioningdecisionsandqualityofservices,ratherthannumberofcomplaintsreceivedorreportswrittenbylocalHealthwatch.

2. Where it is not possible to test outcomes directly, try to find a proxy, eg:• havingastrategyisnotanoutcomeintermsoflocalHealthwatch’simpact,butifalocalHealthwatchhasastrategyitismorelikelytomakeanimpact,sohavingastrategymaybeapartialproxyforimpactandcouldbereferredtoasevidence

• theultimateaimmaybetoimprovehealth,butoutcomesintermsofhealthmaynotbeknownformanyyears,soevidencethatservicesareevidence-basedcanbeaproxyforhealthimprovement.

3. Be clear about the type of evidence required• thethreecategoriesofFacetoFace,Online/ElectronicandExistingSourcesdiscussedinsection3belowcouldeachdelivereitherquantitativeorqualitativeevidence

• withineachcategorycertainmethodswillbemoresuitedtoquantitativeevidenceandotherstoqualitativeevidence

• qualitativeevidencewillbemoreusefulforpurposes,quantitativeevidenceforothersandamixofthetwomaybeusefulforotherpurposes.

Types of evidence Qualitative evidence Quantitative evidence

Purpose Tounderstandthecontextofthesituationandtheprocessesbehind:

• behaviour

• emotions

• responsestosituations

Morelikelytodelvedeepintoexperiencesoffewerpeople.

To gather and understand:

• numbers(ofpeople,events,incidents,complaintsetc)

• datathatcanbeconvertedintonumbers

• sizeandamount

Morelikelytoreachlargernumbers.

Type of question it answers

• how?

• why?

• whatisitlike?

• howcoulditbedifferent?

• howmany?

• howmuch?

• howoften?

• towhatextent?

Basis and final form

Basedonnon-numericaldata.

Deliversstories,narrative,text,videosetc.

Basedonnumericaldata.

Deliversstatistics,graphs,piechartsetc.

Example of possible use by local Healthwatch

AfocusgroupdiscussingLOCALHEALTHWATCH’sservices

• howweretheytreated?

• whatwascommunicationlike?

• whatcouldhavebeenbetter?

Atickboxsurveyofserviceusersasking:

• howmanyhaveheardofLOCALHEALTHWATCH?

• howmanyhavesoughtinfofromLOCALHEALTHWATCH?

• howhelpfulwasinfoonascaleof1to10?

4. Think about how else evidence might be used• evidencemaybehelpfulforotherpurposesinadditiontolocalHealthwatchselfassessmenteg:

◦ evaluationsforcouncillocalHealthwatchcommissioners

◦ evidenceforhealthandsocialcarecommissionersthatlocalHealthwatchisgenuinelyrepresentativeandcanreachcommunitiesandgroups

◦ evidenceofserviceuserexperienceoraccesstoservicesforhealthscrutinycommittees

• differentmethodsmayproducemoreorlessgoodevidenceforotherpurposes.

5. Target method to respondents you are trying to reach• willtheyrespondmorereadilybytalkingorinwriting?

• aretheymorelikelytorespondinasmallgrouporina1:1conversation?

• willtheyseeyoursurveyrequestinadoctor’ssurgeryoronFaceook?

• whichmethodismorelikelytoengagepeoplelongertermandisthismoreimportantthanreachinglargenumbers?

Example of use from elsewhere

PatientVoicesdigitalstoriesaboutlivingwitharthritiscollectedandpublishedbyLeedsUniversitywithhelpfromArthritisCare: http://www.patientvoices.org.uk/wr.htm

NuffieldTrustrandomisedcontrolledtrialtoassesstheimpactoftelehealthandtelecareassistivetechnologiesonlargenumbersofpeople:http://www.nuffieldtrust.org.uk/our-work/projects/impact-telehealth-and-telecare-evaluation-whole-system-demonstrator-project

Section3:Typesofmethodandexamplesofevidence

Examplesaregivenbelowofhoweachmethodmightbeused,buttheseareonlysuggestionsandtherearemanywaystheycouldbeimplementedwhichwillworkbestindifferentwaysforindividuallocalHealthwatch.Themethod(s)canbeappliedtoanynumberofoutcomesandimpactslistedinthelocalHealthwatchoutcomesandimpactsdevelopmenttool.Theticksindicatewhetheramethodcanbeused1:1,withagrouporwithawholecommunity.

Face to Face

METHOD EXAMPLES OF POSSIBLE USE 1:1 Group Community-wide

Semi-structured interviews

Tofindoutwhetherstaff/volunteersfeelclear about their roles boundaries know whotheycangotoforhelpetc.

✓ ✓ ✓

Surveys Toestablishwhetherpeopleincontactwith local Healthwatch understand its roleandpurpose.

✓ ✓ ✓

Focus groups ToestablishwhethervolunteersfeeltheyhaveaclearroleinlocalHealthwatchandaresupportedbytheorganisation.

✓ ✓ ✓

Consultation To assess whether local Healthwatch istrustedandvaluedbycommunities,local Healthwatch users, carers, patients,localHealthwatchcommissioners,HealthwatchEngland

✓ ✓ ✓

Feedback exercise Between local Healthwatch board and seniormemberstoevaluatewhethercertainoutcomesareembeddedwithin the organisation eg that local Healthwatch understands its duties and powersandisclearabouttherespectiverolesofboardandseniorstaff.

TospeakwithpeoplewhohavebeenincontactwithlocalHealthwatchforhelporsupporttoassesstheresultingoutcomesandtogetdirectfeedbackofthesupportreceived.

✓ ✓

Case studies/case study investigations

To assess contact between local Healthwatchandisolatedindividualsandcarersandtheinformationandsupporttheyhavereceived.

✓ ✓

Individual stories Fromolderpeople/childrentofindoutabouttheirengagementwithlocalHealthwatchandhowtheymayhavehelpedtochangeservicesforthebetterthroughtheirinvolvement.

Observation of meetings

Toevaluatewhetherconsumer/serviceuserviewsandconcernsareexpressedthrough local Healthwatch at HWB meetings.

Peer mentoring/Peer review

With neighbouring local Healthwatch to gatherviewsofpeersoneffectivenessofparticularinitiativesorservices

✓ ✓ ✓

Participatory engagement methods and tools eg flip charting, organising ideas.

Participatoryengagementmethodsandtoolsegflipcharting,organisingideas.Toseekviewsofvolunteersonhowwelltheyhavebeensupportedinusingtheirskills/abilities/knowledge.

✓ ✓

Market place and open space methods

Toprovideinformationonaservice/activitiy

‘Helicopter pad’ Tool for collecting comments

Toidentifypositivenegativeandneutralviewstowardsaspecificquestionortopic.

✓ ✓

Assessing information found on local Healthwatch websites

To check whether local Healthwatch financialinformationisaccessibletothepublicandotherinterestedparties.

TocheckthatthevisionoflocalHealthwatchastheindependentconsumerchampionforhealthand social care is understood and communicated.

✓ ✓

Surveys/Polls TohelpestablishwhetherlocalHealthwatchisviewedasaccessibleincludingfeedbackonvenueaccessibility.

✓ ✓

Social Media (Facebook/ Twitter)

Toaskwhatyoungpeoplethoughtofaneventthey’vejustattended

Toseektheirviewsonsexualhealthservices.

✓ ✓

Mobile phone ‘text’ a comment

ToreceivefeedbackregardinghowlocalHealthwatchisviewedbythewidercommunity.

✓ ✓

Online/Electronic

Videos/ video diaries/ comment booths

Todocumentpeople’s(widercommunityvolunteerslocalHealthwatchstaff)experiencesoflocalHealthwatchandhealthandsocialcareservicesillustratingchangesovertime.

✓ ✓ ✓

Surveys/questionnaires

TogetanideaofcommunityknowledgeoflocalHealthwatchwhethertheyfeelitisaccessibleandiftheyknowhowtomakecontact.

✓ ✓

Assessment of documents

TocheckthattheAnnualReportmeetsrequirementsinHealthwatchDirectionsandreflectstheissuesandprioritiesraisedbylocalpeople.

360 degree feedback

To check that local Healthwatch and the Health and Wellbeing Board are workingwelltogether–allpartnersgivefeedbackoneachother.

✓ ✓ ✓

Audit Evaluatingthemake-upoflocalHealthwatchboardmemberstoensureanappropriaterangeofknowledgeandskillsarerepresented.

✓ ✓

Usingexistingsources

Audit Evaluatingthemake-upoflocalHealthwatchboardmemberstoensureanappropriaterangeofknowledgeandskillsarerepresented.

✓ ✓

Reviews Forexample,toidentifywhethermembersofthewidercommunityareinvolvedinlocalHealthwatchGovernanceegaspartofadvisorygroupsasvolunteers.

✓ ✓

Comparison Studies

TocompareandcontrastthewayinwhichhealthcareservicesdescribethemselvesbeforeandaftertheworkoflocalHealthwatch.

Revisiting Facilitated Simulation

Tounderstandwhetherpeople’sviewofhowapreviouslysimulatedeventwouldunfoldhaschangedfollowingworkbylocalHealthwatch.

Contacts monitoring

To check that local Healthwatch has contactsinallcommunitiestoensurealltheseareasarerepresented.

✓ ✓

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Local Healthwatch outcomes and impact development tool · 2019-06-05 · Local Healthwatch outcomes and impact development tool 3 Introduction This outcome and impact development

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