Every Local Healthwatch must have a published decision making process. This guidance helps you to assess whether your current process is fit for purpose, or in need of a refresh.  

It sets out why you need a policy and the benefits a robust process can bring to your team. It explains the legal requirements, and what they mean for your local Healthwatch and provides tips on gathering a robust evidence base and prioritising in your work plan.

You will also find a template which you can adopt and adapt to your team’s needs.

Local Healthwatch conduct research with people to find out their experiences of health and social care services. This means we must carefully consider how we plan our research by assessing the risks for everyone involved.  

This guidance sets out a series of helpful tips to consider when assessing the risks and benefits of your research. We have outlined considerations about data security and protection, the wellbeing of participants, and the risk to Healthwatch including those who are undertaking the research. These are supported by examples to help you better understand how you can apply this to your own projects.   

You will also find some top tips on how to ensure your research is necessary, robust, proportionate, legitimate and appropriate.  

The role of local Healthwatch is to champion the views and experiences of communities across the country. This means that your research should appropriately represent everyone in your local area.  

This guidance will help you to choose a good sample of participants for your research projects. As part of it we have provided explanations for different methods you can use to collect your sample. These are supported by examples to help you better understand how you can incorporate these methods in your own engagement activities.

You will also find some top tips that you can consider when you are planning who you want to talk to and involve in your research.

We offered grants to local Healthwatch to produce a simple guide on how to replicate and adapt engagement approaches that have worked well for them. Thank you to Healthwatch Wiltshire, who produced this guide on how to engage with people who live with dementia.

What is dementia?

NHS England explains: Dementia is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning. There are many different causes of dementia, and many different types. For example, Alzheimer's disease is a type of dementia and, together with vascular dementia, makes up the majority of cases. Dementia symptoms may include problems with:

• Memory loss
• Thinking speed
• Mental sharpness and quickness
• Language, such as using words incorrectly, or trouble speaking
• Understanding
• Judgement
• Mood
• Movement
• Difficulties doing daily activities

Why use this guide?

Here are some of the benefits of using the approach in this guide: 

• Working with people who live with dementia to produce your project promotes equality and gives control to the people whose views you are looking to gather. 
• Working together improves the design of your survey. You can find out if your questions will be understood, and how people may respond to them. Your survey will more accessible to your target group, and you will be able to gain greater insight into people’s experiences.
• Engaging with people at community groups is a good way of enabling open discussions as people are in a familiar and safe environment and may feel happier to share their views.   

We offered grants to local Healthwatch to produce a simple guide on how to replicate and adapt engagement approaches that have worked well for them. Thank you to Healthwatch Croydon, who produced this guide on how to co-produce with seldom heard groups.

What is co-production?

The Care Act 2014 statutory guidance offers the following definition: '"Co-production" is when groups of people get together to influence the way that services are designed, commissioned and delivered. 

Who are seldom heard groups?

The term 'seldom-heard groups' refers to under-represented people who use or might potentially use health or social services and who are less likely to be heard by these service professionals and decision-makers.

These groups used to be described as hard to reach – suggesting that there is something that prevents their engagement with services. Seldom heard emphasises the responsibility of agencies to reach out to excluded people, ensuring that they have access to health and social care services and that their voices can be heard, and is preferred for those reasons.

Examples of seldom heard groups could include:

• Particular ethnic minority groups
• Carers
• People with disabilities
• Lesbian, Gay, Bisexual, Transgender, and Queer people 
• Refugees/asylum seekers
• People who are homeless
• Younger people
• People with language barriers

To summarise, it is anyone who is under-served. These people may have particular needs when it comes to participating.

Why use this guide?

This guide has been developed by Healthwatch Croydon, who will show you how to co-produce a research project with a seldom heard group. This includes every stage of the research project, from scoping to publishing, and will take some of the hard work out of undertaking a research project, highlighting the key stages.

The guide uses a specific project undertaken by Healthwatch Croydon as an example of how to co-produce with seldom heard groups. You can however use this approach with any group concerned with a health and social care issue. Healthwatch Croydon worked with their local college who contacted them looking for organisations to offer work placements for a new pilot called the T-level (technical A-Level). They offered six places for young people to be involved.

Since COVID-19, this model has continued and been adapted to being used entirely online and can be done virtually.

We offered grants to local Healthwatch to produce a simple guide on how to replicate and adapt engagement approaches that have worked well for them. Thank you to Healthwatch Leeds, who produced this guide on how to engage with people using video diaries .

What is a video diary?

A video diary is a film that someone makes of the things that happen to them over a period of time, which they upload to a website. It provides a very personal view of how the subject sees their world and can make viewers feel as if they are on a personal journey with the user. Capturing on-the-spot reactions and thoughts, video diaries should be authentic and provide a record of someone’s experiences in real time.

Why use video diaries?

Here are just some of the reasons you might want to use video diaries:

• Video diaries are a powerful way of ‘bringing the person into the room’ at meetings of senior decision makers. They can really focus discussions around the ‘whole person’ rather than seeing people as faceless users of a specific service.  
• You can make video diaries in a whole variety of settings, from people’s own homes, to care homes, and supported living. It can enable you to reach people whose voices may otherwise go unheard. 
• They are an accessible way of sharing people’s experiences in their own words. You can include subtitles on films, and these can be translated if needed. 
• After the project, you will end up with a resource that could be used in training with frontline health and care staff.  

Find out more reasons why you should consider using video diaries to engage, in our easy to read guide - including steps to take, resources you will need, top tips for success and the benefits to your Healthwatch of using the model.

Equality, diversity, and inclusion are at the heart of our values. 

As an organisation whose sole purpose is to give a strong and powerful voice to people who often go unheard, the Equality Act serves as the minimum for our work.

This requires public authorities and organisations carrying out public functions to consider steps to eliminate unlawful discrimination, advance equality of opportunity and foster good relations between protected groups and others.

Conducting an Equality Impact Assessment for your engagement or research projects is important to help you show your impact.

It is designed to help you show that when your project outcomes are achieved and recommendations have been implemented that this has lead to increased equality and reduced barriers for protected groups and others who experience discrimination or disadvantage; whilst not inadvertently excluding others.

About this resource

The NHS COVID-19 app is part of our large scale coronavirus (COVID-19) testing and contact tracing programme. The app has been launched to help  notify users if they have come into contact with someone who tests positive for COVID-19.

The app allows people to report symptoms, order a coronavirus test, check in to venues by scanning a QR code and it helps the NHS trace individuals that have coronavirus.

The app does this while protecting the user’s anonymity. Nobody, including the government, will know who or where a particular user is.

This guidance sets out further information to help local Healthwatch support the campaign which aims to encourage as many people as possible to download and use the NHS COVID-19 app.

About the app

Why is the app important?

Every person who downloads the app will be helping in the fight against coronavirus (COVID-19).

To use the app you need to be aged 16 years or older, live in England or Wales and own a compatible Apple or Android smartphone that has Bluetooth switched on.

Benefits

• The app helps trace app users who have spent time near other app users, who they may not personally know, and who later test positive for coronavirus.
• The “Check-in” feature supports this functionality by anonymously alerting users who have been at the same venue at the same time.
• App contact tracing reduces the time it takes to alert those who have been in close contact with someone who has COVID-19.
• The app will help the NHS understand where and how quickly the virus is spreading, so it can respond.

Six key features

• Trace - Get alerted if you have been near another app user who has tested positive for COVID-19
• Alert - Lets you know the level of COVID-19 risk in your postcode district
• Check-in - Get alerted if you have visited a venue where you may have come into contact with COVID-19
• Symptoms - Check if you have COVID-19 symptoms and see if you need to order a free test
• Test - Helps you book a test and get your results
• Isolate - Keep track of your self-isolation countdown and access relevant advice

Privacy

The app will not track you or your location. Instead your postcode district helps the app work out where the virus is spreading.

When you first download the app, you will be asked for your postcode district. Your postcode district is the first part of your postcode, which is common to about 8,000 other households.

The app will not hold any personal information. It cannot be used to access a user’s identity or any other information on a user’s phone.  All users can delete the NHS COVID-19 app at any time and this will also delete all data stored on app.

Common questions

NHS Test and Trace have produced an introduction to the NHS COVID-19 app which provides further information on why the app is important, how it works, how privacy is protected and other common questions.

Communication resources

A national marketing campaign will launch on the 24 September to encourage people to download and use the app. NHS Test and Trace have shared a number of resources to help you communicate the benefits of the app to your community.

Social media messages

On social media, use the hash tags #NHSCOVID19app and #HaveYouDownloaded

Example social media messages

Video content

A video as been produced which you can share as part of your communications activity.

Supporting the app in your local media

You can use the following quote if you are asked for a response by your local media

“The NHS contact tracing app has potentially big benefits to offer in the fight against COVID-19 providing there is sufficient uptake from the population. The process of thoroughly testing the app and addressing the concerns that people raised about privacy and data protection was important and should result in greater trust and more people using it. If you have a smartphone we would encourage you to download the app and play your part in combating the spread of the virus.”

Posters you can print

Download an A4 or A3 poster you can print and put up.

Help with advice and information

NHS Test and Trace has produced a number of FAQs and explainers to support people to use the NHS COVID-19 App.

COVID-19 has forced Healthwatch to rely heavily on digital engagement methods as face to face engagement ceased in line with the new Government guidance.

After a series of online sessions with over 80 Healthwatch from across the country in which learning and best practice was shared, we’ve put together some tips for how to engage people well online.

This resource covers:

1. Using your website effectively
2. Using social media effectively
3. Using email marketing effectively
4. Virtual events and meeting
5. Mobilising your volunteers

Using your website effectively

• Advice and information
  Since the arrival of COVID-19 Healthwatch have been inundated with questions about what this means for people and their current care, and what services are available. Creating advice pieces can help people find this information online based on the queries that are coming through regularly. You can use the articles from Healthwatch England too and localise them where possible.
  Do you already have advice content? Review these and make sure that they are up to date and relevant to your area.
• Local information
  Localised information is key for your local Healthwatch website. Remember to always bring your article back to your core purpose. For example, if you are sharing an update about a local service, make sure that you encourage people to share their experiences with you or get in touch should they need more information.
• Blogs
  Showcase the impact that you have made to people using your Healthwatch through blogs from service users and your volunteers.
• Google analytics
  Google analytics can help you to better understand your audience, how your content is performing, and how people are getting to your site. Take a look at the latest training session from Healthwatch England to find out how your local Healthwatch can use this platform to be better informed about which content is having the most impact.

Top Tip: FAQ style articles perform better with regards to Search Engine Optimisation (SEO). Make sure you use headings to break up your content and use keywords throughout your article.

Using social media effectively

Social media is a hugely powerful tool for digital engagement. Our recommendation would always be to select one or two channels and do them well, rather than trying to be on every platform but not have the time to do it properly.

Here are some things that you can start doing to improve reach in your local area:

• Joining local Facebook groups
  Local Facebook groups are a great way to make your Healthwatch known to people that could benefit from your service, or to get people to share experiences to help your research project. Unfortunately not all groups on Facebook will allow business pages to join so it might be that you have to join the group using your personal account. If this is the case, make sure that you make your purpose clear to admins and to the group members. Remember that this is their personal space to share information with each other about issues they are facing.
• DM/Tag on Twitter
  Twitter posts have a very short life cycle. You can extend this by tagging people and using relevant hashtags. Before you post, check out what’s trending to see if there are any relevant hashtags that you can include. Can you raise your profile by tagging in your local MP? This is a great way of making issues known and improve awareness of what your local Healthwatch does.

  You can also DM local organisations to encourage them to share your content. Make sure that the organisation is relevant to the content of the post. For example, local 'Mind' organisations might be interested in posts around mental health, but they wouldn’t be interested in sharing posts about dentistry.

• Make your content relevant
  Are there any awareness days coming up? Is there any news that you can use as a hook to re-promote your content? Keep an eye out for these opportunities.
• Explore paid advertising
  Facebook advertising is one of the most cost-effective ways to reach out to your audience. With increased reliance on digital engagement, it is an effective way of raising the profile of your Healthwatch, as well as to encourage people to share their experiences with you online. You are able to target by location, age, gender and interests.
  The key to Facebook advertising is testing. It won’t work for you straight away, but you can start off with small budgets and then increase as you become more confident and successful.

Top tip: Create a spreadsheet of all of the relevant organisations and their Twitter handles, and organise by area of interest. It takes a while to formulate these lists originally, but it’s a great time saver in the long run and you can just build and build on these lists the more outreach you undertake.

Using email marketing effectively

E-newsletters are a great way to build a relationship with your audience, keeping people and partners up to date with the impact of your work, changes to local services and the latest advice and information.

• Think about your audience before you send your newsletter. Can you segment your audience into members of public vs partners and stakeholders? Make sure that the content is relevant for the audience so that people don’t unsubscribe from your list.
• Are there newsletters from organisations in your local area that you can feature in? This is a great way to increase awareness of your Healthwatch and build relationships with local services.
• Make sure that your newsletter displays short paragraphs that summarise the articles that can be found elsewhere, primarily on your website. You should think of your newsletter as a website traffic source.
• People don’t have time to read lengthy emails – be succinct.
• Personalise emails where possible e.g. Can you address it to a person rather than more generally? Take a look at MailChimp for more information on how to use merge tags to personalise your content.

Virtual events and meetings

The opportunity for face to face engagement is limited, if not completely redundant. This has led everyone to move to online forms of communications including virtual meetings and events. Here are some tips to help you:

• Attend events as a guest speaker
  You can connect with groups that are interested in other events and expand your audience by being a guest speaker. This is a great opportunity to promote your local Healthwatch, provide people with relevant advice and information, and gather intelligence on people’s experiences of services – all without the trouble of having to recruit participants.
• Host an online engagement event
  Use platforms such as Microsoft Teams to host your own online engagement event instead of relying on face to face engagement events.
  Things to consider:
  Agenda - make sure that you make it clear to people what the purpose of the event is. Don’t try to cover off too many things at one, be specific and make it relevant to your target audience.
  What is the user benefit - what do they get out of the event? Online events incur a much lower cost, so it may result in spare budget that could be used to entice people to join e.g. a gift voucher.
  Event promotion -  how you are going to promote the event? Reach out to relevant groups that would be interested in the event topic.

Top tip: Once you have chosen your platform, hold a test event with your team or your volunteers to make sure all the functions work as you expect. It’s good practice to have a slide at the start of any online session with some ‘housekeeping rules’ such as instructing people to mute themselves until they want to speak to stop any interference.

Mobilising your volunteers

You can involve your volunteers through online content such as:

• Website blogs
• Social media posts
• Short online videos
• Sharing surveys with other people/organisations

Volunteers posting photos of themselves during Volunteer’s Week holding a poster saying ‘I volunteer with Healthwatch because…’ proved to be a big hit so keep an eye out for any opportunities like this where you can involve your volunteers with your online content.

You can use this guidance to learn about the different types of bias that you need to consider when you plan your research. This includes:

• Bias in sampling
• Bias in research methods used for data collection
• Bias in data analysis

This guidance also includes worked examples relevant to local Healthwatch research work and top tips on minimising bias.