Working with integrated care systems
Throughout the development of new structures across health and social care, we have worked to support both the Healthwatch network and the systems themselves to ensure that people’s views and needs can be properly represented. Integrated care systems comprise two key components: integrated care boards and integrated care partnerships. The King’s Fund provide a clear explanation of integrated care systems.
This NHS guidance sets out how ICSs should work with people and communities. It includes a section on working with Healthwatch, building on current good work, and draws a distinction between Healthwatch and the wider voluntary, community and social enterprise (VCSE) sector. This guidance can provide a helpful basis for you to discuss engagement plans with ICS engagement leads as well as other Healthwatch in your ICS area.
Our collaboration toolkit can also help you collaborate with other Healthwatch and place and system level.
ICS-related funding
The development of ICSs means local Healthwatch need to work both within their local authority boundary and with their ICS. The NHS guidance recognises that Healthwatch are not ordinarily funded to carry out this work at system level and each ICS should consider what additional support is needed.
Somerset is the first jointly-commissioned Healthwatch between a local authority and an ICS. We are aware of other areas considering a similar approach.
Local Healthwatch reported receiving an increase in funding from £1m in 2021/22 to £1.45m in 2022/23 by ICSs. However, only a select number of Healthwatch are benefiting, adding to the increased variation across the country and within ICS footprints with multiple Healthwatch. Of the 44 ICSs, 16 are not providing funding to Healthwatch. There is a mixed picture around support for Healthwatch in the 23 ICS areas with more complex footprints, involving three or more Healthwatch. 13 such ICSs provide no funding to support coordination and representation.
Representation
When the legislation for ICSs was being developed, we advocated for Healthwatch to have a mandatory place on ICBs. Although this was not agreed and it was left to local determination, local Healthwatch are represented on 31 ICBs and 117 local Healthwatch sit on ICPs as reported by local Healthwatch in Autumn 2023.
Healthwatch working collaboratively
The introduction of ICSs further strengthened the requirement for Healthwatch to work collaboratively. Of the 42 ICSs, 37 involve more than one Healthwatch. The Healthwatch Trademark Licence makes provision for such collaborative working and use of the brand and logo. Please refer to our guide. [add in link].
Healthwatch should sign a data sharing agreement between themselves in addition to the data sharing agreement between Healthwatch England and your Healthwatch. We have produced this template agreement to support collaboration on data sharing.
Our Collaboration Toolkit helps Healthwatch work through the opportunities and challenges that will require you at times to represent each other, carry out engagement together, collate insight, and influence together. A formal agreement will prevent misunderstanding and ensure everyone has clarity on roles. It also includes a memorandum of understanding template to create a joint agreement on how you and your ICS will formally work together.
Support from Healthwatch England
We facilitate a peer network of Healthwatch representatives for each ICS area, which meets quarterly. Dates of meetings are available by searching our events section.
ICS Engagement Leads Network
NHS England and Healthwatch England bring together ICS Engagement Leads and Healthwatch Representatives to discuss how we can best work together and share learning.
Core questions
Healthwatch England and local Healthwatch together have compiled a core set of questions for your ICS across a range of topics.
Asking these is completely optional, and you can ask as many or as few of these as you like. We know you will all be conscious of creating an undue amount of work for NHS colleagues.