What is the Theory of Change?

There are many tools for understanding how organisations make a difference. One widely used by the non-profit sector is called ‘Theory of Change’. 

Your Theory of Change for an individual project or area of work describes a sequence of events or outcomes that you expect to lead to your desired long-term outcomes.

Producing a Theory of Change before starting a new piece of work can help you consider how likely you are to achieve positive changes. It can help you identify anything you might do differently to maximise the likelihood of success and make the best use of your resources. 

Usually, a Theory of Change is produced at a very early stage of planning a piece of work; before the more detailed project plan. 

We regularly provide workshops about using a Theory of Change approach. We can consider providing an online session for your team. Contact jon.turner@healthwatch.co.uk for more information. 

Template to create your own 

Based on a model provided by Healthwatch Islington, we’ve developed a template that you can use to produce your own Theory of Change in an easy format. 

It’s best used after you have attended a workshop. However, the template now includes instructions to remind you about each of the stages. It can help you to understand the process even if you haven't yet been to a workshop. 

The template uses Microsoft Excel. To view and use it properly, you will need to open it using a desktop version of Excel rather than an online or Office 365 version. 

After you’ve opened the document, go first to the tab that says ‘Overall Summary – read first.’ 

Having a page showing your impact can help everyone understand how your Healthwatch improves the lives of people living in your community. By adding new stories about what you have achieved, you can show the difference you have made. 

Here are three examples of Healthwatch who have built their impact page using our guidance: 

• Healthwatch Bristol
• Healthwatch Lambeth
• Healthwatch Sunderland

When creating your impact page from this guidance, it is essential that you:

• Keep each story short and to the point so readers can understand the difference you made. 
• Only add new stories when positive changes have been achieved. 
• Go back and update the stories if new outcomes happen so the content stays up to date. 

The Health and Care Bill is expected to pass in time for changes to come into effect in July 2022. This transformation will change health and social care decision making across 42 ICS footprints. In turn, the way that people's experiences inform these decisions will also need to change. 

Local Healthwatch, have a vital role in ensuring that the public continues to be heard. Whilst they already do this within Local Authority boundaries (at 'place' level), they will now need to work together with other Healthwatch to ensure the system acts on what they hear from communities across wider areas. 

Common themes for success

Although every case study is different based on population needs in each area, there are some common themes for success which you could consider when working with your ICS or local Healthwatch.

• A formalised working agreement between local Healthwatch, which defines how you will work together.
• Clear roles and responsibilities for local Healthwatch when representing on Integrated Care Boards, partnerships and committees.
• Clarity on the local Healthwatch resources currently available and a realistic expectation about what ICS involvement is possible within these limitations.
• The ICS resources local Healthwatch representation, engagement and insight gathering.
• Local Healthwatch are proactive in demonstrating the support they can offer the ICS.
• Local Healthwatch coordinate the sharing of insight and learning from engagement of people and communities and use this expertise to inform system decision making.
• An agreement between local Healthwatch and ICS guides the relationship, recognising the autonomy of local Healthwatch.
• The role of local Healthwatch in development, delivery and governance of ICS people and communities engagement is clearly defined and championed by the ICS.
• The independent role of Local Healthwatch is understood and valued by the system.
• The ICS utilises the strength of local Healthwatch to ensure that the voice of the public is heard.

Healthwatch Together is a collaboration of four local Healthwatch organisations: Healthwatch Blackburn and Darwen, Healthwatch Blackpool, Healthwatch Cumbria and Healthwatch Lancashire. They have come together to provide engagement support across the Lancashire and South Cumbria Integrated Care System (ICS) footprint. 

The Partnership serves a diverse population of 1.8 million people. Some areas have high deprivation, such as Blackpool and Blackburn and Darwen (29.1% of the population live in some of the most deprived area in the country). 20% of adults are not meeting the recommended levels of physical activity and 18.5% of the adult population smoke.

How are they working together? 

• The four local Healthwatch organisations have an agreed Memorandum of Understanding in place establishing how they will act as Healthwatch Together.
• The approach to collaborative working as Healthwatch Together is documented as an 'Our Offer' document and shared with stakeholders such as NHS organisations and local authorities.
• Healthwatch Lancashire acts as the lead organisation, sending representatives to system meetings and coordinating efforts.
• Healthwatch Together has two key forums for strategic and operational collaboration: a monthly strategic meeting where chief executives of the local Healthwatch organisations meet to discuss strategic and operational priorities; a fortnightly operational meeting where teams work together to help shape and deliver projects.
• Using these agreed approaches, Healthwatch Together responds to ICS commissions as follows: A project lead is appointed from one of the local Healthwatch organisations, based on expertise in delivering the work; resources are pooled and then reallocated to deliver the project as required depending on the population of interest, expertise and capacity to deliver; service level agreements are put in place for specific projects where relevant.

What are the enablers of working together? 

• Local Healthwatch organisations in Lancashire and Cumbria have a legacy of strong working relationships with the health and care system, community and voluntary sector. This includes CCG Board representation, supporting past Sustainability Transformation Partnerships, delivering engagement activities, and developing the ICS.
• The ICS and Healthwatch Together ensure that Healthwatch is represented at key local forums, including: 1). the ICS Board and the Strategic Commissioning Committee. In these meetings, Healthwatch Together shares insight from local people to inform high-level decision making. For example, using this group Healthwatch Together has set up governance arrangements for the ICS to engage with local people. 2). The Partnership Board. This ICS sub-group brings together stakeholders and partners more directly.
• Healthwatch Together has developed a way for local people to connect and engage with the ICS, articulated in their support offer. They are also in the process of agreeing a pricing schedule with a menu of options that Healthwatch Together can offer which will enable them to respond quickly to requests for pieces of work.
• A data-sharing agreement is being developed between Healthwatch Together and the NHS across Lancashire and South Cumbria and information sharing routes have been established.

Example of working together 

Healthwatch Together has been commissioned by NHS partners across the ICS to explore local people’s perspectives, especially those from communities whose views are often overlooked, about the New Hospital Programme suggestions for Lancashire.

The plans explore the option to replace one or two local hospitals and instead access specialist clinical services from one hospital site rather than multiple sites.

To do this Healthwatch Together launched an early engagement campaign across Lancashire which will be followed up with a formal consultation process with the public.

Phase one of the engagement efforts informed the business case for the New Hospitals Programme and explored why people felt this was an important change. Phase two of engagement currently involves local Healthwatch using different methods (e.g. surveys and focus groups) to hear from seldom heard communities and vulnerable groups. These include asylum seeker and refugee communities, South Asian women, veterans, and LGBT groups.

Healthwatch Together are using their local knowledge, expertise and connections with voluntary and community groups. The aim of this engagement is to understand people’s views to inform decisions about where the new hospital will be and what services it may offer. As well as producing an independent report, Healthwatch Together is also sharing emerging learning with the project managers across the ICS to inform decision making as they go along.

This case study was produced by the Strategy Unit for Healthwatch England.

The Quality Framework is a self-assessment tool you can use to understand whether your work is practical or needs to improve. 

Healthwatch Cambridgeshire and Peterborough deliver their services to around one million residents, serving one Integrated Care System and seven local authority areas. They talk us through how they use the Quality Framework to support their work.

Why is quality important to you? 

We believe that a visible commitment to quality shows that we are a well-governed organisation that operates with transparency. This increases our commissioner’s confidence in us. 

In 2018 we decided to apply for the Practical Quality Assurance System for Small Organisations (PQASSO) accreditations designed for small charities. We completed the assessment in 2019 and drafted an action plan to work on the identified improvements. 

Why did you decide to complete the Quality Framework?

Despite having just completed the PQASSO, we decided to undertake the Quality Framework because it was far better suited to our needs as it specifically related to Healthwatch. 

How did you carry out the assessment?

The project was led by our Chief Executive Officer, but all the staff helped complete the work. 

We identified a manager to lead for each of the six domains of the quality framework (Leadership and Decision-Making, People, Sustainability and Resilience, Collaboration, Engagement Involvement and Reach, and Influence and Impact.)

The domain lead would work through the questions within the Quality Framework and identify areas for improvement.  

The action plan that we had created for the PQASSO assessment was used and absorbed into our new action plan. 

The initial findings were presented to our Board, who checked that the improvement areas we had highlighted aligned with our strategic direction.

What benefits did you find? 

The benefits of using the Quality Framework can be split into three sections: 

1. People
2. Sustainability and resilience 
3. Engagement, involvement and reach

People

We prioritised gaining our “Investing in volunteers” accreditation. We reviewed our volunteering policy and processes to achieve this, and our existing volunteers helped us with this. 

We also reviewed the Human Resources systems we use to ensure all our records are GDPR compliant. 

Sustainability and Resilience

We developed a better understanding of the value of a business development strategy and put one together. We were also able to write a work plan to support this strategy. 

These written plans in place gave us better clarity of our business goals and offer and enabled us to introduce a project cost analysis review. 

Engagement, Involvement and Reach

The benefits include that we have been able to introduce a demographic analysis of our reach so that we can better target people we do not hear from. 

We have also been able to include engagement with young people in this year’s work programme as it was highlighted as an area we could improve in. To achieve this, we have recruited for a new role of Associate Director to help advise on youth engagement. 

What outcomes did you get from the Quality Framework? 

Many of the changes we have implemented due to the Quality Framework have led to positive outcomes. 

Short term outcomes include:

• Increased volunteer confidence due to our “Investing in volunteers” accreditation.
• Better team working and improved project planning.
• Improved public understanding of our impact through better tracking and reporting. 

Longer-term outcomes include: 

• Increased voice for younger people across Cambridgeshire and Peterborough.
• We can better target who we can influence.
• Our understanding of resource allocation has been improved through the project management systems we now use. 
• We can better amplify the voices of people less often heard from as we enhance our understanding of our reach. 

How will you continue to check quality?

Areas that we are aware of that still need improvement have been included in our annual work programme to ensure we continue to improve. These include: 

• Delivery of our communications and engagement strategy
• Delivery of our business development strategy
• Targeted engagement with less heard from communities
• Embedding use of the Healthwatch England Impact Tracker

As part of our strategic review in 2022, we plan to gather stakeholder perceptions to get more information and insight into areas we can continue to improve. 

What are your overall views of the Quality Framework?

Completing the Quality Framework assessment was a very worthwhile investment of our time. We found it hugely beneficial in identifying areas for improvement. 

We found spreading the different areas of the Framework across the team helped break down the workload and keep it more manageable alongside the rest of our workload. 

The Quality Framework provided our Board and commissioners with the reassurance they wanted, and our quality action plan keeps them informed of our ongoing progress. 

Who is working together?

Eight local Healthwatch organisations in North East London are working together with the North East London Integrated Care System (ICS). These are:

•  Healthwatch Hackney 
• Healthwatch City of London
• Healthwatch Tower Hamlets
• Healthwatch Newham
• Healthwatch Waltham Forest
• Healthwatch Barking and Dagenham
• Healthwatch Havering
• Healthwatch Redbridge

Geographically, the ICS covers a large and complex patch. The inner-city boroughs are more ethnically diverse, have higher levels of deprivation and unemployment and higher density populations. Newham borough is the most diverse in the country and Hackney borough has a significant orthodox Jewish community. The outer city boroughs have older populations.

How are they working together?

• The ICS covers seven former Clinical Commissioning Groups (CCGs), which formally merged into one in April 2021. Prior to the development of the ICS, the eight local Healthwatch worked together within their own CCGs, attending the CCG board and the Patient Participation Groups.
• The developing ICS has provided a route for local Healthwatch to work together via an informal network with regular communication over email.
• Local Healthwatch have been working with the North East London People Engagement Working Group which is developing the strategic approach in advance of the ICS being established in April 2022. Representatives attend either the working group or related sub-groups.
• The ICS and all eight local Healthwatch now meet every two months. This regular meeting provides the ICS Chair, Chief Executive, the Communications and Engagement Lead and the local Healthwatch Leads with a forum for dialogue and a space to highlight local issues.
  • The ICS is co-producing six principles for engagement with partners including local Healthwatch. This incorporates the learning from the Co-production Charter which is currently used in City and Hackney.
  • Healthwatch are also supporting the development of the ICS engagement strategy. Healthwatch is viewed as best placed to champion patient voice for the ICS, to understand local issues and connect the ICS to local people and seldom heard groups.
• Local Healthwatch first worked together in response to a tender from the ICS to deliver community insights through a single database across the ICS, particularly in relation to COVID. The eight local Healthwatch combined their data, using a system already in use by some local Healthwatch to provide ICS level insight (see example below).
• Local Healthwatch have also organised themselves into three partnerships around the footprints of the Hospital Trusts so that they are better able to serve their local hospital or Trust:
  • Hackney and City of London for Homerton University Hospital NHS Foundation Trust.
  • Tower Hamlets, Newham and Waltham Forest for Barts Health NHS Trust.
  • Barking and Dagenham, Havering and Redbridge for Barking, Havering and Redbridge University Hospitals NHS Trust.
• Local Healthwatch are invited to the CCG Governing Body meeting and Primary Care Commissioning Committee. Currently local Healthwatch volunteer to join specific ICS boards based on interest and capacity, but this will be reviewed once the ICS finalises the design of their governance and decision making. There is expected to be further agreement of local Healthwatch participation arrangements in ICS governance, for example sub-committees such as ‘quality, safety and improvement’. Healthwatch are actively involved in and expected to have seats within local place/borough partnership boards.
• Healthwatch activities for the ICS are funded through the ICS engagement budget. Specific commissioned ICS projects are distributed amongst the local Healthwatch taking into account the nature of the work and individual Healthwatch priorities and skill sets.

What are the enablers of working together?

• The ICS held an early development session for all system partners including commissioners, providers, community and voluntary sector leads and local Healthwatch to set the ambition and the priorities for the ICS and strengthen relationships between partners.
• The ICS Chair is a strong advocate for Healthwatch and the voluntary and community sector, ensuring that these organisations have a voice within the ICS. In turn, local Healthwatch provide objective and independent data-informed evidence to the ICS.
• Healthwatch acts as ‘the golden thread’ across system partners, including the community and voluntary sector, providing community insights and sharing reports.
• A mutually beneficial relationship between the ICS Corporate Communications team and Healthwatch. For example, Healthwatch provides local intelligence for the ICS Corporate Communications team and the team support local Healthwatch with publicity strategies.
• There is diversity in Healthwatch senior leaders with respect to age, ethnicity background and interests. Regular structured meetings as well as ad hoc meetings ensure a good level of communication between Healthwatch leaders.
• Local Healthwatch are supportive of one another and willingly share data. They are also able to critically reflect on each other’s projects to make improvements.

Example of working together to deliver community insights

Led by Healthwatch Tower Hamlets and with Healthwatch England as a strategic partner, local Healthwatch in North East London are working collaboratively to produce a Community Insights Repository which collates feedback for providers from different sources, such as NHS Choices, Care Opinion, Google reviews, website feedback, surveys and complaints. The system, together with more detailed community insights projects, was funded in 2020 by the ICS for three years and is governed by a joint steering group of local Healthwatch, Healthwatch England and the ICS.

Healthwatch staff can use the Insight System to synthesise feedback on an issue of interest, providing a full picture of that feature of care across boroughs, services and providers in the ICS. Through this system, approximately 161,000 issues have been recorded based on feedback from almost 44,000 people, and 40 insight reports on areas of interest have been produced to date.

Data from the system also allows local Healthwatch to advocate for improvement efforts where it is most required. For example, using the Community Insights System, local Healthwatch identified residents with disabilities in North East London were the most challenged by poor health and care communication during the pandemic. As a result, Healthwatch were able to target research activity towards this population and produce a range of reports, including easy to understand infographic reports.

In addition, teams from across the ICS have made good use of the Community Insights System to further explore local views before commissioning services. For example, ahead of submitting the North East London Long Term Plan strategy, local Healthwatch were commissioned to host two focus groups and complete 250 questionnaires in each borough. They engaged with 2000 people face to face and 1275 patient surveys were completed. This insight was invaluable in the development of the strategy and directly influenced plans. To actively encourage partners to utilise the system, training sessions are being offered on a regular basis.

This case study was produced by the Strategy Unit for Healthwatch England.

Who is working together?

Six local Healthwatch organisations in South East London are working with Our Healthier South East London Integrated Care System (ICS), including:

• Healthwatch Greenwich
• Healthwatch Lewisham
• Healthwatch Southwark
• Healthwatch Lambeth
• Healthwatch Bexley
• Healthwatch Bromley

What's the population like?

The ICS serves a diverse population of approximately two million people with pockets of deprivation sitting side by side with significant pockets of wealth. Age profiles vary widely across the six boroughs - Bromley has the oldest population in London, and Lambeth and Southwark are the most diverse and youngest boroughs. In Greenwich, with a population of 280,000 people, 47.9% are from an ethnically diverse background with a seven-year range in life expectancy from poorest to wealthiest parts of the borough.

How are they working together?

• Six local Clinical Commissioning Groups (CCGs) formally merged in 2020. This provided the impetus for six local Healthwatch who were already working together to consider how best to organise their collective approach and relationship with the new South East London CCG.
• The six local Healthwatch are now represented by a single South East London Healthwatch Director, who has a dedicated leadership role in ensuring that patient voice across South East London is central to decision making within the ICS.
• The South East London CCG currently funds the director role. System partners are confident about continued funding of this role with the formation of the ICS Partnership.
• Local Healthwatch meet every two weeks with a set agenda, including developments within the ICS and other relevant committees shared by the South East London Healthwatch Director. This forum also provides an opportunity for local Healthwatch to feedback on significant concerns collectively.
• Communication and engagement specialists across local Healthwatch meet regularly with the South East London Healthwatch Director. The Director works with the ICS communications and engagement leads to contribute to developing an ICS engagement strategy.
• Local Healthwatch have a joint working agreement and pool resources for relevant projects. They have developed an approach to team working and allocate tasks based on the issue being addressed and area targeted. For example:
  • Southwark and Lambeth partner together to work on local initiatives which involve Guy's and St Thomas’ and King's hospitals.
  • Lewisham and Greenwich work together to support and progress improvements and developments at the Lewisham and Greenwich NHS Trust, for example policy and process on charges for patients not eligible to access free NHS services. o Lewisham have been active members of a GP task and finish group. This is helping to provide input from local users into fast-moving issues like the development of digital tools and proposed GP mergers. 
  • Greenwich took a key role on the mutual aid governance board during the COVID pandemic.

What are the enablers of working together?

• Local Healthwatch have prior experience of working in partnership at a place-based level with local providers, smaller provider collaboratives, and the previous South East London Sustainability and Transformation Partnership.
• The Healthwatch Director has previously worked as a Healthwatch Chief Executive and has a specific leadership and coordination role for local Healthwatch within the ICS.
• The Healthwatch Director is a member of various governance bodies in the CCG/ICS. This includes the Primary Care Commissioning Committee, the Engagement Assurance Committee, the Equality Committee, the Equalities Task Force (which was set up specifically to look at vaccine distribution and COVID inequalities, and is expanding its remit), the Quality and Safety Subcommittee, the Data Usage Committee, the Information Governance Steering Group of the ICS, and the South London COVID-19 Preventing Mental Ill-Health Taskforce.
• Local Healthwatch perceive their work with the ICS to be an extension of their statutory duties. Joint reports are shared and published on all six local Healthwatch websites.
• Following the local Healthwatch joint working protocol, the Healthwatch Director delivers a progress update to the six local Healthwatch and the ICS. This reports activity against the domains set out in the Quality Framework but also captures impact, for example, where the ICS has accepted evidence or recommendations presented by the Healthwatch and agreed an action plan. This means it can be followed up to ensure the ICS is responding appropriately to feedback from users.

Working together to improve access to GP services

Local Healthwatch are working collaboratively, with support from the ICS, to assess access to GP services in South East London. The purpose of this work is to help the ICS dig beneath the surface satisfaction figures provided by the annual GP Patient Survey, and to properly contextualise the current media stories around problems with access to primary care. This means the ICS has an accurate local picture of current experience and an understanding of why people are having these problems.

To provide this insight, each of the six local Healthwatch is responsible for assessing (with agreed parameters) the quality of information regarding access on GP websites. A website audit tool has been developed and shared across the six boroughs to support this task. In addition. each Healthwatch is tailoring a base survey, that was developed in collaboration, to collect people’s experience of accessing GP services. For example, Lambeth is gathering insight at GP practices; Bexley and Southwark are carrying out qualitative research, in addition to the survey; and Lewisham, Bexley and Bromley have added questions to their survey. To date 1,145 people have participated in the survey.

Developing and administering the survey in collaboration has reduced the administrative burden and allowed for the identification of cross cutting emergent themes that are common across the six boroughs. For example, a key theme that has emerged is that online triage and waiting for telephone calls from GPs causes patients to experience confusion and anxiety. The ICS has committed to using the findings from local Healthwatch to inform local plans to improve patient experience of accessing GP services.

This case study was produced by the Strategy Unit for Healthwatch England.

About

Healthwatch Week ran from 9-12 November 2021 and saw staff and volunteers join us online from across England. Find out the key takeaways from each day and access further resources to help you apply what we learned. 

• Day one
• Day two
• Day three
• Day four

Day one

A message from NHS England

The conference got going with a welcome message from NHS England Chief Executive Amanda Pritchard. Amanda spoke about how much the NHS appreciates the work you do to make care better and the vital role Healthwatch can play in helping to overcome the challenges that health and social care services face. 

Our Chair, Sir Robert Francis QC, then talked about how far we had come, with more than two million people supported to share their experience or get advice last year. However, he warned delegates that we still faced challenges that we must overcome to remain relevant. 

Takeaways from other sessions

Putting our values into practice

Most staff believe our brand is critical to our work but do deliver a strong brand we need to embed our values in our work. Tips include:

• Have clear objectives and follow up on work to understand your impact so we can demonstrate our value of 'acting'.
• Train staff to ensure our communications are accessible to help deliver our value of 'including'. 
• Adopt our new brand behaviours when they are launched. 

Healthwatch brand messaging guidance

Collecting demographic data

Lots of factors, like ethnicity and peoples income levels, can affect peoples care. Collecting demographic data is key to understanding the experiences of different sections of the community. When you live in areas that are not as diverse, this information is even more critical. Asking for demographic data is not always straightforward, but there is training to support you. Every little bit of information helps when collecting demographic data and even answering one question is better than answering none. 

How to collect and use demographic data

Using the quality framework

The Quality Framework self-assessment tool has helped many local Healthwatch understand work areas that might need improvement. Lessons from local Healthwatch who have been through the exercise includes the importance of harnessing the different perspectives of board members, staff and volunteers and prioritising actions over time to make them manageable. 

The Quality Framework: How can it help you?

Communicating the difference we make

People must understand the difference their views have made to local services. Tactics to achieve this goal include:

• Make time to track if changes have occurred and plan this into your work.
• Promoting the improvements that have been achieved rather than the tasks that got you there. 
• Describe what you have achieved engagingly and what would have happened if services had not acted on your evidence. 

Demonstrating impact – new resources

Key reflections

Ending the day, our former national director Imelda Redmond reflected on the unique role of Healthwatch.

Day two

Holding services to account

Day two kicked off with a debate about one of our important roles - holding care services to account. Delegates agreed that this works best when we build constructive relationships with health and social care decision-makers, and we can influence decisions before they are made. Many of you think that carrying out this role will be challenging in the new health and care landscape, but we can if we continue building our skills, relationships and working together to be heard. 

Takeaways from other sessions

Making your communications accessible

Accessibility isn't a box-ticking exercise and should be an essential part of our everyday work. To make sure your communications are accessible, there are straightforward steps you can take, like using ALT tags. You can also avoid doing things, like using complex language, to ensure what you say is easy for people to understand. The brand language guide includes an accessibility checklist you can use.

How can we make our information as accessible as possible?

Using data to make a difference

Once you're collecting demographic data, analysing it to understand what it can tell you involves trial, error and exploration. Top tips include using statistical approaches like ratios and pivot tables to see what you uncover and using external data to make comparisons. 

How to collect and use demographic data

How volunteers can help tackle inequalities

In helping to tackle health inequalities, its important to have volunteers drawn from across the diverse communities we serve. Our volunteers can play an essential role by championing equality in our work, raising awareness of the different perspectives some groups have and helping to build relationships with their communities.

Guide to Volunteering

Day three

A message from Government

Minister of State for Health Mr Edward Argar MP welcomed delegates by speaking about our role in the future NHS landscape.

Takeaways from other sessions

Policy breakfast briefing: Social care

The public are unclear on the recent changes to social care and are increasingly concerned about issues like access, eligibility and how to pay for care. There are a lot of issues across the country at the moment with inconsistent care and financial assessments. This can lead to people giving up and not getting the care they need. We can help by focussing on clear advice and highlighting where local needs are not being met.

Advice and information: What is adult social care? 

Supporting volunteers in the new health and social care landscape

The role of volunteers within the new ICS landscape is unclear and only just over a third of delegates were confident that their ICS had volunteering on their agenda. Without a statutory requirement volunteer and patient involvement is likely to be inconsistent across the country. You can help by raising volunteering with your ICS and encouraging a discussion to find out what roles our volunteers can help with.  

Resources to support volunteering

Representation of people and communities through local Healthwatch 

Having a seat at the ICS table is important that Healthwatch demonstrate the value they bring. Bring able provide to provide evidence we collect at an ICS level and build trust through this valuable insight is key. Having Healthwatch representation will also give us the opportunity to hold systems to account for their decisions. Doing this is often a difficult task that uses a lot of resource, so it is important we come together, support and learn from each other. 

Watch the recording of this session on YouTube.

How are Healthwatch and ICS's working together?

Celebrating the difference we make

Day three also saw our annual network awards ceremony, celebrating the difference you've made over the last twelve months. 

Day four

The final day of the conference included a debate about our role in public health and an overview of net steps following Healthwatch Week.  

Takeaways from other sessions

Using our new Healthwatch brand

Consistently using the new Healthwatch tone of voice and personality takes practice but will help you grab people's attention, keep them interested and build trust. Tips to help you write like Healthwatch include:

• Speak to the reader
• Keep copy short, sharp and write in an active tone
• Use plain English and cut unnecessary information
• Write with specific personality points in mind

Brand messaging guidance

Turning evidence into change: Stakeholder influencing

Local Healthwatch are currently spending a lot of time influencing ICSs and it is not yet clear what the impact of this influencing is. However, we also sit on boards and committees such as Health and Wellbeing boards and this can lead to a lot of impact, helping to build relationships with local stakeholders and ensuring the Healthwatch voice is heard.

A guide to running Healthwatch

Working together: CQC, NICE and Healthwatch England

We are all aligned on our strategy to prioritise tackling health inequalities in our work. This gives us the opportunity to collaborate more, particularly in targeting seldom heard communities and making it as easy as possible for these communities to talk to us. Demonstrating the outcomes of our work will be key to demonstrating success in this new strategy – and all three organisations are looking at new ways of ‘closing the loop’ and showing people the impact their feedback has had.  

Watch the recording of this session on YouTube.

CQC and local Healthwatch working together

To support data sharing on a regional and national level, we need to make sure the information we collect is consistent with each other and key stakeholders.

You can find out more about our progress on digital transformation and the need for us to have a more significant focus on data standards in our blog.

We know through our conversations with the network, that there is more work to be done to:

• Produce a more standardised way to collect data across Healthwatch so that we can strengthen our collective insight. More similar data sets will be critical as Integrated Care Systems (ICS) moves to a statutory footing, helping to allow for easier comparisons.
• Understand the systems that are in use to collect and store data within the network so that we can build on what's working well.
• Know the barriers to data sharing and help overcome these.

So, what are we doing about it?

To start, we’re going to be contacting a sample of local Healthwatch who do not currently use the CiviCRM to ask a series of questions about your current approach to digital and data sharing.

Having already done this for 12 Healthwatch this approach has shown to be hugely insightful and has shaped our work and plans moving forward.

What will we do with the findings?

Create a standard taxonomy to help with data sharing

We will be revisiting our 'minimum viable taxonomy' in light of the information we've received from local Healthwatch about how data is categorised. Our aim is to help standardise the information while retaining a degree of flexibility at local levels.

We then will look at a solution to aid sharing data in the most straightforward and least resource-intensive way possible back with Healthwatch England to host in one place. It will enable data to be brought together for conclusions on a local, regional and national level.

We want to reassure you that we are currently working with a data consultant to ensure we operate to the highest level of data standards. Data sharing between local Healthwatch as well as with Healthwatch England is part of this work.

Use the insight to aid our decision around supporting the CiviCRM

At the moment, we've committed to supporting the CiviCRM until March 2023. We know that for some local Healthwatch the CiviCRM is not easy to use, and reporting can be complicated. However, before we can decide to move away from the system, we need to understand:

1. Alternative systems that work well within the network so that we can fully assess other viable options
2. The core business needs that an alternative system will need to provide
3. How data will be shared with Healthwatch England if we did not have the CiviCRM

How can I help?

We will try to contact as many of the local Healthwatch who do not currently use the CiviCRM as we can from the end of October.

If you’re contacted, we will be asking you for a couple of hours of your time to demonstrate the systems you use, and ask some additional questions. We will also talk you through our plans in a little more detail with the opportunity to ask questions.

If you haven't been approached by Friday 19 November but would like to participate, please email digital@healthwatch.co.uk.

For those who use the CiviCRM, we will be looking to speak with you in 2022.

About this resource

Being able to demonstrate your impact is important in helping you to secure future funding and so that Healthwatch is seen as a credible organisation locally and nationally.

To help you identify how you can further develop your work to focus on outcomes and impact we have created a self-assessment tool.

This resource helps you spend about an hour looking at different areas of your work and actions you can take to improve your ability to plan, identify and communicate impact.

You can complete this as an optional add on part of your Quality Framework process or use it on its own at any other point in time.