This year, my team and I thoroughly enjoyed reading through your annual reports. It’s such a rewarding and motivating experience to see the difference you're making for communities across England. From influencing local plans and strategies to ensuring public communications are accessible and understandable, revising service delivery for better effectiveness, and facilitating people’s involvement in service design—you’re making a tangible impact. It’s clear how much your work means for the experience and health outcomes of local people.

There’s a strong consensus across the Healthwatch network that demonstrating impact is essential to maintaining support and securing funding. This priority has been reinforced in our conversations with local authority commissioners and other key stakeholders—demonstrating outcomes is a clear expectation we've incorporated into the new template contract specification we are developing at their request. Highlighting impact is also vital for making the case for Healthwatch’s future sustainability and growth. That’s why we’ve made impact a core service value and placed greater emphasis on outcomes in our updated annual report template.

Next steps

At Healthwatch England, we’re tasked with forming an opinion on the effectiveness of local services. The outcomes achieved by each local Healthwatch are key proxy indicators that inform our reporting on the State of the Network – the picture of the effectiveness of Healthwatch. We look forward to showcasing examples of Healthwatch outcomes across health and care, particularly those addressing inequalities, including our forthcoming National Awards 2024.

In just two years, there’s been a remarkable shift towards outcomes-focused reporting. In 2021/22, only 40% of annual reports demonstrated a good level of outcomes reporting. This year, we saw that figure rise to 80%! The progress over the past year alone is impressive: between the 2022/23 and 2023/24 reports, a third of the network significantly increased their focus on outcomes reporting, with another third showing a marked improvement.

Moreover, the majority of annual reports that communicated outcomes highlighted changes with a clear impact on reducing health inequalities—a tremendous shift in focus that the network has achieved in a few short years.

There’s still a little way to go for some Healthwatch to communicate achievements as effectively as the front-runners. However, we’re confident that in most cases, it’s a matter of following up on completed work or refining how the story is told about what’s achieved for local residents. 

For the Healthwatch that may be struggling with outcomes reporting, we understand there can be various challenges. It might also be that we’re not fully capturing the real picture from the annual reports alone. That’s why we’ll be reaching out to better understand your experiences locally and explore how we can provide further support.

Thank you for your ongoing dedication and for sharing the incredible work you do. It’s inspiring to see the progress made and the growing focus on outcomes that truly make a difference for local communities. Together, we are building a stronger, more impactful Healthwatch network.

For further information about this or the wider impact programme then please feel free to contact jon.turner@healthwatch.co.uk 

At last year's conference, I outlined a key strategic objective: to address the sustainability and variation within the Healthwatch network—something many of you highlighted when I first joined Healthwatch England.

With a general election on the horizon, we knew we had to be ready to make our case for change and seize any potential legislative opportunities.

Since then, these discussions have been both necessary and, at times, challenging. You've shared firmly held views rooted in your conviction and experience – including those at odds with the proposal preferred by our National Committee with Healthwatch England as commissioner, referenced in National Committee member Jane Laughton's blog.

We all agree on the scale of our challenges: unsustainable, inequitable funding and negative variation, often driven by factors beyond individual Healthwatch control, such as commissioning.

Without change, some Healthwatch will become unviable, leaving communities without a public champion and eroding the collective influence we've worked hard to build.

However, we didn't foretell the Dash Review, which now examines local Healthwatch and Healthwatch England alongside patient safety organisations.

These tough conversations have prepared us for any changes from the review. We are committed to supporting it, enabling local Healthwatch to have a voice in the process and putting forward our case for change.

Your views have been crucial in shaping our thinking. We've heard about the critical role Healthwatch plays in your communities, the importance of local decision-making and the deep relationships you hold with local people, groups and stakeholders.

The case for local Healthwatch in every area has been heard. There's consensus that we must maintain and strengthen relationships with local authorities while carefully keeping what's working well in certain areas. There is much more work to be done on what this looks like.

Is the proposal fully developed? No, it remains a high-level proposal as part of our broader case for change. 

In any case, we are committed to presenting all the models we've explored and their respective advantages and risks. Ultimately, if we succeed in making our case, it will be up to government decision-makers to shape our future, including decisions on our funding. A full implementation and transition plan will be required.

Healthwatch provides significant value, with even greater untapped potential. Reading your annual reports and hearing about your impact on my visits to your communities has been inspiring.

From your insight into driving national change to individual Healthwatch contributing to select committees and collaborating to influence ICB decision-making, we achieve far more than our size suggests.

For just a penny per person per week, we deliver incredible value—and we know we can achieve even more.

In the wake of the Darzi Review, much attention has focused on fixing the NHS. We’re poised to play our part in helping to shape the 10-Year Plan for the NHS with the involvement of local Healthwatch.

We believe social care needs the same focus—a message we will continue to champion. As the public's health and care champion, Healthwatch must be central to any revitalised system—where lived experiences, particularly from those facing inequalities, drive improvement and accountability.

This is key to ensuring a more equitable system with better outcomes for all.

I joined the Healthwatch England Committee in September 2023 to bring the voice of local Healthwatch to committee discussions and decisions. At the time I was the Chief Executive Officer (CEO) of Healthwatch Nottingham and Nottinghamshire, a post I held for five years until I stepped down at the end of 2023. 

I believe passionately in the value of local Healthwatch. We achieve some amazing things locally and nationally. But as a Healthwatch CEO I faced issues that many of you will have experienced:

• How to fulfil our huge remit across health and care with poor levels of funding (Healthwatch Nottingham and Nottinghamshire are some of the lowest-funded Healthwatch in the country based on pence per head of population). This was more difficult because of increasing multiple needs in our local communities, especially those with no voice and those experiencing health inequalities.
• Our contracts were for only three years, creating challenges with long-term planning for our strategy and impact.
• Increasing numbers of partners and groups to connect to, including four place-based partnerships and the integrated care board. These were important partnerships, but they generated yet more meetings to attend. 

Like many Healthwatch, these issues limited our capacity to empower local people to have a voice and hold local NHS and care organisations to account. They limited the number of communities and providers where we could make a difference with in-depth investigation, so we could not always achieve as much impact as would have liked. 

Why we need to change 

Local Healthwatch are crucial. We are the only organisations with the independence and statutory power to hold health and care services to account for listening to their communities. If their voices are not heard, services will be commissioned in a way that does not work for them or excludes them altogether. 

Individual local Healthwatch make their own decisions about how to prioritise, which leads to an inconsistent approach across the local Healthwatch network. As King’s College London said in its report on Healthwatch: “The diversity of the Healthwatch network … has considerable implications for equity of access to influencing health and care planning and provision for residents across England”. This affects our brand and profile.

Despite consistently raising this issue with the previous administration, Healthwatch funding has continued to decrease. Under the current economic climate this is unlikely to change. The risk is that we reach a point where delivering Healthwatch England and Healthwatch becomes financially unviable.

The total resource for Healthwatch England and the local Healthwatch network is £28m, £25m of which funds local Healthwatch. How can we work differently to achieve more and deliver a more consistent local Healthwatch offer across England, without additional funding? 

What needs to happen now

Healthwatch England has led a 12-month engagement process during which chairs, lead officers and staff representing 101 local Healthwatch have contributed their views and debated the issues. A working group of representatives from ten local Healthwatch representatives has had further detailed discussions. With 153 Healthwatch it is no surprise that differing views exist. However, the need for change is something we all recognise. We now need to decide how we are going to change.

There are some things that must not change, such as our independence, and our statutory power to hold commissioners and providers to account. We have also agreed that we must not lose the localism of local Healthwatch.

Any decisions about a future Healthwatch model will be made by the Department of Health and Social Care. Healthwatch England will present the range of views to them, acknowledging the range of views within our network. 

However, after carefully reviewing the options, the Healthwatch England Committee supports the model where Healthwatch England assumes the role of commissioner – a solution we heard loudly during our conversations with the Healthwatch network. 

I want to thank each of you for contributing over the last few months to help us explore our shared values and consider what it means to put them into action. It was inspiring to hear so many great examples in my meetings with chairs and lead officers and also in my conversations with five Healthwatch leaders, which you can watch on our YouTube channel.

In case you are new or missed these discussions, I am delighted to share our five values, agreed by you, Healthwatch England staff members and our committee:

The journey so far

When we embarked on this journey last year, we committed to ensuring that our values don't become mere words on paper. It's about embodying these values in our everyday work and interactions.

Since we collectively agreed on our five values and announced them at our National Healthwatch Impact Awards event in March 2024, we have met with several of our peer network groups to discuss what we can do to turn our values into action in our different roles.

Here are a few of the fantastic ways that you are all living our shared values.

Equity

• We establish safe, inclusive spaces where everyone can share their views and value and respect the opinions of others.
• We comply with the Equality Act 2010 in all aspects of staff recruitment and care, collect demographic data, and ensure our staff continue a learning journey on equality, diversity, equity and inclusion. 

Collaboration

• We collaborate with all other local Healthwatch within our integrated care system footprint and offer feedback collectively. 
• We involve providers in projects from the start to ensure their buy-in and give recommendations the best chance of being acted upon.

Independence

• We balance our critical friend role with being a valued system partner.
• We publish our decision-making process and are clear about the involvement of laypeople and volunteers. 

Truth

• We challenge system and provider messages when they do not align with feedback from local people.
• We make sure all reports and insights have a solid evidence base.

Impact

• We track, record and promote outcomes and impact for our work. 
• We give feedback on the difference we make to people whose experiences we have gathered.

At Healthwatch England, we’re making time to reflect on how our values and behaviours shape our work, recognising that getting this right is essential to building the culture that defines, inspires, and drives us forward.

We’ve run several sessions for staff to explore how our behaviours align with our individual roles. We’ve presented some scenarios for staff to reflect on how they can apply our values and behaviours in their work and all staff objectives include application of the values and behaviours.

We’ve asked each staff member to identify at least one behaviour to discuss with their line manager during one-to-ones – something we aim to repeat throughout the year and our National Committee will be developing a charter based on these values and behaviours.

Moving forward

Although each Healthwatch is independent, with some being part of larger organisations with their own set of values, it's crucial that we can all align with a common set of values. This cohesion resonates with our funders and stakeholders, emphasising our commitment to the communities we serve. Furthermore, it demonstrates our unity as we advocate for our future sustainability. 

I'm already looking forward to our National Conference 2024, where we'll have the opportunity to reflect on these shared values.

Together, let's harness the power of our shared values to drive meaningful impact and enhance our effectiveness in serving the public.

National Conference 2024 

This year the National Conference is being held on Tuesday 12 November at the QEII Centre in central London. Register today to secure your place for a day of opportunities to hear from key speakers from the health and care sector and the chance to network, share and learn from your Healthwatch peers. 

For full details about the conference and to secure your place

Register now

Healthwatch Impact Awards 2024 

Are you proud of something you’ve achieved in the past year? For this year’s awards, we’ll be considering any project which has made life better for local people, that has been delivered individually, or in collaboration with other Healthwatch, or with other partners. The work should either have been undertaken between September 2023 and September 2024, or undertaken before that, but the improvements it has led to have been implemented between these dates. 

Awards entry is now open and the closing date is Friday 11 October.

We’ll also invite all shortlisted entries to share how they achieved change at the Healthwatch Impact Showcase Day on Thursday 13 March 2025.

What criteria do you need to address?

In no more than 500 words, please outline the difference your Healthwatch has made for people and communities. To gain maximum scores for your submission, you should address each of the criteria points below and stay within the word count for each section. The panel will not consider any information over the word count.

1. Summarise the main aims and outcomes of your piece of work.

 You should introduce your application with a summary of what the work was about and what you achieved.

Maximum word count: 30. This section is not scored.

2. Which service/s did your work relate to?

Give basic information about the area of work. 

Maximum word count: 20. This section is not scored.

3. What change was needed, and how did you identify this? 

We will score entries on: 

• A clear identification from your research/engagement work of what problem(s) existed. 
• How your wider understanding of services, and/or your connections helped you recognise the issue. 

Maximum word count: 100. This section is worth up to 10 points.

4. What did you do to achieve change? 

We will score entries on: 

• How your research/engagement activity considered people with different profiles who might have different experiences. 
• Steps you took to understand the experience of seldom heard groups. 
• How you involved people with real-life experience. 
• What conclusions you reached. 
• A succinct account of what you did to share and report your insight. 
• A considered and effective approach to influencing decision-makers. 

Maximum word count: 200. This section is worth up to 20 points.

5. How will people’s experiences of the service/s now be better, and why is that important? 

The first round of shortlisting will score entries on responses to this question alone.

We will score entries on a clear and compelling description of:

• The outcomes your Healthwatch has achieved for people’s direct experience of services.
• Awareness of reasonably anticipated wider impact on their lives. 

Maximum word count: 150. This section is worth up to 30 points.

6. Supporting evidence

Please share up to two pieces of evidence which we will take into account when scoring your application. You can include details of indicators and testimonials (written) that help confirm the improvements that you achieved. See the sections below for full details of what you need to provide.

We will score entries on how between September 2023 and September 2024 the outcomes you have described have happened and that these will be leading to people’s experience of services improving.

Maximum overall score

A total of 60 points are available for an entry. 

Other important information

•  Your entry must not be a piece of work for which you previously received a Healthwatch award.
• To be considered, your submission must be for work that demonstrates outcomes between Sept 2023 – Sept 2024, and that demonstrates achievements that are still benefiting people.
• You should submit one entry per Healthwatch. However, you can also submit a joint entry for a piece of work done in collaboration with other Healthwatch (inc ICS groupings). The same piece of work cannot be submitted twice, as a joint or individual entry. Maximum two entries in total. 
• Successful entries must include details of the tangible change this work has created for local people between the dates specified. Your entry must demonstrate how your Healthwatch has improved health or care services. Remember that the first round of shortlisting will only involve scoring entries on Question 5, ‘How will people’s experiences of the service/s be better and why is that important?’ Entries that move past that stage will then be scored on all questions.
• The panel recognise that the work you are describing could have contributed to improvements in a range of ways: improving a service's design, delivery, or quality; involving people in co-creation; reducing risks to patients; improving public information and communication; increasing the priority given to an issue by helping the system reflect on its true impact on people's lives; influencing strategy, planning, decision-making or commissioning of services. However, for your entry to be successful it’s still essential that you consider the point above and describe more specifically why what you achieved will result in people’s experience of services being better and what that improvement will be.
• The work must have been delivered under the Healthwatch brand and must be funded through core or commissioned work.
• Healthwatch providers change, but often staff and volunteers transfer to the new provider. Let us know if this is your situation, and we will take this into consideration – we want to celebrate what your team has been able to achieve.

Supporting evidence

You can upload a maximum of two pieces of evidence as part of your overall submission. We will not accept any forms of evidence apart from those detailed below.

Important information

Your evidence could be as follows, on no more than one side of A4:

• Link/s to pages of external websites of other organisations. (Please add these to a Word document and identify which criteria point or section the link relates to). 
• Statements from your commissioner or a representative from an external service partner(s).
• News article that can clearly highlight the difference you’ve made for local people.

Please note: this year, video evidence is not required and will not be taken into account as part of your evidence. 

If you include more than two pieces of evidence, only what we consider to be your first A4 page will be considered with your entry.

Closing date for applications:

The closing date for all applications is Friday 11 October.

What happens next?

A panel made up of Healthwatch England representatives and Committee members will judge the awards based on a shortlist provided to them. Find out more about the Healthwatch England Committee. 

The shortlist will be drawn up by scoring applications based on how well they met the criteria set out above, along with the two pieces of evidence provided with each entry.

• All applicants, including shortlisted entries, will be notified of the outcome on Friday 17 January.
• All shortlisted entries will then be invited to deliver a short online live session on Thursday 13 March, as part of the Healthwatch Awards Showcase Day. The day will be an opportunity for all network colleagues to attend sessions and hear from those shortlisted, and gain insight into the change being made across Healthwatch. By entering the awards, if you are shortlisted, you must be able to commit to present highlights of your entry as a short online session on Thursday 13 March 2025. 

Award winners will be announced on Thursday 13 March as part of the Impact Showcase Day, being held online.

For any queries on the awards or evidence criteria, please email the team on: annualconference@healthwatch.co.uk