'The Healthwatch Network: A National Picture of Key Trends' highlights that while impact and income generation have increased and many more Healthwatch are sharing data, variation means it's hard to compare activity levels and core funding has experienced a real-terms cut. 

In the report, we also consolidate key information we collect from the Healthwatch network to look at key areas including: 

• Demonstrating impact
• Relationships with integrated care systems and the Care Quality Commission
• Funding and commissioning
• Colloaboration and current/future priorities

We highlight some of the diverse outcomes Healthwatch across the country have achieved, including making services more accessible, helping to expose safety concerns and improving access to dental appointments. 

We also use the report to explain what we are doing, and what more you as the Healthwatch network could be doing, to further help each other and the communities we serve. 

Over the past few months, I have spoken at regional forums and other events about some of the changes we propose to make in how we work with local Healthwatch. These changes follow on from what we shared with you in Our Future Focus and in my last blog with Louise Ansari.

In proposing these changes, we're keeping in mind the priorities you shared with us:

• Reducing the asks we make of you.
• Having a better understanding and making the most of local Healthwatch achievements.
• Improving two-way communication.

Here’s what I’m covering and what they mean for your Healthwatch:

1. Demonstrating your value – advance notice of the questions in the annual survey, which we will ask you to complete in September 2023.
2. Understanding the diversity of Healthwatch – advance notice that we will be asking you to complete a survey on the demographic profile of your Healthwatch in November 2023. In the meantime, we are providing a template to help you collect this information.
3. Sharing your accomplishments – we’re busy analysing your annual reports, and we want you to continue to share the difference you make.
4. Working with the Care Quality Commission – we’re supporting Healthwatch with the new approach to assessing local authorities and Integrated Care Systems.
5. Quality Framework – we’re continuing to support Healthwatch who want to undertake the Quality Framework and have introduced a badge for those Healthwatch who have completed it.
6. Check-in with your Regional Manager – we’re encouraging all Healthwatch to have, at least, an annual check-in to understand your support needs.
7. Integrated Care Systems – a new ICS Healthwatch Representatives network is holding its first meeting on 12 October.
8. Data sharing – just a big thanks to for everyone sharing your data, including demographic data.

Demonstrating your value

In response to your feedback, this year we have reduced the number of questions in the annual survey.

Click here to see what data we intend to collect in the annual survey in September.

Our annual report, which is presented to Parliament, makes the case for investment in Healthwatch and supports the National Committee with their statutory role in ensuring Healthwatch activities are carried out properly.

Understanding the diversity of Healthwatch

In our last blog, we asked for your help to significantly improve the response rate to our Healthwatch People Diversity Survey, as the response rate was less than 40% in 2022.

We said we would send you the questions in advance, which you can view here.

This year we are asking for data on the combined total of your staff, volunteers and Board. The data you provide will be anonymous and not linked to your individual Healthwatch – but we will ask whether your Healthwatch has completed the survey using a linked but separate survey.

If you currently do not have the required data on the demographic composition of your staff, volunteers and Board/Advisory Board members, you can use the Healthwatch Diversity Survey template which is available on this page and in SMART Survey if you have an account. Go to ‘My Surveys’ in SMART Survey, make a copy and then you can send this to your staff, volunteers and Board members.

Given that Healthwatch advocate for health equity, it is important that we strive to reflect the communities we serve. Our training programme includes support for Healthwatch on improving volunteer and Board diversity. We want to track whether these and other measures that individual Healthwatch are taking are making a difference. We'll report the results back to the network.

Sharing your accomplishments

You told us we should make better use of your stories of change – to support raising our profile, demonstrating what Healthwatch have achieved and sharing what's working with Healthwatch and our external stakeholders.

We're currently analysing all of your annual reports to get a picture of the individual and collective impact of Healthwatch. We'll draw on your examples to support our national work and share them in forthcoming newsletters.

Please also start using our new Impact Tracker or the simplified sheet to tell us about the difference you’re making on an ongoing basis. The more of your recent success stories available to promote and talk to national stakeholders about, the better.

Working with the Care Quality Commission

You may be aware that the Care Quality Commission (CQC) are piloting how they will assess local authorities and Integrated Care Systems. Healthwatch England is working with CQC to support local Healthwatch in the pilot areas which will be evaluated. We will share learnings from the pilots with Healthwatch so you know what to expect and how CQC will engage with you.

You will have a dedicated point of contact within CQC, but be aware that  some posts are yet to be filled. If you are unsure who to contact at CQC, please get in touch with your Regional Manager.

Quality Framework

Demonstrating your effectiveness is never more important than in difficult financial times. Over three quarters of Healthwatch have now completed the Quality Framework - with 50 in the last year.

We’re continuing to support Healthwatch who want to undertake the self-assessment process. Some have used the process to help prepare for a tender process, while others have used it in preparation for a new strategy. We’ve seen several Healthwatch use it to consider how they apply equality, diversity and inclusion across their work. We’re recommending Healthwatch complete it every three years.

Analysis of completed Quality Frameworks demonstrates many strengths, including reaching and engaging with people facing the greatest health inequalities and managing people. Healthwatch reported challenges with the role of Boards/Advisory Boards who support the governance and decision-making of Healthwatch and meeting the statutory requirement for transparency in our work. In response, we developed an extensive programme to support your boards with recruitment and self-appraisals, from which we developed guidance for both hosted and standalone Healthwatch.  

We’ve made it easier to complete using the improved Smart Survey format, which we expect all Healthwatch to use after December 2023.

We’re introducing a badge so your Healthwatch can demonstrate your commitment to improvement. This could be displayed on your website footer, email signature or other appropriate materials. If you are eligible, you will receive an offer directly.

Check-in with your Regional Manager

We encourage all Healthwatch to have at least an annual check-in with their Regional Manager. We use these meetings to check if you have any support needs and talk through the Quality Framework if you have recently completed it. It’s a really important opportunity for us to make sure we understand your needs so we can inform our national work and how we can best support you.

Integrated Care Systems

In response to requests from Healthwatch, we are establishing a network for Healthwatch ICS Representatives, with the first meeting taking place on 12 October. For ICS areas with more than one Healthwatch, you will need to decide among yourselves who will represent your area. You can sign up here.

Data sharing

Local Healthwatch tell us that our new Data Sharing Platform is easy to use. Between April and June, 21,839 pieces of feedback were shared with us by 54 Healthwatch from 28 ICS areas. We’re in the process of onboarding the remaining Healthwatch and supporting you to regularly share your data.

We are also seeing a welcome increase in demographic data, which helps our analysis and enables us to highlight where the health and care system needs to listen better and take further action, including on tackling inequalities.

A big thank you to everyone for helping us; keep sharing your data and reach out if you need any help: DataSharing@Healthwatch.co.uk.

1. Annual Satisfaction Survey 

   Every year, your insights have been instrumental in shaping our support to Healthwatch. This year, we are requesting each Healthwatch to complete the satisfaction survey responses on behalf of your organisation. This survey will provide a comprehensive understanding of the views and experiences of your staff, volunteers, and board members collectively, helping us to learn and tailor our support to better meet your needs. 

2. Healthwatch People Diversity Survey. 

   As part of our commitment to Equality, Diversity, and Inclusion, set out in our Roadmap, we collect data about the demographic profile of Healthwatch staff, volunteers, and Board/Advisory board members. We use the data to help us track the extent to which we reflect the communities we serve and whether the measures taken by individual Healthwatch together with the training provided by Healthwatch England are making a difference. You can view and download the questions below.

The single survey is made up of two parts for your convenience and efficiency. Both sets of information will need to be uploaded together. You can access the template survey, and it is also available in SMART survey to copy and download and use for those Healthwatch with a licence.

To upload your data, please go to this link. Survey responses are needed by 28 February 2024. 

Healthwatch are increasingly focussing on planning for, identifying and communicating outcomes and impact achieved for people who use health and care services. This contributes to ensuring your organisation's financial stability and increases support from members of the community.

About this resource

Recruiting a volunteer to take on responsibilities relating to monitoring outcomes can help give this work a greater profile within your Healthwatch. In particular, the role could provide additional capacity to update the Impact Tracker and liaise with other team members to check on how different areas of work and opportunities to influence are progressing.

This document provides guidance and tips on introducing an Impact Assistant volunteer role. It includes a suggested role profile.

The profile for this role has been developed so that it can be adapted to meet your specific local needs. Create your own role description by using whichever of the listed activities you feel will be most useful for your team.

Link to other resources

This guidance and role profile is an addition to our other volunteer role descriptions, which are available for you to use and adapt.

It's a legal requirement for your local Healthwatch to produce an annual report by the end of June. To help you do this, use our template, which is available in PowerPoint and InDesign formats on the Communications Centre (Brandstencil).

The template includes a branded design, as well as guidance on how to complete your report, what to change and what you need to include in your report.

Please note you will need to be logged in to see the resources on The Communications Centre. There is one account per local Healthwatch, however if you are having problems accessing your account please email hub@healthwatch.co.uk

Visit Communications Centre 

Images

It's great if you can personalise the report with local photography. However, we've also added a new album on our Flickr library, with images that you can use throughout your report.

These images are all selected to fit with the new visual brand guidelines. 

View Flickr album 

Who to send your annual report to

Once you have published your annual report, you need to send it to:

• Healthwatch England (use the web form below)
• Care Quality Commission
• NHS England - by emailing England.healthwatchannualreport@nhs.net 
• Senior Integrated Care System leaders for your area
• The Overview and Scrutiny Committee of your local authority
• The local authority that commissions your service 

Deadline

The deadline for submitting your annual report is Friday 30 June 2023.

If you have any problems or concerns meeting this deadline, please speak to your regional manager as soon as possible. 

How do I submit my report?

To submit your report, you need to upload your finished document through the web form linked below

Upload your report here

Each year we ask you for:

• information about your activities (the Annual Survey)
• feedback on the support we provide you (Satisfaction Survey).

We also ask about your learning needs every two years.  

We use this information to shape the support we provide to you.

How we’ve used what you told us previously

Communications and asks

We heard mixed views about how we communicate with you. Some of you have seen a better flow of communications. However, we’ve had a strong message that we should reduce the number of asks and improve how we communicate our priorities. 

You should have noticed that we’ve introduced the Month Ahead – which sets out forthcoming campaigns, publication of new resources and guidance and the priority areas we would like you to tell us about, such as winter pressures. We share this on Workplace and in the newsletter on a monthly basis.

Support on Integrated Care Systems

At the time of the last Satisfaction Survey, Integrated Care Systems were not yet legal entities. You told us that support and resources on working with ICSs had been welcome. In the annual survey, 80% of you reported that relationships were effective when working with other Healthwatch within ICSs and 70% reported effective relationships with your ICS/ICB.

Understanding the demographic profile of staff volunteers and Board members

Along with last year’s annual survey, we included an anonymous survey on the demographic profile of Healthwatch boards, staff and volunteers to understand the extent it reflects the national profile with respect to protected characteristics. We want to track the diversity in the network – the importance of which Berkeley Wilde, CEO of the Diversity Trust recently spoke about at the meeting of Lead Officers to assist in understanding whether the actions Healthwatch are taking individually and collectively are having an impact.

Disappointingly, due to a low response rate we are unable to carry out meaningful analysis and establish an accurate benchmark. Only 40% of Healthwatch completed the survey. We will be repeating the survey in 2023 and will review how best to improve the response rate from Healthwatch and would welcome your cooperation.

It’s a familiar scene.  It’s mid-June, and the Healthwatch lead officer is pulling together content for the annual report. The hoped-for lull in other work demands has again proved to be something of a mirage, so it’s another evening at the keyboard, writing up accounts of outcomes achieved over the year and ensuring all statutory content is included. “If only I’d spent a bit of time earlier in the year …” she thinks to herself. 

If this scenario resonates with you, then maybe there are a few things you could do right now that you’ll thank yourself for in five months’ time. 

Of course, I'm not suggesting you spend ages writing annual report content in January! 

But a bit of time spent now on some of the following things could really pay dividends when the time comes to produce an engaging report about your work up to the end of March. This helps to demonstrate the value of Healthwatch to local people, your funders, Integrated Care System (ICS) and other stakeholders. 

We're really seeing yearly improvements in how you're evidencing outcomes and impact. Last year over 70% of Healthwatch annual reports included references to outcomes that had been achieved. That's up from 50% the year before! This is fantastic to see, as local authority commissioners also tell us how important it is for their Healthwatch to be aware of communicating this. But there's still variation in whether the write-up conveys something about how improvements are likely to be felt by people using the services. Taking that extra step of mentioning a service change's wider impact really helps convey the value of your Healthwatch's contribution. 

To think more about the wider impact of your work, don't forget to take a quick look at this e-learning module on outcomes and impact. 

1. Consider which areas of work and outcomes you’re likely to headline? 

This year, the design of our template will again suggest the report is kept short so that people are likely to read it.

This means choosing two or three areas of work to succinctly showcase, with as much focus as possible on how you’ve contributed to positive change for the public. The two information and signposting case studies and paragraphs on "Three ways we have made a difference" should also focus on impact. 

If outcomes from work started in previous years have now been achieved this financial year, then there's no reason you can't feature those. It's all part of the story of what service you deliver for the public. 

Key things to consider: 

• Do you have an idea now about which areas of work you’re likely to feature?  
• Is there anything additional you could do now in your planning or delivery which can help evidence the outcomes of that work?  
• Is there anyone you could ask now for a quote about the difference you made? 
• Could you hold a workshop with your team and others to reflect on your strongest achievements? 

2. Decide if you'll be able to reuse much of your ‘Statutory Statements’ section. 

Most Healthwatch will be able to reuse or just slightly update the text in the sections of your last report:

• The way we work
• Methods and systems used across the year’s work to obtain people’s views and experience
• Health and Wellbeing Board

Since April 2021, you may have done more face-to-face activities, so most updating will be about this. Other content might stay exactly the same. Make a note of that now, and be pleased you are already a step ahead!

Other figures on the number of people who've shared experiences, signposting and information enquiries, website and social media reach and funding levels will be needed for both your annual report and the annual national survey. Healthwatch England will be sending this out around the same time as you submit your annual reports, as they need to report the figures to parliament. Having these numbers to hand will save time on both fronts. 

3. Decide which volunteers you’d like to feature and ask them for content now. 

There’s no reason you can’t ask volunteers to write a personal profile and send you a preferred photo at any point in the year.

This can help make sure you can feature those who’ve contributed lots but might move on before the year ends. Plus, ensuring you aren't rushing last minute to find a photo that’s the right size and not pixilated – we’ve all been there! 

Three profiles of up to 80 words with photos usually fit well on the one page. 

Aim to feature different stories about why they volunteered or the work they’ve done to make a difference to your community. 

This is also an opportunity to show people from diverse backgrounds who read your report and who might want to volunteer that they’d be welcome. 

4. Take a look at what other Healthwatch did last year. 

By looking at the approach taken by some other Healthwatch, you can start to talk to your team about how you write for your next report. 

Each week until the end of February, I'll post on the Annual Reports Workplace group an example of one of last year's reports with a strong impact focus. 

You'll then need to decide if anyone in your team should join our workshops about writing for impact that we have coming up from March 2023. Keep a lookout for these and other related learning opportunities on our events listings page. 

Here’s to hoping that this year producing the annual report feels more than ever like a fantastic opportunity to showcase the outcomes that Healthwatch has achieved. 

It's helpful to try to ensure we have a shared understanding across the Healthwatch service of what we all mean when we use the words'  outcomes' and 'impact'. 

This basic introductory course is for any staff member or volunteer with Healthwatch. It's an ideal short session to be completed as part of an individual induction process. 

By taking this course, you'll understand: 

• The difference between outputs, outcomes and impact. 
• How do these relate to Healthwatch work. 
• Why it's important for a Healthwatch to think about outcomes and impact. 

This will help you contribute to planning activities and ensure your work with Healthwatch is as successful as possible. 

Before you start 

This course should take you no more than one hour to complete. It's best to do it all in one go, but you can return to it if necessary. 

Tell us what you think

Please tell us how useful you found the course, and if there is anything else that you would have liked included. Email Marianne, Learning and Development Manager at Healthwatch England, with your feedback. 

The first phase involved undertaking an initial research project with six local Healthwatch who interviewed people from ethnic minority communities with either limited or no English about their experience accessing health and care services. 

Local Healthwatch shared their reflections from the project, including their experience working closely with us on a national campaign and engaging with diverse, hard-to-reach communities. 

Background to the project

We funded six local Healthwatch to interview people from ethnic minority communities with limited or no English. 

The six local Healthwatch were:

• Healthwatch Camden
• Healthwatch Croydon
• Healthwatch Hackney
• Healthwatch Liverpool
• Healthwatch Norfolk
• Healthwatch Reading

Local Healthwatch engaged 109 people from diverse ethnic minority communities, including people who identify as Arab, Bangladeshi, Chinese, Polish, Ukrainian, Somalian and Honduran.  

Additionally, 38 staff members working in different healthcare settings took part in the research to share their experiences. 

Find out more about the findings from the research project. 

What worked well?

Local Healthwatch reflected that a key strategy was to work with local organisations with existing contacts in hard-to-reach communities.

The project created a need to build strong relationships with new organisations. These relationships were cemented as local Healthwatch worked closely with local organisations.

Local Healthwatch reflected that a powerful aspect of the project was that local organisations felt they were part of a national campaign. As a result, organisations were motivated to maintain good communication with local Healthwatch. In turn, this expanded the reach of Healthwatch to new and broader audiences. 

Monetary incentives were helpful and, at times, were used to pay for administration for other organisations. Local Healthwatch felt it worked well to be given the authority to use funding as they thought necessary to establish community contacts. 

Local Healthwatch also felt that this project helped them become more aware of existing communities in their local area and their challenges. We heard how Healthwatch was the 'talk of the town' amongst some local communities who recognised that Healthwatch allowed them to amplify their voices at a national level. This project helped to establish a trusting connection with this community.

Outcomes from taking part in the AIS primary research project

• Healthwatch Hackney is working with their local council, which currently has no policy around interpretation, and there is no consistency with using interpretation services. Healthwatch Hackney feels its findings will be helpful in this context.
• Healthwatch Liverpool reported that Liverpool Trusts had been spurred to review Accessible Information Standard (AIS) policies. They also felt the issue is much more on the radar now locally.

What didn't work so well?

It was challenging to find professional interpreters. Local Healthwatch had to work with multiple agencies, experienced cancellations and lost money when interpreters did not show up. The cost of professional agencies is high and would not be feasible within the budget if Healthwatch had required professional agencies for all participants. 

Finding interpreters for specific languages, such as Ukrainian and Tamil, was also challenging which could be more costly. Community contacts were vital here, as they were willing to provide interpretation at a low cost or even for free.

Local Healthwatch would have liked to have recruited a more representative sample and found it easier to speak to people women from specific communities.

Reflections from Healthwatch England

We were impressed by the strength of the community contacts and the ability of local Healthwatch to recruit such a diverse sample in a short timeframe.  

In future projects, we will aim to improve the support provided to local Healthwatch to deliver successful projects, including greater consideration of the following:

• Provide more one-to-one support and training. For example, more thorough testing of questions and role-play activities with Local Healthwatch to establish greater confidence in qualitative interviewing techniques and familiarity with materials.
• Provide greater support around unique project challenges. For example, how to deal with the additional challenges of working with interpreters. 
• Better time management of the project and ensuring local Healthwatch have enough time to prepare with minimal impact on existing projects and priorities. 
• Better support for local Healthwatch around how to share data with us to minimise the risk of sharing personal data and ensure data is cleaned and in a usable format. 
• Provide more guidance around how to develop and utilise findings at a local level.

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.’