About the logo

The Quality Framework is a self-assessment process that helps a local Healthwatch understand what aspects of your service are working well and identify areas for further improvement.

The process requires hard work and commitment and some local Healthwatch have asked for a visual device they can use to show they have been through this process and communicate their commitment to continuous improvement.  

The quality logo:

• Is an acknowledgment of having completed a self-assessment quality assurance process at a point in time. The logo is given retrospectively to Healthwatch who have completed the self-assessment and who have conducted a review with their Regional Manager.
• Can be used to indicate to external stakeholders that you regularly self-assess your quality against a set of standards set by us and are committed to quality improvement. It can support you as an enterprising Healthwatch to demonstrate that you are continually improving.

Terms and conditions for using the quality logo

• You can use the quality logo if you have completed a Quality Framework self-assessment and you have conducted a review of the findings with us.
• You can use the quality logo from the date of your review meeting and, in line with the Quality Framework process, use of the logo is valid for three years.
• The logo should not be more prominent than the local Healthwatch mark or used directly alongside the mark.
• However, it can be used to support communications. For example, it can be used at the bottom of  email signature, letterhead stationery, website, or on marketing materials. Guidance on how to use the quality logo is available, along with the logo in a range of formats. 
• The quality logo is a brand asset provided by Healthwatch England. So, like any brand asset, it can no longer be used if a service provider's contract to provide a local Healthwatch service comes to an end.
• The logo cannot be transferred if there is a change of provider, they will need to undertake a fresh self-assessment.The logo can only be used by the specific local Healthwatch who have completed the self-assessment and should not be used by other local Healthwatch who come under a multiple provider if they have not undertaken the assessment.
• This logo is not intended to be perceived as a quality mark as this would give false assurance that we have conducted an audit or inspection. It is confirmation to stakeholders that you have committed to working with us to continuously improve.
• The quality logo must not be used in any manner that expresses or might imply the affiliation, sponsorship, endorsement, certification, or approval, other than as set forth in these terms.
• Except for size, the logo must not be altered in any manner, including proportions, colours and elements. Nor should it be animated, morphed, or otherwise distorted in perspective or dimensional appearance.

Text to support the logo

Committed to quality

At Healthwatch Anytown, we aim to provide the best service we can to our community and to make the greatest difference we can to local people.

To help us be the best we can be, every three years we undertake a comprehensive assessment of our work using a tool called the Quality Framework.

This helps us to understand what we are doing well and where we might need to improve.

You all provide an information and signposting service, as it is a statutory function. These differ in scope and scale due to local commissioning arrangements, but you told us that many of you have seen an increase in complex calls since the pandemic and many are now facing the challenge of providing the service from home.   

You also told us there can be a need for more clarity on the role of Healthwatch and the remit of the information and signposting service with the public, commissioners and sometimes within Healthwatch themselves. We also know that due to high levels of commitment, some staff feel they go above and beyond due to a lack of alternative sources of help. 

We met with 14 people who either manage or deliver Healthwatch information and signposting service across 12 different Healthwatch to find out how they address the current challenges and see if we could identify some good practices and principles. Above all, we urge you to be clear about your service and remit with your teams, board, commissioners, and the public.  

What can I do to meet these challenges?  

Read on for a summary of their ideas and suggestions to help you manage your own information and signposting service. It isn’t guidance but could be a useful conversation starter in your teams.   

Your good practice checklist  

• Update your home working policy to include regular contact with colleagues and the manager and try to schedule annual leave to ensure one person is not covering the service alone. 
• Include out-of-office voicemail and e-mail auto-responder messages with clear guidance on opening hours, how long it will take to get a response, useful numbers, and local information. 
• Include information and signposting as an agenda item in your regular team meetings to allow people to discuss calls and get advice and support from colleagues.  
• Build relationships with the Integrated Care Board and health and social care partners to understand local support options and agree on circumstances when you can make escalations and referrals. 
• Ensure you have the right level of insurance for the level of service you deliver. 
• Join or set up local information and advice hubs where queries can be handled by the most appropriate organisation so that callers are not given more numbers to call. 
• Create a clear information and advice section on your website. Include details of local organisations, the support they provide, and frequently requested information such as how to register with a GP, make a complaint and access emergency dental care. Check out our website for up-to-date advice content you can localise for your own website.    
• Include a clear section on your website covering what you offer but also what you don’t do to help manage expectations. 
• Agree on the number of calls that are reasonable to take in a day and develop a process to prioritise these so that staff wellbeing can be looked after. Decide how to set the phone system to deal with out-of-hours calls and if you have the capacity to respond to the number of voicemail messages that are left (i.e. in effect, provide a 24-hour service) 
• Consider if there are supporting roles that would allow volunteers to contribute to the information and signposting service. 
• Work with local voluntary and community sector partners to share insight into needs that are not being met and the impact on local people. Make the case for funding an enhanced service over and above traditional ‘information and signposting’. 
• Consider working towards becoming a 'Trauma Informed Organisation', which includes include incorporating the principles into all staff policies from induction and training and ongoing support for staff.  
• Update your call-handling process to give clear guidance on ending calls if a person becomes aggressive. Include a structure to end calls where there is no solution and a debrief process to support call handlers.  
• Access dedicated support that is available for information and signposting staff. This includes: 
  • How to structure a call webinar 
  • Handling challenging calls webinar 
  • Assessing safeguarding and risk webinar (for I&S staff) 
  • Call handling guides 
  • Listening skills webinar 
  • Personal resilience and wellbeing webinar  

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.

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.

In Our Future Focus: the Healthwatch England Strategy for 2023-26, there is much mention of the challenges and opportunities we face, and how the context of health and care has changed, in a way that feels like it will be here to stay for the foreseeable future at the very least.

With the NHS and social care under unprecedented demand, and with its resources under enormous pressure, what does this mean for our role in ensuring people’s experience of care helps shape improvement? 

How can we be stronger organisations in our own limited resource context? How can you build impact in an environment where commissioning is often a challenge to stability? How can we perform our statutory duty of supporting you better?

As we celebrate our 10^th anniversary, we’ve much to be proud of - here’s why and what you have told us.

You show time after time how:

• You are connected to your communities –whether it is getting cervical screening sorted for Bangladeshi women, gathering feedback on cancer services from those facing health inequalities or bringing attention to the impact of vaping on young people
• You can bring the right people around the table to find solutions and act as a critical friend
• You stay true to your independence and hold bodies to account

We could list others, but here are some harder things that we hear:

• “I’ve never heard of Healthwatch”
• “You come over as amateurish”
• “You don’t meet your potential”
• “I listen to you grudgingly because of your statutory role”
• “Healthwatch need to reach beyond those we already hear from”

The response to these challenges could simply be: we do our best on the (shrinking) resources at our disposal. After all, our funding has reduced by 20% and 38% respectively, with significant variation across the network. Staff retention and the ability to plan ahead are also affected by short term contracts; and changing health and care structures make influencing harder.

But the truth is when the economic environment is harsh, it’s even more critical to demonstrate our value and ensure our house is in order – especially if we are making the case for our sustainability.

Our future relationship

In our strategy consultation, this is what you’ve asked us to do. This builds on what you’ve said to us and the team over the last few years.

Resource and commissioning 

If there is a legislative opportunity, we want to be ready with a sustainable and effective model – tried and tested if there is time. We’ll need your help to build on what’s already working well and look at the different options.

In the meantime, we will continue to work with local authorities to support effective commissioning, including looking at a more consistent approach to contract monitoring.

Our culture 

Culture defines our internal and external identity, motivates and keeps our people and makes us feel part of a team and movement. Many of you have already set out the values and behaviours that underpin your culture. We'll be looking at our own culture, and we thought it would be beneficial to do this alongside the network so we can all adopt or align to a shared set of values and behaviours. This work will commence in Autumn 2023.

Communications 

You told us that two-way communication between us should improve, the number of asks can feel burdensome, and it can be challenging to find the information and resources you need. We’ll review how we communicate, including revamping the network site – with your help. This will be ready by March 2024.

Impact, facilitating peer support and collaboration 

Mindful of your feedback about not making too many asks, we’re keen to better understand the impact you are achieving, spot any trends across the network to inform our policy work and make sure we promote it to all our audiences – including other Healthwatch. We will also offer to facilitate collaboration between Healthwatch and peer support networks – all the time making this optional so as not to impact your local priorities. We’ve started having these conversations at regional forums and will set out our approach in more detail before September 2023.

Professionalism and skills 

Our value relies on the professionalism and skills of our people – staff, boards and volunteers. With your help, we’ve set out the core skills and corresponding training and support options – many of which are developed and delivered by network members. You can find out more here.

Equality, diversity and inclusion 

We are continuing our commitment to support equality, diversity and inclusion, set out in the Roadmap. You will see we are offering a programme of training; we will be looking to profile Healthwatch activity that addresses inequalities; we will continue to support the Equality Diversity and Inclusion Peer Network and support sharing of best practice.

We also want to ensure we understand the Healthwatch network’s profile amongst communities and people with protected characteristics. We’ll need your help to significantly improve the response rate to our anonymous Healthwatch People Diversity Survey, as we previously had a low rate of return. We will shortly send you the survey questions in advance, so you have plenty of time before we collect the survey results in November 2023.

The value of Healthwatch

So yes - we must take on board the harsher things that are said about us, but equally I hear that we punch above our weight; that Healthwatch are being commissioned on the strength of your connection to communities, the value you bring to your systems; and how you support each other to overcome challenges and capacity issues.

I wholeheartedly believe that by supporting each other and collaborating on the priorities outlined above, we can secure our sustainability and unleash the full potential of the Healthwatch movement, which will ultimately improve care and the lives of the people we serve.

With unprecedented challenges facing NHS and social care services, we've launched 'Our future focus' - a plan setting out what we want to achieve by 2026 and the steps we will take to get there. 

Why have you decided to refresh your strategic direction?

The environment in which we operate has changed. Seventy-five years after its birth, the NHS and the social care system face enormous challenges and big questions about how we invest in future services.

How can services:

• Tackle the care backlog and building a future service that can help people stay well and support those in need will be challenging?
• Help address the deep inequalities, which see factors like where you live, ethnicity or gender result in different health outcomes?
• Work together to provide better, more joined-up, efficient care that gives more control to you?

Health and social care decision-makers can't answer these questions alone and need the public's input. And this is where Healthwatch comes in. 

You've demonstrated the power of feedback to help services understand what's working, spot issues and think about how care can be better. But, with investment in our work under pressure, we need to think carefully about where focus our efforts to make the biggest difference. 

This is why, in 2022, our committee initiated a review of our strategic direction.

What will Healthwatch England focus on? 

We will focus on three aims: 

1. To support more people who face the worst outcomes to speak up about their health and social care, and to access the advice they need.
2. To support care decision-makers to act on public feedback and involve communities in decisions that affect them.
3. To be a more effective organisation and build a stronger Healthwatch movement.

Read 'Our future focus' to find out more about how we will achieve these aims, but the steps we plan to take include:

• Continue to raise our profile so every community, especially those facing inequalities, knows we are there for them.
• Focus on the big issues that most concern the public and the communities that face the worst inequalities. These include access to primary care services, social care and women's health. 
• Work with the NHS at every level – locally, regionally and nationally – to find solutions and make listening to service users the default approach across all health hand care.
• Harness the resources of the Healthwatch network more efficiently and put our funding on a sustainable footing.

Why have you decided to focus on these three aims?

We have chosen these three aims because they are flexible enough to help us respond to a changing environment but focused enough to ensure we can have specific and sustained impact, crating change based on feedback from people. 

We've incorporated many things that you told us were important to you. These include:

• Continuing to raise the profile of Healthwatch, so people know how we can help;
• The importance of social care, as well as doing more to tackle access issues in primary care, as this is one of the main issues people tell us about;
• Taking steps to try and address funding issues and variation across the Healthwatch network; and
• Reduce the asks we make of you, streamline our communications and make it easier to find help and resources.  

How will you know if you are successful?

Each aim includes measures to help us know if we have been successful. We will know if we are successful if:

• More people than ever know who we are and how we can help. We have a powerful supporter base, representing every community, who share feedback, get involved in our work and know the difference their views have made.
• The voice of people is heard at every level of health and social care. The strength of our evidence, especially when it comes to health inequalities, is acted on more than ever to provide better care.
• We have the funding, culture, skills and infrastructure we need to be our best.

What was achieved by the last strategic review?

Our future focus looks at what has improved since the last time we reviewed our strategic direction and areas that still need to improve. However, key achievements include: 

• Greater public awareness of Healthwatch and what we do.
• We better understand who uses our service and shares their experiences with us.
• Knowing the critical ingredients for delivering a high-quality Healthwatch service and the support you need from us to deliver this.
• We can better demonstrate our impact, and an increasing number of health and social care decision-makers value us.

How did you involve people in developing your future focus?

We started the process last Autumn. We're grateful to everyone who helped shape our plan by sharing their thoughts, ideas, and reflections.

As well as looking at all the existing evidence we have, we undertook several activities, including:

• Getting regular input from a reference group made up of local Healthwatch leaders;
• Workshops with our staff and Committee;
• Discussions at Healthwatch Week 2022, where we were joined by staff and volunteers from across the country; 
• Sessions with Healthwatch lead officers and chairs;
• 1-2-1 meetings with NHS, social care and third-sector leaders; and
• Events with patients, service users and those that represent them. 

What does this plan mean for me, and how can I get involved?

The support we provide to you should continue to improve. We'll also be providing lots of opportunities to get involved.

If you have a question, please speak to a Healthwatch team member. 

It is good practice for all local Healthwatch to have clear agreements about roles, responsibilities and decision-making.

You told us you wanted more support for Healthwatch boards.  Margaret Curtis and Phil Morgan, the two consultants from local Healthwatch who led the board support programme in 2022-23, have produced these checklists and templates that will help you in your role as a Healthwatch Chair or board member, in both hosted and standalone Healthwatch.

You will find all of the resources you need below, so that board support is all available on one easy to use page.

These existing resources will also be fundamental for Chairs and board members.

Decision-making template and guidance

How we make decisions (Easy Read)

Code of conduct template and guidance

Conflict of interest template and guidance

Guide to running a Healthwatch

English local authorities have a legal duty to commission local Healthwatch.  Healthwatch England has a role to play in supporting local authorities with this function to make sure they understand their duty and learn from good practice.  We do this through publishing a guide for commissioners and through individual support to them.

We have launched an update to our guide, following the enactment of the Health and Care Act 2022, and to reflect local authorities’ key learnings from their experience of over a decade of commissioning local Healthwatch.

About the commissioners' guide 

The guide: 

• explains the key statutory requirements relating to Healthwatch;
• outlines local authorities' role in commissioning local Healthwatch for their area;
• explains Healthwatch England’s role and how this relates to both local authorities and local Healthwatch;
• sets out how commissioners can use the Healthwatch Quality Framework to commission and monitor local Healthwatch;
• identifies ways that commissioners can set clear expectations on outcomes and impact to ensure their Healthwatch is effective;
• provides a checklist to support local authorities when developing a tender specification, contract or grant agreement.

Download the guide

Before you start, think about whether you need to collect people’s names and contact details. If you don’t, then GDPR doesn't apply, and you don’t need to have a consent question for personal data in your survey or feedback form. 

This document includes examples of how to word intriductions and questions about consent and explicit consent in:

• Surveys
• Webforms
• Interviews and focus groups

If you have any questions about this guidance or the examples, please contact the research team: research@healthwatch.co.uk. 

We rely on local Healthwatch insight to understand trends in how people experience health and social care services. It is also a legal requirement for Healthwatch to share their data with Healthwatch England.

Formalising data sharing 

As part of our work to strengthen our data standards, all Healthwatch are required to sign a data sharing agreement. 

This has been developed on the advice of data protection experts and in line with guidance from the Information Commissioners Office, for any system or process involving data sharing between Healthwatch and Healthwatch England. The agreement sets out our roles and standards of what is expected from the arrangement and each party, with a schedule for each system.