Updated Framework

We have refreshed the domains of the Quality Framework and added in more detail covering equality, diversity and inclusion along with more information on working with Integrated Care Systems. 

The new Framework is available to complete via Smart Survey, to make it quicker and easier for you to complete.  

How it can help?

• Understand where your work is currently effective and where you can make improvements
• Informs local authorities on how to commission and monitor an effective Healthwatch
• Enables Healthwatch England to identify where further help is needed by individual Healthwatch and how we can improve the support and training we provide.

Quality Framework domains

1. Leadership and Decision Making: This looks at the importance of having clear goals and a rationale for your work. It also looks at the strength of your leadership and governance, both of which are key to successfully navigating a complex environment whilst maintaining independence and accountability.
2. People:  This recognises the importance of staff and volunteers. It can help you understand whether your board, staff and volunteers have the right knowledge, skills and support to deliver an effective, consistent service.
3. Sustainability and Resilience: This focuses on a business model that enables you to plan and operate effectively, as well as adapting to the changing needs of communities.
4. Collaboration: This recognises the value of working in partnership, and of learning from other Healthwatch.
5. Engagement, Involvement and Reach: This focuses on our main statutory activities. It looks at how you go about reaching out to all sections of your community, gathering people’s views, providing advice and information, and involving people in your work.
6. Influence and Impact: This focuses on our purpose by looking at the difference you make by ensuring those in charge of health and care services hear and act on people's views. 

Using the Quality Framework

Why not sign up to use the Quality Framework? If you get involved, we will offer you 1-2-1 support and talk through any guidance or training needs you have as a result of completing the Framework.

If you have already started working through the previous Excel spreadsheet, we will continue to offer you support to complete the Framework this way, however we recommend people starting out use the simplified Smart Survey version. 

Please get in touch with Delana Lawson if you are interested in learning more.

What is a taxonomy?

The taxonomy are the fields of data you collect in your feedback from the public. They consist of two main types:

• The key fields we want you to share with us
• Other optional fields, including a wider selection of demographics

Why is this taxonomy important? 

This new taxonomy has been built based on you feedback as we want it to meet your needs as well as ours. 

Ensuring that your taxonomy meets ours is essential for you to be able to meet the legal requirement to share your data with us. 

Find out whether you need to make any changes to your existing taxonomy with our simple guide that clearly sets out the fields you need to be collecting. 

Step one: The Annual Survey

What is the Annual Survey?

Our network has achieved so much over the last few years, even in the face of challenging circumstances. It’s important that you get the right support to run a high-quality local service. That’s why we need to understand how things work on the ground for you and the constraints you face.

The Annual Survey gives us a bird’s eye view of local engagement, resources, funding, reach and impact. As well as targeted support, the information helps us protect and generate income, support new partnerships, and report to Parliament through our annual report.

How can you complete the Annual Survey?

The survey is mandatory, and you should submit one response per Healthwatch. It should take around 30 minutes to complete. We recommend you look through the questions below and collect any required information before you begin the survey.

Take the Annual Survey

Download the Annual Survey questions (PDF)

This guidance for Memorandums of Understanding (MoU) provides a structure which local Healthwatch and the Integrated Care System (ICS) can use and adapt to reach an agreement on how they will work together.

This Guidance is designed to use existing and emerging guidance and legislation, whilst also taking into consideration the differences that exist across systems.

Before you start drafting an Memorandum of Understanding with your ICS, you should work with other local Healthwatch to develop a collaboration agreement. This will help you determine a shared understanding of how you want to work together with other local Healthwatch first. To do this, check out our Collaboration Toolkit, which gives you a step by step guide on how you can build a solid working relationship with other Healthwatch.

About this course

Suppose you are new to projects and would like to get an overview of project management principles, are more experienced in project management and looking for fresh ideas, or just want an insight into project planning in a Healthwatch environment. In that case, this online course is for you.

What will I learn?

You will pick up tips and techniques that will provide you with the clarity and confidence to get the project outcomes you deserve.

This e-learning course shows you project planning techniques adapted to reflect feedback from local Healthwatch teams. The result is a practical approach focussing on what is important to you. It provides tools to create your project plan and aims to help you understand:

• Why planning your outcomes before you start is essential.
• Good decision making and where it fits into project planning.
• How to keep the focus on your objectives.
• How all the aspects of planning flow together in a project plan: a clear structure.
• The smooth transition from planning to project delivery.
• Be confident in your communications - the right people at the right time.
• The importance of evaluating your project.

How long will it take, and what does it involve?

This e-learning course will take you under 60 minutes to complete. We have tried to keep this course short enough to complete in one sitting, to help you on get the best learning experience possible. However, you can save your progress if you need to. 

Don't forget to download your certificate of completion at the end of the course. 

The e-learning is divided into the four stages of project planning, based on our Project Checklist, which you can access and download within the introduction to this course.

Project checklist

We have also developed a excel spreadsheet template for you to use to plan your own projects. 

Download the template

One of our statutory duties is: "Promoting and supporting the involvement of people in the commissioning, provision and scrutiny of local care services."

Why? Because we know that if health and care services make decisions without involving those affected by them, the outcomes are likely to be less effective. And this is why local Healthwatch across England work so hard to make sure that local people play an active and influential part in decisions about care. 

But, do we practice what we preach by maintaining the same standards that we expect of others? Do we have a common understanding of what good participatory practice in Healthwatch looks like? And do we have examples of excellence that need to be more widely shared?

We've launched a new research project to help answer these questions and ensure we're doing all we can to involve communities who face inequality in making decisions about our work. 

Who is running the research?

We've commissioned Expert Citizen and Power With. Using a peer-led approach, they will map the current ways in which we make decisions with people who are affected by the issues we are hoping to influence. For example, to what extent do people with lived experience of an issue shape the questions we ask, how we engage communities and the recommendations we then make?  

What will be delivered?

Expert Citizens and Power With will:

• Work with a group of people affected by health inequality to develop a shared understanding of participatory approaches and a way to measure their efficacy.
• Develop case studies illustrating exemplary practices across local Healthwatch. 
• Hold two training sessions to present the project's findings and introduce participatory tools you can use. 

Introduction

Throughout 2022 we will be introducing new standards and ways of working to improve consistency and make it easier to be effective in what you do, both individually and collectively, without diminishing your independence about how you go about your work.

This guidance sets out what we need every local Healthwatch to do to:

• Help meet your statutory activity and build a more consistent, high performing Healthwatch network; and
• Support Healthwatch England to carry out our functions.
• Protect and enhance the reputation of Healthwatch at all levels

The guidance also aims to help you plan for how you will meet these expectations from April 2023 and operate under an updated Healthwatch trademark license issued later in 2022.

Why has this guidance been produced?

Healthwatch has come so far over our short history. We have demonstrated that it pays to listen and act on what people tell you if you want to deliver better care.

We are uniquely placed, with a Healthwatch in every area of the country, to build on this progress to help NHS and social care services plan and design care that better meets the needs of local communities.

Based on what you have told us, there is a strong consensus that we need to go further to:

• Build a more consistent Healthwatch network that can demonstrate our value to the public and our partners.
• Ensure we can have an influential voice at a national, regional and local level.

Therefore, over the next year, we will take several steps to help ensure:

• Compliance with the standards required for the use of the Healthwatch brand.
• Local Healthwatch shares information with Healthwatch England.
• Local Healthwatch can demonstrate their effectiveness and impact. 
• Effective collaboration when local Healthwatch need to work together to understand and act on the experiences of people.

This guidance aims to help you understand our expectations of local Healthwatch services, remind you of your legal obligations and help you plan for any steps you may need to take over 2022-23 to meet our updated trademark license.

What do we need every Healthwatch to do?

This section tells you what we need you to do, why and how you can.

Do you have a question?

If you have a question, please do not hesitate to talk to your Regional Manager.

Talk to us

What is the Quality Framework?

The Quality Framework is a self-assessment tool to help you understand where you are currently providing an effective service, and where you can make improvements.

There are six domains in the framework:

1. Leadership and decision-making
2. People
3. Sustainability and resilience
4. Collaboration
5. Engagement, involvement and reach
6. Influence and impact

Healthwatch Worcestershire have been contracted to deliver the service since 2013. They currently have ten members of staff and six co-opted volunteer Board members. We asked them about their experience of using the Quality Framework.

Why did you decide to undertake the Quality Framework?

We saw this as an opportunity to achieve more than a standard self-assessment process might offer. We used it as a team building exercise and involved neighbouring Healthwatch to help us learn and improve.

We aimed to minimise our use of unnecessary resources, improve our transparency and credibility and include an element of peer review by other local Healthwatch.

We decided to carry out some workshops to address and meet the criteria of the Quality Framework.

How did you approach completing the Quality Framework?

We held two workshops to address the domains of the Quality Framework.

The first workshop was held in person and attended by Directors, co-opted Board members, the staff team and support from other local Healthwatch – Healthwatch Herefordshire and Healthwatch Warwickshire. This workshop covered the following domains:

• Leadership and decision-making
• Engagement, involvement and reach
• Influence and impact

The second workshop was held online and attended by Directors, co-opted Board members and the staff team. This workshop covered the remaining areas of the Quality Framework and developed an action plan.

What challenges did the Quality Framework highlight?

Completing the Framework highlighted several challenges that we were facing. These included:

• Worcestershire has a population of 588,000 people, of which approximately 5% identify as being a member of an ethnic minority.
• Communities living with health inequalities are spread across the six district council areas within Worcestershire. 
• Commissioners and providers within Worcestershire services currently do not capture enough equality monitoring data.
• Historically we have received low responses to surveys from minority groups.
• The COVID-19 pandemic caused huge disruption to our engagement activities.

Once we identified these challenges, we were able to build an action plan to address them.

How did you improve your service following completing the Quality Framework?

We were able to build an action plan to ensure we addressed the areas that needed improvement. This plan included appointing a Lead Officer for Equality, Diversity and Inclusion, rewriting our policy, and exploring how we could reach communities we weren’t hearing from and identifying opportunities to diversity our membership.

During the pandemic we were able to put this action plan in place whilst completing our COVID-19 vaccination survey. We connected with community leaders, Worcestershire’s Interfaith Forum and community groups and individuals representing ethnically diverse communities.

Our action plan proved successful for our COVID-19 vaccination survey - we received 357 responses:

• 33% of respondents were from Black or Asian backgrounds and 10% identified as White European.
• 49% of responses came from a district that normally has low response rate
• We were able to build new connections and form relationships with partners.

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. 

Many of you have already used the Quality Framework with our support, working with staff and volunteers to review six key domains that apply to every local Healthwatch.

Healthwatch Haringey has worked with Healthwatch England on the development of the Quality Framework since the beginning. Here they share more about their approach and immediate and longer-term benefits.

What made you want to use the Quality Framework?

We have helped with the work to develop the Quality Framework from the start, so we were already aware of the benefits it could bring. 

We volunteered to be one of the early adopters of the Quality Framework for several reasons:

1. Contract renewal: Our contract was coming to an end, and we felt that the Quality Framework was an excellent way for us to assess our current performance and would help us to gather evidence of effectiveness and impact to inform upcoming contract negotiations. 
2. Continuous improvement: We wanted to pause and reflect on where we were and better understand where we needed to focus our efforts in the future to increase our effectiveness and strengthen our impact.
3. Board involvement: Our Board members had engaged with developing the Quality Framework and had found it helpful and wanted to continue their participation. We also saw this as an opportunity to get Board members re-energised about our work.
4. Benefits to host organisation: Healthwatch Haringey is one of a range of contracts delivered by Public Voice CIC. Board members and staff found the Quality Framework very useful for assessing the effectiveness and impact of our organisation. The parent company or host organisation can use the Quality Framework to evaluate their performance in addition to local Healthwatch. 

Who did you involve, and how long did it take? 

Investing the time and effort in fully completing the Quality Framework was essential to us as we knew it would help us reflect on what we did well and what we needed to improve and, in the longer term, enhance the effectiveness and impact of our work. 

The more time and effort you put in, the more you get out of the process, and the more valuable it is to your Healthwatch. 

Whilst completing the Quality Framework involves the whole team, we felt there needed to be one person leading and coordinating the process – someone who had a good overview of our full range and depth of work.

Our Research and Engagement Manager led the process, coordinated the whole team’s input, and completed the documentation. 

It took us three months to complete the Quality Framework from start to finish in and around our day-to-day work. As we were piloting the Quality Framework process for Healthwatch England, we set a strict deadline for completion. 

How did Healthwatch England support you during this process?

Our Regional Manager, Alvin Kinch, reviewed our Quality Framework submission and provided detailed feedback on how we could improve and strengthen it, sharing ideas and good practice from elsewhere, ensuring we got the most out of the process. 

What changes did you see? 

We set out three areas for improvement for the coming year, with a clear focus on what we would be doing differently to make these improvements happen. From this process, we found several immediate and longer-term benefits. 

Immediate benefits

• Open and honest discussions with our Commissioner
  We used the insight gained from the process to inform our discussions with our Commissioner, highlighting our strengths and being open about areas for development and improvement plans. 
• Stability and security from new contract
  We were awarded the Healthwatch Haringey contract for a new three-year term, with a contract value almost the same as previous years, despite local authority budgets facing cuts. Our contract renewal for three more years gives us a level of security, knowing we have a stable and reliable income stream. 
• Improved teamwork 
  Working as a whole team and collectively reviewing our strengths and weaknesses helped build team relationships, improve communication, and boost team morale. Staff valued taking time out from their daily tasks to pause, reflect and take stock. We now meet monthly to ensure that we have a clear overview of our work, allowing everyone to help shape priorities and work plans for the coming year. 
• Re-engaging our Board
  Our board members are responsible for delivering a broad portfolio of contracts, not just Healthwatch Haringey. Going through the Quality Framework process helped us re-engage board members in our work and helped shape our plans for the coming year. 
• Strengthening our annual report
  The Quality Framework made us focus on the impact of our work. This provided a wealth of information that we could use in our Annual Report highlighting changes and improvements we had helped to deliver to our community. 

Benefits one year on:

One year after completing the Quality Framework, we met with our Healthwatch England Regional Manager to see what impact this had made. We found that we had: 

• Improved how we work with our neighbouring Healthwatch 
  Monthly meetings with the five local Healthwatch in North Central London have been invaluable in improving communication, identifying common themes and challenges, learning from each other and increasing our impact. We’re now working on our first joint project together. 
• Improved how we work with Healthwatch England
  More of our staff are attending events and training put on by Healthwatch England. We’re also engaging more on joint work with Healthwatch England and have learnt a lot through doing this.  
• Renewed our energy and focus on reaching out to our diverse communities
  We’ve focused on building longer-term relationships with more of the diverse communities in Haringey. Over the last year, we’ve developed excellent working relationships with our Turkish and Kurdish communities. We’re now looking at ways we can create similar relationships with Black African communities in Haringey.
• Moved to a more outcomes-based approach to better understand our influence and impact
  We now invest much more time and energy in follow-up after we’ve published a report. We make sure our work leads to tangible improvements and change based on what the public tells us. Through this focus on outcomes, it is much easier to assess and evidence the effectiveness of our work. 
• Improved how we communicate with partners, stakeholders and the public
  We have invested more staff time in Communications over the past year and have become much better at shouting about our successes and informing people of the difference we’re making. 
  
  We regularly update our website with what we’re working on and the outcomes of that work and send a monthly newsletter brimming with content that fully reflects the range and variety of our work. 

Interested?

Find out what the quality framework is and how you can get involved.

Find out more