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

Event for local authority commissioners

To launch the updated guide we are holding an event on Thursday 30 March 2023 from 2pm to 3pm for local authority commissioners to give them the opportunity to ask questions. 

Book the event 

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.

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.

Collecting, storing and analysing data can be achieved using a CRM/database like Charity Log or Salesforce. Some Healthwatch have fed back that these solutions are not affordable.

This guidance looks at the pros and cons of data capture using a form or survey tool (Smart Survey), data storage using Excel and briefly touches on data analysis using Excel or Microsoft Power Bi – either the free or subscription service.

There is a step by step guide to setting up Microsoft Forms plus links to the templates for both Microsoft Forms and Smart Survey – both of which you can amend to meet the requirements of your Healthwatch. The templates are based on the Healthwatch taxonomy and there is a commentary on how this applies to the questions in the templates.

We need to demonstrate diversity and inclusion in all of our work. To understand different approaches, we funded two local Healthwatch to work closely with others across the network, share their model and provide support to help their colleagues replicate or adapt those successful methods.   

In this article, we'll tell you about Healthwatch Essex's Learning Disability Ambassador scheme, the 2021 pilot where other local Healthwatch got together to discuss the approach and how you can do the same in your own Healthwatch.  

About the Learning Disability Ambassador Scheme 

Working with their local hospital, Healthwatch Essex recruited and trained 14 volunteers with learning disabilities to undertake visits to the hospital and identify improvements. This includes reviewing signage, accessible information, and the language used. 

Ambassadors also met with Healthwatch Essex staff and the hospital's patient experience manager to discuss issues affecting them and others in their network and attend focus groups and steering group meetings. They contributed to case studies and social media campaigns led by Dan Potts, Healthwatch Essex engagement manager, to showcase the difference they are making.

We spoke to Dan, and he shared his top tips for involving volunteers with learning disabilities.  

Map your stakeholders first  

These might include charity organisations, hospitals, local councils, health care professionals or other agencies working in a similar field. 

Use your stakeholders to help with recruitment

Recruitment is easier once you have a stakeholder map. Make a flyer or leaflet to share virtually and face to face in shops and community settings. During your recruitment, include an informal interview face to face or online to enable you to understand the needs of the individual and what you can do for them during their role. 

Keep recruitment simple and accessible

Include an informal interview face to face or online to understand the needs of the individual and what you can do for them during their role. Remember, it is not always about what the volunteer can do to help your organisation but more about how you can add value to their future.  

Make sure you have everything you need in Easy Read  

Ensuring information is accessible is vital to including disabled people in our work, but it also benefits everyone. You should make sure your crucial volunteer documents are available in Easy Read.  

If you want to create Easy Read documents:  

• Limit text – keep it very simple and don’t use any jargon.  

• Use clear images – either illustrations or pictures of real people, objects and places.  

• Do not overthink it – if you are asking for someone’s address, you do not always have to use a postcode symbol.  

• Attend a training course (Healthwatch England provides these) or find a local provider to help you produce Easy Read formats.  

Our Easy Read role description, application form, volunteer agreement, declaration of interest and volunteer handbook are all available below as downloads which you are welcome to use.  

Work as a team and be patient

Co-production works best when people with lived experience form a working group alongside health and care professionals to influence how services are designed, commissioned and delivered. Make sure you manage your volunteers’ experience. These are huge organisations, and it can take time and a lot of patience to influence and change services.  

Get your engagement method right 

Remember that all voices should be heard and that each project may need a different approach. It may be a survey, focus group, one-to-one conversations or social media campaign but remember to be flexible in meeting the needs of your volunteers.   

Carry out volunteer well-being checks  

The well-being of your volunteers is so important. Check-ins are a great way to keep up to date with how they are feeling and give them time and space to share any concerns they may have. These can be by phone or face-to-face. Remember, well-being checks are not always about mental health and well-being. It could be something they have seen or witnessed that they feel they need to bring up with you, or it could be that they are struggling with their physical health and need to take some time off. This will help you support and retain your volunteers.  

We asked Dan for his reflections on a small group of local Healthwatch coming together to discuss his approach and what they all learned. 

• Being able to share good practice between local Healthwatch was brilliant as everyone is so different, and you can learn from each other. 

• There was a high level of engagement and sharing from the group, and everyone was committed, which made it easy to facilitate. 

• Everyone appreciated the supporting resources and documents, particularly the Easy Read forms, role descriptions and handbook.  

• Six Healthwatch had made progress which they were happy to give updates on in the second session. 

What have local Healthwatch done as a result? 

• Recruited learning disability ambassadors. 

• Ran a learning disability steering group meeting. 

• Worked on digital transformation and addressed learning disability access to Zoom and Teams.

• Set up a learning disability health check programme.

The guide has been produced by the Care Quality Commission (CQC) in conjunction with us and local Healthwatch. 

The guide contains information on:

• The role of CQC
• How CQC work
• What CQC can offer local Healthwatch
• What local Healthwatch can offer CQC

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)