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

About

Healthwatch Week ran from 9-12 November 2021 and saw staff and volunteers join us online from across England. Find out the key takeaways from each day and access further resources to help you apply what we learned. 

• Day one
• Day two
• Day three
• Day four

Day one

A message from NHS England

The conference got going with a welcome message from NHS England Chief Executive Amanda Pritchard. Amanda spoke about how much the NHS appreciates the work you do to make care better and the vital role Healthwatch can play in helping to overcome the challenges that health and social care services face. 

Our Chair, Sir Robert Francis QC, then talked about how far we had come, with more than two million people supported to share their experience or get advice last year. However, he warned delegates that we still faced challenges that we must overcome to remain relevant. 

Takeaways from other sessions

Putting our values into practice

Most staff believe our brand is critical to our work but do deliver a strong brand we need to embed our values in our work. Tips include:

• Have clear objectives and follow up on work to understand your impact so we can demonstrate our value of 'acting'.
• Train staff to ensure our communications are accessible to help deliver our value of 'including'. 
• Adopt our new brand behaviours when they are launched. 

Healthwatch brand messaging guidance

Collecting demographic data

Lots of factors, like ethnicity and peoples income levels, can affect peoples care. Collecting demographic data is key to understanding the experiences of different sections of the community. When you live in areas that are not as diverse, this information is even more critical. Asking for demographic data is not always straightforward, but there is training to support you. Every little bit of information helps when collecting demographic data and even answering one question is better than answering none. 

How to collect and use demographic data

Using the quality framework

The Quality Framework self-assessment tool has helped many local Healthwatch understand work areas that might need improvement. Lessons from local Healthwatch who have been through the exercise includes the importance of harnessing the different perspectives of board members, staff and volunteers and prioritising actions over time to make them manageable. 

The Quality Framework: How can it help you?

Communicating the difference we make

People must understand the difference their views have made to local services. Tactics to achieve this goal include:

• Make time to track if changes have occurred and plan this into your work.
• Promoting the improvements that have been achieved rather than the tasks that got you there. 
• Describe what you have achieved engagingly and what would have happened if services had not acted on your evidence. 

Demonstrating impact – new resources

Key reflections

Ending the day, our former national director Imelda Redmond reflected on the unique role of Healthwatch.

Day two

Holding services to account

Day two kicked off with a debate about one of our important roles - holding care services to account. Delegates agreed that this works best when we build constructive relationships with health and social care decision-makers, and we can influence decisions before they are made. Many of you think that carrying out this role will be challenging in the new health and care landscape, but we can if we continue building our skills, relationships and working together to be heard. 

Takeaways from other sessions

Making your communications accessible

Accessibility isn't a box-ticking exercise and should be an essential part of our everyday work. To make sure your communications are accessible, there are straightforward steps you can take, like using ALT tags. You can also avoid doing things, like using complex language, to ensure what you say is easy for people to understand. The brand language guide includes an accessibility checklist you can use.

How can we make our information as accessible as possible?

Using data to make a difference

Once you're collecting demographic data, analysing it to understand what it can tell you involves trial, error and exploration. Top tips include using statistical approaches like ratios and pivot tables to see what you uncover and using external data to make comparisons. 

How to collect and use demographic data

How volunteers can help tackle inequalities

In helping to tackle health inequalities, its important to have volunteers drawn from across the diverse communities we serve. Our volunteers can play an essential role by championing equality in our work, raising awareness of the different perspectives some groups have and helping to build relationships with their communities.

Guide to Volunteering

Day three

A message from Government

Minister of State for Health Mr Edward Argar MP welcomed delegates by speaking about our role in the future NHS landscape.

Takeaways from other sessions

Policy breakfast briefing: Social care

The public are unclear on the recent changes to social care and are increasingly concerned about issues like access, eligibility and how to pay for care. There are a lot of issues across the country at the moment with inconsistent care and financial assessments. This can lead to people giving up and not getting the care they need. We can help by focussing on clear advice and highlighting where local needs are not being met.

Advice and information: What is adult social care? 

Supporting volunteers in the new health and social care landscape

The role of volunteers within the new ICS landscape is unclear and only just over a third of delegates were confident that their ICS had volunteering on their agenda. Without a statutory requirement volunteer and patient involvement is likely to be inconsistent across the country. You can help by raising volunteering with your ICS and encouraging a discussion to find out what roles our volunteers can help with.  

Resources to support volunteering

Representation of people and communities through local Healthwatch 

Having a seat at the ICS table is important that Healthwatch demonstrate the value they bring. Bring able provide to provide evidence we collect at an ICS level and build trust through this valuable insight is key. Having Healthwatch representation will also give us the opportunity to hold systems to account for their decisions. Doing this is often a difficult task that uses a lot of resource, so it is important we come together, support and learn from each other. 

Watch the recording of this session on YouTube.

How are Healthwatch and ICS's working together?

Celebrating the difference we make

Day three also saw our annual network awards ceremony, celebrating the difference you've made over the last twelve months. 

Day four

The final day of the conference included a debate about our role in public health and an overview of net steps following Healthwatch Week.  

Takeaways from other sessions

Using our new Healthwatch brand

Consistently using the new Healthwatch tone of voice and personality takes practice but will help you grab people's attention, keep them interested and build trust. Tips to help you write like Healthwatch include:

• Speak to the reader
• Keep copy short, sharp and write in an active tone
• Use plain English and cut unnecessary information
• Write with specific personality points in mind

Brand messaging guidance

Turning evidence into change: Stakeholder influencing

Local Healthwatch are currently spending a lot of time influencing ICSs and it is not yet clear what the impact of this influencing is. However, we also sit on boards and committees such as Health and Wellbeing boards and this can lead to a lot of impact, helping to build relationships with local stakeholders and ensuring the Healthwatch voice is heard.

A guide to running Healthwatch

Working together: CQC, NICE and Healthwatch England

We are all aligned on our strategy to prioritise tackling health inequalities in our work. This gives us the opportunity to collaborate more, particularly in targeting seldom heard communities and making it as easy as possible for these communities to talk to us. Demonstrating the outcomes of our work will be key to demonstrating success in this new strategy – and all three organisations are looking at new ways of ‘closing the loop’ and showing people the impact their feedback has had.  

Watch the recording of this session on YouTube.

CQC and local Healthwatch working together

The Quality Framework is a self-assessment tool you can use to understand where your work is currently effective and where you can make improvements.

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

We asked Healthwatch Northumberland to talk us through the process they followed and the learning they think you should know.

Why did you start, and how did you plan the work?

In March 2020, our board decided to complete framework, with the aim of having an action plan in place by the following March. The timescale felt feasible and would give us important insight to help us negotiate our contract renewal and develop our next year’s business plan.

We first thought we’d review all the domains simultaneously, with our staff, volunteers and contract holder.  But, in response to the COVID-19 pandemic, instead of holding one workshop, we had six online meetings to discuss each domain using the prompts provided by the framework. 

Each meeting involved a mix of our internal stakeholders and we enabled those less comfortable with online meetings or large groups to participate.

Who did you involve, and how did you gather your initial evidence?

The process was great because it gave us a chance to involve everyone.

However, to ensure volunteers and staff could fully contribute, we worked hard before the review sessions to make clear the purpose of the Quality Framework and how the assessment would work. This meant we focussed discussions on the review, not the process.

We invited everyone to at least one event, with a mix of staff, board members and volunteers represented. Attendees were allocated by availability or the knowledge they had of the area. Overall, 20 people took part.

It was important to think about people’s different needs. For example:

• For neurodivergent participants, make sure the meetings are not too long (1-1.5 hours),
• Use smaller groups so those who are less confident can take part.

Our chair led all the sessions and wrote up the notes. Our lead officer, who coordinated the project deliberately did not attend to enable the widest discussion.

Each session helped us gather evidence, highlighting examples of existing good work or our future aspirations. We also used the sessions to assess our current performance, giving each domain a red, amber or green (RAG) status. We also circulated the meeting notes so everyone could comment.

Following the meetings, the project coordinator and the chair also reviewed the notes and RAG status for accuracy, discussed the findings and identified themes, issues and any potentially contentious areas.

This review was critical, as it highlighted issues outside our remit or capacity or where work has taken place that the participants might now know about.

How did you build your broader evidence?

Our project coordinator then gathered the further evidence needed for each area of work and produced a summary.

An example of the evidence gathered for the people domain.

• Volunteer and staff role descriptions
• Induction plans and processes
• Code of conduct policy
• Overview of induction training
• Volunteer agreements
• Our strategic plan
• Equality and diversity policy

The project coordinator also drafted a Context and Environment Document by:

• Reviewing internal strategic planning documents, strategies, board reports and minutes, impact records and re-using relevant supporting information from evidence summaries.
• Reviewing external material and strategic documents such as local authority strategic plans, Joint Strategic Needs Assessment and Care Quality Commission reports.

The aim was to produce a ‘pen portrait’ of the context and environment we faced.

An example of the issues we looked at and the length of each section

• 149 words: Our local authority values Healthwatch, understands our role and is committed to at commissioner, officer and elected member levels
• 66 words: Robustness of local health and care services and system
• 1,491 words: Strength of local health and care stakeholder relationships
• 97 words: Local authority attitude to voluntary sector generally
• 61 words: Other local organisations doing engagement in health and care
• 162 words: Number of local providers and commissioners
• 180 words: Geographic and demographic challenges (e.g. levels of deprivation, poverty, health inequalities)
• 147 words: Local partners' attitude to involving people in their work
• 35 words: Value of our core contract and grant
• 44 words: Length of any contracts and grants
• 33 words: Number of full-time equivalent staff funded by your local authority core funding

How did you review the evidence and create your action plan?

We used our annual board planning day to review our evidence and to create an action plan. All our staff and volunteers were invited, as was our local authority.

We first started by looking at our review of the context and environment. We then broke into small groups to look at each domain and review and priories any proposed actions.

An example of how-to prioritise actions over three years:

Do First - things that are so important they need to be done in the first year if the action plan

Do Next - actions that would take longer and could wait for year two

Do Later – longer-term improvements in year three 

Do Not Do – things that are not achievable or are unnecessary

The day resulted in a list of actions, which we then developed into a plan, with information about who would deliver what and when.

Our Board then agreed the plan and asked for progress reports twice a year. We also communicated the plan to our staff and volunteers.

How much resource did the self-assessment take?

Over the five months we took, most of the costs related to the days spent on the project by our chair, project coordinator and volunteer officer.

A breakdown of time spent

• Preparation and briefings by lead officer - one day

• Preparation, review meetings and follow up by board, staff and volunteers - two days

• Review evidence, agree RAG rating, write action plan by lead officer, chair and staff - three days

• Support meeting with Healthwatch England by lead officer - two hours

Can you tell us more about any outcomes?

Since we agreed the plan, we’ve seen some real changes in different areas of work

Collaboration: We are working more closely with neighboring local Healthwatch, sharing resources, doing joint projects, and ensuring we have a strong collective voice in our Integrated Care System.

People: We have identified ways to have better induction for staff and volunteers. A new anonymous feedback survey also means we can monitor staff and volunteer satisfaction.

Engagement, involvement and reach:  We’ve done lots of work, using support from Healthwatch England to make equality, diversity and inclusion a driver of our public engagement work.

Any overall tips you would give to others?

The experience has been useful, good preparation for our contract retender and given us a better focus on key issues. Final overall reflections would include:

• Take a full-team approach
• It’s natural to worry about gaps you may find or feel guilty that you cannot address every issue.
• Encourage people to be challenging and pragmatic but not pedantic
• Build trust, be transparent and support people to take part to remain focussed
• Make use of the support from Healthwatch England.

It's hard to believe Healthwatch has been in place since nearly a decade, and in Healthwatch Commissioners terms, I feel like a dinosaur as I have been here almost from the beginning!

Over the years, Healthwatch England has worked hard to provide leadership, guidance and support to local Healthwatch and commissioners alike.  This support felt much more visible at  the outset as we all beavered ahead in setting up the Healthwatch function in our respective areas, and over the years, there have been times when as a commissioner, I thought, ‘What is Healthwatch England doing now? What are they working on? What can we help with?’

At an event for Healthwatch Commissioners in July, we collectively agreed to work closer with Healthwatch England to help shape the support provided to local Healthwatch and Commissioners.

As part of this, we decided to set up a Commissioners Reference Group. With this group, we hope to work closely with Healthwatch England to shape and improve guidance and support to local authorities with our statutory duty to commission effective local Healthwatch.

At the event in July, we heard from Healthwatch England colleagues about the things they are currently prioritising, a key one relating to the changes in health structures and the implications this might have on local Healthwatch including:

• The role of local Healthwatch at ICS level
• What capacity and resource might be needed
• How we can capture good practice and highlight challenges to stakeholders and decision-makers.

They’re currently bringing this together into a toolkit, supported by webinars and training for local Healthwatch to help them to influence Integrated Care Systems and add the most value.

As a representative on this board, I’m hoping to support Healthwatch England with planning events, shaping policy, sharing commissioning practice and grappling with some old age conundrums such as ‘demonstrating impact’ and looking at whole structures, systems and processes through an equality, diversity and inclusion lens.

Another important aspect for me will be the responsibility of being an effective ‘representative’.  How other representatives and I bring in the broader perspectives of commissioners and how we ensure we keep them up to speed with some of the key things happening is central to making this work.

We all know how important it is to collaborate, and this Reference Group brings enormous potential. Having a way for us to share what we’re working on, learn from one another and work together on live issues will make a big difference and add strength to the network.

We’re all working to that same end goal; we all have a vested interest in Healthwatch and ensuring everyone gets the health and care they need.

So I want to end by letting you know how I’m feeling right now… I’m feeling hopeful that by working better together we can have a greater impact at a time when it is possibly needed more than ever!