Healthwatch – Getting Practical

Practical Action on Healthwatch

The recent helpful document – “Building successful Healthwatch organisations” produced by the LGA, Regional Voices and the NHS Institute starts at long last to put a bit of meat on the bones of what has, up until now been a process strong on rhetoric and weak on practicalities.

The “10 top tips” in the document focus mainly on how local authorities and their partners should manage the development process. The 15 case studies that follow start to give a feeling for the ambition of commissioners and the shape of the services that are being developed.

The case studies (10% of local authorities in England) are a mixed bag. They fall into the usual three categories – some really good ones, those that are still thinking things through – with a bit too much of a focus on organisational forms – and 2 or 3 that are embarassingly bad. I am not going to finger the ones that I think are bad – but frankly any place that claims to already have the model sorted and to have an existing organisation that provides an excellent service immediately sets off warning bells for me.

The ones that I thought were the most useful – in order of importance are:

• Lambeth – a strong focus on outcomes and a real clarity about a citizen led model
• Kent – very strong on the need for a powerful analytical function – providing the evidence to support strategic challenge
• Hertfordshire – Importance of effective capability for investigations and the need for real expertise in community infrastructure.
• Staffordshire – Interesting research following quite large scale consultation – although model not clear

Anyone close to Healthwatch will understand just how difficult the task is – as we struggle to come up with a powerful engaged whole system model of citizen led quality assurance with real clout but limited resources.

The table below sets out some of my thinking – looking at some of the imperatives and the service and capability that might be required. This is very much work in progress!

Of course what it does not show is how the service should be structured  and the relative balance of investment across the different functions. Please comment on it!

Whole System

A final thought -this is not just about commissioning Healthwatch and then saying the job is done – I think this is one of the reasons that LINks struggled so much. The local commissioning system has to build the role of Healthwatch into how it works. Health and Wellbeing Board members will need to champion local Healthwatch outside meetings – as well as changing their organisations behaviours – for example – building in a requirement to engage with Healthwatch into the contracts of all local providers – including GPs.