Away Day

Wednesday 1 October 9:30am -3:30pm

Docklands Sailing Club

Agenda

Arrive 9:30

1 / Looking Back What have we achieved over the last 12 months and did we make a difference?
Reviewing feedback from the Reflective Audit, members feedback and the evaluation of the voluntary and community organisations sub-contracting model (attached)
  • what did Healthwatch do well
  • what didn’t we do so will

Measuring impact
Self assessment of achievement against the outcomes and impact framework (attached)
Lunch 12:30 -1:00
2 / Looking Forward – What have we learnt and how can we have more impact?
2.1Do we have the right resource allocation and staffing structure to meet our aims?
  • setting the direction for our business model moving forward. Core and income generation

2.2 Setting our priorities for the next 12 months. How could we have more of an impact?
  • working with our stakeholders to agree where we can make a difference CCG, Local Authority (Adult Social Care, Public Health, Health and Wellbeing Board and JSNA) priorities
  • building capacity around community research
  • discuss ways to improve signposting, complaints (what projects can be undertaken to improve this), ICASS

3 / Governance
  • Achievement against Healthwatch Good Governance Guide Health
  • Governance Flow Chart
  • Committee recommendations
  1. Finance and Personnel
  2. Review and Monitoring
  3. Communication and Engagement
  • Training Needs

4 / AOB
Finish 3:30

Board Away day

1 October 2014

Docklands Water Sports and Sailing Centre

9:30-3:30

Present: Amjad Rahi, David Burbidge, Sharmin Shajahan, Emma Cassells, William Colverson, Jobeda Ali, Myra Garrett
Staff: Dianne Barham, Shamsur Choudhury, Beverley Annan
LBTH: ShanaraMatin
Apologies : Enayet Sarwar, Daniel Kerr
Agenda / Action
1 / Looking back – reviewing reflective audit and measuring impact
  • As we have been established for over a year, we need company policy procedures to be in place- we can use NAVCA to formalise HR procedures and governance structures-they need to be in place with clear conflicton interest policy. Must be done before organisation NHS England has commissioned to look at HWTH framework visit us.
Reflective Audit
Board members discussed reflective audit at length and following points were raised:
  • HWTH needs to improve relations and have a better understanding with all level of Bart’s workers (inc senior management and lower level workers)
  • CCG and others use HWTH as a tick box and having said that we need to make sure that if this is the case we are having an impact with work that we do /produce for these organisations. Amjad mentioned that HWTH are consulted after decisions are made so how can we have an impact. Emma also felt that if we focus on CCG priorities, then we miss how our residents feels and how we can help them.
HWTH Service specification
Impact
Discussion raised the points that HWTH is doing a lot but is it having the necessary impact?
  • Look at Advisory Group- are they living up to function?- members felt they are currently being used as a communication and engagement group and this is stopping HWTH from going out and engaging with the wider Tower Hamlets community.
  • Discussion expanded on this and it was felt that co-production is needed between us and residents/ organisations in Tower Hamlets.
Suggestions for improvement:
More streamlined process.
Indicators of impact as this can help measure our impact but also inform where we need to engage and that can manage impact and also output of work. Make us cost effective and resource effective.
Develop a HWTH definition on what co-production means and would this help us develop how we will use this when it comes to our service delivery.
Voluntary Community Sector
Discussion touched on using VCO’s and sub-contracting them to work for HWTH- key platform to help deliver HWTH to community
  • Patient Leaders- going well, report on progress to be given out soon.
  • Tower Hamlets Friends and Neighbours project on the housebound hasn’t gone particularly well- comments seemed to only come from their service users and not a cross section- not representative of the voice of tower hamlets.
Young people panel- Going well, 20 young people on board. Designed a Shisha awareness campaign going to be used in a Public Health campaign. Next project will be around mental health in young people especially during exam times.
Barts Voices
  • organisations given £1000/£2000
  • quality of feedback varied. Wasn’t the calibre that we wanted- maybe too many organisations- lack of staff/skill set. Understanding of the project.
Mental Health Task Group
Going well, community options (received £5000) to manage user group. Made sense to link with community options who already have a user group and have links to the community.
Members feedback
On volunteering, members discussed the use our own volunteers to do work but also the use of VCO’s. Members raised:
  • Need to assess what we want from young people who volunteer for HWTH are we supporting existing volunteers enough- need to do a better job to maintain and attract high calibre volunteers. Member suggested having small number of good active volunteers.
  • Also Shanara raised discussing with volunteers what they want to do, ask how we can engage young people. What are we doing/saying to volunteers? On quality of volunteers, use board members to interact with HWTH volunteers and also when it comes to managing VCO’s and if we use them to run projects.
  • Suggested that HWTH need to go over challenges and go over where we can make improvements(improve maintenance and management of volunteers)
  • Amjad: target those who can’t access services and also those who are affected by inequality of health services. Need to sustain volunteers- keep them long term. People don’t perceive giving us info as volunteering
ELBA train and support volunteers- we can ask for help regarding a need for high calibre volunteers- but who will manage the volunteers?
  • Marketing and branding of projects- it was raised that groups we sponsor reflect HWTH not the organisation managing them. Improve management of projects as well e.g. VCO’s good at accessing groups but need to do training with them on collecting info, maybe go with them.
  • More targeted research- go after a specific issue and collect data on demographic so we can highlight which ethnicity is having issues etc.
  • Need to make sure work agrees with our core values
  • Need to analyse our finances/business model so when it’s held up to scrutiny it matches our core values- members would like projects to reflect this. Also it’s important for the business model to be prepared for the cut to finances by LBTH and also when it comes to generating our own income.
  • Business model to also cover next 5 years- where we are going? Ask residents, LBTH, Barts what they want from us, where should we go in the future.
  • CCG, Barts, LBTH- asking HWTH to do work for them- was a one off but now it’s more common- Members discussed the implications of this e.g. HWTH aren’t set up to be doing this and if we use volunteers they may need training on doing interviews etc., understand health and safety concerns when making visits to hospitals
  • HWTH in the past has signposted commissioners to other organisations who can do work for them- shouldn’t do that. If we want to be seen as organisation that can do work in community, need to put down our strengths (cheap/ reach difficult to access communities)
  • Focus on getting the core budget right and then work on generating income.
/
  • use NAVCA to formalise HR Procedure, governance structure.
  • need to define HWTH definition of co-production- put up on website
  • invite the Young people panel to present Shisha Awareness film to the Advisory Board
  • more of a staff presence is needed in the young people panel meetings

Outcome and Impact Framework
  • Self-evaluation on how we have done so far- (please consult document Healthwatch Tower Hamlets- Key Outcomes for 2014- 2017)
(Members and HWTH staff went through document and used RAG rating system to evaluate how we are doing).
HWTH On wider community explaining purpose of HWTH- AMBER
HWTH- building constitution, engaging stakeholders, local communities- GREEN
HWTH reflects issues raised by local people- (change wording on key outcomes as far as possible, HWBB, JSNA, CCG need to align their activities with priorities identified by HWTH). Members reiterated that HWTH need to have priorities right, listen to community look at JSNA and focus our work. GREEN
HWTH demonstrates transparency including use of finance- some members felt we needs more transparency on this issue e.g with new website and cost for that.
-Amjad told Di that we need to have an audit- give audit to board and that can inform on future away days. AMBER
HWTH includes seldom heard through engagement- Shamsur discussed HWTH engaging with these groups through enter and view at Health E1 and the project on the housebound. Members suggested that we focus on learning difficulties, those with physical disabilities. Emma asked about those who work in Tower Hamlets- what are we doing for them. HWTH Website to help with that, also outreach to help reach them esp. at tube stations before after work. Member suggested reaching out to groups associated with them. Members also raised issue of not everyone who uses services like planned care in Royal London aren’t necessarily from Tower Hamlets- how do we know we have succeeded in reaching seldom heard?- AMBER
HWTH has a plan for collecting views-members discussed the impact of the HWBB, health scrutiny panel and if the groups were making a difference /
  • Constitution needs to be on the website
  • Canary Wharf group- get info on those who work and what health services they use

2 / Looking forward – What have we learnt and how can we have more impact?
Board members discussed what they wanted to happen going forward with HWTH- staff was not present during the conversation)
What can we do differently- member feedback
  • Bringing some functions that are performed by Urban Inclusion in house e.g. finance management and they also discussed bringing the voluntary sector work in house.
  • HWTH can then develop a role for contract manager, finance manager and members suggested using volunteers for this or a local community organisation (Di spoke of HW hackney- and a board member runs a community accountancy firm- their books are done by a volunteer and they are able to do finance reports- Di suggested this was an option for us and if members had any suggestions to let us know)
  • Bill suggested that HWTH Sit down with a finance organisation who can advise us on our business model and from there we can see and develop any extra roles that may be needed.
  • Regarding the voluntary sector, it was agreed that we would decide priorities and then we can decide whether we need voluntary sector.
  • Di and Myra told members that finance sub-committee discussed developing a HWTH community research element- we can contract that out and it a way to generate income.
Di went over and members agreed that in principle
  • In terms of new posts- finance, contract management, volunteer support.
  • Agreed that also to achieve core requirements we spend money on new post and then we can think about the voluntary sector and money generation.
  • Develop community intelligence roles/s.
  • Shanara offered that with regards to collecting research, research team at LBTH can help us develop projects
/
  • need to find out more about workplace pension as this will go into effect next year- how does HWTH figure in this?
  • agreed to pay a small amount to get all documents up to date- suggested that getting an HR person on the board could help with that.
  • HWTH to develop a business model before we can discuss hiring/spending money and finding ways to generate income. Look at options and develop structure.
  • Look into procuring research volunteers from the local university e.g. QMUL

Setting priorities-making more of an impact
Work with Barts
Di informed members of comments report and as common theme pulled out was system processes particularly with Bart’s services- e.g. appointments, patient transport, staff attitude.
Member feedback
Members discussed how could HWTH help with this without HWTH turning into a complaints service.
  • Members agreed that HWTH have to focus on the getting action from Barts on attacking the culture of bad staff attitude e.g are they holding staff training on patient care etc
  • Emma suggested using patient pathways and highlighting to Barts the specific team/dept along that patient journey that are having issues.
  • Bill led on from that and told the board to highlight the good and bad depts. /wards then present findings to Barts.
Priorities- fitting in with CCG, JSNA, Bart’s, Public Health
  • Integrated care-HWTH can play role that makes sure integrated care isn’t about clinicians and is about the patient e,g mental health, end of life care, isolated patients. Jobeda can provide case studies on end of life care, with people living alone. Fits with CCG priority
  • User led mental health services- Focus should be on how HWTH can make sure that mental users are leading on delivering and monitoring mental health services. Link to Community leading health solutions- members agreed this centred on co production and fits in CCG, JSNA, and Public health. HWTH need to design own concept of co –production. David agreed this would be good for peer led research work. Di suggested picking area to focus this on e.g. stigma of mental health in faith communities
  • Access to GP surgeries- members agreed a need to refocus questions on this. Question should be on how HWTH can resolve the issue? More work to be done on this one.
  • Staff attitude/complaints at Royal London –members again agreed that focus should be on patient’s journey through royal London. We can then analyse the complaints procedure and also give examples of good ward/bad ward via enter and view visits. Fits with Barts, CCG
  • Stronger links with diverse faith groups- HWTH need to understand what they do. Di and some members see it as opportunity to hear from those who are seldom heard e.g. eastern European community, Chinese community- they both visit churches. Can help raise HWTH profile, talk to faith leaders on what their opinion is on what the issues are in the community. Fits with Public Health
Other priorities
  • Child health-Rather than duplicate work already being done (schools, LBTH) HWTH will continue with young people’s panel and add 16-18 year olds to that- link to young people mental health project. DI to build on this and bring it to next meeting
  • Adult Social Care- what is HWTH doing? Di offered bring in work we are already doing e.g. housebound project and link to social care. Jobeda suggested need to do work on direct payments, contracts with service providers.
HWBB communication and engagement sub group– what came from that meeting was HWTH can help develop a group of user rep organisations and this will feed into CHS, Care act, integrated care (Age UK, Link Age plus, TH Friends and Neighbours) bring them together as one body to consult but we also provide them with support. Tell us what their user’s experiences are of social care etc. /
  • HWTH to combine Barts PALS data and combining that with our database of comments.
  • Members decided combining intergraded care with Community Health Services to make one priority.
  • once the website goes live, ask people to rate domiciliary care (those that do have access to a computer- website priority
  • Di to have meeting with CCG, LBTH public health- ask how they can help take our priorities further

Governance
Committee Recommendations
  • Advisory group-Members discussed the function of the group which is a forum for people to come to inform HWTH -representing a cross section of community, LGBT, Older people etc
Bill asked where is the community representation and members decided there should be another local community group to feed information to the HWTH communications and engagement sub group and also the advisory group.
  • Board members- Need to increase by 3. Already have Marufz Zaman. Leslie Pavitt not interested in becoming board member. Need 2 more. -board suggested changing meeting times-
Governance Flow Chart
Members approved the new project proposal form. Members also approved the governance flow chart
Training Needs
Training needs in future to go before the board. Some members can each have training on one function to help improve HWTH. David suggested e-learning as a training need /
  • Have clear HWTH map available on the website- possibly with a mind map. HWTH in the centre surrounded by CQC, HWE, LETBE,- lets people know how people link into us etc. local committees as well. e.g look at Kings Fund example of NHS structure.
  • contact ELBA and getting a rep on board.
  • circulate training list again to members
  • change the marketing and engagement plan for comms and engagement sub group to just marketing plan

AOB
Patient X
Members discussed this and the importance of following the patient’s journey. David, Bill, Jobeda, Di to be part of programme
Next board meeting
Members decided to push this back to November.
Enter and view
Bill raised the issue of what questions should HWTH be asking- this is due to a recent Enter and View visit to Day Centres- raised the question -Were they using us to get information on organisations because they want to retender services?
Members debated whether HWTH ask questions that other organisations want us to answer and the answers were that we should be charging LBTH if we are using our unpaid volunteers.Bill and Shamsur- told Shanara that we have a structure and process to enter view however the enter and view to the daycentres didn’t fit with this and LBTH needs more advice on what HWTH remit is.
HWTH Website
going ahead- Bill, bill, Jobeda and Bev to meet with website company. /
  • Bev to call patient X’s and ask for an update on appointments etc.- have set question on the experience and then we can see the journey
  • -Bev to email members alternative dates for board meetings.
  • Shanara to clarify the remit of HWTH to LBTH. What our purpose is and what we are here for.

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