Application Pack

Healthwatch Champions

Welcome!
Thanks for your interest in becoming a Healthwatch Barnsley Champion. In this form, we have outlined what we do and the different ways you can be involved. We look forward to receiving your completed form, which can be emailed to or sent to/handed in at our office at The Core, County Way, Barnsley, S70 2JW.
If you require clarification, further information or assistance to complete the form, please call us on 01226 320106, or email us at
We accept CVs, as long as they relate to the points detailed under desirable skills and knowledge.
What is Healthwatch Barnsley?

Healthwatch Barnsley is the independent consumer champion for both health and social care.

We:

  • aim to encourage high standards of health and care provision and to challenge poor services;
  • have the power to enter and view health and social care services;
  • influence how services are set up and commissioned by having a seat on the local Health and Wellbeing Board;
  • carry out engagement to gather the views of local people and represent these views to commissioners and service providers;
  • produce reports which influence the way services are designed and delivered;
  • provide information and support about local health and social care services;
  • forward information and recommendations to Healthwatch England and the Care Quality Commission.

Healthwatch Barnsley is supported through Voluntary Action Barnsley and led by a Shadow Boardwho help to determine our strategic direction. Although we are commissioned by the local authority,weoperate independently, responsible for our own decisions andfuture plans.

Volunteering

Volunteers are very important to Healthwatch and are an integral part of our organisation. We rely on their contribution to our work which enables us to respond to our customers throughout Barnsley. We would not be able to do this without them. We ask our volunteers to make a time commitment that they will adhere to. This ensures that the people who need us can rely on our presences should they need us.

We also ask volunteers to commit to receiving training that is relevant to their role.

If you are unable to meet these commitments, please consider whether the Healthwatch role is the right one for you. If you decide it is, we will offer you the opportunity to develop your skills and be part of a team that is well supported and much appreciated.

Healthwatch Barnsley Champions
Healthwatch Barnsley Champions support engagement work by being active in their own local area, representing and channelling the views of local people.

As an organisation, we have an interest in a range of health and social care needs and types of services throughout Barnsley. However, our Champions may focus on a specific type ofservice and/or a local area.

Please circle your preferred area below

South Barnsley
Rockingham, Hoyland Milton, Wombwell, Darfield
Penistone
Penistone West / Penistone East
North East Barnsley
Royston, Monk Bretton, Cudworth, North East
Dearne
Dearne South, Dearne North
Central Barnsley
Dodworth, Kingstone, Central, Stairfoot, Worsborough
North Barnsley
Darton East, Darton West, St Helens, Old Town

Please indicate if you have a specific interest group you would like to work with by placing a tick in the relevant box:

Lesbian, Gay, Bisexual Transgender (LGBT)
Mental Health
Physical Disability
Sensory Impairment
Learning Disability
Carers
Older People
Children and Young People
Minority Groups (please specify)….

Your role as a Healthwatch Barnsley Champion will be to:

-Tell people about our work and encourage them to be involved;

-Promote our events and projects to local people and or people with a common service/need interest;

-Assist our staff team to gather the views of local people or people with certain needs who use certain services (running focus groups, carrying out consultations, surveys and questionnaires);

-Support our staff team at events by staffing the display stands and promoting our work;

-Introduce our staff team to groups, networks and individuals who can support our work and/or who are willing to feedback their views;

-Make new contacts in local communities;

-Encourage organisations and individuals to sign up as members;

-Encourage other people to consider being Healthwatch Barnsley Champions.

Volunteers with an interest in becoming Enter and View Representatives will undergo additional training which will allow them to enter and view a range of health and social care services across Barnsley, as directed by Healthwatch Barnsley. Authorised Enter and View representativeswill plan and arrange (with support from the staff team) visits to services. This role will include talking to staff, patients and carers about their experiences and making recommendations based on the feedback generated, to improve standards where appropriate.More information on this role can be provided upon request.

Desirable skills and knowledge
The points below are a guide only, to help you decide if this role is right for you.

Ideally you will:

-Be resident in Barnsley with some time to give to the role;

-Have an awareness of, or interest in, health and/or social care services;

-Have an interest in improving health and social care services locally;

-Have a good understanding of confidentiality;

-Be able to follow guidance and instructions;

-Have the ability to develop a good rapport with local people;

-Have good written and verbal skills;

-Be able to communicate with a wide range of people;

-Be able to work within a team.

Benefits to you:

-Free training relevant to the role will be provided;

-Reasonable travel and out of pocket expenses will be reimbursed on production of receipts and travel claims;

-Enjoy the experience of volunteering as part of a friendly team and meeting new people;

-Become involved in making a difference to your local community;

-Increase your confidence and gain new skills;

-Use your experience with Healthwatch Barnsley to seek work in health and social care or other fields of employment;

-Ongoing support from members of the staff team.

APPLICATION FORM

If you are interested in becoming a volunteer with us in the capacity just specified, please complete the following form.

Name: / Date Of Birth:
Address:
Contact Number:
E-Mail:
We will contact you via email unless you notify us otherwise. Please check the box if you wish to receive correspondence by post
Why are you interested in being a Healthwatch Champion?
Please provide a brief summary of your work/volunteering/life experience:
Please provide any information of your awareness of and/or personal interest in health and/or social care services in Barnsley:
Please identify the personal qualities you have that you will be able to bring to the role of Healthwatch Barnsley Champion.
Although it is not essential, if you do have any experience in any of the following areas, please provide details:
Consulting with people undertaking consultations and/or surveys
Delivering talks, presentations and or facilitating focus groups
Supporting and or delivering events and displays
From the role description attached, please indicate below the areas of activity within the Healthwatch Barnsley Champion role you would be interested in:
Promotional activities Gathering views (surveys etc.)
Developing contacts/networks Raising awareness/seeking involvement
Producing reports Other please specify…
Enter and View
What days are you normally available?
How many hours are you able to commit to?
Have you had a recent DBS (Disclosure And Barring Service) check?
If yes, please attach.Yes No

Relationships

If you are related to a director, or have a relationship with a director or employee of any of the below, please state the relationship
-Health or social care providers and their employees within Barnsley;
-Providers affiliated with a private company, supplying goods and services to local healthcare providers;
-Commissioners of health and social care services in Barnsley;
-Current senior employees of Barnsley Council;
-Current senior employees of the Clinical Commissioning Group.

REFERENCES

Please give the name and details of two referees

* DECLARATION

The information in this form is true and complete. I agree that any deliberate omission, falsification or misrepresentation in the application form will be grounds for rejecting this application or subsequent dismissal as a volunteer by the organisation. Where applicable, I consent that the organisation can seek clarification regarding professional registration details.
I agree to the above declaration:
Signature
Name / Date

MONITORING INFORMATION

This section will be detached from your application form. The information collected will only be used for monitoring purposes in an anonymised format and will help Healthwatch Barnsley analyse the profile of applicants in support of our equal opportunities policies.

We recognise and actively promote the benefits of a diverse community and are committed to treating all volunteers with dignity and respect regardless of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. We therefore welcome applications from all sections of the community.

Gender  Male  Female  I do not wish to disclose this

I would describe my ethnic origin as:

Asian or Asian British

 Bangladeshi  Indian

 Pakistani  Any other Asian background

Black or Black British

African  Caribbean

 Any other Black background

Mixed

White & Asian  White & Black African

 White & Black Caribbean Any other mixed background

White

 British  Any other white background

 Irish

Other Ethnic Group

 Chinese  Any other ethnic group

 I do not wish to disclose this

Date of Birth ______

Please select the option which best describes your sexual orientation

 Heterosexual  Bisexual

 Gay  Transgender

 Lesbian I do not wish to disclose this

Please indicate your religion or belief

 Atheism  Islam

 Buddhism  Jainism

 Christianity  Sikhism

 Judaism  Hinduism

 Other I do not wish to disclose this

The Equality Act 2010 protects disabled people - including those with long term health conditions, learning disabilities and so called "hidden" disabilities such as dyslexia. If you tell us that you have a disability, we can make reasonable adjustments to ensure that any selection processes are fair and equitable.

Do you consider yourself to have a disability? /
 Yes
 No
I do not wish to disclose this
Please state the type of impairment which applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please mark ‘other’.
 Physical Impairment  Long-standing illness
 Learning Disability/Difficulty  Mental Health Condition
 Sensory Impairment  Other
I do not wish to disclose this
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