Healthwatch Hertfordshire Engagement Strategy

1. Introduction

Department of Health has appointed Hertfordshire LINk as a pathfinder Local Healthwatch. The pathfinder application (submitted by Hertfordshire County Council) set out the planned developments in the transition of Hertfordshire LINk to Healthwatch Hertfordshire.

A presentation and paper on Hertfordshire LINk’s engagement were given to the shadow Health and Wellbeing Board on 5 October 2011. This paper now sets out the proposed engagement strategy for Healthwatch Hertfordshire (as developed so far) and the work in progress developing that strategy.

The aim of Healthwatch is to facilitate the vision that, within the parameters of the budget provided, they should ensure that the NHS and Social Services provided to the population of Hertfordshire should genuinely be centred on wishes of patients and carers. This to be achieved by giving the people of Hertfordshire a greater say in how services are run by allowing the experience and collective views of those who use the services to influence, advise and guide the commissioning and provision of those services. By monitoring the provision of services from a trusted friend perspective to optimise provision but to also report to providers, CQC and Monitor as necessary failures to provide and to identify and follow up such failures.

The structure of this paper is as follows.

· Section 2 sets out the work in progress towards developing the Healthwatch Hertfordshire engagement strategy. This work will continue throughout the year.

· Section 3 sets out the engagement strategy as it is formulated to date.

· Section 4 considers the time-scales for developing the strategy.

· Section 5 sets out some key dependencies of the implementation of the strategy.

Over its four years of existence, Hertfordshire LINk has progressively evolved, increasing its engagement with both the public and the statutory authorities. The engagement strategy for Healthwatch Hertfordshire represents another significant step forward in this evolution. Its implementation will present a challenging demand on its management, which includes the board, the proposed Stakeholder Forum and the local support team. The accumulated experience of the Hertfordshire LINk’s volunteers and support team will be crucial in the effective implementation of this strategy.

2. Developing the strategy

Engagement with the public

Anyone living or working in Hertfordshire can raise issues and concerns about health and social care services with the LINk, and the same will apply for HealthWatch Hertfordshire. In addition, the LINk has a registered membership of those people and organisations that wish to be more closely involved with LINk activities. The registered membership is made up of individuals, voluntary and community organisations, and Twitter/Facebook followers. A check, using the JSNA’s Mosaic software, shows that the current individual membership is broadly representative of the population of Hertfordshire.

Part of the pathfinder plan is to widen and deepen engagement with the public. To this end a series of workshops have been planned. The agendas for the voluntary sector workshops were formulated by a steering group of voluntary sector members. The first two workshops for the voluntary sector were held in January and February 2012. A further four local workshops are planned for District Councils, and local district groups, during May and June. A briefing for County Councillors was planned for February, but was cancelled due to weather conditions. A new date is being sought.

Outcomes from the workshops (so far)

The workshops showed a strong desire by both the voluntary sector and LINk to work more closely and effectively together. Various ways forward for Healthwatch Hertfordshire were recommended as follows.

· A greater emphasis on public relations, to communicate HealthWatch activities to the public, including the use of the press, TV, and radio.

· The provider of a strong signposting service, which is an effective intelligence base, having good quality information on need and services, with the availability of information, overnight and at weekends, and engages to completion and satisfaction. It could also be a point of contact for a range of service providers, commissioners and statutory bodies to find out what the public think of services.

· Greater emphasis on local (e.g. District) health and social care issues.

Delegates to the workshops also affirmed many existing Hertfordshire LINk policies and practices, including the following.

· Since Healthwatch Hertfordshire (like LINk) will cover the whole range of health and social care services across Hertfordshire, prioritisation of the issues to focus on is essential.

· The importance of the statutory right of the Enter and View programme

· The need to support the care of vulnerable people – one of the current priorities of Hertfordshire LINk

· Healthwatch Hertfordshire (like LINk) should be network organisation, and not duplicate work by other organisations, but provide support to them.

· The importance of sub-groups (theme groups), focused on specific aspects for example, children, mental health, the elderly, learning disability etc.

· An openness of operations, with the use of the internet and newsletters to communicate with members and the public at large.

Data sharing

A joint Hertfordshire LINk/POhWER task group have been working on the specification for data sharing between the ICAS service and LINk. This work is to be extended to data sharing with the voluntary sector. Data sharing is an important component of the work of LINk and HealthWatch. There is a large amount of data produced by the statutory authorities. However, that data has not always addressed the issues and concerns of the public. Three examples are as follows.

· Hospital Trusts produce numerous surveys of patient experience. However, these surveys have not identified the experience of very vulnerable patients (e.g. those with sensory or physical disabilities, learning disabilities, dementia, etc.). However, the Equality Delivery System project could change this for the future, making the patient experience surveys much more informative.

· The CQC carried out a National survey in 100 hospitals of the care of the vulnerable elderly. This gained considerable media attention and concern. However, the survey included only one hospital in Hertfordshire, and that was compliant with CQC standards.

· Hertfordshire LINk was alerted, by Herts Society for the Blind and by the Stevenage local patient group, and others, to serious concerns of patient experience with the appointments system at the new Lister Surgicentre. Herfordshire LINk with the Herts Society for the Blind raised the problems with the general manager of the Surgicentre. Although some action was taken by the centre, LINk was not satisfied and has asked NHS Hertfordshire (the commissioning agency) to investigate the appointments’ system. NHS Hertfordshire’s investigation is on-going.

These examples illustrate the need for a flexible approach to data sharing. The problem is huge and Hertfordshire LINk recommends that the JSNA acts as a hub for data sharing, and that access to underlying data for both the Health and Wellbeing Board and Healthwatch is structured into future commissioning contracts.

Appointment of the Corporate Body Local HealthWatch Board

HealthWatch Hertfordshire plans to move to a corporate status in 2012-13, and possibly register as a charity, in accordance with the provisions of the Health and Social Care Act. As part of this move, and in accordance with the views expressed at the workshops, it is intended to establish electoral colleges for the election of the board. It is also intended to have a two-tier structure of a small board and a larger consultative/advisory body or Stakeholder Forum. Both tiers will have representation from the wider public and the third sector, elected officers, and members from various representative groupings, for example GP practice groups.

In the meantime, the LINk board has agreed to co-opt additional members. At its March meeting the board co-opted an Executive Member of Herts Community Assembly, and an Executive from the CVS group, with the aim of further strengthening the LINk’s engagement with the voluntary sector.

The choices signposting service

One of the statutory functions of a Local Healthwatch will be to provide a signposting service for the public, on the choices available for health and social care. Hertfordshire LINk is already a signposting member of Herts Help.

Hertfordshire LINk believes that there is a particularly strong need for such a service in health care and where a patient needs both health and social care. This will be a new service, but Hertfordshire LINk has already taken some initial steps pending greater clarity from the legislation. While this will undoubtedly mean close working with Herts Help it is clear from consultation to date that a greater depth and a very specific form of information is required from this service.. A public meeting was held in February on the Choose and Book system, for booking hospital appointments. This is an excellent system. It requires the co-operation of the patient’s GP, but NHS Hertfordshire informs us that around 50% of GPs do not offer this service to their patients. The purpose of the LINk public meeting was to empower patients to request that service from their GP. The LINk sensory and physical disabilities theme group is holding another public meeting on this subject, to address the particular needs of disabled people.

Engagement with the statutory authorities

Hertfordshire LINk already has extensive engagement with the statutory authorities for health and social care in the County. This will continue with Healthwatch Hertfordshire. However, the LINk has had relatively little engagement with public health. This will be an extension of our engagement with the statutory authorities. The LINk has recently appointed representatives to the local Health and Wellbeing Groups. Another important area of engagement, which needs to be urgently developed, is with the JSNA, as mentioned above.

3. The HealthWatch Hertfordshire engagement strategy in outline

Public engagement

· Electoral colleges will be established for the election of the board of the Healthwatch Hertfordshire corporate body, and also for the election to the second tier advisory/consultative assembly/ stakeholder forum. The electoral colleges will have wide public representation across the County, including the voluntary sector and community groups.

· LINk/HealthWatch public relations will be reviewed, with the purpose of extending the reach of HealthWatch in the County. The existing (LINk) external communications, such as the website, and the use of Twitter and Facebook will be part of a wider programme, which will include external media coverage.

· National branding for Healthwatch will be adopted, when developed by the Department of Health.

· The existing LINk (members) theme group structure will be extended to work with similar voluntary and community groups. Public meetings will continue to be held to inform and collect public views and concerns.

· Healthwatch Hertfordshire will develop its engagement with District Councils and local district groups, with the focus on local health and care issues, as well as County wide issues. This will include GP practice Patient Reference (and Participation) Groups. Details will be formulated following the four planned District workshops.

· The Enter and View programme will continue, be enhanced, and extended to include Physical Environment Assessment Team (PEAT) visits. (PEAT visits are currently organised by NHS agencies). Research and surveys will continue to be used to inform the programme.

· Healthwatch Hertfordshire will continue to be a signposting member of Herts Help.

· A further signposting service to give the public independent information on choices in health and social care will be developed, as required by the Health and Social Care Act. The initial priority will be on choices in health care and where citizens require both health and social care. It will include choices in acute care, community care, primary care, and mental health care, including the choices for out-of-County health services. Existing databases and systems, such as NHS Choices, Choose and Book, as well as Herts Help, will be used as appropriate.

Engagement with the statutory authorities

· HealthWatch Hertfordshire will (continue to) be a member of the Health and Wellbeing Board.

· The existing LINk engagement will continue with NHS and Foundation Trusts, Clinical Commissioning Groups and their local boards, Primary Care, and independent sector providers to the NHS, adult and children’s social services, and the scrutiny committees. These contacts will be from board level down, in the case of the NHS, the Heath and Adult Care cabinet panel, and social care Directors down in the case of social services. HealthWatch Hertfordshire will continue to provide representatives on the strategic commissioning groups. Regular meetings will also continue with the CQC. The Quality Accounts reviews and inputs will continue, as will involvement with the NHS EDS project.

· HealthWatch Hertfordshire will extend its engagement with the Public Health Directorate, and in particular with the JSNA.

· HealthWatch Hertfordshire will prioritise the issues for engagement with the statutory authorities. At the same time, it will maintain contact with all the health and social care services, so that if a major crisis should occur in any part of those services, HealthWatch Hertfordshire is in the position to respond quickly to that situation.

· Healthwatch Hertfordshire will be actively involved with Healthwatch England

4. Timescales

Hertfordshire LINk continues with its statutory responsibilities until 31 March 2013, and has a very active programme of work. HealthWatch Hertfordshire is currently due to commence operation on 1 April 2013. LINk activities, plus the transition work to HealthWatch represent a very heavy workload on volunteers and the LINk’s local support team. The LINk transition group therefore intends to progressively plan and implement the changes to Healthwatch taking advantage of the period to 31 March 2013.

5. Dependencies of the strategy

HealthWatch Hertfordshire’s engagement strategy assumes that public engagement by the statutory authorities will continue. In particular it assumes that the Clinical Commissioning Groups, NHS and Foundation Trusts, and social services will continue with public consultations when significant changes are proposed to their services.

The above strategy also assumes that adequate funding will be made available to Healthwatch Hertfordshire to implement the strategy. The precise resources required by Healthwatch Hertfordshire for the above strategy have still to be defined, but are likely to be much closer to the government assessment of need than the current provision. The strategy also assumes that adequate funding will be made available to Hertfordshire LINk during 2012-13 to plan in detail and progressively implement the strategy, so as to be ready for as full activity as possible on 1st April 2013.

Henry Goldberg

Chair, Hertfordshire LINk

Healthwatch Hertfordshire Engagement Strategy