Engaging with Healthwatch

National Voices’ local influencing and campaigning network brings together professionals in member organisations who run campaigns that try to effect change at a local, as well as national level. At our last network meeting in September, Jacob Lant, Head of Policy and Public Affairs at Healthwatch England joined members to talk about how charities can work with Healthwatch locally and nationally.

Whilst many network members have worked with Healthwatch in the past, none of us fully understood how they operated and how best to work with them to benefit those we support.

This blog attempts to make things a bit clearer for voluntary sector organisations looking to work with Healthwatch.

Healthwatch’s structure and operational model

Healthwatch is a national network of statutory organisations set up to give local people a say in how health and social care services should be run.

The network has a national body, Healthwatch England, and 152 independent local Healthwatch covering each local authority area in the country. Every Healthwatch sets their own priorities based upon local intelligence. However, the combined priorities are analysed on an annual basis and are used to set the workplan for Healthwatch England.

The network is supported by a team of regional managers split across four regions – North, London, South and Central. Local Healthwatch across these regions meet on a quarterly basis to share intelligence, discuss priorities and identify opportunities for joint working.

Healthwatch have a range of statutory duties and powers. These include the ability to visit any taxpayer funded health and care service to speak to people about their experiences of care and report this to providers, commissioners and national regulators. Each Healthwatch also has a seat on their local health and wellbeing boards.

Through the conversations they have with health service users, they amass huge amounts of data on people’s experiences. This is where their campaigning power lies: the data enables them to identify issues and evidence their campaigns. They publish analysis and top line data, and are happy to work with charities to delve into the detail on specific issues and conditions. You can email research@healthwatch.co.uk with requests.

Healthwatch England has recently changed its strategy to be more focused on partnership working. To support this it is hiring a campaigns officer; once in post this person will be a good point of contact for the VCSE sector.

How do Local Healthwatch operate?

Local Healthwatch (LHW) are self-governing, but are funded by Local Authorities through Government grants. Local Authorities have a statutory duty to make contractual arrangements for a LHW to exist in their area. LHW vary hugely in their size, with the average often employing only three or four people to cover a huge range of duties and geographical areas. They may deliver just core Healthwatch functions, or they may be commissioned to provide a wider range of services, such as complaints advocacy.

The effectiveness of a LWH largely depends upon funding. In larger LHW, senior staff are more experienced and have back office support. They will have both the gravitas to influence their local Clinical Commissioning Group and Council, and the capacity to do so. Unfortunately, effectiveness is not related to need, and it’s a real risk that disadvantaged areas who have faced devastating cuts to public health budgets, and are already identified as a risk to widening health inequalities, may be less well represented.

This funding model also leaves LHW exposed to council funding cuts. As Councils look to cut back to the bare bones, they may reduce the non-statutory elements of LHW contracts and seek “value for money” where there are statutory requirements (excuse me for being so cynical, as a local authority Councillor, my free time is preoccupied by fretting about funding cuts). This could well be the case – Jacob told us how funding has fallen 36% in five years.

LWH relationship with the VCSE sector is equally variable. It can be influenced by the background of the LHW staff, how established VCSE networks are in the local authority and the priorities of the LWH.

And this brings us  to one of the other key points we grilled Jacob on –

How does Healthwatch set its priorities?

The simple answer is that they use intelligence gathered from conversations and the huge amount of data they collect to inform their local and national agendas.

In reality, priority setting is a complicated process, where LHW feed up to the national body, trends are analysed, and policy experts use their expertise to tease out the most vital issues. Whilst a long process, it’s democratic and intelligence driven.