Essex
Strategic Plan 2013-2016
An independent voice for the people of Essex
Contents 1. What is Healthwatch Essex?
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2. Why Healthwatch?
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A people’s champion A legal requirement Our challenge
3. How will we work?
Our principles A complex landscape A ‘peaks and troughs’ model Who will listen to Healthwatch?
4. Our work
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Outreach and engagement • Volunteers • Training • Voice Network
Research
5. A timetable for change
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This is a huge challenge, but we believe that we can make a difference
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1. What is Healthwatch Essex? Our vision is to be an independent voice for the people of Essex, helping to shape and improve local health and social care services. We are an independent organisation with powers in law. We believe that people’s views and lived experience of health and social care matter. And we are here to make their voice heard. By capturing and articulating people’s voice, we can positively influence the commissioning and delivery of health and social care in Essex. This is a huge challenge, but we believe that we can make a difference. Our aim is to create a thriving network of trained volunteers, who can engage effectively with the public, who can carry out high quality social research, and who can influence the decisions made by local and national health and social care authorities. This requires us to work constructively, and in partnership, with the NHS and local authorities, as well as the county’s many voluntary and community organisations.
Our ambition is to be an effective agent of local change, and to reflect the highest standards of national and international best practice.
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2. Why Healthwatch? A people’s champion We know that, historically, the health and social care system hasn’t always listened to patients, users, carers, or the public at large. Indeed, neither has it convinced people that when the system does listen, it will act. Our research shows that users of health and social care overwhelmingly want their experiences to be used to make the system better for everyone. But many people don’t know how to share their views, even if they wish to, and feel that their involvement wouldn’t make any difference.
A legal requirement To address this problem, the Government passed the Health and Social Care Act 2012 that aims to ‘put patients and the public first’ through strengthening their collective voice. This Act created a national network of local Healthwatch organisations, and a national umbrella organisation, Healthwatch England, from April 2013. Under this legislation, Healthwatch Essex has a responsibility to:
promote and support the involvement of people in the commissioning, provision and scrutiny of local care services obtain the views of people about their needs for, and their experiences of, local care services make reports and recommendations about how local care services could be improved Source: Local Government and Public Involvement in Health Act, 2007, as amended by the Health and Social Care Act, 2012
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In turn, commissioners and providers have a responsibility to listen to Healthwatch Essex, and to respond to our reports and recommendations within 30 days, saying what actions they intend to take and, if none, why.
Our challenge Our task is to engage with the people of Essex, to listen to their voice, and to gather their lived experience of health and social care. At the same time, we also have to tackle a culture and practice within health and social care that has not always encouraged meaningful engagement and involvement. Our challenge is to answer the question that was put to us by one user of Essex health and social care – ‘If Healthwatch is going to listen to me, who is going to listen to Healthwatch?”. This Plan outlines how we intend to meet this challenge over the next three years.
3. How will we work? Our principles Our work is underpinned by a series of principles that we believe lay the foundation to Healthwatch Essex being an effective voice for the people of Essex. We will: • be a strong, local citizen voice, making a difference to health and social care provision for the people of Essex • collect the real voice of the people of Essex • set the standard for excellent public engagement • provide innovative ways to gather the lived experience of the people of Essex • be a network of networks • build the capacity and use the existing expertise of voluntary sector and community groups in Essex •
use our networks and public engagement to gather meaningful and robust local evidence and intelligence, capable of influencing key decision making in health and social care
• provide a platform from which diverse and seldom heard voices from across all Essex can be heard
People do not know how to share views, but they’ve certainly got views – there’s a whole group of people not being listened to Focus group attendee, cited in ‘User engagement research’, conducted on behalf of Healthwatch Essex, 2012
• work hard to be a respected and credible organisation, working in partnership across all sectors of health and social care • be unafraid to challenge service providers and commissioners • ensure that all Essex people have access to timely and good quality information and advice
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A complex landscape We work within a health and social care landscape that is vast and complex. It covers a population of nearly 1.5m people (not including Southend and Thurrock) and has an annual expenditure of around £3.4bn in 2013-14. The sector is hugely fragmented, with many local, regional and national bodies. The landscape of Health and Social Care in Essex • Five Clinical Commissioning Groups • NHS England • Essex Health and Wellbeing Board • Twelve district, borough and city councils • Five acute hospital trusts • Two mental health partnership trusts • Essex County Council Social Care • Health Education East of England • East of England Ambulance Trust • Community providers • Care Quality Commission/Monitor • Thousands of voluntary organisations
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By contrast, the core Healthwatch Essex team of staff is small. This includes a Chief Executive Officer, a Commissioning and Research Manager, an Engagement Manager, a Communications Lead, and an Administrator. We’re very aware that we need to target our limited resources where they can achieve maximum impact and to address unmet needs. We have thought carefully about our role, and how we can work constructively with our partners across health and social care. This includes the groups, forums and committees whose role it is to engage and involve the public and service users. It also includes the many voluntary and community organisations in Essex, which already represent the views and experiences of their members and beneficiaries. We do not intend to ‘re-invent the wheel’, but to work together with existing groups, organisations and networks. We also recognise the historic shortcomings of the health and social care system to engage and involve its patients and service users in an effective or meaningful way. We must therefore work to raise not only the profile, but also the quality of engagement and involvement across health and social care.
A “peaks and troughs” model Our approach to prioritising our work is based on what we call the ‘peaks and troughs’ model (see diagram).
Level or intensity of engagement
Cross-cutting issues NHS e.g. Patient Reference Groups
Social Care e.g. Planning Groups
Seldom heard or marginal groups
Older people e.g. Age UK Essex
Self-help and community groups
We do not undertake individual advocacy or complaints work. We are here to build up a picture of where people feel care is good and where it needs improving.
Who will listen to Healthwatch? We already have some influence due to our powers in law. But we recognise that these powers only become meaningful if Healthwatch Essex is perceived to be a constructive, credible and respected partner. That’s why we’re working hard to build relationships, and to ensure that we are an equal, but independent, partner on the county’s many partnership Boards, committees and forums.
Areas of health and social care
We sit on the: This recognises that the level of patient and public engagement is inconsistent across health and social care. At the so-called ‘peaks’ where levels of engagement are already high (such as where there are existing patient groups or voluntary groups), we can add value by sharing information and promoting good practice. But where there are ‘troughs’ of engagement (such as around the care needs of marginal or ‘seldom heard’ groups), we can be more proactive in gathering and highlighting people’s voice. Most importantly, our position as a countywide, independent organisation provides us with a unique ‘whole-systems’ perspective. We will tackle the crosscutting issues that affect all users of health and social care, such as when service quality falls down at the intersections between organisations.
• Health and Wellbeing Board • Quality Surveillance Group • Essex Workforce Partnership (Health Education East of England) • Essex Joint Strategic Needs Assessment Steering Group We also work closely with statutory partners and voluntary organisations to make sure their aspirations and arrangements for engaging and involving people are fit for purpose. Working in partnership does not mean that we shy away from adopting a critical stance – we will always challenge our partners where we feel this is right.
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4. Our work Our work can broadly be divided into two key strands: outreach and engagement, and research.
Outreach and engagement • Volunteers Volunteers are at the heart of Healthwatch Essex. Known as ‘Ambassadors’, they help us to reach out, capture and articulate the views of a very large and varied population. We also know that peer engagement and participation within communities is the most effective way of gathering people’s voice and lived experience.
• Training We expect all our Ambassadors to be effective in their roles, and we want them to feel supported and engaged in meaningful activities. All our Ambassadors undergo tailor-made, rigorous training, designed with our training partner, Voluntary Sector Training. This equips them with the skills they need to listen and gather lived experience, and to be effective in liaising with and influencing statutory partners. Our Research Ambassadors will benefit from peer research training designed by Anglia Ruskin University. To help raise the standard of patient and public engagement and involvement, and to build capacity within Essex, we also offer our training to health, social care and voluntary sector partners.
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There are three types of Healthwatch Essex Ambassador: Community Ambassadors link Healthwatch Essex to the citizens of Essex. They are the ‘eyes and ears’ of the organisation, gathering people’s voice and lived experience. Strategic Ambassadors are the link between Healthwatch Essex and statutory organisations, such as Clinical Commissioning Groups, NHS Trusts and local authorities. They support these organisations to engage and involve people in the development and delivery of health and social care services. Research Ambassadors carry out high-quality, applied social research into particular issues. They may be involved in carrying out questionnaires, focus groups, or interviews.
• Voice Network
Research
We know that we’re not the only organisation speaking up on behalf of the people of Essex. By joining forces with local voluntary and community groups that are working first hand with patients and service-users, as well as their family members, carers, friends, and colleagues, we can build a comprehensive picture of health and social care in Essex. We call this our “Voice Network” and have grouped our activities around six main themes:
To be an influential voice for the people of Essex, we believe our recommendations need to be firmly rooted in evidence. That’s why, alongside our outreach and engagement work, we also undertake applied social research. This includes studies into specific topics, large and small, to better understand people’s views and experiences.
1. Health services, including primary and acute care 2. Mental health 3. Children and young people 4. Carers 5. Disability (including physical, sensory and learning disabilities) 6. Older people We’re inviting local health and social care charities and organisations to become a member of one or more of these virtual networks of experience and expertise. We will ask these groups for their insight on a particular issue, and share with them the outcomes of our work.
Our aim is to use innovative and rigorous methods of social research, and to make Healthwatch Essex visible on a national scale, competing alongside comparable charities, think tanks and universities. The principles of co-production and participation are central to our research programme. Much of this work will be run ‘in house’, overseen by our Commissioning and Research Manager, and involving our Research Ambassadors. But we recognise that we won’t always have the skills or capacity within Healthwatch Essex, and so we will collaborate with and commission research from external organisations, local universities, NHS and social care agencies, and voluntary organisations.
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5. A timetable for change The tasks set out in this Strategic Plan are ambitious. But we believe they are also necessary, if we are to be an independent voice for the people of Essex, helping to shape and improve health and social care. Our challenge is to bring about a shift in the culture and practice of patient, service-user and public engagement and involvement and this will not happen overnight. Our Strategic Plan sets out the steps we need to take over the next three years to achieve this vision. Our operational plan – available on request – provides more detail on how we intend to do this. Our success will be demonstrated by the esteem in which we are held by our statutory and voluntary partners and the general public, and by the difference we have made to local services.
On the horizon We are in discussion with Essex County Council to create a completely new and integrated information and signposting service across health and social care. The aim is to give people more control and choice about their health and care.
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2013 – 2014 Make Healthwatch Essex fit for purpose • our main focus is to establish our governance, strategy, finance and staffing •
we will raise awareness of Healthwatch Essex among the general public, and build relationships with the statutory and voluntary sector
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we will position ourselves as a constructive and credible partner of the NHS and social care
2014 – 2015 Roll out networks of outreach and engagement • our key goal is to gather evidence of voice and lived experience from patients, service users and the public •
we will recruit and train Healthwatch Essex Ambassadors – volunteers who will gather people’s voice and lived experience – and support our statutory partners to have patient engagement arrangements that are fit for purpose
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we will launch our Voice Network, a local network which builds on the experience and expertise of health and social care organisations in the voluntary sector
• we will establish our programme of applied social research
2015 – 2016 Focus on change and impact •
we will be a confident and mature organisation, respected by our partners for giving evidence-based recommendations and finding solutions in common to the challenges facing health and social care in Essex
• we will be embedded in the minds of the public as the organisation to make their voice heard • we will have made progress towards placing patients and service users at the heart of NHS and social care services
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Why not get involved? Visit our website: www.healthwatchessex.org.uk Follow us on Twitter: @HWEssex Like us on facebook: /healthwatchessex Email us: enquiries@healthwatchessex.org.uk Phone us: 01376 572829 Write to us: RCCE House, Threshelfords Business Park, Inworth Road, Feering, Essex CO5 9SE
March 2014 Healthwatch Essex. A company limited by guarantee and registered in England No. 8360699. Registered office as above.