Transcript Document

Healthwatch and user led organisations
Frances Hasler,
April 2012
(With acknowledgements to Department of Health, for the diagrams and some of the slide content)
The new system…strengthening the collective voice
‘National champion voice’
DH – Secretary of State
Healtwatch and user led organisations
respond in
writing
continuous
NHS Commissioning Board
CQC
Monitor
dialogue
Ombudsman
‘Local champion voice’
Local authority
influencing
Local HealthWatch
health and well being board
OSC / scrutiny function
Community groups, Voluntary organisations
Mental health
Working age individuals
BME groups
Clinical Commissioning Groups
Older people
Carers
Disability groups
…others
Providers
Arrangements will ensure sharing of information to involve, consult
and protect the public
advisory
HealthWatch England
Local and national Healthwatch
Healtwatch and user led organisations
•
Strengthening the voice of patients, users of services and the public and to help achieve this:
 Local Healthwatch organisations to be the local consumer voice
 Healthwatch England will be a national independent consumer champion
•
Continuity of existing arrangements:
 local authorities will have duty to deliver local Healthwatch
 It will continue to be for health and social care
•
What will be different:
 from influence to decision making with a seat on health and wellbeing board.
 help individuals as well as understand and present community views
(Providing advice and information about access to and choice in health and social care
services, and either providing, or signposting to, advocacy for those wishing to make an NHS
complaint)
 Healthwatch England will be used nationally by Secretary of State, Monitor, NHS
Commissioning Board as well as CQC
Healtwatch and user led organisations
The way local Healthwatch will work
• A requirement on local Healthwatch to carry out its work in a way that is
representative of people who live in the local authority's area, and people
who use services (whether or not they live there). It includes people who live
there but use services elsewhere.
• Local Healthwatch must be a social enterprise; regulations will set out the
criteria such a body must fulfil (for example that it is non-profit-distributing).
• Similarly to LINks, it will be open to all local people and local community
organisations. Also similarly to LINks, a local Healthwatch can not be part of a
local authority or health trust
• Although local Healthwatch may subcontract or work in partnership in order to
fulfil its role, there will only be one local Healthwatch body in each area
• Local Healthwatch will be carrying out public functions, so will be subject to
Equality Act, also Freedom of Information and Data Protection laws.
Healtwatch and user led organisations
Strengths of local Healthwatch
• A clear route to influencing local commissioning, having a direct voice on the
local health and wellbeing board.
• Regulations will make sure that relevant bodies (including Healthwatch
England) have to respond to information requests or reports or
recommendations made by local Healthwatch
• Back up from Healthwatch England, which will provide general advice and
assistance to local Healthwatch, and a route to influence national issues
where necessary.
• Healthwatch England can also make a formal advance to a local authority
where the local Healthwatch is in difficulty.
• Local Healthwatch will be a clear, recognisable entity, through use of the
unified Healthwatch “brand” to help to make it more accessible to local people
Health and wellbeing boards
Healtwatch and user led organisations
The Health and Social Care Bill:
• Sets up Health and wellbeing boards (HWBs) as council Committees
• Establishes a core membership, with flexibility to expand locally
• Mutual obligation on councils and NHS commissioners to undertake Joint
Strategic Needs Assessment (JSNA)+ joint health and wellbeing strategies
• Sets expectation of alignment of health, social care, public health (and other)
commissioning plans
• Promotes joint commissioning and integrated provision
• Sets a duty for HWBs to involve users and the public in JSNA and JHWS
• Gives HWBs a role in annual assessment of clinical commissioning groups
(also a non-statutory role in their initial authorisation)
• Between 8 and 16 members (ideally)
What will Boards actually do?
Healtwatch and user led organisations
HWBs are not operational bodies, but:
HWB working in partnership:
•
They set priorities, and provide shared system
leadership
•
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They set a context, a common purpose, and
shared priorities
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They promote collaboration and service
integration
•
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They bring together key elements of public
services in one Executive body
•
They are focussed on outcomes, not just
services
•
They can make things happen across the
public sector
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a joint strategy to underpin commissioning of
services,
ensuring alignment of service commissioning
plans (health and social care, children and
adults)
promoting integrated commissioning and
provision
working in partnership on the causes of illhealth
enabling service change where required
engaging the public and listening to the
public’s views
aligning the resources of local organisations
Healtwatch and user led organisations
Clinical Commissioning Groups
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Responsible for most of the NHS budget
Helped by Commissioning Support Organisations
Locally controlled; including ‘lay’ representation
Must engage: CCGs need to be able to show they will ensure inclusion of
patients, carers, public, communities of interest and geography,
• It should be evident how the views of individual patients are translated into
commissioning and how shared decision-making with patients, about their
care, is promoted.
Healtwatch and user led organisations
NHS Commissioning Board
• The NHS Commissioning Board is a major part of the Government's plan to
modernise NHS. It will:
• directly commission certain services including: primary medical care,
specialised commissioning, offender and some military health;
• promote patient choice; ensure a comprehensive system of Clinical
Commissioning Groups, and supporting and holding them to account;
• allocate of, and account for, NHS resources;
• and reduce inequalities in access to healthcare
• It will establish a culture and leadership approach which puts engagement and
involvement at its heart
• Around three quarters of the Board’s staff will work in local offices and the four
commissioning sectors.
• There will be a National Director of Patient Engagement, Insight and
Informatics alongside medical, nursing and operations directors
NHS Commissioning Board – roles
Healtwatch and user led organisations
Engagement, Involvement and Choice
Leading the
Commissioning System
Board as:
• Exemplar of an
engaging organisation
• Champion of
engagement and
choice
• Upholder of the NHS
Constitution
Ensuring the
Commissioning System
Supporting
Commissioning
Board as:
Board as:
• Consortia
authorisation,
operation and
accountability
• Enabler of public
accountability
• User of system insight
• Facilitator of effective
commissioning
• Resource for consortia
Acting as a
Commissioner
Board as:
• Commissioner
• User of insight and
patient experience
• Quality improver
• Enabler of choice
• Engaging organisation
Corporate Body
Board as:
• Engaging
organisation
• Patient and public
voice at every
level
• Leader of public
opinion
• Strategic partner
Healtwatch and user led organisations
Health and Wellbeing Boards and the NHS
Commissioning Board
• Key relationship of HWBs and Healthwatch in respect of health care
commissioning is with local Clinical Commissioning Groups
• But; they also need to work with the NHS Commissioning Board
– As commissioners of primary care and specialist services (e.g. specialist
cancer services)
– As holders of the contract with clinical commissioning groups (eg on
authorisation and annual assessments)
– With a national role to ensure the NHS delivers better outcomes within
available resources
• And with clinical networks and senates (e.g. on best practice, service
re-design and service reconfiguration)
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Healtwatch and user led organisations
Opportunities for user led organisations
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Huge emphasis on ‘user voice’
Everyone learning together
Freedom to create a Healthwatch that fits the local situation
Drawing on existing local resources to get best quality and value of service
Emphasis on making sure that less heard voices are included
Local Healthwatch organisations set their priorities based upon information
and intelligence gathered on local health and social care
• Strong emphasis on collaboration, building relationships, local HW as a critical
friend on the health and wellbeing board
• Some strong local CCG pathfinders, already including VCS
Healtwatch and user led organisations
Potential challenges for user led organisations
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Healthwatch being seen as the only voice or the ‘safe’ voice
Healthwatch absorbing available resource
Route to influence for specialist services still not clear
CCGs more focused on statutory partners than on VCS
Disruption of existing arrangements for involvement, information and advocacy
Too complex to make an impact
Programme Timescales – Health and Wellbeing
Boards and HealthWatch
Healtwatch and user led organisations
Oct - Dec
2011
Jan – Mar
2012
Shadow running HWBs,
begin to refresh JSNAs
Apr – Jun
2012
Jul – Sep
2012
Oct – Dec 2012
HWBs operate on non-statutory basis,
produce JHWS and input to
commissioning plans
HWB early implementers, Healthwatch pathfinders,
emerging clinical commissioning groups,
share learning to support implementation
Jan – Apr
2013
April 2013
HWBs fully
operational
in every
upper-tier
local
authority,
local
Healthwatch start
date
October;
Start date and
Healthwatch
England
14
How can you develop partnerships with Healthwatch and HWBs?
Healtwatch and user led organisations
• Healthwatch will need to have really effective networks to be able to do its job
• You are well-established as a “voice” for people who use health and social
care services
• You are linked in to other user organisations; you know how to “sign-post”
• Health and Wellbeing boards need to take a broad perspective across public
services. They also need to get citizens to look after their own health better
• You see disabled people as “whole people” in a “whole system”; they may
need support with social care, housing, education etc, not just health care
• Don’t wait for these new bodies to look for you; go and introduce yourselves!
Healtwatch and user led organisations
Further information
Voluntary sector support
• DH strategic partners – Disability Rights UK; Regional voices (LVSC); National
Voices, etc.
Online
• http://knowledgehub.local.gov – search for “health and wellbeing boards”
• www.healthandcare.dh.gov.uk – search for “healthwatch”
• www.london.nhs.uk – search for “clinical commissioning groups”
• www.cqc.org.uk – search for “healthwatch”