The development of Local Healthwatch in Kent Part one: key findings
The development of Local Healthwatch in Kent Part one: key findings
The development of Local Healthwatch in Kent Part one: key findings
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<strong>The</strong> <strong>development</strong> <strong>of</strong><br />
<strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong><br />
Assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong><br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs
This project was funded by <strong>Kent</strong> County Council<br />
and the Department <strong>of</strong> Health.<br />
<strong>The</strong> project was supported by NHS <strong>Kent</strong> and Medway.<br />
2<br />
<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
Contents<br />
Executive Summary........................................................................................ 4<br />
Introduction and Aims..................................................................................... 6<br />
Methods......................................................................................................... 8<br />
‘Every Decision About Me, With Me’ workshop............................................ 12<br />
Summary <strong>of</strong> Key F<strong>in</strong>d<strong>in</strong>gs............................................................................. 16<br />
Recommendations....................................................................................... 30<br />
Acknowledgements...................................................................................... 40<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 3
Executive summary<br />
This report describes a structured series <strong>of</strong> <strong>in</strong>terviews, focus groups and<br />
workshops <strong>in</strong> preparation for the <strong>development</strong> work to design <strong>Kent</strong> <strong>Local</strong><br />
<strong>Healthwatch</strong> (K LHW). Researched and written by the Centre for Public<br />
Scrut<strong>in</strong>y, it provides an <strong>in</strong>dependent assessment <strong>of</strong> the read<strong>in</strong>ess <strong>of</strong> statutory<br />
and community stakeholders from across <strong>Kent</strong> to co-produce an effective<br />
local <strong>Healthwatch</strong> organisation.<br />
At the heart <strong>of</strong> the report is a description <strong>of</strong> the participatory workshop<br />
that was held at the end <strong>of</strong> the process that brought together over 40<br />
stakeholders from across <strong>Kent</strong> and from across a range <strong>of</strong> organisations and<br />
roles. Titled ‘Every Decision About Me, With Me’ the workshop <strong>in</strong>troduced<br />
an appreciative <strong>in</strong>quiry approach to the <strong>key</strong> questions <strong>of</strong> what a local<br />
<strong>Healthwatch</strong> organisation should do and how it should be organised to<br />
achieve this. A series <strong>of</strong> <strong>key</strong> messages based on areas <strong>of</strong> consensus amongst<br />
participants are presented, <strong>in</strong>clud<strong>in</strong>g:<br />
• Acknowledg<strong>in</strong>g the strong <strong>in</strong>terest and enthusiasm for K LHW across<br />
<strong>Kent</strong> and the desire for it to be a successful and strong champion for local<br />
people<br />
• Highlight<strong>in</strong>g that all parties believe that an <strong>in</strong>formed and <strong>in</strong>dependent<br />
organisation will be a powerful driver for effective commission<strong>in</strong>g and the<br />
provision <strong>of</strong> quality services<br />
• Build<strong>in</strong>g on the learn<strong>in</strong>g and experience from LINks<br />
• Recognis<strong>in</strong>g that the local aspirations for K LHW and the new roles it will<br />
play mean that different organisational forms and processes will need to be<br />
considered<br />
• Identify<strong>in</strong>g the new skills and competencies staff and volunteers will need to<br />
make K LHW effective<br />
• Plac<strong>in</strong>g a commitment to engag<strong>in</strong>g and <strong>in</strong>volv<strong>in</strong>g diverse and seldom heard<br />
groups from across <strong>Kent</strong> at the centre <strong>of</strong> how K LHW is developed and<br />
how it works at a practical level<br />
• Develop<strong>in</strong>g public and stakeholder credibility for K LHW by develop<strong>in</strong>g clear<br />
roles and support for staff and volunteers<br />
• Tak<strong>in</strong>g a whole system approach to the success <strong>of</strong> local K LHW and<br />
recognis<strong>in</strong>g the role that all partner organisations <strong>in</strong>clud<strong>in</strong>g commissi<strong>one</strong>rs<br />
and decision makers will play <strong>in</strong> this<br />
• Ensur<strong>in</strong>g that K LHW pays significant attention to social care and the<br />
<strong>in</strong>tegration <strong>of</strong> services <strong>in</strong> <strong>Kent</strong> as well as to healthcare<br />
• <strong>The</strong> importance <strong>of</strong> co-produc<strong>in</strong>g K LHW <strong>in</strong> a way that demonstrates and<br />
models best practice that will be taken forward by the organisation<br />
4<br />
<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
A range <strong>of</strong> suggestions and practical proposals have been collected about the<br />
essential local elements for an effective K LHW:<br />
• Ways to work across the scope and diversity <strong>of</strong> the county<br />
• Tools and creative approaches for work<strong>in</strong>g with different stakeholder groups<br />
• Possible organisational models and governance approaches<br />
• Examples <strong>of</strong> the competencies, skills and knowledge that staff and<br />
volunteers <strong>in</strong> K LHW are go<strong>in</strong>g to need and ways to support this by<br />
harness<strong>in</strong>g exist<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g programmes <strong>in</strong> <strong>Kent</strong><br />
• Insights from seldom heard groups and ways to overcome exclusion<br />
• Build<strong>in</strong>g on what is already work<strong>in</strong>g well <strong>in</strong> <strong>Kent</strong> <strong>in</strong> terms <strong>of</strong> engagement<br />
activities across health, social care and the community and voluntary sector<br />
• Approaches to communication<br />
• Methods <strong>of</strong> collect<strong>in</strong>g and align<strong>in</strong>g data and <strong>in</strong>formation about public views<br />
with the work and timel<strong>in</strong>es <strong>of</strong> commissi<strong>one</strong>rs and decision makers<br />
• Align<strong>in</strong>g K LHW with health and social care structures to maximise <strong>in</strong>fluence<br />
• Advice on how K LHW can form effective work<strong>in</strong>g relationships with<br />
statutory bodies such as the Health and Wellbe<strong>in</strong>g Board, Overview and<br />
Scrut<strong>in</strong>y Committees and Cl<strong>in</strong>ical Commission<strong>in</strong>g Groups<br />
• Identify<strong>in</strong>g potential barriers and challenges and the strategies for<br />
overcom<strong>in</strong>g them<br />
<strong>The</strong> report is divided <strong>in</strong>to two parts. <strong>Part</strong> <strong>one</strong> ( this document) describes<br />
the aims and methods used by the assessment and then <strong>of</strong>fers a summary<br />
<strong>of</strong> the <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs from the workshops, focus groups and <strong>in</strong>terviews.<br />
Recommendations are then provided to guide further <strong>development</strong> work<br />
based on a consensus <strong>of</strong> views about what needs to happen next.<br />
<strong>Part</strong> two compiles the data from the contributions <strong>of</strong> all the participants<br />
and provides more detailed <strong>in</strong>formation about their thoughts, op<strong>in</strong>ions and<br />
perspectives. Contributions are h<strong>one</strong>st and direct but were always <strong>of</strong>fered<br />
with the commitment to promote a collaborative approach to K LHW <strong>in</strong> <strong>Kent</strong><br />
based on reflection, learn<strong>in</strong>g and <strong>in</strong>sight.<br />
<strong>Kent</strong> is well placed to beg<strong>in</strong> the transition to K LHW and has strong<br />
commitment from a wide variety <strong>of</strong> stakeholders to ensure the process<br />
is successful. <strong>The</strong> participation that has been achieved by the statement<br />
<strong>of</strong> read<strong>in</strong>ess assessment provides the foundations to ma<strong>in</strong>ta<strong>in</strong> close<br />
relationships dur<strong>in</strong>g the co-production phase and cont<strong>in</strong>ue the practical work<br />
<strong>of</strong> turn<strong>in</strong>g local peoples’ vision <strong>in</strong>to reality.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 5
Introduction and aims<br />
A local <strong>Healthwatch</strong> for <strong>Kent</strong> will be established <strong>in</strong> October 2012 subject<br />
to the successful passage <strong>of</strong> the Health and Social Care Bill 1 . It will be the<br />
<strong>in</strong>dependent consumer champion across <strong>Kent</strong> to promote better outcomes <strong>in</strong><br />
health and social care. <strong>The</strong> organisation will have a number <strong>of</strong> <strong>key</strong> functions<br />
<strong>in</strong>clud<strong>in</strong>g act<strong>in</strong>g as a po<strong>in</strong>t <strong>of</strong> contact for <strong>in</strong>dividuals, community groups and<br />
voluntary organisations. It will promote the views <strong>of</strong> local people to <strong>in</strong>fluence<br />
commission<strong>in</strong>g and will have a seat on the Health and Wellbe<strong>in</strong>g Board<br />
where <strong>key</strong> decisions will be taken. K LHW will gather views and experiences<br />
<strong>of</strong> people us<strong>in</strong>g services <strong>in</strong> <strong>Kent</strong> to <strong>in</strong>fluence national health and social care<br />
services through <strong>Healthwatch</strong> England (HWE).<br />
As part <strong>of</strong> the transition from LINks to K LHW this report describes a<br />
statement <strong>of</strong> read<strong>in</strong>ess assessment to capture the views and <strong>in</strong>sights <strong>of</strong> a<br />
wide range <strong>of</strong> stakeholders to <strong>in</strong>form the <strong>development</strong> process.<br />
<strong>The</strong> project is sponsored by <strong>Kent</strong> County Council and the Department <strong>of</strong><br />
Health, and supported by NHS <strong>Kent</strong> and Medway. It has been designed and<br />
delivered by the Centre for Public Scrut<strong>in</strong>y. <strong>The</strong> Centre is an <strong>in</strong>dependent<br />
charity that is recognised as a leader for promot<strong>in</strong>g transparent, <strong>in</strong>clusive<br />
and accountable healthcare and social care and for co-ord<strong>in</strong>at<strong>in</strong>g practical<br />
national and local support to embed these pr<strong>in</strong>ciples <strong>in</strong> the implementation<br />
<strong>of</strong> the health reforms. <strong>The</strong> Centre for Public Scrut<strong>in</strong>y has experience<br />
<strong>of</strong> support<strong>in</strong>g the <strong>development</strong> <strong>of</strong> LINks across England and br<strong>in</strong>gs an<br />
<strong>in</strong>dependent perspective to the statement <strong>of</strong> read<strong>in</strong>ess. It has recently<br />
published research on the <strong>development</strong> <strong>of</strong> <strong>Healthwatch</strong> titled ‘Smooth<strong>in</strong>g the<br />
Way: Develop<strong>in</strong>g local HealthWatch through lessons from <strong>Local</strong> Involvement<br />
Networks’ (2011).<br />
<strong>The</strong> assessment is designed to support <strong>Kent</strong> County Council’s role as set<br />
out <strong>in</strong> the Health and Social Care Bill for local authorities to commission<br />
arrangements for local <strong>Healthwatch</strong> organisations <strong>in</strong> partnership with local<br />
stakeholders. <strong>The</strong> statement <strong>of</strong> read<strong>in</strong>ess report describes the read<strong>in</strong>ess <strong>of</strong> all<br />
statutory and other stakeholders <strong>in</strong> <strong>Kent</strong> and is <strong>in</strong>formed by explor<strong>in</strong>g four <strong>key</strong><br />
questions:<br />
• What should local K LHW do?<br />
• What k<strong>in</strong>d <strong>of</strong> organisation does K LHW need to be?<br />
• What environment needs to be created for K LHW to flourish?<br />
• What commission<strong>in</strong>g and procurement process will secure effective and<br />
efficient K LHW arrangements?<br />
1 As at November 2011 the Health and Social Care Bill was subject to Parliamentary approval<br />
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<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
<strong>The</strong> assessment has engaged a wider variety <strong>of</strong> <strong>in</strong>dividuals and groups<br />
<strong>in</strong>clud<strong>in</strong>g:<br />
• Executive councillors and senior <strong>of</strong>ficers <strong>in</strong> <strong>Kent</strong> County Council<br />
• Councillors on Overview and Scrut<strong>in</strong>y Committees<br />
• Social care commissi<strong>one</strong>rs and providers<br />
• Healthcare commissi<strong>one</strong>rs and providers<br />
• NHS and social care patient and public engagement staff<br />
• LINk members, governors and host staff<br />
• Patients, carers and advocacy groups<br />
• Voluntary, community and civil society organisations<br />
• Representatives and experts work<strong>in</strong>g with seldom heard groups<br />
A full list <strong>of</strong> participants is <strong>in</strong>cluded <strong>in</strong> part two <strong>of</strong> the report.<br />
<strong>The</strong> project took place aga<strong>in</strong>st the backdrop <strong>of</strong> the public consultation about<br />
‘Allocation Options For Distribution Of Additional Fund<strong>in</strong>g To <strong>Local</strong> Authorities<br />
For <strong>Local</strong> <strong>Healthwatch</strong>, NHS Compla<strong>in</strong>ts Advocacy, PCT Deprivation Of<br />
Liberty Safeguards’ which will be report<strong>in</strong>g later <strong>in</strong> the year. At the same time<br />
the Health and Social Care Bill will be start<strong>in</strong>g the process <strong>of</strong> be<strong>in</strong>g scrut<strong>in</strong>ised<br />
by the House <strong>of</strong> Lords and may be subject to changes and amendments as<br />
the Parliamentary process cont<strong>in</strong>ues.<br />
Aims<br />
<strong>The</strong> aims <strong>of</strong> the statement <strong>of</strong> read<strong>in</strong>ess are:<br />
• To explore levels <strong>of</strong> understand<strong>in</strong>g, skills and capacity at <strong>in</strong>dividual,<br />
corporate and community levels <strong>in</strong> relation to the <strong>development</strong> <strong>of</strong> K LHW<br />
• To make recommendations to the <strong>Local</strong> <strong>Healthwatch</strong> Development Group<br />
(LHWDG) for future action on the basis <strong>of</strong> evidence <strong>of</strong> read<strong>in</strong>ess gathered<br />
through the project.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 7
Methods<br />
Stage One: Develop<strong>in</strong>g an overall structure<br />
Follow<strong>in</strong>g consultation with the multi-stakeholder <strong>Kent</strong> <strong>Local</strong> <strong>Healthwatch</strong><br />
Development Group the project team captured a full range <strong>of</strong> possible areas<br />
and questions relevant to the assessment. It was apparent from an early<br />
stage that the topic <strong>of</strong> K LHW generated a lot <strong>of</strong> queries and issues for local<br />
people and organisations and it was important to be able to place a structure<br />
around these. It was also clear that <strong>key</strong> terms such as ‘<strong>in</strong>formation’ and<br />
‘choice’ had different <strong>in</strong>terpretations for people so it was essential to have a<br />
method that would enable participants to share their understand<strong>in</strong>g and vision<br />
for what K LHW meant to them. This was written up as an assessment format<br />
for the project and through an iterative process new issues and questions<br />
were added. <strong>The</strong> format ensured that important issues could be held <strong>in</strong><br />
<strong>one</strong> place and addressed as the project developed. 11 broad themes were<br />
identified from this work:<br />
1. Vision for K LHW<br />
2. LINks experience and learn<strong>in</strong>g relevant to the transition to K LHW<br />
3. Function 1 <strong>of</strong> K LHW: a consumer champion<br />
4. Function 2 <strong>of</strong> K LHW: <strong>in</strong>formation and signpost<strong>in</strong>g to support choice<br />
5. Function 3 <strong>of</strong> K LHW: compla<strong>in</strong>t advocacy services<br />
6. Collect<strong>in</strong>g <strong>in</strong>telligence and work<strong>in</strong>g with HWE<br />
7. Alignment with partners – relationships, data and processes<br />
8. Organisational form<br />
9. Operational issues<br />
10. Development<br />
11. Commission<strong>in</strong>g and procurement<br />
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<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
<strong>The</strong>se themes formed the basis <strong>of</strong> <strong>key</strong> l<strong>in</strong>es <strong>of</strong> enquiry and a range <strong>of</strong><br />
<strong>in</strong>dicative questions were developed for each theme which could be used for<br />
the design <strong>of</strong> the participation tools that would explore the themes <strong>in</strong> greater<br />
depth with different stakeholders.<br />
‘Representativeness’ was felt to be a crucial over-arch<strong>in</strong>g issue for all aspects <strong>of</strong><br />
<strong>Healthwatch</strong>. <strong>The</strong>refore it was <strong>in</strong>tegrated <strong>in</strong>to all themes to embed the issues <strong>of</strong><br />
diversity and <strong>in</strong>clusion rather than treat<strong>in</strong>g them separately. Identified questions<br />
<strong>in</strong> each theme meant that ‘representativeness’ could be explored <strong>in</strong> context.<br />
<strong>The</strong> assessment format tool is <strong>in</strong>cluded <strong>in</strong> part two <strong>of</strong> the report along with<br />
the ground rules <strong>of</strong> participation <strong>in</strong> the process.<br />
Stage Two: Design<strong>in</strong>g participation tools<br />
<strong>Part</strong>icipation tools were designed based on the assessment format.<br />
<strong>The</strong>se were:<br />
• Semi-structured <strong>in</strong>terviews with senior staff from different stakeholder<br />
organisations <strong>in</strong>clud<strong>in</strong>g LINks, the PCT cluster, the <strong>Local</strong> Authority<br />
• <strong>The</strong>med focus group discussions<br />
• Solution focused workshops<br />
Each <strong>in</strong>terview and focus group prioritised a small selection <strong>of</strong> seven or eight<br />
<strong>key</strong> questions from the wider assessment format that were felt to be relevant<br />
to specific audiences. Responses from participants were then grouped<br />
aga<strong>in</strong>st the 11 themes.<br />
Advisers from the Centre for Public Scrut<strong>in</strong>y also participated <strong>in</strong> a half-day<br />
workshop on K LHW set up by LINks to capture the views <strong>of</strong> LINks members<br />
and governors.<br />
A set <strong>of</strong> participant ground rules was developed to outl<strong>in</strong>e the process and<br />
how the <strong>in</strong>formation from the participation tools would be used.<br />
To compliment the direct participation tools an opportunity was provided for<br />
<strong>in</strong>terested parties to also contribute thoughts and op<strong>in</strong>ions by email.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 9
Stage Three: Deliver<strong>in</strong>g the <strong>in</strong>terviews and focus groups<br />
Dur<strong>in</strong>g August and September 2011 the Centre for Public Scrut<strong>in</strong>y ran a<br />
series <strong>of</strong> <strong>in</strong>terviews with 18 <strong>in</strong>dividuals.<br />
This was followed up by a series <strong>of</strong> four themed focus groups on the follow<strong>in</strong>g<br />
perspectives:<br />
• Cl<strong>in</strong>ical Commission<strong>in</strong>g Groups<br />
• Members <strong>of</strong> the public not part <strong>of</strong> LINks<br />
• Community and voluntary sector<br />
• Gypsy and Traveller community <strong>in</strong> <strong>Kent</strong><br />
Outputs from these pieces <strong>of</strong> work were written up and used to <strong>in</strong>form further<br />
engagement with stakeholders as <strong>key</strong> themes emerged.<br />
Stage Four: Reflect<strong>in</strong>g on f<strong>in</strong>d<strong>in</strong>gs through<br />
a participatory workshop<br />
<strong>The</strong> learn<strong>in</strong>g from the <strong>in</strong>terviews and focus groups was used to design a<br />
<strong>one</strong>-day workshop for stakeholders to explore <strong>key</strong> themes from the work<br />
so far and to prioritise issues for the future <strong>development</strong> <strong>of</strong> K LHW. Over 40<br />
<strong>in</strong>dividuals attended the workshop represent<strong>in</strong>g a wide variety <strong>of</strong> groups, roles<br />
and agencies.<br />
<strong>The</strong> purpose <strong>of</strong> the workshop was to beg<strong>in</strong> the process <strong>of</strong> jo<strong>in</strong>tly design<strong>in</strong>g<br />
aspects <strong>of</strong> K LHW. <strong>The</strong> day was called ‘Every Decision About Me, with Me’<br />
illustrat<strong>in</strong>g the appreciative approach used. Four sessions focused on <strong>key</strong><br />
themes which had emerged from the <strong>in</strong>terviews and focus groups.<br />
<strong>Part</strong>icipants were <strong>in</strong>dividually <strong>in</strong>vited to ensure there was a mix <strong>of</strong> people<br />
who would relate to K LHW from all perspectives. For example there were<br />
people from user groups, carers, people who might be part <strong>of</strong> K LHW,<br />
council <strong>of</strong>ficers and politicians who might be <strong>in</strong>volved <strong>in</strong> commission<strong>in</strong>g or<br />
sitt<strong>in</strong>g on boards where K LHW will participate and others. Each workshop<br />
provided an opportunity for dialogue. Us<strong>in</strong>g pre-drafted future or aspiration<br />
statements, participants developed a shared sense <strong>of</strong> how they wanted K<br />
LHW to operate. Some participants suggested areas they felt needed to be<br />
developed <strong>in</strong> order to create the agreed future. Other participants jo<strong>in</strong>ed them<br />
<strong>in</strong> breakout groups to do some detailed work on the identified area. <strong>The</strong>se<br />
were written up and <strong>key</strong> po<strong>in</strong>ts fed back.<br />
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Stage Five: Report<strong>in</strong>g<br />
<strong>The</strong> f<strong>in</strong>al statement <strong>of</strong> read<strong>in</strong>ess report was produced by the Centre for<br />
Public Scrut<strong>in</strong>y outl<strong>in</strong><strong>in</strong>g the contributions and learn<strong>in</strong>g from all participants<br />
and provid<strong>in</strong>g an assessment for the <strong>development</strong> <strong>of</strong> K LHW and<br />
recommendations for the next six months.<br />
<strong>The</strong> report is structured <strong>in</strong> two parts. <strong>The</strong> first part (this document) provides<br />
a description <strong>of</strong> the aims and methods and then provides a summary <strong>of</strong> <strong>key</strong><br />
f<strong>in</strong>d<strong>in</strong>gs from the workshop and from the wider engagement with participants.<br />
A series <strong>of</strong> recommendations are then listed that draw on the areas <strong>of</strong><br />
consensus and <strong>in</strong>sight that have emerged. <strong>Part</strong> two <strong>of</strong> the report provides<br />
the more <strong>in</strong>-depth data and evidence from the <strong>in</strong>terviews, focus groups and<br />
workshop.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 11
Every Decision About Me, With Me:<br />
Insights from the workshop<br />
<strong>The</strong> day comprised <strong>of</strong> four sessions, two tak<strong>in</strong>g place simultaneously <strong>in</strong> the<br />
morn<strong>in</strong>g and afternoon with over 40 <strong>in</strong>vited participants who came from a<br />
wide range <strong>of</strong> groups that have a stake <strong>in</strong> the future K LHW. <strong>The</strong> focus <strong>of</strong><br />
each session was identified from <strong>key</strong> issues which had emerged from the<br />
<strong>in</strong>terviews and focus groups. <strong>The</strong>y were:<br />
• Competent and skilled K LHW<br />
• K LHW is hear<strong>in</strong>g every<strong>one</strong>; seldom heard groups a th<strong>in</strong>g <strong>of</strong> the past<br />
• Wow! My story makes a difference!<br />
• K LHW an essential player at the table; a flourish<strong>in</strong>g organisation with a vital<br />
contribution to health and social care plann<strong>in</strong>g<br />
Each session looked at a draft aspirational statement. <strong>The</strong>se statements<br />
described how K LHW might work at its best. Groups were asked to use the<br />
statement to reach agreement about what they would jo<strong>in</strong>tly like to create <strong>in</strong><br />
relation to the workshop focus. <strong>Part</strong>icipants then identified areas they would<br />
like to develop to establish this desired future. <strong>The</strong>se areas became the focus<br />
for breakout groups which other participants jo<strong>in</strong>ed.<br />
<strong>The</strong> focus <strong>of</strong> the breakout groups are given below for each session as well as<br />
the <strong>key</strong> actions the whole workshop group agreed at the end <strong>of</strong> the session.<br />
More detailed notes <strong>in</strong> relation to the future statements and breakout groups are<br />
available as part <strong>of</strong> the wider dataset from this work (part two <strong>of</strong> the report).<br />
Competent and skilled <strong>Kent</strong> <strong>Local</strong> <strong>Healthwatch</strong><br />
Breakout Groups:<br />
• Develop Governance and Models, Roles & Responsibilities<br />
• Cl<strong>in</strong>icians and Cl<strong>in</strong>ical Commission<strong>in</strong>g Groups (CCGs) understand K LHW<br />
and K LHW understands CCGs and cl<strong>in</strong>icians<br />
• Communication - accessibility and awareness<br />
• Skills and Tra<strong>in</strong><strong>in</strong>g<br />
Key themes from the breakout sessions were:<br />
• ‘A time <strong>of</strong> flux. A time <strong>of</strong> <strong>in</strong>novation and opportunity’.<br />
• Ma<strong>in</strong>ta<strong>in</strong> ongo<strong>in</strong>g and open channels <strong>of</strong> communication and conversation<br />
throughout and beyond the transition process; different stakeholder<br />
and provider perspectives may result <strong>in</strong> different perceptions and<br />
understand<strong>in</strong>g.<br />
• <strong>The</strong> process and purpose are def<strong>in</strong>ed and clear.<br />
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• A free-flow <strong>of</strong> <strong>in</strong>formation to enable K LHW to hold service providers to<br />
account.<br />
• Start connect<strong>in</strong>g roles with functions now so that there is clarity about what<br />
skills and experience are required to demonstrate capacity to deliver.<br />
• Unique sell<strong>in</strong>g po<strong>in</strong>ts <strong>of</strong> K LHW, CCG and other providers need to dovetail<br />
/jigsaw with a complete understand<strong>in</strong>g <strong>of</strong> what each provider contributes<br />
to the richness <strong>of</strong> delivery; this should be clearly communicated to the local<br />
community.<br />
• K LHW builds on skills and competencies where they already exist and<br />
develops a framework based on the new LHW functions described <strong>in</strong> the<br />
Bill so that local capacity can be developed where necessary.<br />
• Develop a communications strategy to raise awareness and accessibility <strong>of</strong><br />
K LHW now.<br />
<strong>Kent</strong> <strong>Local</strong> <strong>Healthwatch</strong> is hear<strong>in</strong>g every<strong>one</strong>:<br />
seldom heard groups a th<strong>in</strong>g <strong>of</strong> the past<br />
Breakout Groups:<br />
• Set up and recruit to K LHW<br />
• K LHW enables people to know that their ideas and suggestions are<br />
seriously considered, and are told <strong>of</strong> the outcome<br />
• Methods <strong>of</strong> engag<strong>in</strong>g with seldom heard groups<br />
• Def<strong>in</strong>e and engage with different seldom heard groups<br />
Key themes from the breakout sessions were:<br />
• LINk/<strong>Healthwatch</strong> to be more representative<br />
• Value groups we want to <strong>in</strong>volve – thank you/effective feedback<br />
• Value volunteers – say thank you and give feedback<br />
• <strong>The</strong> mission statement – K LHW will be modern and flexible<br />
• Map exist<strong>in</strong>g <strong>in</strong>formation<br />
• Innovative approaches e.g. develop a <strong>Healthwatch</strong> party tool, community<br />
ambassadors<br />
• Ensure that appropriate transition mechanisms are <strong>in</strong> place<br />
• Information is up to date and communicated well<br />
• Keep, encourage exist<strong>in</strong>g volunteers<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 13
Wow! My story makes a difference!<br />
Breakout Groups:<br />
• Co-operative Culture<br />
• Mak<strong>in</strong>g changes for small groups – ‘how can their stories be heard?’<br />
• How to turn ‘stories’ <strong>in</strong>to a real change for the better<br />
Key themes from the breakout sessions were:<br />
• People understand how the healthcare and social care systems work<br />
and how to access them<br />
• K LHW helps make the systems understandable to others<br />
• Turn stories <strong>in</strong>to someth<strong>in</strong>g better. <strong>The</strong>re may be th<strong>in</strong>gs to learn from PALs<br />
about ways to use stories more powerfully<br />
• NHS Choices is very health specific; it could l<strong>in</strong>k up with organisations to<br />
make them more accountable. <strong>The</strong>re was a concern that LHW would not<br />
be able to advertise NHS Choices<br />
• Look at the journey and use what is work<strong>in</strong>g well, break down barriers<br />
• We need a more co-operative culture; many voices are better than <strong>one</strong>.<br />
Involv<strong>in</strong>g people at a local level can be a route for publicity and <strong>in</strong>formation.<br />
A culture where people can ask for <strong>in</strong>formation, oppose changes they do<br />
not want, promote effective spend<strong>in</strong>g<br />
• Nom<strong>in</strong>ated liaison person to work with small groups – <strong>in</strong>crease knowledge<br />
background <strong>of</strong> groups and ensure small group’s confidence <strong>in</strong>creased by<br />
be<strong>in</strong>g heard<br />
• Change the m<strong>in</strong>dset <strong>of</strong> those <strong>in</strong>volved <strong>in</strong> budget<strong>in</strong>g<br />
• K LHW <strong>in</strong>volved at every level <strong>of</strong> decision mak<strong>in</strong>g. Information <strong>in</strong>to<br />
commission<strong>in</strong>g questionnaire - <strong>in</strong>formation from the right place to the right place<br />
<strong>Kent</strong> <strong>Local</strong> <strong>Healthwatch</strong> an essential player at the table;<br />
a flourish<strong>in</strong>g organisation with a vital contribution to<br />
health and social care plann<strong>in</strong>g<br />
Breakout Groups:<br />
• <strong>Kent</strong> County Council provides a clear statement <strong>of</strong> service requirements for<br />
tender<strong>in</strong>g based on the three functions, outcomes and impact.<br />
• Well commissi<strong>one</strong>d, well lead, well supported, well connected, well<br />
<strong>in</strong>formed, well <strong>in</strong>tegrated.<br />
• Equality <strong>of</strong> outcomes and representation or be<strong>in</strong>g representative –<br />
representative <strong>of</strong> user groups or an organisation.<br />
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Key themes from the breakout sessions were:<br />
• A dedicated <strong>Healthwatch</strong> R& D unit, called a <strong>Local</strong> <strong>Healthwatch</strong><br />
Observatory, separate from day to day runn<strong>in</strong>g:<br />
1. Analys<strong>in</strong>g and shar<strong>in</strong>g <strong>in</strong>formation,<br />
2. Collat<strong>in</strong>g evidence from other sources,<br />
3. Shap<strong>in</strong>g services <strong>in</strong> outcome <strong>in</strong>formation, speak<strong>in</strong>g with authority, not<br />
just <strong>one</strong> voice, collat<strong>in</strong>g to enable people to make an <strong>in</strong>formed choice,<br />
seen as a credible organisation.<br />
• Transparent criteria for commission<strong>in</strong>g and decommission<strong>in</strong>g. Robust terms<br />
<strong>of</strong> reference, safety around K LHW’s <strong>in</strong>dependence e.g. if local authority<br />
doesn’t like it.<br />
• Commissi<strong>one</strong>rs are clear the K LHW is provid<strong>in</strong>g a service to health and<br />
social care users.<br />
• An asset is us<strong>in</strong>g and improv<strong>in</strong>g what is out there e.g. PALS, LINk. What<br />
works well <strong>in</strong> the community? Parity <strong>of</strong> service e.g. currently services<br />
<strong>of</strong>fered <strong>in</strong> East and West <strong>Kent</strong> differ?<br />
• Equity <strong>of</strong> outcomes: service specifications which ensure responsiveness<br />
and equity, regularly monitor<strong>in</strong>g service outcomes and impacts –<br />
<strong>development</strong> benchmark<strong>in</strong>g.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 15
Summary <strong>of</strong> Key F<strong>in</strong>d<strong>in</strong>gs<br />
Detailed contributions from participants are provided <strong>in</strong> part two <strong>of</strong> the report.<br />
This section provides a broad overview <strong>of</strong> the <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs and messages<br />
from stakeholders.<br />
Vision for a successful K LHW<br />
<strong>Part</strong>icipants demonstrated a good general awareness <strong>of</strong> the proposals for<br />
<strong>Healthwatch</strong> at local and national level. Many identified the need for more<br />
detailed brief<strong>in</strong>gs on the content <strong>of</strong> the policy documents emerg<strong>in</strong>g from the<br />
Department <strong>of</strong> Health and all wished to be kept up to date on the progress <strong>of</strong><br />
the K LHW.<br />
Many participants commented on the value <strong>of</strong> the statement <strong>of</strong> read<strong>in</strong>ess<br />
process. <strong>The</strong>y found that opportunities to participate <strong>in</strong> the <strong>in</strong>terviews, groups<br />
and workshops provided a reflective space to explore their own views and<br />
positions on <strong>Healthwatch</strong> <strong>in</strong> more depth. Several participants commented that<br />
engag<strong>in</strong>g <strong>in</strong> a structured exercise helped to provide a focus to their emerg<strong>in</strong>g<br />
views on K LHW. This opportunity enabled them to value the experience,<br />
strengths and assets already available <strong>in</strong> <strong>Kent</strong> and to have a voice early on <strong>in</strong><br />
the process <strong>of</strong> develop<strong>in</strong>g K LHW before <strong>key</strong> decisions are f<strong>in</strong>alised.<br />
<strong>Healthwatch</strong> is welcomed by the vast majority <strong>of</strong> participants both <strong>in</strong> its local<br />
and national forms. It is seen as a positive <strong>development</strong> <strong>of</strong> exist<strong>in</strong>g patient,<br />
public and service user engagement work across <strong>Kent</strong>. Four aspects <strong>of</strong> the<br />
<strong>Healthwatch</strong> proposals are particularly welcomed by participants:<br />
• <strong>The</strong> vision <strong>of</strong> ‘no decision about me, without me’<br />
• <strong>The</strong> concept <strong>of</strong> a consumer champion<br />
• <strong>The</strong> focus on the needs and voice <strong>of</strong> diverse and different groups across<br />
the community<br />
• <strong>The</strong> ability to coord<strong>in</strong>ate data on public experiences and op<strong>in</strong>ions and<br />
present it <strong>in</strong> an <strong>in</strong>formed way<br />
<strong>Part</strong>icipants were able to contribute many different elements to a vision<br />
for what a successful K LHW looks like. <strong>Part</strong> two <strong>of</strong> the report lists these<br />
elements <strong>in</strong> full. Most issues were complimentary to a wider vision and <strong>of</strong>ten<br />
described similar themes <strong>in</strong> different language or from different perspectives.<br />
<strong>The</strong> <strong>key</strong> areas <strong>of</strong> consensus for the vision were:<br />
• K LHW must champion the service user and patient perspective <strong>in</strong> a<br />
constructive way. It must be their voice and be an effective advocate for<br />
their <strong>in</strong>terests<br />
• K LHW will need to be credible with three groups - the wider public, people<br />
who use its services and with organisational stakeholders (<strong>in</strong> particular<br />
commissi<strong>one</strong>rs and decision makers)<br />
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• All parties welcome <strong>in</strong>formed challenge from the patient and service user<br />
perspective<br />
• It will need to be able to work with and champion diverse groups from<br />
across <strong>Kent</strong><br />
• K LHW will need to be visible and accessible through clear communication<br />
and effective brand<strong>in</strong>g<br />
• It will need to be able to establish sophisticated and robust relationships<br />
with commissi<strong>one</strong>rs and decision makers based on mutual respect and an<br />
appreciation <strong>of</strong> the different roles that each stakeholder plays<br />
• K LHW will need to work <strong>in</strong> a transparent and open way<br />
• It will need to be able to demonstrate and evidence it’s impact on health<br />
and social care services<br />
For some participants their vision <strong>of</strong> K LHW focused on what it might prevent,<br />
<strong>of</strong>ten cit<strong>in</strong>g the example <strong>of</strong> Mid-Staffordshire Hospital and the need for a<br />
strong patient voice when th<strong>in</strong>gs start to go wrong. <strong>The</strong>y had a particular<br />
concern with issues <strong>of</strong> patient safety and welcomed the potential <strong>of</strong> K LHW<br />
to scrut<strong>in</strong>ise and highlight concerns.<br />
<strong>The</strong> credibility <strong>of</strong> K LHW was an important concern for many participants. If<br />
K LHW was not credible then participants felt that its effectiveness would be<br />
limited. Credibility would need to be established early on <strong>in</strong> the design stages.<br />
<strong>The</strong> <strong>key</strong> features <strong>of</strong> a credible K LHW were:<br />
• Independence<br />
• Good governance<br />
• <strong>The</strong> quality <strong>of</strong> relationships it is able to develop with commissi<strong>one</strong>rs,<br />
decision makers and providers<br />
• A skilled and competent team <strong>of</strong> staff and volunteers<br />
• <strong>The</strong> ability to present a range <strong>of</strong> views and voices <strong>of</strong> local people<br />
• An understand<strong>in</strong>g <strong>of</strong> the health and social care commission<strong>in</strong>g processes<br />
and decision mak<strong>in</strong>g timetables<br />
• <strong>The</strong> ability to present data and f<strong>in</strong>d<strong>in</strong>gs <strong>in</strong> an effective and <strong>in</strong>fluential way<br />
• Accessibility to patients, service users and the public across <strong>Kent</strong><br />
• Clarity <strong>of</strong> communications with the public and stakeholders<br />
• Transparency <strong>of</strong> <strong>in</strong>ternal processes, prioritisation, decision mak<strong>in</strong>g and<br />
impact<br />
• Seek<strong>in</strong>g and respond<strong>in</strong>g to feedback on the <strong>development</strong> and work <strong>of</strong><br />
K LHW<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 17
Th<strong>in</strong>gs that were likely to damage the credibility <strong>of</strong> K LHW <strong>in</strong>cluded:<br />
• A narrow focus on s<strong>in</strong>gle issues<br />
• Be<strong>in</strong>g dom<strong>in</strong>ated by personal issues or agendas<br />
• A lack <strong>of</strong> evidence<br />
• Weak or distant relationships with commissi<strong>one</strong>rs and decision makers<br />
• Failure to follow up or feedback on work<br />
• Unrepresentativeness<br />
• Tokenism<br />
<strong>Part</strong>icipants were able to identify a range <strong>of</strong> barriers that would need to be<br />
overcome to ensure K LHW is successful. <strong>The</strong>mes <strong>in</strong>cluded:<br />
• How local people may perceive K LHW <strong>in</strong> relation to previous health and<br />
social care engagement <strong>in</strong>itiatives such as LINks and Community Health<br />
Councils. <strong>The</strong>y may have particular associations with these groups and<br />
may question the longevity <strong>of</strong> this new organisation<br />
• <strong>The</strong> complexity <strong>of</strong> the health and social care systems<br />
• <strong>The</strong> challenge <strong>of</strong> work<strong>in</strong>g at a local level across a county with the scale and<br />
complexity <strong>of</strong> <strong>Kent</strong><br />
• <strong>The</strong> pace <strong>of</strong> change<br />
<strong>Local</strong> expectations for K LHW are high amongst <strong>in</strong>formed stakeholders.<br />
<strong>The</strong>y recognise that the transition to K LHW provides an opportunity to stop<br />
and reflect on learn<strong>in</strong>g around public engagement and apply this to the new<br />
organisation. It is important that the <strong>development</strong> process and the early<br />
months <strong>of</strong> K LHW activity delivers concrete evidence <strong>of</strong> the potential <strong>of</strong> the<br />
local organisation. Clear communications and def<strong>in</strong>itions <strong>of</strong> role, purpose and<br />
priorities are essential to properly manage expectations.<br />
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<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
Evolv<strong>in</strong>g from LINks<br />
<strong>Part</strong>icipants’ contributions about LINks were varied and there was less<br />
consensus about the <strong>key</strong> messages than for other elements <strong>of</strong> the ‘statement<br />
<strong>of</strong> read<strong>in</strong>ess’ assessment. Differences <strong>of</strong> op<strong>in</strong>ion were <strong>of</strong>ten based on the<br />
relationship a respondent had with LINks <strong>in</strong>clud<strong>in</strong>g their experience and<br />
background knowledge <strong>of</strong> work<strong>in</strong>g together. Perspectives also varied based<br />
on participants’ role with<strong>in</strong> LINks itself.<br />
Key areas <strong>of</strong> consensus were:<br />
• An appreciation <strong>of</strong> the learn<strong>in</strong>g, experience and knowledge that LINks has<br />
collected<br />
• Build<strong>in</strong>g on this experience to ensure K LHW is effective<br />
• Valu<strong>in</strong>g the contributions <strong>of</strong> volunteers, members, governors and staff<br />
• <strong>The</strong> importance <strong>of</strong> ensur<strong>in</strong>g that the transition from LINks to K LHW is <strong>in</strong><br />
the best <strong>in</strong>terests <strong>of</strong> local people<br />
• Recognis<strong>in</strong>g the uncerta<strong>in</strong>ty for LINks volunteers and staff and ensur<strong>in</strong>g<br />
they have a voice and support dur<strong>in</strong>g the transition<br />
As LINks has developed and applied what it has learnt to the latest phase <strong>of</strong><br />
its work plan a number <strong>of</strong> positive themes have emerged:<br />
• F<strong>in</strong>d<strong>in</strong>g new ways to work across <strong>Kent</strong> at the local, ward, district and<br />
county levels<br />
• Work<strong>in</strong>g <strong>in</strong> partnership with the Patient <strong>Part</strong>icipation Groups l<strong>in</strong>ked to GP<br />
surgeries<br />
• Build<strong>in</strong>g new relationships with GPs<br />
• New <strong>in</strong>itiatives to promote transparency with<strong>in</strong> LINks <strong>in</strong>clud<strong>in</strong>g the sett<strong>in</strong>g <strong>of</strong><br />
priorities<br />
• Develop<strong>in</strong>g the engagement <strong>of</strong> children and young people<br />
LINks volunteers and host staff have been active <strong>in</strong> their support for<br />
the ‘statement <strong>of</strong> read<strong>in</strong>ess’ assessment and have provided significant<br />
contributions, <strong>in</strong>sight and practical support. It is important to recognise that<br />
the transition from LINks to K LHW does represent an end<strong>in</strong>g for this part <strong>of</strong><br />
peoples’ lives and also <strong>in</strong>troduces uncerta<strong>in</strong>ty for the future. Research by the<br />
Centre for Public Scrut<strong>in</strong>y identifies that a well managed transition to K LHW<br />
is the best strategy to ensure that good volunteers are not lost to the process.<br />
However, there were areas <strong>of</strong> difference about LINks and these emerge <strong>in</strong><br />
some <strong>of</strong> the data presented <strong>in</strong> part two <strong>of</strong> the report. This learn<strong>in</strong>g is valuable<br />
as it articulates some <strong>of</strong> the challenges that public engagement <strong>in</strong>itiatives face<br />
and highlights learn<strong>in</strong>g that will need to be <strong>in</strong>corporated <strong>in</strong>to the <strong>development</strong><br />
<strong>of</strong> K LHW. <strong>The</strong>re was a general consensus that K LHW would build on the<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 19
learn<strong>in</strong>g from LINks and seek to overcome some the barriers to successful<br />
public engagement <strong>in</strong> new ways. Key themes <strong>in</strong>cluded:<br />
• <strong>The</strong> limits to which LINks has been able to be representative <strong>of</strong> different<br />
groups <strong>in</strong> <strong>Kent</strong> and to <strong>in</strong>volve them directly <strong>in</strong> it’s work<br />
• Limits to the general awareness <strong>of</strong> the role <strong>of</strong> LINks across <strong>Kent</strong><br />
• <strong>The</strong> need to strengthen relationships with commissi<strong>one</strong>rs<br />
• <strong>The</strong> perception <strong>of</strong> a greater focus by LINks on health rather than social care<br />
• <strong>The</strong> importance <strong>of</strong> provid<strong>in</strong>g feedback on LINks activities and their impact<br />
• Ways to prioritise work <strong>in</strong> a transparent way<br />
• Internal decision mak<strong>in</strong>g processes<br />
Most participants <strong>in</strong> the statement <strong>of</strong> read<strong>in</strong>ess assessment felt that whilst K<br />
LHW will build on the LINks experience it will be a different organisation with a<br />
broader range <strong>of</strong> functions and as a consequence will draw on a wider set <strong>of</strong><br />
tools and methods.<br />
<strong>Healthwatch</strong> as a consumer champion<br />
<strong>The</strong> shift to the consumer model was welcomed by the majority <strong>of</strong><br />
participants as it complimented the commission<strong>in</strong>g perspective <strong>in</strong> health<br />
and social care. <strong>The</strong>re was a recognition that commissi<strong>one</strong>rs were spend<strong>in</strong>g<br />
the m<strong>one</strong>y <strong>of</strong> local <strong>Kent</strong> people and that the public should be empowered<br />
to be more aware <strong>of</strong> how this was tak<strong>in</strong>g place. <strong>The</strong>re was also a universal<br />
view that an <strong>in</strong>formed consumer voice was <strong>in</strong> the best <strong>in</strong>terests <strong>of</strong> effective<br />
commission<strong>in</strong>g and that it could enhance the commission<strong>in</strong>g process with<br />
<strong>in</strong>telligence from those receiv<strong>in</strong>g services from providers.<br />
To be an effective consumer champion K LHW will need to:<br />
• Identify and build relationships with consumers<br />
• Recognise the diverse and different needs <strong>of</strong> people <strong>in</strong> <strong>Kent</strong><br />
• Provide mechanisms for them to share their views and experiences<br />
• Provide them with clear and relevant <strong>in</strong>formation<br />
• Coord<strong>in</strong>ate <strong>in</strong>dividual consumers to enable them to act as a group and<br />
have a collective <strong>in</strong>fluence<br />
• Present their views and collective experiences <strong>in</strong> an effective way<br />
• Be present and observe practice and performance <strong>in</strong> provider organisations<br />
• Be representative <strong>in</strong> terms <strong>of</strong> the staff and volunteers <strong>in</strong>volved directly <strong>in</strong> the<br />
work <strong>of</strong> <strong>Healthwatch</strong><br />
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<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
K LHW will need to use a mix <strong>of</strong> communication methods to reach the public.<br />
<strong>The</strong>se <strong>in</strong>clude:<br />
• Face to face<br />
• Workshops<br />
• Teleph<strong>one</strong><br />
• Traditional mass media<br />
• Web based communication<br />
• Social media<br />
<strong>The</strong> title <strong>of</strong> ‘<strong>Healthwatch</strong>’ has been well received and participants felt that the<br />
brand<strong>in</strong>g was helpful <strong>in</strong> expla<strong>in</strong><strong>in</strong>g the purpose <strong>of</strong> the organisation. An important<br />
po<strong>in</strong>t was made by many participants that there would need to be a clear<br />
dist<strong>in</strong>ction between this new <strong>in</strong>itiative and the current <strong>Kent</strong> Health Watch.<br />
As an effective consumer champion, K LHW will need to focus on:<br />
• Quality <strong>of</strong> services<br />
• Co-design and co-production <strong>of</strong> services<br />
• Monitor<strong>in</strong>g and evaluation <strong>of</strong> services<br />
• Transparency <strong>of</strong> the commission<strong>in</strong>g process<br />
• Accessibility <strong>of</strong> services<br />
• Risk and patient safety<br />
K LHW will need to understand where decisions are made with<strong>in</strong> health and<br />
social care organisations and ensure that it can promote local voices at these<br />
dist<strong>in</strong>ct po<strong>in</strong>ts. A mapp<strong>in</strong>g <strong>of</strong> decision mak<strong>in</strong>g processes and timetables<br />
would enable K LHW to coord<strong>in</strong>ate its engagement activities.<br />
Social care issues were very important to all participants and they wanted to<br />
see a clear strategy from K LHW to address them. <strong>The</strong>re was a recognition <strong>of</strong><br />
the tendency for health issues to take priority and it was important to balance<br />
this <strong>in</strong> the design phase.<br />
K LHW should be an advocate and driver for the <strong>in</strong>tegration <strong>of</strong> health and<br />
social care issues. Work<strong>in</strong>g from the patients perspective K LHW will be well<br />
placed to highlight the ways that services can be connected and provided <strong>in</strong> a<br />
seamless way. For pr<strong>of</strong>essionals work<strong>in</strong>g across health and social care there<br />
was a strong desire to have a consumer champion who could drive this issue<br />
and provide <strong>in</strong>formed challenge to commissi<strong>one</strong>rs. <strong>The</strong>re was a concern that<br />
K LHW may replicate exist<strong>in</strong>g silos <strong>in</strong> the health and social care system and it<br />
is important that this is recognised and avoided.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 21
All participants shared an aspiration for K LHW to be effective <strong>in</strong> the way<br />
it works with diverse groups <strong>in</strong> <strong>Kent</strong>. It was important that K LHW takes a<br />
proactive approach to identify<strong>in</strong>g groups it will engage, identify<strong>in</strong>g the barriers<br />
they face and develop<strong>in</strong>g concrete and specific strategies to overcome these.<br />
K LHW should be able to evidence how it works with seldom heard groups<br />
from across <strong>Kent</strong>.<br />
<strong>Part</strong> two <strong>of</strong> the report captures a wide range <strong>of</strong> different groups that have<br />
been proposed and champi<strong>one</strong>d by participants. A number <strong>of</strong> pr<strong>in</strong>ciples<br />
emerged <strong>in</strong> discussions about how to identify and prioritise these groups:<br />
• Data should be used from the Jo<strong>in</strong>t Strategic Needs Assessment and other<br />
sources<br />
• Data should be triangulated with <strong>in</strong>sight from local community and voluntary<br />
groups who have direct contact with groups<br />
• Individuals stories and experiences are essential to <strong>in</strong>form the engagement<br />
strategy<br />
• It is important to recognise that some groups may be located <strong>in</strong> small parts<br />
<strong>of</strong> <strong>Kent</strong> whilst others may be distributed across the county<br />
• Health <strong>in</strong>equality data should be l<strong>in</strong>ked to equality and diversity data<br />
• Where there are already exist<strong>in</strong>g networks for these groups across <strong>Kent</strong> K<br />
LHW should make strategic contact with the network coord<strong>in</strong>ators – for<br />
example <strong>in</strong> the case <strong>of</strong> learn<strong>in</strong>g disability and cancer networks<br />
• Different engagement strategies are needed with different groups<br />
<strong>Part</strong>icipants provided many <strong>in</strong>sights and local knowledge about diverse and<br />
seldom heard groups <strong>in</strong> <strong>Kent</strong>. Data <strong>in</strong> part two <strong>of</strong> the report provides a long<br />
list <strong>of</strong> groups but it is recognised that it is still not exhaustive and K LHW will<br />
need to be constantly question<strong>in</strong>g itself and challeng<strong>in</strong>g assumptions about<br />
diversity <strong>in</strong> <strong>Kent</strong>. <strong>The</strong> most frequently menti<strong>one</strong>d groups for K LHW to identify<br />
and engage were:<br />
• Children and young people<br />
• Older people liv<strong>in</strong>g <strong>in</strong> residential and nurs<strong>in</strong>g homes<br />
• Older people with dementia and their carers<br />
• Gypsy and Traveller community<br />
• Young people with mental health needs<br />
• People with learn<strong>in</strong>g disabilities<br />
• Rural populations<br />
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It was felt that a proper understand<strong>in</strong>g <strong>of</strong> all the diverse groups <strong>in</strong> <strong>Kent</strong> should<br />
<strong>in</strong>form K LHW’s engagement strategy. Work<strong>in</strong>g <strong>in</strong> partnership with specialist<br />
community and voluntary sector groups was identified as an essential way for<br />
K LHW to reach all the different groups <strong>in</strong> <strong>Kent</strong>. <strong>The</strong>y will need a varied set <strong>of</strong><br />
approaches as <strong>one</strong> approach will not suit all groups and will cause barriers to<br />
engagement for some. <strong>The</strong>refore K LHW will need to develop or adapt tools<br />
to work with and get feedback on their success <strong>in</strong> this area.<br />
K LHW should be held to account by <strong>Kent</strong> CC as ‘commissi<strong>one</strong>r’ for its<br />
impact <strong>in</strong> this area. To be credible K LHW needs to demonstrate a wide<br />
participation <strong>of</strong> diverse groups.<br />
<strong>The</strong>re was a general view that people liv<strong>in</strong>g <strong>in</strong> residential and nurs<strong>in</strong>g homes<br />
were particularly vulnerable and unable to access other forms <strong>of</strong> service user<br />
engagement <strong>in</strong> the community. K LHW would need to f<strong>in</strong>d ways to build<br />
relationships with this group <strong>in</strong> their residential sett<strong>in</strong>gs to champion their needs.<br />
LINks work with young people has started to identify some <strong>key</strong> issues when<br />
work<strong>in</strong>g with these groups:<br />
• <strong>The</strong> importance <strong>of</strong> directly <strong>in</strong>volv<strong>in</strong>g children and young people<br />
• <strong>The</strong> experience that many health services are designed primarily with adult<br />
patients <strong>in</strong> m<strong>in</strong>d<br />
• Understand<strong>in</strong>g what makes a ‘young person friendly’ service<br />
• Learn<strong>in</strong>g from young people <strong>in</strong>itiatives, networks and groups across <strong>Kent</strong><br />
<strong>The</strong>re also emerged from the participation work a sense that health and social<br />
care consumers <strong>in</strong> <strong>Kent</strong> have at least four dimensions to their experience and<br />
that K LHW would need to be able to work at each <strong>of</strong> these levels. <strong>The</strong>se<br />
dimensions were:<br />
• <strong>The</strong> diversity and identity <strong>of</strong> <strong>in</strong>dividuals and their families – recognis<strong>in</strong>g that<br />
people <strong>of</strong>ten have a number <strong>of</strong> different identity characteristics <strong>in</strong>clud<strong>in</strong>g<br />
factors such as gender, ethnicity, sexuality and disability<br />
• <strong>The</strong> local community where they live – which would also <strong>in</strong>clude the rural<br />
and urban differences<br />
• <strong>The</strong> services and providers that they access – which may be located <strong>in</strong> different<br />
parts <strong>of</strong> <strong>Kent</strong> from where they live or may even be across county boundaries<br />
• <strong>The</strong> health and social care conditions they may share with other <strong>in</strong>dividuals<br />
<strong>in</strong> <strong>Kent</strong> – for example, long term conditions, be<strong>in</strong>g a cancer patient, carer<br />
roles or hav<strong>in</strong>g a young child<br />
<strong>Part</strong>icipants identified opportunities for K LHW to support the personalisation<br />
agenda by rais<strong>in</strong>g awareness and support<strong>in</strong>g <strong>in</strong>dividuals to become active<br />
consumers.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 23
Information and signpost<strong>in</strong>g to support choice<br />
K LHW should review and learn from exist<strong>in</strong>g signpost<strong>in</strong>g and <strong>in</strong>formation<br />
resources from other organisations <strong>in</strong> <strong>Kent</strong> and beyond. It is particularly<br />
important to engage and <strong>in</strong>volve staff from PALS, customer services and<br />
compla<strong>in</strong>ts roles. <strong>The</strong> <strong>in</strong>formation function is seen as a pr<strong>of</strong>essional role that<br />
cannot be effectively delivered by volunteers. <strong>The</strong>re may be opportunities for<br />
volunteers to support pr<strong>of</strong>essionals but there are limits to what they can be<br />
expected to manage.<br />
K LHW needs to be able to work with commissi<strong>one</strong>rs to identify the options<br />
and opportunities for consumer choice so that it can signpost effectively.<br />
Possible areas that participants identified where K LHW may support the<br />
public to make choices <strong>in</strong>clude:<br />
• Choice <strong>of</strong> GP practice<br />
• Choice <strong>of</strong> nurs<strong>in</strong>g or residential home<br />
• Choice <strong>of</strong> hospital for elective surgery<br />
• Choice <strong>of</strong> support group<br />
• Maternity choices<br />
<strong>The</strong> quality <strong>of</strong> the <strong>in</strong>formation function is seen as central to the credibility <strong>of</strong><br />
K LHW and needs to be managed <strong>in</strong> a robust way with a clear identification<br />
<strong>of</strong> risks.<br />
As well as provid<strong>in</strong>g <strong>in</strong>formation to <strong>in</strong>dividual patients and service users,<br />
K LHW would also be well placed to communicate general health and social<br />
care <strong>in</strong>formation across <strong>Kent</strong>. It could be a powerful conduit for public<br />
<strong>in</strong>formation and for awareness rais<strong>in</strong>g. Information could be adapted by<br />
K LHW to ensure that it reaches diverse groups.<br />
Compla<strong>in</strong>ts Advocacy<br />
Compla<strong>in</strong>ts advocacy is seen as an <strong>in</strong>tegral part <strong>of</strong> a successful K LHW.<br />
All participants were <strong>in</strong> favour <strong>of</strong> this option be<strong>in</strong>g actively pursued. <strong>The</strong>re<br />
were important debates about the def<strong>in</strong>ition <strong>of</strong> compla<strong>in</strong>ts advocacy and the<br />
dist<strong>in</strong>ction with the wider compla<strong>in</strong>ts function. It was felt very important that<br />
the role was clearly def<strong>in</strong>ed and communicated.<br />
Data from the compla<strong>in</strong>ts advocacy function should be <strong>in</strong>tegrated <strong>in</strong>to the<br />
other data and <strong>in</strong>sights that K LHW will collect. Triangulation <strong>of</strong> data and<br />
patient experience was seen as a pr<strong>in</strong>ciple benefit <strong>of</strong> K LHW.<br />
<strong>Kent</strong> already has a number <strong>of</strong> compla<strong>in</strong>ts functions located <strong>in</strong> Primary Care<br />
Trusts, the County Council and providers. It is important that these functions<br />
are properly mapped and understood. A number <strong>of</strong> advocacy functions exist<br />
24<br />
<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
and K LHW will need to collaborate with these and avoid duplication. <strong>The</strong><br />
work <strong>of</strong> ICAS should provide good learn<strong>in</strong>g opportunities.<br />
Intelligence and <strong>Healthwatch</strong> England<br />
<strong>The</strong> role <strong>of</strong> HWE is welcomed and participants felt it was essential that K LHW<br />
was able to provide the detailed data and trends that the national body will<br />
need to have an effective consumer voice at the national level. It was clear<br />
that much more work is required to ensure K LHW can work <strong>in</strong> a mutually<br />
complementary way with HWE go<strong>in</strong>g forward.<br />
Many participants were concerned that the wider <strong>Healthwatch</strong> system should<br />
be able to operate as an early warn<strong>in</strong>g system for when th<strong>in</strong>gs go wrong for<br />
patients and service users. Frequent references were given to ensur<strong>in</strong>g that<br />
the system was robust enough to respond to serious problems such as at<br />
Mid-Staffordshire Hospital. Collat<strong>in</strong>g patient stories and experiences at the<br />
local level would be essential to highlight<strong>in</strong>g problems.<br />
Alignment with partners: relationships, data and<br />
processes<br />
<strong>Part</strong>icipants felt it was essential that the <strong>development</strong> <strong>of</strong> K LHW took a whole<br />
system approach and aligned its form and function to both the community<br />
and stakeholder organisations <strong>in</strong> health and social care.<br />
Key organisations identified by participants <strong>in</strong>cluded:<br />
• Health commissi<strong>one</strong>rs <strong>in</strong>clud<strong>in</strong>g the Primary Care Trust cluster and Cl<strong>in</strong>ical<br />
Commission<strong>in</strong>g Groups<br />
• Social care commissi<strong>one</strong>rs<br />
• <strong>The</strong> shadow Health and Wellbe<strong>in</strong>g Board<br />
• Overview and Scrut<strong>in</strong>y Committees for health and for social care<br />
• Provider organisations <strong>in</strong> the public, private and voluntary sector<br />
• Community and voluntary organisations<br />
<strong>The</strong>re was also a recognition that the health and social care environment is<br />
complex and <strong>in</strong> the process <strong>of</strong> change. <strong>The</strong> develop<strong>in</strong>g K LHW would need to<br />
be able to understand this dynamic environment, build effective relationships<br />
at both a senior and operational level, and be flexible enough to respond to<br />
changes and <strong>development</strong>s. Many examples and <strong>in</strong>sights have been provided<br />
for how K LHW can align its data and report<strong>in</strong>g to have impact and <strong>in</strong>fluence<br />
with stakeholders.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 25
At the same time all participants felt that K LHW would need the skills and<br />
<strong>in</strong>sight to understand commissi<strong>one</strong>r and provider data to be able to analyse<br />
it and make <strong>in</strong>formed challenge. This would also <strong>in</strong>clude an understand<strong>in</strong>g <strong>of</strong><br />
the methodologies used to collect data.<br />
<strong>The</strong>re was a strong recognition from commissi<strong>one</strong>rs that an effective K LHW<br />
would enhance their ability to commission, co-produce new services, decommission<br />
where appropriate and monitor performance and quality.<br />
Social care and health commissi<strong>one</strong>rs are well placed to use their<br />
procurement and contract<strong>in</strong>g roles to ensure that collaborations with K LHW<br />
are built <strong>in</strong> to contracts with providers.<br />
It was identified that further work needs to be undertaken with provider<br />
organisations that so far have not been a full part <strong>of</strong> the statement <strong>of</strong><br />
read<strong>in</strong>ess exercise. This could be taken up by the K LHW Development Group<br />
<strong>in</strong> the next phase <strong>of</strong> its work programme.<br />
Organisational form<br />
Three organisational forms have emerged from participants as contenders for the<br />
structure <strong>of</strong> K LHW as a ‘body corporate’. <strong>The</strong>se would benefit from more detailed<br />
exploration and <strong>development</strong> <strong>in</strong> the next phase <strong>of</strong> the <strong>development</strong> process.<br />
From the ‘Every Decision About Me, With Me’ workshop a proposal for a<br />
distributed model <strong>of</strong> K LHW where the functions <strong>of</strong> the body are embedded<br />
<strong>in</strong> exist<strong>in</strong>g organisations across a range <strong>of</strong> themes, issues and seldom heard<br />
groups <strong>in</strong> <strong>Kent</strong>. This could be achieved by locat<strong>in</strong>g K LHW champions <strong>in</strong><br />
organisations and network<strong>in</strong>g them via a core body. Exist<strong>in</strong>g models <strong>of</strong><br />
practice such as the experience <strong>of</strong> Citizens Advice Bureaux may provide a<br />
template for explor<strong>in</strong>g this model.<br />
A second form is a consortia model <strong>of</strong> a smaller group <strong>of</strong> local organisations<br />
with differ<strong>in</strong>g specialisms to deliver K LHW across the county.<br />
<strong>The</strong> third form is the more traditional hub and spoke model. This model<br />
would have a s<strong>in</strong>gle organisation at the centre that provides the coord<strong>in</strong>ation<br />
<strong>of</strong> all the K LHW functions and also provides the governance role. <strong>The</strong> core<br />
would then work with separate specialist units <strong>of</strong> the organisation for the<br />
delivery <strong>of</strong> different K LHW functions.<br />
<strong>Part</strong>icipants recognised that it would be very difficult for <strong>one</strong> s<strong>in</strong>gle<br />
organisation to have all the skillsets and specialisms required to deliver K LHW<br />
on their own. It was also felt that <strong>one</strong> s<strong>in</strong>gle organisation was unlikely to be<br />
well placed to engage with the variety <strong>of</strong> seldom heard groups <strong>in</strong> <strong>Kent</strong>. It was<br />
also felt very strongly that K LHW should work <strong>in</strong> a highly coord<strong>in</strong>ated way<br />
with organisations that already deliver similar functions rather than replicat<strong>in</strong>g<br />
these functions or compet<strong>in</strong>g with other organisations. <strong>The</strong> latter was felt to<br />
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e a risk as local people may get confused about where to go for <strong>in</strong>formation<br />
and signpost<strong>in</strong>g.<br />
Different proposals also emerged from the work regard<strong>in</strong>g the legal form for<br />
the body corporate <strong>in</strong>clud<strong>in</strong>g charities, <strong>in</strong>corporated charities, community<br />
<strong>in</strong>terest companies and social enterprises.<br />
Operational Issues<br />
As participants explored the operational issues for K LHW they were able<br />
to <strong>of</strong>fer a variety <strong>of</strong> <strong>in</strong>sights <strong>in</strong>to the range <strong>of</strong> issues that would need to be<br />
considered <strong>in</strong>clud<strong>in</strong>g:<br />
• Governance <strong>of</strong> the ‘body corporate’<br />
• Accountability to commissi<strong>one</strong>rs <strong>of</strong> K LHW<br />
• Management structures<br />
• Roles <strong>of</strong> paid staff<br />
• Roles <strong>of</strong> volunteers<br />
• Status <strong>of</strong> members<br />
• Relationships with affiliated organisations<br />
• Internal policies and procedures<br />
• <strong>Part</strong>nerships with other <strong>Healthwatch</strong> organisations<br />
• Selection process <strong>of</strong> people <strong>in</strong> governance positions<br />
• Representativeness<br />
Learn<strong>in</strong>g from the experience <strong>of</strong> LINks and the Host organisation is important<br />
for understand<strong>in</strong>g the role and challenges <strong>of</strong> operat<strong>in</strong>g a public engagement<br />
organisation <strong>in</strong> health and social care. <strong>Part</strong>icipants felt that the most important<br />
start<strong>in</strong>g po<strong>in</strong>t for develop<strong>in</strong>g an operational framework was to def<strong>in</strong>e roles,<br />
competencies, skills and knowledge required <strong>of</strong> staff, volunteers and members.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 27
Development<br />
<strong>Part</strong>icipants were keen to see significant attention given to the <strong>development</strong><br />
programme for K LHW and felt that support<strong>in</strong>g staff and volunteers to have a<br />
structured programme was essential to the success <strong>of</strong> the <strong>in</strong>itiative. <strong>The</strong>y also<br />
recognised that <strong>development</strong> was a two-way process and that stakeholder<br />
organisations would benefit from engag<strong>in</strong>g with K LHW <strong>in</strong> an organised<br />
programme. <strong>Part</strong>icipants were generous <strong>in</strong> <strong>of</strong>fer<strong>in</strong>g their support and time as<br />
well as access to <strong>in</strong>-house tra<strong>in</strong><strong>in</strong>g opportunities.<br />
A whole system programme <strong>of</strong> <strong>in</strong>duction for K LHW is essential to build<br />
relationships and raise awareness <strong>of</strong> the new body. A more detailed tra<strong>in</strong><strong>in</strong>g and<br />
<strong>development</strong> programme should compliment and build on the <strong>in</strong>duction phase.<br />
<strong>Part</strong>icipants felt that the <strong>development</strong> programme should be l<strong>in</strong>ked to work<br />
on the roles and competencies required for K LHW and should be available to<br />
staff and volunteers.<br />
Commission<strong>in</strong>g and procurement<br />
<strong>The</strong> commission<strong>in</strong>g and procurement process for K LHW should be managed<br />
on the pr<strong>in</strong>ciples <strong>of</strong> co-production, <strong>in</strong>formed by the follow<strong>in</strong>g factors:<br />
• <strong>The</strong> K LHW ‘body corporate’ will need to be well placed to coord<strong>in</strong>ate any<br />
distributed delivery <strong>of</strong> functions. It will need a clear central governance<br />
structure to ensure accountability and clarity <strong>of</strong> role and functions.<br />
• Different organisations may have the specialisms to deliver specific parts<br />
<strong>of</strong> the <strong>Healthwatch</strong> brief.<br />
• <strong>Local</strong> organisations are well placed to provide evidence, understand<strong>in</strong>g<br />
and <strong>in</strong>sight <strong>in</strong>to the needs <strong>of</strong> local communities and seldom heard groups.<br />
• <strong>The</strong> need to align commission<strong>in</strong>g goals to the needs and <strong>in</strong>terests <strong>of</strong><br />
health and social care consumers across <strong>Kent</strong>.<br />
• <strong>The</strong> importance <strong>of</strong> identify<strong>in</strong>g the types <strong>of</strong> evidence that commissi<strong>one</strong>rs<br />
would need to measure the effectiveness <strong>of</strong> K LHW.<br />
<strong>Part</strong>icipants welcomed the need for the commissi<strong>one</strong>r to ensure that K LHW<br />
could demonstrate and evidence its work with diverse and seldom heard<br />
groups. This role should be strongly emphasised <strong>in</strong> the contract.<br />
Some participants felt that it was too early on <strong>in</strong> the process to give concrete<br />
views on the actual procurement process other than at the most general levels.<br />
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Debates<br />
Dur<strong>in</strong>g the statement <strong>of</strong> read<strong>in</strong>ess assessment stakeholders were able to<br />
articulate a number <strong>of</strong> debates and areas <strong>of</strong> potential tension with<strong>in</strong> the<br />
<strong>Healthwatch</strong> proposals. It was recognised that these issues would be<br />
an <strong>in</strong>evitable part <strong>of</strong> any transition to a new organisation and that it was<br />
healthy to identify and explore the themes <strong>in</strong> anticipation <strong>of</strong> any possible<br />
disagreements. <strong>Part</strong>icipants felt that collaborative work<strong>in</strong>g at an early stage <strong>in</strong><br />
the <strong>development</strong> <strong>of</strong> K LHW could provide some jo<strong>in</strong>t solutions to these issues<br />
or practical ways to respect and hold these tensions. <strong>The</strong> debates <strong>in</strong>cluded:<br />
• <strong>The</strong> accountability <strong>of</strong> K LHW to both it’s commissi<strong>one</strong>r and to local people<br />
<strong>in</strong> <strong>Kent</strong> alongside HWE.<br />
• <strong>The</strong> dual relationship between K LHW and <strong>Kent</strong> County Council. K LHW<br />
will be commissi<strong>one</strong>d by <strong>Kent</strong> County Council and will also be work<strong>in</strong>g with<br />
the authority to champion the voices <strong>of</strong> local people who use social care<br />
services. In this role K LHW will be exam<strong>in</strong><strong>in</strong>g decisions and plans <strong>of</strong> <strong>Kent</strong><br />
County Council.<br />
• <strong>The</strong> role <strong>of</strong> <strong>Kent</strong> County Council as the lead partner <strong>in</strong> the co-production <strong>of</strong><br />
K LHW as a new organisation and the process <strong>of</strong> how aspects <strong>of</strong> LINks will<br />
evolve <strong>in</strong>to K LHW.<br />
• <strong>The</strong> role <strong>of</strong> K LHW on the Health and Wellbe<strong>in</strong>g Board as both a champion<br />
for local people’s voices and as a partner <strong>in</strong> strategic decisions that may<br />
have unpopular consequences.<br />
• <strong>The</strong> need for K LHW to represent the consumer voice and <strong>in</strong>telligence from<br />
signpost<strong>in</strong>g and advocacy work across <strong>Kent</strong> when diverse groups may<br />
have different views and priorities.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 29
Recommendations<br />
<strong>The</strong> follow<strong>in</strong>g series <strong>of</strong> recommendations is based on the synthesis <strong>of</strong><br />
contributions from participants. <strong>The</strong> <strong>key</strong> forum for consider<strong>in</strong>g and manag<strong>in</strong>g<br />
these recommendations should be the <strong>Local</strong> <strong>Healthwatch</strong> Development<br />
Group established <strong>in</strong> June 2011. Each recommendation is followed by a<br />
suggestion for the lead agency to deliver the proposal.<br />
Involv<strong>in</strong>g stakeholders<br />
1. All participants <strong>in</strong> the statement <strong>of</strong> read<strong>in</strong>ess process should receive<br />
a copy <strong>of</strong> the report and be <strong>in</strong>vited to <strong>of</strong>fer further comments and<br />
reflections. <strong>The</strong>se contributions should be <strong>in</strong>corporated <strong>in</strong>to the work<br />
<strong>of</strong> the <strong>Local</strong> <strong>Healthwatch</strong> Development Group. Suggested lead: <strong>Kent</strong><br />
County Council<br />
2. All participants should form the core <strong>of</strong> a database <strong>of</strong> <strong>in</strong>terested<br />
parties <strong>in</strong> the <strong>development</strong> <strong>of</strong> K LHW. <strong>The</strong>y should be kept <strong>in</strong>formed<br />
<strong>of</strong> progress and provided with further opportunities to engage <strong>in</strong> the<br />
<strong>development</strong> <strong>of</strong> plans. <strong>The</strong> core database should be expanded to<br />
<strong>in</strong>clude a wider group <strong>of</strong> stakeholders, services users and patients<br />
and a communication plan developed. Suggested lead: <strong>Kent</strong> County<br />
Council<br />
3. A timel<strong>in</strong>e for the <strong>development</strong> <strong>of</strong> K LHW should be developed and<br />
shared with stakeholders. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
4. <strong>The</strong> commitment and <strong>in</strong>terest amongst stakeholders highlighted by<br />
the statement <strong>of</strong> read<strong>in</strong>ess process should be used to cont<strong>in</strong>ue to<br />
take a whole system approach to the <strong>development</strong> <strong>of</strong> K LHW over the<br />
next six months. <strong>The</strong> <strong>Local</strong> <strong>Healthwatch</strong> Development Group should<br />
consider the use <strong>of</strong> toolkits from appreciative <strong>in</strong>quiry and ‘strengths<br />
based approaches’ to <strong>in</strong>form its work. Suggested lead: All parties<br />
5. LINks and other stakeholders <strong>in</strong>clud<strong>in</strong>g Patient <strong>Part</strong>icipation Groups<br />
and CVS organisations should be <strong>in</strong>vited to cont<strong>in</strong>ue to collect and<br />
share stories from patients and service users about their experiences<br />
and what K LHW could mean to them. <strong>The</strong> stories will give further<br />
<strong>in</strong>sight about what an effective K LHW should do and how it would<br />
help local people. <strong>The</strong> stories should be collated and used to <strong>in</strong>form<br />
the co-production <strong>of</strong> K LHW. Suggested lead: LINks<br />
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<strong>Healthwatch</strong> Development<br />
6. <strong>The</strong> <strong>Local</strong> <strong>Healthwatch</strong> Development Group is well placed to lead the<br />
multi-stakeholder <strong>development</strong> <strong>of</strong> K LHW <strong>in</strong> the county. All <strong>development</strong><br />
activities should be coord<strong>in</strong>ated through this body to ensure consistency<br />
<strong>of</strong> approach and clear communication with the public. <strong>The</strong> small core<br />
group should consider ways to <strong>in</strong>volve a wider group <strong>of</strong> stakeholders<br />
and participants <strong>in</strong> regular <strong>development</strong> sessions and themed<br />
workshops. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
7. <strong>The</strong> core group should use the statement <strong>of</strong> read<strong>in</strong>ess report to review<br />
its terms <strong>of</strong> reference and core membership. Task and f<strong>in</strong>ish groups<br />
should be considered as a way to deliver the detail <strong>of</strong> the work plan.<br />
Suggested lead: NHS <strong>Kent</strong> and Medway<br />
8. Based on the data <strong>in</strong> this report, the <strong>Local</strong> <strong>Healthwatch</strong> Development<br />
Group should develop and share a written vision statement for K LHW.<br />
<strong>The</strong> vision statement could be l<strong>in</strong>ked to stories and case studies that<br />
could provide examples <strong>of</strong> how K LHW will work <strong>in</strong> practice. <strong>The</strong> vision<br />
statement should demonstrate how K LHW will be a credible and<br />
effective organisation. Suggested lead: All parties<br />
9. <strong>The</strong> <strong>development</strong> plan for K LHW should explicitly address ways to<br />
promote the vision statement <strong>in</strong> practice and mitigate the risks and<br />
barriers to success identified by participants <strong>in</strong> this report. <strong>The</strong> plan will<br />
need to <strong>in</strong>clude a realistic assessment <strong>of</strong> available resources and ways<br />
to provide appropriate project management. Suggested lead: <strong>Kent</strong><br />
County Council<br />
10. <strong>The</strong> <strong>Healthwatch</strong> Transition Plan and Pathf<strong>in</strong>der work should be<br />
aligned with the work <strong>of</strong> the <strong>Local</strong> <strong>Healthwatch</strong> Development Group<br />
to ensure that efforts are coord<strong>in</strong>ated and that learn<strong>in</strong>g and local<br />
knowledge is embedded <strong>in</strong> the <strong>development</strong> <strong>of</strong> K LHW. It is important<br />
that LINks volunteers and host staff cont<strong>in</strong>ue to participate <strong>in</strong> the next<br />
stages <strong>of</strong> the transition and are provided with clear <strong>in</strong>formation and<br />
support. Suggested lead: LINks<br />
11. Learn<strong>in</strong>g and experience from LINks and the host organisation should<br />
cont<strong>in</strong>ue to <strong>in</strong>form the <strong>development</strong> <strong>of</strong> K LHW. LINks should be <strong>in</strong>vited<br />
to provide a series <strong>of</strong> case studies about their impact and provide an<br />
analysis <strong>of</strong> the <strong>key</strong> factors that have underp<strong>in</strong>ned their successes and<br />
the challenges and barriers they have faced. Evidence and advice<br />
should also be <strong>in</strong>vited from other organisations with specialist skills<br />
<strong>in</strong>clud<strong>in</strong>g PALS and ICAS. Suggested lead: LINks<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 31
Organisational models<br />
12. Build<strong>in</strong>g on the work <strong>of</strong> the vision statements and contributions<br />
from the statement <strong>of</strong> read<strong>in</strong>ess assessment, the <strong>Local</strong> <strong>Healthwatch</strong><br />
Development Group should create a local outcomes framework to<br />
provide a high level overview <strong>of</strong> what K LHW should aim to achieve<br />
and how it will measure this. Suggested lead: <strong>Kent</strong> County Council<br />
13. <strong>The</strong> <strong>Local</strong> <strong>Healthwatch</strong> Development Group should co-produce<br />
more detailed models <strong>of</strong> options for the organisational form <strong>of</strong> K<br />
LHW. <strong>The</strong> Development Group should recognise the work already<br />
completed dur<strong>in</strong>g the ‘Every Decision About Me, With Me’ workshop<br />
<strong>in</strong> September 2011 – <strong>in</strong> particular the <strong>development</strong> <strong>of</strong> the distributed<br />
model put forward by participants. <strong>The</strong>y should <strong>in</strong>volve a wider group<br />
<strong>of</strong> stakeholders through their networks <strong>in</strong> this process. <strong>The</strong> process<br />
<strong>of</strong> co-produc<strong>in</strong>g these models will enable the Development Group to<br />
capture the contributions <strong>of</strong> stakeholders and identify strengths and<br />
weaknesses <strong>of</strong> each model. Support from a procurement specialist will<br />
be essential to advise on supply side issues and explore opportunities<br />
for pre-tender<strong>in</strong>g exercises. Suggested lead: <strong>Kent</strong> County Council<br />
14. Once the models have been developed, the <strong>Local</strong> <strong>Healthwatch</strong><br />
Development Group should facilitate a structured review process<br />
<strong>of</strong> the models and explore them <strong>in</strong> terms <strong>of</strong> the procurement model<br />
for K LHW. <strong>The</strong> models should be assessed on a number <strong>of</strong> factors<br />
identified by participants <strong>in</strong> the statement <strong>of</strong> read<strong>in</strong>ess:<br />
• Ability to deliver the local vision <strong>of</strong> K LHW as set out <strong>in</strong> the vision<br />
statement<br />
• Credibility with the public<br />
• Credibility with commissi<strong>one</strong>rs and decision makers<br />
• Ability to work effectively with diverse and seldom heard groups<br />
• Ability to work across the geographical area <strong>of</strong> <strong>Kent</strong><br />
• Ability to effectively collect, collate and present data on local voice<br />
and experience<br />
• Flexibility to align with the chang<strong>in</strong>g health and social care<br />
environment <strong>in</strong> <strong>Kent</strong><br />
• <strong>The</strong> potential for clear and transparent governance<br />
• Deliverability with<strong>in</strong> organisational and f<strong>in</strong>ancial boundaries<br />
• Avoidance <strong>of</strong> unnecessary replication <strong>of</strong> exist<strong>in</strong>g <strong>in</strong>itiatives and<br />
projects Suggested lead: <strong>Kent</strong> County Council<br />
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15. In parallel with the <strong>development</strong> <strong>of</strong> the organisational models, the<br />
governance needs <strong>of</strong> K LHW should be mapped. Consideration<br />
should be given to the Centre for Public Scrut<strong>in</strong>y f<strong>in</strong>d<strong>in</strong>g <strong>in</strong> wider<br />
research about LINks that a lack <strong>of</strong> clarity around governance can<br />
lead to uncerta<strong>in</strong>ty at the expense <strong>of</strong> deliver<strong>in</strong>g a work programme.<br />
Governance <strong>development</strong> should cover:<br />
• Legal duties and accountabilities<br />
• Accountability to the <strong>Kent</strong> public<br />
• Accountability to the commissi<strong>one</strong>r <strong>of</strong> K LHW<br />
• Internal roles and accountabilities<br />
• Decision mak<strong>in</strong>g and prioritisation systems<br />
• <strong>Part</strong>icipation <strong>of</strong> diverse groups <strong>in</strong> governance<br />
• Means <strong>of</strong> assurance<br />
• Transparency and efficiency<br />
• Responsibilities to the membership<br />
• Code <strong>of</strong> conduct<br />
• Conflict resolution Suggested lead: <strong>Kent</strong> County Council<br />
16. <strong>The</strong> <strong>development</strong> <strong>of</strong> the <strong>in</strong>formation and signpost<strong>in</strong>g function should<br />
<strong>in</strong>volve <strong>in</strong>dividuals and organisations who already have expertise <strong>of</strong><br />
this role <strong>in</strong> <strong>Kent</strong>. It will be important to understand the nature and<br />
frequency <strong>of</strong> exist<strong>in</strong>g requests for these services. It is also important to<br />
identify best practice and potential barriers to overcome <strong>in</strong> design<strong>in</strong>g a<br />
successful service. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
Sett<strong>in</strong>g up<br />
17. A clear set <strong>of</strong> summaries <strong>of</strong> the competencies, roles, skills and<br />
knowledge for K LHW staff and volunteers should be developed and<br />
shared. <strong>The</strong>se should be based on the issues identified by participants<br />
<strong>in</strong> the statement <strong>of</strong> read<strong>in</strong>ess process and captured <strong>in</strong> part two <strong>of</strong> the<br />
report. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
18. <strong>The</strong> <strong>development</strong> <strong>of</strong> K LHW should be based on a clear mapp<strong>in</strong>g<br />
exercise <strong>of</strong> the <strong>key</strong> partners and organisations it will need to work with<br />
to be effective. This mapp<strong>in</strong>g exercise should <strong>in</strong>form the <strong>development</strong><br />
<strong>of</strong> the organisational form <strong>of</strong> K LHW based on the functions it needs to<br />
fulfil. As a m<strong>in</strong>imum the mapp<strong>in</strong>g should address:<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 33
• Patient and service user groups<br />
• Carers groups<br />
• Community groups<br />
• Commissi<strong>one</strong>rs <strong>in</strong> health and social care<br />
• Cl<strong>in</strong>ical Commission<strong>in</strong>g Groups<br />
• Shadow Health and Wellbe<strong>in</strong>g Board<br />
• Overview and Scrut<strong>in</strong>y Committees for health and for social care<br />
• Providers<br />
• Public health services<br />
• <strong>Local</strong>ity and district partnerships<br />
• Community and voluntary sector groups<br />
• Community champions<br />
• PALS, compla<strong>in</strong>ts and other <strong>in</strong>formation and signpost<strong>in</strong>g<br />
pr<strong>of</strong>essionals Suggested lead: <strong>Kent</strong> County Council<br />
19. <strong>The</strong> design <strong>of</strong> K LHW should be based on an appreciation <strong>of</strong> the<br />
exist<strong>in</strong>g engagement work that is already tak<strong>in</strong>g place across <strong>Kent</strong> to<br />
engage and support patients and service users. <strong>The</strong> <strong>development</strong> <strong>of</strong><br />
K LHW should seek to avoid duplication and address any concerns or<br />
tensions that exist<strong>in</strong>g organisations, networks and projects may have<br />
about its <strong>development</strong>. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
20. An assessment should be made <strong>of</strong> the opportunities and possibilities<br />
to embed K LHW functions <strong>in</strong> <strong>key</strong> local areas <strong>of</strong> delivery identified by<br />
participants. <strong>The</strong>re is an emerg<strong>in</strong>g list <strong>of</strong> opportunities described <strong>in</strong><br />
more detail <strong>in</strong> the report. Consideration should <strong>in</strong>clude:<br />
• Children’s Centres<br />
• <strong>Kent</strong> County Council Information Gateways<br />
• Patient <strong>Part</strong>icipation Group networks<br />
• Pan-<strong>Kent</strong> patient and service user networks<br />
• Community and voluntary sector organisations work<strong>in</strong>g with<br />
seldom heard groups<br />
• Gypsy and Traveller support services<br />
• Colleges and Universities<br />
• Exist<strong>in</strong>g advocacy services <strong>in</strong> <strong>Kent</strong> Suggested lead: <strong>Kent</strong> County<br />
Council<br />
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21. It is important to recognise the scale and complexity <strong>of</strong> <strong>Kent</strong>. K LHW<br />
will need to learn from the work <strong>of</strong> LINks and other participation<br />
<strong>in</strong>itiatives to engage people at the local, district, county levels as<br />
well as <strong>in</strong> terms <strong>of</strong> their crosscutt<strong>in</strong>g health and social care needs.<br />
Suggested lead: <strong>Kent</strong> County Council<br />
Induction, tra<strong>in</strong><strong>in</strong>g and <strong>development</strong><br />
22. A whole system <strong>in</strong>duction programme should be mapped for K LHW<br />
based on the opportunities and <strong>of</strong>fers made by participants <strong>in</strong> the<br />
statement <strong>of</strong> read<strong>in</strong>ess work. This <strong>in</strong>duction programme should have<br />
four aims:<br />
• To enable K LHW to understand the roles and functions <strong>of</strong> the<br />
different agencies and bodies <strong>in</strong> the wider health and social care<br />
environment <strong>in</strong> <strong>Kent</strong><br />
• To build relationships between K LHW and <strong>key</strong> leaders <strong>in</strong><br />
commission<strong>in</strong>g, decision-mak<strong>in</strong>g, provider and scrut<strong>in</strong>y<br />
organisations<br />
• To raise awareness <strong>of</strong> K LHW<br />
• To enable K LHW to ‘hit the ground runn<strong>in</strong>g’ once it is formed and<br />
quickly build strong and effective collaborations Suggested lead:<br />
NHS <strong>Kent</strong> and Medway<br />
23. A more <strong>in</strong>-depth tra<strong>in</strong><strong>in</strong>g and <strong>development</strong> programme should be<br />
developed for K LHW staff and volunteers to compliment the <strong>in</strong>duction<br />
process. <strong>The</strong> programme should cover the range <strong>of</strong> issues and needs<br />
identified by participants <strong>in</strong> the statement <strong>of</strong> read<strong>in</strong>ess process. It<br />
should avoid replication <strong>of</strong> <strong>development</strong> efforts by draw<strong>in</strong>g on the<br />
exist<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g available <strong>in</strong> house through <strong>Kent</strong> health and social<br />
care organisations and others which have been <strong>of</strong>fered to K LHW by<br />
participants <strong>in</strong> the statement <strong>of</strong> read<strong>in</strong>ess process. <strong>The</strong> tra<strong>in</strong><strong>in</strong>g and<br />
<strong>development</strong> programme should be tailored to the needs and learn<strong>in</strong>g<br />
styles <strong>of</strong> participants and recognition given to mak<strong>in</strong>g the programme<br />
accessible to seldom heard groups. Suggested lead: NHS <strong>Kent</strong> and<br />
Medway<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 35
Work<strong>in</strong>g across the new landscape<br />
24. Development work should be supported between the shadow Health<br />
and Wellbe<strong>in</strong>g Board and K LHW to develop a shared vision for their<br />
partnership and the terms <strong>of</strong> engagement. Consideration should be<br />
given to runn<strong>in</strong>g a simulation or role play exercise for members <strong>of</strong> both<br />
shadow groups to explore ways to work together effectively and to<br />
identify strategies to overcome any potential barriers or challenges.<br />
Suggested lead: <strong>Kent</strong> County Council<br />
25. Similar work should be explored with the Overview and Scrut<strong>in</strong>y<br />
Committees for health and for social care. Suggested lead: <strong>Kent</strong><br />
County Council<br />
26. <strong>The</strong> <strong>Local</strong> <strong>Healthwatch</strong> Development Group should seek to work with<br />
Dover District shadow Health and Wellbe<strong>in</strong>g Board to promote their<br />
participation <strong>in</strong> the <strong>development</strong> <strong>of</strong> K LHW and identify any specific<br />
issues for how the two bodies will work together. Of particular <strong>in</strong>terest<br />
will be the management <strong>of</strong> health and social care issues that crosscut<br />
the district and county levels. Suggested lead: <strong>Kent</strong> County Council<br />
27. Commissi<strong>one</strong>rs, the shadow Health and Wellbe<strong>in</strong>g Board and other<br />
decision makers should be <strong>in</strong>vited and supported to identify a set <strong>of</strong> K<br />
LHW friendly processes and behaviours to enable them to contribute<br />
to the environment <strong>in</strong> which K LHW can flourish. Suggested lead:<br />
NHS <strong>Kent</strong> and Medway<br />
28. <strong>The</strong> social care role <strong>of</strong> K LHW should be given as much priority as the<br />
health role <strong>in</strong> the <strong>development</strong> <strong>of</strong> K LHW structures, tra<strong>in</strong><strong>in</strong>g and plans.<br />
Social care issues need to be embedded <strong>in</strong> K LHW from the start and<br />
tra<strong>in</strong><strong>in</strong>g provided to both K LHW and social care commissi<strong>one</strong>rs to<br />
raise awareness <strong>of</strong> this purpose <strong>of</strong> the organisation. Suggested lead:<br />
<strong>Kent</strong> County Council<br />
29. K LHW should reflect on potential opportunities to champion the<br />
<strong>in</strong>tegration <strong>of</strong> health and social care services <strong>in</strong> <strong>Kent</strong>. <strong>The</strong> <strong>development</strong><br />
and <strong>in</strong>duction <strong>of</strong> K LHW should assess opportunities to promote<br />
<strong>in</strong>tegration. K LHW’s own <strong>in</strong>ternal processes should avoid replicat<strong>in</strong>g<br />
health and social care silos and provide <strong>in</strong>ternal challenge to support<br />
an <strong>in</strong>tegrated vision. Suggested lead: <strong>Kent</strong> County Council<br />
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Inclusion<br />
30. A written strategy for engag<strong>in</strong>g diverse groups across <strong>Kent</strong> should be<br />
developed. Identification <strong>of</strong> groups should be based on the collation<br />
<strong>of</strong> exist<strong>in</strong>g community mapp<strong>in</strong>g exercises and county level data such<br />
as the Jo<strong>in</strong>t Strategic Needs Assessment. It will also be important<br />
to identify groups that have not already been <strong>in</strong>cluded <strong>in</strong> this work.<br />
Evidence based engagement strategies should be developed to meet<br />
the specific needs <strong>of</strong> different groups with a clear appreciation <strong>of</strong> the<br />
barriers and challenges they face. K LHW should work <strong>in</strong> partnership<br />
with the local groups and networks that support these communities<br />
already. <strong>The</strong> contributions <strong>of</strong> participants to the statement <strong>of</strong> read<strong>in</strong>ess<br />
should be used as a start<strong>in</strong>g po<strong>in</strong>t for the identification <strong>of</strong> seldom<br />
heard groups. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
31. Where possible K LHW should seek direct access to the knowledge<br />
and expertise <strong>of</strong> members <strong>of</strong> diverse and seldom heard groups and<br />
their organisations to <strong>in</strong>form K LHW strategy and practical work.<br />
<strong>The</strong>se groups should be directly <strong>in</strong>cluded <strong>in</strong> the co-design <strong>of</strong> plans.<br />
For example, <strong>Kent</strong> citizens liv<strong>in</strong>g <strong>in</strong> residential and nurs<strong>in</strong>g homes are<br />
<strong>one</strong> group identified by the report. Suggested lead: NHS <strong>Kent</strong> and<br />
Medway<br />
Compla<strong>in</strong>ts Advocacy<br />
32. It is essential to clearly dist<strong>in</strong>guish between <strong>in</strong>dependent compla<strong>in</strong>ts<br />
advocacy and the compla<strong>in</strong>ts functions that will rema<strong>in</strong> embedded<br />
with<strong>in</strong> commission<strong>in</strong>g and provid<strong>in</strong>g organisations. A clear def<strong>in</strong>ition<br />
<strong>of</strong> compla<strong>in</strong>ts advocacy needs to be agreed by local stakeholders and<br />
used as the basis for the <strong>development</strong> <strong>of</strong> these advocacy activities.<br />
Suggested lead: <strong>Kent</strong> County Council<br />
<strong>Healthwatch</strong> Observatory<br />
33. Explore the possibility <strong>of</strong> a sub-regional <strong>Healthwatch</strong> Observatory<br />
to coord<strong>in</strong>ate <strong>in</strong>formation and data on patient and service user<br />
choice to support the local <strong>in</strong>formation and signpost<strong>in</strong>g role for local<br />
<strong>Healthwatch</strong> organisations. <strong>The</strong> purpose <strong>of</strong> the Observatory would<br />
be to provide a locus for expert skills <strong>in</strong> the collation, analysis and<br />
presentation <strong>of</strong> patient and service user data to support K LHW. It<br />
would also apply these skills to analys<strong>in</strong>g and giv<strong>in</strong>g <strong>in</strong>sight to data<br />
and <strong>in</strong>formation produced by commissi<strong>one</strong>rs and providers. By shar<strong>in</strong>g<br />
the resource between a number <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> organisations<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 37
across a sub-region it will be possible to pool expertise <strong>in</strong> an efficient<br />
and <strong>in</strong>formed way and recruit the appropriately skilled staff for this<br />
specialised role. Other options should also be explored for the delivery<br />
<strong>of</strong> this function. Suggested lead: NHS <strong>Kent</strong> and Medway<br />
34. To enable K LHW to be able to collate and present its f<strong>in</strong>d<strong>in</strong>gs and<br />
the consumer voice effectively to commissi<strong>one</strong>rs and decision makers<br />
some <strong>in</strong>itial work should be commenced to explore the format and<br />
report<strong>in</strong>g tools that it could use. Stakeholders from public health, the<br />
shadow Health and Wellbe<strong>in</strong>g Board, commissi<strong>one</strong>r and provider<br />
organisations, overview and scrut<strong>in</strong>y and Cl<strong>in</strong>ical Commission<strong>in</strong>g<br />
Groups should be <strong>in</strong>vited to co-design an outl<strong>in</strong>e methodology and<br />
format with the <strong>Local</strong> <strong>Healthwatch</strong> Development Group. It is also<br />
important to identify the report<strong>in</strong>g expectations <strong>of</strong> HWE and the Care<br />
Quality Commission <strong>in</strong> this work. Suggested lead: NHS <strong>Kent</strong> and<br />
Medway<br />
Us<strong>in</strong>g this report<br />
35. <strong>The</strong> statement <strong>of</strong> read<strong>in</strong>ess report should be used as a tool to engage<br />
and beg<strong>in</strong> an <strong>in</strong>formed discussion with provider organisations <strong>in</strong><br />
<strong>Kent</strong> about the role and functions <strong>of</strong> K LHW. Suggested lead: <strong>Kent</strong><br />
County Council<br />
36. <strong>The</strong> Assessment Format for <strong>Healthwatch</strong> developed as part <strong>of</strong> the<br />
statement <strong>of</strong> read<strong>in</strong>ess project and <strong>in</strong>cluded <strong>in</strong> part two <strong>of</strong> this report<br />
should cont<strong>in</strong>ue to be used to <strong>in</strong>form the <strong>development</strong> process. It is<br />
important to recognise that the Assessment Format is not a static<br />
document and new questions and areas should be added to it as<br />
the work progresses. <strong>The</strong> Assessment Format could also be used<br />
to review progress on the <strong>development</strong> <strong>of</strong> K LHW <strong>in</strong> six months time.<br />
Suggested lead: <strong>Kent</strong> County Council<br />
37. <strong>The</strong> report and methodology is <strong>in</strong>tended to provide a ‘live’ case study<br />
for the Department <strong>of</strong> Health. It is anticipated that the issues raised <strong>in</strong><br />
this report can <strong>in</strong>form and support LHW <strong>development</strong> <strong>in</strong> other areas.<br />
Tools developed for this process can be accessed via the Department<br />
<strong>of</strong> Health and Care Quality Commission channels for broader use. All<br />
partners <strong>in</strong> <strong>Kent</strong>, and <strong>in</strong> particular the <strong>Local</strong> <strong>Healthwatch</strong> Development<br />
Group, should be encouraged to share their learn<strong>in</strong>g with the wider<br />
<strong>development</strong> <strong>of</strong> local <strong>Healthwatch</strong> across England. Suggested lead:<br />
NHS <strong>Kent</strong> and Medway<br />
38<br />
<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
38. Ensure the video <strong>of</strong> the ‘Every Decision About Me, With Me’<br />
workshop is shared widely with stakeholders <strong>in</strong> <strong>Kent</strong> and those with<br />
a <strong>Healthwatch</strong> <strong>development</strong> role elsewhere <strong>in</strong> England. <strong>The</strong> video is<br />
designed to be a learn<strong>in</strong>g and <strong>development</strong> tool. Host the video on<br />
appropriate websites to ensure it is accessible. Suggested lead: NHS<br />
<strong>Kent</strong> and Medway<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 39
Acknowledgements<br />
<strong>The</strong> K LHW Statement <strong>of</strong> Read<strong>in</strong>ess project has been funded by <strong>Kent</strong> County<br />
Council and the Department <strong>of</strong> Health. <strong>The</strong> project is supported by NHS <strong>Kent</strong><br />
and Medway. It has been led locally by Lorra<strong>in</strong>e Denoris, Director <strong>of</strong> Citizen<br />
Engagement and Communications, NHS <strong>Kent</strong> and Medway and coord<strong>in</strong>ated<br />
by Tish Gailey, Health Policy Manager, <strong>Kent</strong> County Council.<br />
Three expert advisers from the Centre for Public Scrut<strong>in</strong>y formed an<br />
<strong>in</strong>dependent team to design and deliver the participative research activities<br />
and produce this report. <strong>The</strong>y are Paul Cutler, Judith Emanuel and Sally<br />
Brearley. <strong>The</strong> Centre for Public Scrut<strong>in</strong>y is an <strong>in</strong>dependent charity (registered<br />
number 1136243).<br />
<strong>The</strong> project was actively supported by the <strong>Kent</strong> LINks and their host <strong>Kent</strong> and<br />
Medway Networks Ltd. <strong>Part</strong>icular support was provided by Brenda O’Neill<br />
and Richard Beckwith.<br />
<strong>The</strong> project was also supported by members <strong>of</strong> the <strong>Kent</strong> <strong>Local</strong> <strong>Healthwatch</strong><br />
Development Group.<br />
<strong>The</strong> project team wishes to thank the follow<strong>in</strong>g <strong>in</strong>dividuals for their support<br />
and contributions to the project:<br />
Ann Sutton, Chief Executive, <strong>Kent</strong> and Medway PCT Cluster<br />
Col<strong>in</strong> Tomson, Chair, <strong>Kent</strong> and Medway PCT Cluster Board<br />
Councillor Roger Gough, <strong>Kent</strong> County Council Cab<strong>in</strong>et Member for Health<br />
Reform<br />
Councillor Graham Gibbens, <strong>Kent</strong> County Council Cab<strong>in</strong>et Member for<br />
Public Health<br />
Sarah Andrews, Director <strong>of</strong> Nurs<strong>in</strong>g, <strong>Kent</strong> and Medway PCT Cluster<br />
Carol Cassam, Associate Director Nurs<strong>in</strong>g & Quality (East) and Lead for<br />
Safety and Patient Experience<br />
Cathi Sacco, Director <strong>of</strong> Strategic Commission<strong>in</strong>g for Families and Social<br />
Care (Interim), <strong>Kent</strong> County Council<br />
<strong>Kent</strong> and Medway PCT Cluster Non Executive Directors<br />
Anne Tidmarsh, Director <strong>of</strong> Older People and Physical Disability, <strong>Kent</strong> County<br />
Council<br />
Dr Merad<strong>in</strong> Peachy, Director <strong>of</strong> Public Health, <strong>Kent</strong> County Council<br />
Councillor Jenny Whittle, <strong>Kent</strong> County Council Cab<strong>in</strong>et Member for<br />
Specialist Children’s Services<br />
Liz Coleman, Head <strong>of</strong> Customer Services, <strong>Kent</strong> and Medway PCT<br />
Councillor Nick Chard, Chair <strong>of</strong> <strong>Kent</strong> County Council Health Overview and<br />
Scrut<strong>in</strong>y Committee<br />
40<br />
<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
Julie Van Ruyckevelt, West <strong>Kent</strong> Primary Care Trust<br />
Members <strong>of</strong> the Cl<strong>in</strong>ical Commission<strong>in</strong>g Groups across <strong>Kent</strong><br />
Representatives <strong>of</strong> the Community and Voluntary Sector across <strong>Kent</strong><br />
Members <strong>of</strong> the Health Matters Reference Group<br />
And f<strong>in</strong>ally thank you and acknowledgement to all those who participated <strong>in</strong><br />
the Every Decision About Me, With Me workshop and <strong>in</strong> the <strong>in</strong>terviews and<br />
focus groups.<br />
<strong>Part</strong> <strong>one</strong>: <strong>key</strong> f<strong>in</strong>d<strong>in</strong>gs 41
42<br />
<strong>The</strong> <strong>development</strong> <strong>of</strong> <strong>Local</strong> <strong>Healthwatch</strong> <strong>in</strong> <strong>Kent</strong>: assess<strong>in</strong>g read<strong>in</strong>ess for <strong>Local</strong> <strong>Healthwatch</strong>
<strong>The</strong> Centre for Public Scrut<strong>in</strong>y<br />
<strong>Local</strong> Government House<br />
Smith Square<br />
London SW1P 3HZ<br />
Tel 044 (0)20 7187 7362<br />
www.cfps.org.uk<br />
CfPS is a registered charity no 1136243<br />
November 2011<br />
L11-656