Healthwatch needs to punch its weight? We're up for the fight

A recent HSJ leader article challenged Healthwatch to punch its weight. So are local Healthwatch organisations actually flexing their muscles? Here in Essex, we certainly are.

‘Our first goal was to establish the credibility of Healthwatch Essex with health and social care partners’

At Healthwatch Essex, we set our task to be an independent voice for the people of the county, helping to shape and improve social care. But this organisational vision reflects a much loftier long term aim – no less than to help change the culture and practice of engagement and involvement in the NHS and social care.

This is no mean feat and will take time. For too long, patient experience has been the Cinderella of the trio that makes up quality; her sisters – clinical efficacy and patient safety – have always received more attention.

But listening to patient and service user experiences, and involving this in key decisions, is a path all our services need to follow if the quality of health and care is to improve in these challenging times.

Establishing credibility

So how are we going about this in Essex? Our first goal was to establish the credibility of Healthwatch Essex with health and social care partners.

‘Our aim is that our reports are robust enough not to be easily ignored or dismissed’

A negative legacy from our immediate predecessor organisation meant that we were initially met with scepticism. But since then, we have worked hard to demonstrate that we are doing things differently.

Our key message has been that voice and lived experience matter. But more than that, we argue that this has to be seen as part of the solution to the many challenges facing the health and care system, and not part of the problem.

This means engaging the right people, at the right time, using the right method.

And for our part? It means, for example, that Healthwatch Essex volunteers go through a rigorous appointment process, as well as a bespoke training programme. Their role is to gather and represent the voice and lived experience of the people of Essex, and as our ‘eyes and ears’, must be suitable for this role.

Alongside this, we run a programme of rigorous social research, carrying out studies into specific topics that have been brought to our attention by the public or our statutory partners. Our aim is that our reports and recommendations are firmly rooted in good quality evidence – and that they’re robust enough not to be easily ignored or dismissed.

Supporting statutory partners

Spending time at the outset to make sure that our role and purpose is well understood has already meant we are making a difference.

‘We’ve supported local CCGs and acute trusts to adapt their patient engagement arrangements to provide meaningful strategic insight’

When, in autumn 2013, cancer services at Colchester University Foundation Trust came under scrutiny over the quality of care, we were invited to work with the NHS to make sure that patient experience was at the heart of their response.

We joined their incident management team, and have worked alongside the CCG, NHS England and the trust to conduct our own (independent) study of people’s experiences of cancer services in Colchester. The results of our study will feed into the trust’s action plan.

Dr Shane Gordon, chief officer for North East Essex CCG, has recognised our support: “Throughout our review of cancer services, Healthwatch Essex has been with us every step of the way, ensuring patient experience is at the heart of our decision making.”

Transforming patient engagement

We believe an important part of our role is to support our partners within the NHS and social care to engage and involve patients, service users and carers effectively in their decision making.

‘Early investment of time is the reason why we have begun to be accepted as a credible partner in Essex’

We’ve supported several of our local CCGs and acute trusts to adapt their patient engagement arrangements to make sure they provide meaningful strategic insight and timely, relevant feedback that accurately reflects the voice and lived experience of their local community.

Our input has seen results in West Essex. As Irene McLean, assistant director of West Essex CCG, says: “Healthwatch Essex has provided strategic, tactical and practical insight that has been invaluable in transforming our citizen engagement arrangements. As a result, local people now have more opportunities to be part of our decision making.”

More widely, Healthwatch Essex jointly convenes a regular forum of all NHS patient experience teams, alongside the local area team of NHS England.

Through this, patient experience representatives from both commissioners and providers regularly come together and share examples of best practice. The aim is to raise the quality of patient and service-user engagement across the county.

We believe that this early investment of time and resource is the reason why we have begun to be accepted as an equal and credible partner in Essex, in what is a very complicated health and social care landscape.

It’s this credibility that allows us to have the impact and influence that is essential for us to be an independent and effective voice for the people of Essex.

Dr Tom Nutt is chief executive of Healthwatch Essex