Introducing Healthwatch Wiltshire: the new health & social care watchdog
Over the past few days, Christine Graves has been taking a special interest in the morning’s headlines about the NHS. News of cover-up, inadequate reports, disarray at the Care Quality Commission (CQC) and the terrible distress of parents over the Morecombe Bay baby death scandal, strikes home for Christine Graves, the Chairman of the new Healthwatch Wiltshire organisation.
Christine Graves has almost forty years’ experience in social care. She worked with the stroke rehabilitation unit at Marlborough’s Savernake Hospital for ten years. More recently she was commissioning mental health services for Wiltshire Council. She retired last September and was chosen to lead the county’s new patient involvement body.
Healthwatch Wiltshire is part of the new and complex geography the coalition government designed for the NHS in its restructuring of organisations and responsibilities. It started life on April 1.
Marlborough News Online asked Christine Graves how the launch was going: “Are we up and running? No we are not. But it’s more important to get it right than get it quick.”
Part of the challenge has been the proper transfer of staff from the previous patient organisation – the Wiltshire Involvement Network (WIN – and see below.) This process ends on July 1. Then she and the directors will be able to see whether they need to recruit more staff.
Healthwatch Wiltshire is commissioned by Wiltshire Council and funded by money from central government passed to the Council, but not ring fenced. In Wiltshire’s case the full amount has gone through to Healthwatch Wiltshire which will cover both health and social care involvement throughout the county.
Their budget is not large: “I’m not saying we wouldn’t like more resources – but it’s mainly about the skills of our staff and engaging with people.”
This local Healthwatch will be independent of both Wiltshire Council and of the central, umbrella organisation, Healthwatch England. Indeed they are so independent that they have to pay Healthwatch England for use of the logo.
Besides Mrs Graves, they have at present an office, four directors and are established as a Community Interest Company. One of the four directors is Marlborough resident Paul Lefever who used to chair the Friends of Savernake Hospital.
Chairman and directors are voluntary positions. The chairman’s role was advertised as involving a commitment of 3-5 days a month. However, in order to get it up and running, she and her directors are presently working on tasks normally done by officials, they are discussing whether they should get some pay for the first year.
As though the present spate of NHS headlines were not enough of a warning, Chapter Six of Robert Francis QC’s final report on the many unnecessary deaths and appalling care at Mid-Staffs hospital shows how essential a proper health watch organisation can be. His chapter is titled: “Patient and public local involvement and scrutiny”.
In Mid-Staffs the succession of local patient involvement bodies (see below) failed over the years in their prime duty. They failed to alert the right people to what they were learning about the care in hospitals in their area. The Staffordshire LINk group (equivalent to our WIN) was simply considered to be ‘dysfunctional’.
Wiltshire Council wanted the Healthwatch they commissioned to be grown in Wiltshire for Wiltshire, so they did not contract an ‘off-the-peg’ set-up from a national charity or national social enterprise. Mrs Graves emphasises that “The Council has been and are being very supportive without seeking to influence the outcome.”
The only request the Council made was that Healthwatch Wiltshire use its Area Board network to spread information about NHS services and to gather views of the public.
Healthwatch Wiltshire will be proactive in checking on patient safety. They have the power to ‘enter and view’ almost all types of health and social care establishment.
It has to be evidence not gossip. Mrs Graves wants to encourage individuals to act responsibly when they’re visiting a care home or hospital and see something that’s not right: “We should all be brave enough to find someone in charge and say I know you’re going to be disappointed in what I’ve just seen….”
“We do have to get involved proactively in quality of care issues. But the way to really resolve those issues is to get the right services in place for the next ten to fifteen years.”
Healthwatch Wiltshire will have a role in the complex process of commissioning health and social care services. This role may not be quite as central and influential as originally signalled by the Department of Health.
However Healthwatch Wiltshire does have a voting seat on Wiltshire’s Health and Wellbeing Board which is led by the Council and oversees health and social care services. And it has a non-voting seat on Wiltshire Clinical Commissioning Group’s (CCG) governing body which has taken over from the Primary Care Trust.
Mrs Graves thinks of Healthwatch Wiltshire as the CCG’s ‘critical friend’: “It’s a very fine and challenging line to keep us engaged and to make sure they hear the message even if it’s something they don’t want to hear.”
“I am confident that the CCG and the Council will listen to what Healthwatch Wiltshire has to say. It will all be advice and evidence from the people we’ve listened to. If they don’t listen to us, we have ‘the teeth’ to make people listen.”
Mrs Graves is passionate about getting a real debate going about health. Healthwatch Wiltshire will also be proactive in hearing what people think about the services in their area and what they want.
Some of the feedback to their staff will come from twenty or so partner organisations working across health and social care: “I would just like people to talk either to us or any of the partners we are engaging with – so we can listen.”
“We’ve got to have a conversation about health”. Mrs Graves does not like to use the terms ‘customer’, ‘client’ or even ‘patient’ – she prefers ‘people’ because it’s inclusive.
The way Mrs Graves wants it to work is by creating networks – perhaps, for example, finding one young mother in as many playgroups as possible who, when they’ve all had their say over a coffee about the latest price of clothes or their husbands’ lack of washing up skills, will start a fifteen minute chat about what they’d like the NHS to do and what care they’d like their parents to have when they’re older. And then tell Healthwatch Wiltshire what matters to these mums.
Watch this space for news of Healthwatch Wiltshire’s phone number and website.
| HEALTHWATCH – the background
Organisations giving patients a way to engage with – and complain about – their local health services are not new.
In 1974 Community Health Councils (CHC) were set up. In 2003 they were replaced in England by Patient and Public Involvement Forums (PPIF) which reported directly to the Department of Health. In 2005 these were replaced by Local Involvement Networks (LINks.)
Wiltshire’s version was the Wiltshire Involvement Network or WIN. LINks were very local and had no central or umbrella organisation sitting in Whitehall. They were swept away by the coalition government’s radical NHS reform Bill which became law last year.
The 152 local Healthwatch organisations report their findings and concerns to Healthwatch England. Or if the matter is urgent and vital directly to the CQC or the Department of Health. Unlike LINks, local health watch organisations will cover health and social care provided for children as well as adults.
One rule the government has laid down is that local Healthwatch organisations cannot be political and cannot campaign. So they will not be on the front line demonstrating against a hospital closure. But they will be passing on people’s concerns about the consequences of any closure.