Healthwatch is the consumer champion for health and social care.  There is a local Healthwatch in each county or single tier local authority area.  They promote and support the involvement of local people in the commissioning, provision and scrutiny of health and social care services.

They do this by obtaining the views and experiences of patients, social care users and the wider public, and using them to influence local authority and health commissioners, doctors, hospitals, councils and other providers.  Local Healthwatch also provide advice and information about access to local health and social care services.

Healthwatch is for people who use health and social care services now, but also anyone who might need them in the future – which is in effect everyone.

They follow on from, and take over the functions of Local Involvement Networks (LINks), which themselves took over from Patient and Public Involvement Forums and before that Community Health Councils (which were established in 1974).

There is also a national body, Healthwatch England and which came into operation in October 2012 (see more below).

Healthwatch was set up by the Health and Social Care Act 2012.

In essence, the role of local Healthwatch organisations is:

• to influence the development of health services and adult social care and the promotion of health
• to inform people about health and social care and choices available, and
• to act as a watchdog, pursuing people’s interests with local service providers

In slightly more detail, the functions of local Healthwatch are summarised by the Department of Health as:

• “provide information and advice to the public about accessing health and social care services and choice in relation to aspects of those services;
• make the views and experiences of people known to Healthwatch England helping it to carry out its role as national champion;
• make recommendations to Healthwatch England to advise the Care Quality Commission to carry out special reviews or investigations into areas of concern (or, if the circumstances justify it, go direct to the CQC with their recommendations, for example if urgent action were required by the CQC);
• promote and support the involvement of people in the monitoring, commissioning and provision of local care services;
• obtain the views of people about their needs for and experience of local care services and make those views known to those involved in the commissioning, provision and scrutiny of care services; and
• make reports and make recommendations about how those services could or should be improved.”
• (Source: Local Healthwatch: A strong voice for people – the policy explained, Department of Health, London, 2012 March, p.14)

In addition:

• Local Healthwatch has a seat on the local authority statutory Health and Wellbeing Board.
• Local Healthwatch has a statutory right to be involved in the preparation of the JSNA (Joint Strategic Needs Assessment) and the Joint Health and Wellbeing Strategy (JHWS)

Further:

• To enable it to undertake these functions, Healthwatch has powers (which the LINks also had) to ‘enter and view’ premises of health and social care providers.

• Additionally, local authorities took on responsibility for commissioning NHS complaints advocacy from April 2013. The intention is that local Healthwatch will either provide the service or be able to signpost people to the provider of the service.

Local Healthwatch organisations are commissioned by the local authority (County or unitary).  According to the Department of Health, they can do this through a tender process or grant-in-aid funding (1).  LHWs have to be ‘social enterprises’ (essentially, corporate, non-profit making bodies, able to employ staff).

Part of the role of Healthwatch is to hold the local authority to account (in relation to social care).  However the local authority commissions Healthwatch and determines its funding (the authority has an allocation of funding for the purpose from central government, but it is not ringfenced, so they can decide the level of funding).

Healthwatch England is a statutory committee of the Care Quality Commission (CQC).  Its role is to provide leadership and support to local Healthwatch organisations, and to enable the collective views and experiences of people who use services to influence national policy, advice and guidance.

Healthwatch does not have a unique role in engaging with patients, carers and the public.   In addition to the existing statutory requirements for public involvement on councils and health bodies, the Health and Social Care Act 2012 puts new duties to involve patients and the public onto Clinical Commissioning Groups (CCGs), Health and Wellbeing Boards (HWBs), Healthwatch and NHS England.  If these bodies try to fulfil their duties separately, there is a risk of duplication, waste of resources, repeatedly burdening the same groups with consultation and an ineffective role for the community voice.  There is a good case, therefore, for co-ordination and collaboration between those bodies.

In addition to the engagement activities of public bodies (such as surveys, public meetings and patient feedback), some of the other ways in which the public can be involved include:

• PALs (Patients Advice and Liaison) service (which continue to be provided by a number of different sorts of bodies)
• NHS Complaints Advocacy for people wanting to complain about NHS services, commissioned by local authorities since April 2013.
• Patient reference groups, which provide feedback to GP surgeries
• NHS Choices website
• through groups such as those supporting or representing those with particular conditions, such as diabetes or neurological conditions
• Independent channels such as Patient Opinion

Footnotes:

(1) Letter from David Behan, to Chief Executives and others, 2^nd March 2012, http://healthandcare.dh.gov.uk/files/2012/03/behan-letter.pdf
A late amendment to the Health and Social Care Bill changed LHWs from being ‘statutory corporate bodies’ to ‘non-statutory corporate bodies’, the difference being that “that the former is directly incorporated (so having its own legal personality) by an Act of Parliament and the latter is incorporated by registration under an Act of Parliament.”  What that means in practice is that the local authority can tender for the provision of the service.

See also: Healthwatch resources (relevant documents and websites)