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1Healthwatch Birmingham

Healthwatch Birmingham: Our Legislative Duty – Information for health and social care system organisations


This document overviews and references the legal requirements for Healthwatch Birmingham and sets out what we are doing and how, to discharge these duties.

• TheoverviewoflegalrequirementshasbeentakenfromtheHealthwatchEnglanddocument‘Interpreting the Arrangements to be made by relevant bodies in respect of local Healthwatch Organisations Directions 2013: Information for Local Healthwatch’.

• InformationabouthowHealthwatchBirminghamismeetingtheserequirementshasbeentakenfromtheHealthwatchBirminghamBusinessPlan.

1. What the legislation says Healthwatch Birmingham must do. Legislation sets out particular activities 1 which Healthwatch Birmingham must carry out and which are part of the contractual arrangements Birmingham City Council makes with us.

These duties are:

1.1HealthwatchBirminghamhasaseatonBirmingham’sHealthandWellbeingBoard2andwehaveavotewhendecisionsaremade.

Healthwatch Birmingham uses this seat to:

• Ensurethattheviewsandexperiencesofpatients,carers,thepublicandserviceusersaretakenintoaccountwhenlocalneedsassessmentsandJointStrategicNeedsAssessmentsarecarriedoutandwhentheHealthandWellbeingBoardmakesstrategicdecisions.Wecanrequestevidencetocheckthatthisishappeningandmakingadifference3.ThisensuresthatHealthwatchBirminghamhasaroleinpromotingpublichealth,healthimprovementsandintacklinghealthinequalities.

• GatherinformationthathelpsHealthwatchBirminghamunderstandwhatPatientandPublicParticipationandInvolvementactivityismakingadifferenceandenableustodisseminategoodpractice.

• Ensurethatcommissioning,providingandscrutinyorganisationstacklehealthinequalities.

http://www.healthwatch.co.uk/sites/healthwatch.co.uk/files/20130405_understanding_the_directions_for_relevant_bodies_final_3_0_0.pdf




1.2HealthwatchBirminghammustenablepeopletosharetheirviewsandconcernsabouttheirhealthandsocialcareservicesandmakesuretheyunderstandthattheircontributionwillhelpbuildapictureofwhereservicesaredoingwellandwheretheycanbeimproved.

We do this in several ways:

• OnlinethroughanengagementtoolcalledtheFeedbackCentreontheHealthwatchBirminghamwebsite.Peoplecanpostcommentsabouttheirexperiencesofcare24hoursaday.

• Face-to-facethroughacommunityengagementprogrammewhichensuresserviceuserandcarerexperiencesandviewsarecollatedinall10districtsofBirmingham.

• Face-to-faceatafocusgroup.FocusgroupsarearrangedwhenHealthwatchBirminghamneedsinsightsintoaspecificaspectofhealthandsocialcare.

• Face-to-faceduringanEnterandViewvisit.ThesevisitsenableHealthwatchBirminghamtogathertheexperiencesofusersandcarersatthepointofexperience.

• BytelephoneviatheHealthwatchBirminghamInformationandSignpostingLine.

• Byencouragingpeopletocontributetoconsultationsorganisedbycommissionersorproviders.

• Byadvisingpeopleatpointofcontacthowtheirexperienceswillbeused.IftheywishtheycanjointheHealthwatchBirminghammailinglistandbecomeinvolvedwithourwork.

1.3HealthwatchBirminghammustprovidepeoplewithinformationabouttheirchoicesandwhattodowhenthingsgowrong.Thisincludessignpostingpeopletotherelevantproviderorprovidingsupportourselves(ifcommissionedbythelocalauthority)toindividualswhowanttocomplainaboutNHSservices.

We achieve this by:

• Publishingan‘InformationRoute’onourwebsiteoftheprovidersandchoicesavailabletopeopleinBirminghamregardingtheiroptionswhenthingsgowrong.


• OurInformationandSignpostingLinewhichismannedbyvolunteerswhosignpostpeopletotherelevantproviderandprovidesupporttocommunityengagementworkerstoensureeffectivesignpostingandreferralhappens‘fromthefield’.

• Recordingallcontacts.Thisdata,andthereasonwhypeoplearecomplainingorseekinghelp,canbeusedasanindicatorofapotentiallyavoidablehealthinequitywhichmightpromptaninvestigationorfeedintoanongoinginvestigation.

• Auditingeveryorganisationtowhichwehavemadedirectreferrals.Ourauditprogrammealsoinvolvescontactingpeoplewehavereferredforfeedbackabouttheirexperience.ThisdatamaybeusedtoinformorhelpshapefutureHealthwatchBirminghaminvestigations,reportsandrecommendations.

1.4HealthwatchBirminghammustprovideorsignpostpeopletoinformationaboutlocalhealthandcareservicesandhowtoaccessthem.

How we do this:

• Peoplecontactingusareeitherprovidedwithorsignpostedtotheappropriatesourceofinformation.

1.5HealthwatchBirminghammustprovideauthoritative,evidence-basedfeedbacktoorganisationsresponsibleforcommissioningordeliveringlocalhealthandcareservices.

We do this by:

• Ensuringthefeedbackwegatherabouttheexperiencesandviewsofpeopleisevidencebased,collectedinascientificallyrobustmannerandisgroundedinpoliciesandlegislation(particularlythepoliciesandlegislationwhichrequireustomeetequalitystandardsandinvolvethepublicincommissioning).

• ByscrutinisingtheQualityAccountsofouracutehealthcareprovidersandmonitoringwhetherBirminghamCityCouncilisachievingitsAdultSocialCareOutcomesFrameworkperformancemeasures.

• ByscrutinisingthecontentandprocessofpublicconsultationsandgivingthepublicanopportunitytocontributetoHealthwatchBirmingham’sresponsestothoseconsultations.


• Byanalysingpatientexperiencedatasets.Ifthisdataraisesanyconcernswewilleitherraisetheissuedirectlywithaproviderorlaunchaninvestigationintoaproviderorsystem.WewillalsofeedthisdataintotheinvestigationsofotherorganisationsincludingtheWestMidlandsQualitySurveillanceGroup,ourlocalclinicalcommissioninggroups,theCareQualityCommission,HealthwatchEngland,childrenoradultSafeguardingBoardsorHealthOversightScrutinyCommittees.

• ByauditingthePatientandPublicInvolvement(PPI)arrangementsofourlocalprovidersandcommissioners.

1.6HealthwatchBirminghammusthelpandsupportourthreelocalclinicalcommissioninggroups(CCGs)tomakesurethatservicesreallyaredesignedtomeetcitizens’needs.

We do this by:

• Listeningtopatient,thepublic,serviceuserandcarerexperiencesofusingservices(throughcommunityengagement,ourFeedbackCentreandEnquiryLine)andbringanyevidenceofhealthinequitiestotheattentionofourCCGs.

• Usingthisexperiencedatatohighlightanyhealthinequitiesandensuringactionistakentoredressthem.

• PromotingopportunitiesforpatientandpublicinvolvementintheactivitiesofourCCGs.

• RespondingtoCCGconsultationsandenablingpatients,thepublic,serviceusers,carersandthirdsectororganisationstoinformourresponses.

• MakingouronlinefeedbackWidgetfreelyavailableandencouragingCCGstoadoptit.

• AuditingthePatientandPublicInvolvementactivitiesofourCCGsandreportingormakingrecommendationsonthemwhenappropriate.

• EnsuringCCGsaudittheirPPIqualityandmeettherequiredNHSEnglandstandards.

• AskingCCGPrimaryCareCommissioningBoardschallengingquestionsandseekingassurancethattheyareconductingeffectivePPIactivities.

• CarryingoutspecificPPIworkcommissionedbytheCCG.


1.7HealthwatchBirminghammustbeinclusive,reflectthediversityofthecommunityitservesandmustrepresentlocalpeopleanddifferentusersofservices,includingcarers.

We do this by:

• EnsuringthemakeupofourBoard,volunteerandstaffteamscomplieswithourEqualityandDiversityPolicy.

• Developinganapproachtoourworkwhichensuresthattheneedsofourdiversecommunityareattheheartofeverythingwedo.

• Bringinganyverifiedevidenceofhealthinequitytotheattentionofcommissioners,providersandthewiderhealthandcaresystemandcallingforactiononthoseconcerns.

• Listeningtotheconcernsourpopulationraiseswithus.

• Helpingotherpeopletolistenby:

• Usingaqualitystandardandaudittoolwehavedevelopedwhichhelpscommissionersandproviderstomonitorhowwelltheyarelisteningtotheviewsoftheirpopulations.

• Encouragingcommissioningandprovidingorganisationstoadoptthepartnerversion(FeedbackWidget)ofourFeedbackCentre.

• ScrutinisingpublicconsultationsandtheQualityAccountsofcommissioningandprovidingorganisationstomakesuretheyarelisteningtotheirpopulations.

• Encouragingthepublictobecomeinvolvedinconsultations.

2. Healthwatch Birmingham must produce an annual report which includes details of its activities and expenditure at the end of each financial year 4.

Thereportispublishedonourwebsite,isdisseminatedviasocialmediaandissentto:HealthwatchEngland,BirminghamCityCouncil,NHSEngland,ourthreeCCGs,theCareQualityCommissionandtheOverviewandScrutinyCommitteeofBirminghamCityCouncil.


3. Healthwatch Birmingham must have a procedure for making relevant decisions 5 which includes provision as to who may make such decisions and provision for involving lay persons or volunteers in such decisions.

Relevant decisions include:

• Howtoundertakeouractivities.

•Whichhealthandcareserviceswearelookingatcoveringwithouractivities.

• Theamountswewillspendonouractivities.

•Whethertorequestinformation.

•Whethertomakeareportorarecommendation.

•WhichpremisestoEnterandViewandwhenthosepremisesaretobevisited.

•Whethertoreferamattertooneofouroverviewandscrutinycommittees.

•Whethertoreportamatterconcerningouractivitiestoanotherperson.

• Anydecisionsaboutsubcontracting.

• Thisdocumentispublishedonourwebsiteandformspartofinductionofnewstaff,volunteersandBoardmembers.

4. Healthwatch Birmingham must open its meetings to the public 6.

Ourmeetingsareheldinpublicwithnotification,papersandagendaspublishedonourwebsiteatleastthreedaysinadvance.Resolutionsaretakentoexcludethepublicornewsagenciesfromameeting,orpartofameeting,wherepublicitywouldbeprejudicial.

5. Healthwatch Birmingham can subcontract the delivery of particular activities 7.

Wedonotcurrentlysubcontractanyofouractivities.


6. Healthwatch Birmingham can ask providers for information which they must make available 3.

HealthwatchBirminghamasksprovidersforinformationforitsthreeworkareas:investigationsintopotentialhealthinequity,auditandscrutiny.

We do this:

• Usuallythroughexistingorreferredrelationshipsorbyjustasking.

• ThroughtheFreedomofInformationActwheninformationisrequiredforinvestigativework.

ThereisaseparaterequirementonNHSBodiesandLocalAuthoritiestoimplementthenecessaryarrangementstoensurethatindependentprovidersrespondtoHealthwatchBirminghamrequestforinformation8.

7. Healthwatch Birmingham can escalate matters relating to social care services to its two Health Oversight and Scrutiny Committees (HOSC) (Sandwell and West Birmingham HOSC and Birmingham HOSC).

TheHOSCmustacknowledgereceiptandkeepusinformedofanyactiontheytake9.

8. Healthwatch Birmingham has the power to ‘Enter and View’ providers 10, 11 so that we can observe matters relating to health and social care services.

Weusethispowertomakeannouncedorunannouncedvisitstohealthorsocialcareproviderswhenwehaveareasonablebeliefthatthisisthemostappropriatewaytocollectinformationandpeople’sexperiencesaboutapotentialhealthinequity.Volunteersarespeciallytrainedforthisprocedureandalistofourauthorisedrepresentativesispublishedonourwebsite.


9. Healthwatch Birmingham covers health and care services.

Becauseourinvestigativeworkispromptedbyuserorcarerexperienceweproactivelyseekandcollectexperiencesfromallpartsofthehealthandcaresystemthroughcommunityengagement,marketingandcommunication,includingsocialmedia.

10. Healthwatch Birmingham cannot Enter and View premises where Birmingham City Council social services are provided for people under the age of 18.

HoweverifwehaveareasonablebeliefthatweneedtoEnterandViewsuchaserviceinordertocollectexperiencedatathisconcernisreferredtoHealthwatchEngland,theCareQualityCommissionoroneofourHealthandOversightScrutinyCommittees.

11. Reports and Recommendations.

Tohelpmaketheviewsofpeopleknowntothepeoplethatareresponsibleforthecommissioning,providing,managingorscrutinisingoflocalcareservices,HealthwatchBirminghamisrequiredtomakereportsandrecommendations.Thesecancoverhowlocalcareservicescouldoroughttobeimproved.Whenproducingareportwethinkhardaboutwhotheaudienceswillbesomostofthetimespecificpeoplefromcommissioners,providersorscrutinyknowwhatwearedoing.WemaintainactivemembershipofanumberofBoardsandCommitteeswithinourhealthandsocialcaresystemtoestablishandmaintaingoodrelationshipsand‘criticalfriendships’whichhelpusmakedecisionswhendevelopingrecommendationsandpublishingreports.Serviceprovidersmusthaveregardtoourviews,reportsandrecommendationsandrespondtoexplainwhatactiontheywilltake,orwhytheyarenottakingaction12.Wetakenoteoftheirresponsesandtrackprogress.ReportsandrecommendationsaresharedwithHealthwatchEnglandandsomearepublishedontheHealthwatchEnglandwebsite.


12. Campaigning.

Regulations13allowustospeakoutandtocampaign(includingforpolicyorlegislativechange)asaconsumerchampion.Campaignsaremostlikelytoberelatedtothecontentorapplicationofanationalorlocalpolicyrelatingtoreducinghealthinequity,publicinvolvementoraccesstoservices.Wewillfirstseektoworkwithorreferthemattertooneormorethirdsectororotheragenciesifwethinktheyarebetterpositionedtoinfluencetherequiredchange.

13. Working with Healthwatch England.

HealthwatchBirminghammustshareitsviews,reportsorrecommendationswithHealthwatchEngland.HealthwatchEnglandareapartneroftheCareQualityCommission(CQC).Whenasked,wewillgetinvolvedintheworkofHealthwatchEnglandandshareourdataandviewswiththem.WearealsoabletoescalateissuesweareconcernedabouttoHealthwatchEnglandandsometimesweaskthemtopublishtheirownreportortoadvisetheCareQualityCommission(CQC)onaparticularcourseofaction14.

14. Lay people and volunteers.

HealthwatchBirminghamhasarrangementsinplacetoensurethatlaypeopleandvolunteersareproperlyinvolvedinourgovernanceandactivitiesasrequiredbytheregulations15.OurChairandBoardmembersarelaypeople.VolunteersareabletoinfluencetheBoardagendadirectlythroughtheChairorthroughvolunteermanagers.DirectorsandvolunteersmeetinformallyonaquarterlybasisandvolunteersareencouragedtoattendpublicBoardmeetings.VolunteersareintegraltorunningallouractivitiesincludingtheEnquiryLine,CommunityEngagement,AuditandScrutiny,EnterandViewandothermeansofcollectingpeople’sexperienceofusinghealthandcareservices.Theyinformourpolicyresponsesandhelptoshapeourinvestigations,theanalysisofdataanddevelopmentofrecommendationsandconclusions.


15. Private sector services.

HealthwatchBirmingham’sactivitiescoverprivateandindependentproviderswhoareinreceiptofpublicfunding.Thismeansserviceswhichpeoplepayforprivately,forexampleanon-NHSdentist,orprivatehospitalwherethisispaidforbyamemberofthepublicortheirinsuranceprovider,arenotwithinthescopeofouractivities.WesignpostpeoplewhowantinformationaboutmakingacomplaintabouttheseservicesdirectlytotheOmbudsmanandtotheCQC.WedonottakeanyactionasalocalHealthwatch.

16. The role of Healthwatch Birmingham in relation to the CQC.

IfwebelievewehaveidentifiedaqualityorsafetyissuewithaservicethatneedsinvestigatingwemayaskHealthwatchEnglandtoadvisetheCQCaboutanyspecialreviewsorinvestigationsthatmayberequired.Howeverbeforewestartaninvestigationlikethiswewouldtakecaretoensurethatnootherorganisationisalreadyundertakinginvestigativeworkinthatareatoavoidduplication.Ifwebelievethatthereisaconcerne.g.wherethereisanimmediaterisktoanindividual(butitisnotasafeguardingissue)wewillescalatethemattertotheCQCandcopytheescalationtoHealthwatchEngland.

17. The role of Healthwatch Birmingham in relation to Monitor and Trust Special Administrators.

MonitorandtheNHSTrustDevelopmentAuthority(NHSTDA)arenowpartofNHSImprovement(from1stApril2016).TrustSpecialAdministratorscanbeappointedbyMonitorwhenaTrustisfoundtobefinanciallyunsustainable.OnceappointedtheTrustSpecialAdministratormustoffertomeetwithHealthwatchBirminghamandaskforawrittenresponsetoitsviews16.IfinvitedtomeetwithorprovideawrittenresponsetoMonitororTrustSpecialAdministratorswedoso,howeverwealsohaveinformationsharingproceduresinplaceaspartofourmembershipoftheWestMidlandsQualitySurveillanceGroup.


18. The role of Healthwatch Birmingham in relation to Quality Accounts.

ThenineNHSFoundationTrustsinBirminghamarerequiredtosendusareportonthequalityofcaretheyprovide(the‘QualityAccount’)withintheiroverallannualreportandmaketheseavailabletothepublicbyApril3017,18.WeaimtoprovideanevidencebasedchallengetothecontentofallTrustQualityAccountsbyanalysingthefeedbackwehavereceivedfrompeopleusingthoseservices.ThisstatementmuststatewhetherornotwethinkthereportisafairreflectionofthefullrangeofservicesprovidedandthenhastobeincludedintheAppendixoftheQualityAccount.

19. Requirements relating to the Public Sector Equality Duty.

HealthwatchBirminghamissubjecttoageneralequalitydutywhichrequiresushave‘dueregard’totherelevantstatutoryneeds19ofourwork.BirminghamisoneofthemostdiversecitiesinEuropeandHealthwatchBirminghamtakesitsgeneralequalitydutyveryseriously.OurEqualityandDiversityPolicyoutlineshowthesedutiesaremet.

20. Requirements of Healthwatch Birmingham relating to Freedom of Information 20.

WehaveagreedFreedomofInformationArrangementswithBirminghamCityCouncil.

This means that

• FreedomofInformationrequestsabouttheactivities,strategyorgovernanceofHealthwatchBirminghamcometousandwenotifytheCouncil.

• FreedomofinformationrequestsaboutthecommissioningorperformanceofHealthwatchBirminghamgototheCouncilwhonotifyourChair.


References:1. Section221(2)ofTheLocalGovernmentandPublicInvolvementin

HealthAct(2007

2. Section194oftheHealthandSocialCareAct2012

3. Section224oftheLocalGovernmentandPublicInvolvementinHealthAct2007

4. Section227ofTheLocalGovernmentandPublicInvolvementinHealthAct(2007)

5. Regulation40,TheNHSBodiesandLocalAuthorities(PartnershipArrangements,CareTrusts,PublichealthandLocalHealthwatch)Regulations2012

6. ThePublicBodies(AdmissionstoMeetings)Act1960,asamendedbySection189oftheHealthandSocialCareAct2012.


8. ThearrangementstobemadebyRelevantBodiesinRespectofLocalHealthwatchRegulations2013

9. TheLocalAuthority(PublicHealth,HealthandWellbeingBoardandHealthScrutiny)Regulations2013


11. TheLocalAuthorities(PublicHealthFunctionsandentrytoPremisesbyLocalHealthwatchRepresentatives)Regulations2013

12. Section221[3a]andSection224oftheLocalGovernmentandPublicInvolvementinHealthAct2007andimplementedby“ThearrangementstobemadebyRelevantBodiesinRespectofLocalHealthwatchRegulations2013”

13. Regulation36,TheNHSBodiesandLocalAuthorities(PartnershipArrangements,careTrusts,PublichealthandLocalHealthwatch)Regulations2012

14. Section221(2)andSection227(4)ofTheLocalGovernmentandPublicInvolvementinHealthAct2007

15. Regulation38andRegulation40(g),theNHSBodiesandLocalAuthorities(PartnershipArrangements,careTrusts,PublichealthandLocalHealthwatch)Regulations2012

16. Section65H(e)(8)and(9)oftheNationalHealthServiceAct2006

17. TheNationalHealthService(QualityAccounts)Regulations2010

18. TheNationalhealthService(QualityAccounts)AmendmentRegulations2010

19. Section149oftheEqualityAct2010

20. Part2ofSchedule1oftheFreedomofInformationAct2000

Healthwatch Birmingham CobaltSquare,83HagleyRoad,Birmingham,B168QG

www.healthwatchbirmingham.co.ukIinfo@healthwatchbirmingham.co.ukI01216360990Companyregistrationnumber:08440757

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