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

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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.

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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.

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• 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.

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• 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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

7. Section222oftheLocalGovernmentandPublicInvolvementinHealthAct2007

8. ThearrangementstobemadebyRelevantBodiesinRespectofLocalHealthwatchRegulations2013

9. TheLocalAuthority(PublicHealth,HealthandWellbeingBoardandHealthScrutiny)Regulations2013

10. Section226oftheLocalGovernmentandPublicInvolvementinHealthAct2007

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