Councils are now thinking about how they fulfil their responsibility to commission an independent local Healthwatch service from April next year, and for many there is a growing realisation that this is not as straightforward as it might first have seemed.
There is a lot of local discretion and opportunity to think innovatively about this important new service. However, this also puts a huge amount of pressure on councils, many of whom may have preferred a bit more top down direction from the Department of Health.
The localism agenda is designed to support communities to decide which services are right for them. By investing wisely in the commissioning of a local Healthwatch, councils can put in place processes that embed real engagement with users of services. The evidence and intelligence that this activity generates can then inform the public, service commissioners and providers.
Councils need to think about ensuring that the independent corporate body that delivers the service is sustainable. For many who are already exploring this path, this is proving a real challenge. This is due to the diversity of services that are covered by a local Healthwatch, including information provision, community outreach and NHS complaints advocacy (if councils decide to include this in the contract.)
The legislation states that a local Healthwatch needs to be delivered by an independent corporate body operating as a social enterprise but, in our experience, there are few organisations who, acting independently, could deliver the full range of services. This provides a dilemma.
One option is to simply go to the market in the traditional way through open tender and hope a provider or consortium emerges to bid for the service. Depending on the maturity of the local community sector, this could work but it could also be a very high risk strategy. Another option is to take a more proactive “market-making” approach and engage with local organisations to bring potential providers together.
Communities feel strongly that any new local Healthwatch organisation shouldn’t try to recreate existing capacity but rather should tap into existing expertise, especially in the areas of community engagement and information provision.
Most areas have a wide range of local organisations with specialisms and networks that if brought together could deliver a comprehensive and powerful service. It is also true that, by and large, these organisations would rather come together in collaboration rather than be forced into winner-takes-all competition with each other.
How could this be achieved? Some councils are encouraging the development of a new independent corporate body that can act as a co-ordinating hub for local organisations to channel their services through.
This can be achieved in a number of ways. The council can take the lead in developing the new organisations, as Staffordshire CC is doing through the establishment of the new Engaging Communities Staffordshire Community Interest Company. Or it can support local organisations to come together to develop the new organisation themselves, as Kent CC is doing.
With the increasing interest in shaping services around local needs with local populations, this single co-ordinating organisation avoids the problem of ‘too many players on the field’ which can be confusing for people faced with a multitude of ways to engage.
Andrew Laird is director of Mutual Ventures, a social enterprise consultancy. Jessie Cunnett is director of the consultancy firm Patient Public Involvement Solutions.