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A linchpin for local scrutiny of the NHS

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Described by the government as “the new consumer champion” for health and social care, local Healthwatch finally became a reality in April, replacing local involvement networks (LINks).

For councils a key priority will be to get the measure of how local Healthwatch bodies and Healthwatch England will engage with communities and authorities and what sort of potential they offer for change.

With this in mind, LGC invited a group of key players to take part in a webinar on how to sustain an effective local Healthwatch organisation.

The event was facilitated by advisers Capsticks and brought together Katherine Rake, chief executive of Healthwatch England, Andrew Larter, deputy director for people, communities and local government policy at the Department of Health, Paul Rideout, senior adviser on Healthwatch at the LGA (on secondment from East Sussex CC) and Chris Brophy, a partner at Capsticks.

Webinar chair and acting editor of LGC Nick Golding introduced the debate by making the observation that, with the Mid Staffordshire NHS Foundation Trust scandal still reverberating around the health service, local Healthwatch has the potential to be “the linchpin for local public scrutiny of the NHS”.

The purpose of the network, agreed Mr Larter, would be, very simply, “to create an audible, credible, challenging and influential national consumer voice for people, patients and groups in the community who use health and social care services”.

The devolution of health to a local level and the creation of health and wellbeing boards is already changing the healthcare and public health environment significantly, agreed Ms Rake. Local Healthwatch is about giving the public - the consumer - a seat at the table as well as, through Healthwatch England, providing leadership and creating an evidence base on consumers’ experience of health and social care.

All of which, of course, almost inexorably brings us back to the heavy cloud of Mid Staffordshire and the Francis report. In the wake of Mid Staffordshire there is now a real determination to get things right, “a real willingness to recognise the centrality of patients’ experience in the delivery of health and social care”, Ms Rake said.

“In order to do that we need to ensure people’s concerns are heard at an early stage and, in fact, put right at an early stage, before they even escalate into complaints,” she added.

How the NHS engages with, and perceives, local Healthwatch and Healthwatch England will therefore be critical, with Mr Larter, arguing the interaction would need to be on multiple levels.

“One of the critical bits to build on is that many clinical commissioning groups will have really robust patient groups. Many foundation trusts have already got really broad membership organisations that help them do their business. They will vary in not just how they interact with a new organisation such as local Healthwatch, they will have pre-existing views about how good LINks and mechanisms were in their area before them,” he said.

“So I hope they will start by being open-minded and seeing the value in the discussion and I hope they will see the benefit in not just talking, having a binary relationship, but looking right across the piece, not just the NHS but all the other organisations that provide services,” he added.

How local Healthwatch reaches out to individuals will also be vital, agreed Mr Brophy, as will the links and encouragement it offers to children, people with dementia (or their carers) and adult and children safeguarding boards.

“You can’t have every member of the public or patient as a member of your local Healthwatch, so you are going to have to think about how you are going to link in the representatives of the different communities and groups,” he said.

Inevitably there will be tensions between local Healthwatch bodies and councils, Mr Rideout predicted, not least in terms of discussions around allocation of resources.

“But with Healthwatch England and the LGA giving really good leadership as to what ‘good’ looks like for local Healthwatch we’ve got a much better way of dealing with those situations where there is conflict or where communities aren’t being served well,” he said.


  • Katherine Rake, chief executive, Healthwatch England
  • Andrew Larter, deputy director for people, communities and local government policy, Department of Health
  • Paul Rideout, senior adviser on Healthwatch, LGA
  • Chris Brophy, partner, Capsticks
  • Nick Golding, acting editor, LGC (chair)

To see the webinar visit

How to Sustain an Effective Local Healthwatch Organisation - LGC exclusive webinar in association with Capsticks. For more on social enterprises go to the dedicated channel at:

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