PPGs and Local Healthwatch
PPGs and Local Healthwatch
Healthwatch was created by Part 5 of the Health and Social Care Act 2012 (the Act) which paved the way for a national body, Healthwatch England (HWE), and a local organisation for each local council in England with social care responsibilities, local Healthwatch (LHW).
Healthwatch is a governmental statutory mechanism intended to strengthen the collective voice of users of health and social care services and members of the public, both nationally and locally. Locally, it has additional powers to those held by Local Involvement Networks (LINks) which it replaces. The Act established LHW from April 2013.
What is local Healthwatch?
There is one LHW for each local authority area with social services responsibilities (152 in all in England). Each LHW is a ‘body corporate’ (ie a legal entity) which is a social enterprise. The aim of LHW is to give
citizens and communities a stronger voice to influence and challenge how health and social care services are provided within their locality.
LHW also provide or signpost people to information to help them make choices about health and care services. A LHW is an independent organisation, able to employ its own staff and involve volunteers, so that it can become an influential and effective voice of the public in relation to health and social care. Each LHW has to keep accounts and make its annual reports available to the public.
Powers and duties of local Healthwatch
Distinct roles and purpose of PPGs and Local Healthwatch:
The essential differences and distinctions between PPG’s and LHW are:
PPGs are ‘grass roots’ groups which develop organically in communities from volunteer patients wishing to take a more active role in working with their GP practice. PPGs work in a partnership based on mutual trust and respect with their GPs and practice teams to ensure that services provided by their practice are responsive to patients needs and the quality ogf care continuously improves.
Local Healthwatch is established under statute from the government. Local Authorities have a statutory duty to make contractual arrangements for a LHW organisation to exist in their area for the involvement of local people in the commissioning, provision and scrutiny of health and social services. The main role of LHW is to monitor health and social care services across the whole Local Authority area.
Target group and scale:
PPG’s have a micro focus on individual patients and GP Practices working from within the Practice whereas LHW has a much wider macro focus on outreach and engagement with the whole geographic community within a local authority area and often across L.A. boundaries.
Focus of patient feedback:
PPG’s have direct access to and gather feedback from individual patients specifically about GPs, primary care services and the Practice whereas LHW gathers feedback and looks for trends on health care overall and social care services.
PPG’s focus specifically on improving the quality of general practice and primary care localised to their practice. Changes and improvements to services are directed towards and often implemented collaboratively between individual PPGs, GPs and practice teams.
In contrast, LHW’s work on issues identified from broad trends in the feedback received from a community-wide range of groups and individuals and make recommendations for change to the full range of health and care stakeholders in their area.
PPGs develop a unique relationship with individual GPs and practice teams based on mutual trust and respect as partners in driving up quality. PPGs undertake practical activities on behalf of the practice such as conducting surveys, assisting with flu campaigns, running practice health awareness events etc. LHW operate and interact on a more arms length basis with the whole health and care system due to the scale of their geographic and statutory remit.
Reaching an understanding: PPGs and Local Healthwatch
Given that PPGs and LHW’s exist alongside one another and operate in the same localities but for different purposes, it may be helpful for PPGs and LHWs to consider how they might clarify and reach a common understanding of their respective roles and purpose so that it is understood by all stakeholders including patients.
The extent to which relationships may need to be formalised and/or articulated will vary depending on local circumstances. As a minimum it will be useful for PPGs and LHW to have a clear understanding of their respective roles and the distinction between them.
In some cases it may be appropriate for PPGs and LHW to formalise their relationship through the development of a written memorandum of understanding (MoU) or a partnership agreement or protocol. As Local Healthwatch is now formally established it may be pertinent to start a conversation about these issues as soon as possible.
Engagement with the locality CCG and local commissioning decisions are likely to be the main arena when clarity and possibly a working protocol are most appropriate. In this scenario it may be that a protocol is most usefully developed between a PPG locality network, if one exists, and the relevant LHW that, as a minimum, clarifies and describes:
If required a more detailed statement of principles and protocols might clarify and identify the following:
It will be particularly important for PPGs to understand how they can feed the concerns of the patient population into their relevant LHW to inform ongoing monitoring of services on a wider scale including secondary and social care provision. This should include feedback for example on quality reviews, proposed substantial variations in services, to Health and Wellbeing Boards and to local authority health scrutiny committees and for Joint Strategic Needs Assessments etc
A potential important role for LHW could be to systematically bring together findings and good practice examples from PPGs to inform the work of CCGs, Health and Wellbeing Boards and local authority health scrutiny committees.
National Department of Health guidance emphasises to LHW the importance of being ‘networked in to PPGs’ to ensure that it is picking up on existing engagement mechanisms to help inform its work and successfully represent the views of patients, service users and the public.