Healthwatch Kent is involved in the Sustainability and Transformation Plan (STP) work in several ways, which all need balancing and managing effectively. This means we need to be completely transparent about how we work.
If you want to know more about what the Sustainability & Transformation Plan (or Partnership as it is now becoming known), you can read about it and sign up to receive the newsletter via the website: www.kentandmedway.nhs.uk
Read the latest update and give your views: http://kentandmedway.nhs.uk/summerupdate/
Healthwatch Kent is involved in the STP in three different ways:
Healthwatch Kent always works in partnership with health and social care organisations as this is the most effective way of ensuring we get patient feedback to the right people in those organisations. We wanted to dedicate time to ensuring there was a clear process for patients and public to be involved in the STP at the highest level. A key part of this was the development of the Kent & Medway Patient & Public Advisory Group (PPAG) which I have mentioned before in this blog and built on the excellent work of the East Kent Engagement Group that had already existed for almost a year.
Healthwatch Kent is run by a community enterprise company called Engaging Kent CIC, a social enterprise that must reinvest any money it makes into its key objective, which is ensuring that Kent residents are fully engaged and consulted by public services.
Engaging Kent CIC entered into the contract to deliver Healthwatch Kent in 2013, long before the STP was even thought of. With the STP came a whole new lot of activity around engaging and involving people in those plans, and the time we needed to dedicate to ensuring that involvement happened was beyond the scope of the original core contract.
We agreed to have a small amount of funding from the STP Programme so that I, as Chief Executive, could support the development and continuation of the PPAG. This included managing the recruitment and support of members of the public, acting as interim chair at the monthly PPAG meetings and picking up many of the actions from those meetings. We also pay the out of pocket expenses for the members of the public and I represent the PPAG at the Kent & Medway STP Programme Board which also meets monthly. I also attend other STP meetings as required.
What is part of Healthwatch Kent’s core contract is scrutinising how well the STP Programme is involving patients and public by acting as critical friend on how it is doing.
As I am already involved in supporting the STP and this makes it harder for me to be objective, this is undertaken by our Steering Group, which is made up of volunteers who have had training on best practice from the Consultation Institute and follow our best practice guide on consultations: http://www.healthwatchkent.co.uk/sites/default/files/healthwatch_kent_best_practise_guide_to_consultation_final.pdf
They review the evidence and provide a critical friend report on the positives and areas for improvement from the point of view of informed lay people. You can see an example of a critical friend report here.
This ensures Healthwatch Kent can remain independent in our scrutiny role. The Steering Group have already met with the lead for engagement and senior project managers in the STP to be completely transparent about how they go about this scrutiny.
As we have highlighted areas for improvement with various organisations in the last few years, those organisations have sometimes offered to resource us to help them, and pay us to do engagement on their behalf.
We have thought long and hard about how agreeing to do this impacts on our independence and ability to scrutinise that organisation objectively. However we also know what is best practice as we developed a guide on it and know we can do it to a high quality. In fact, we will not accept a commission unless we feel we can do it without compromising those best practice guidelines.
To ensure a separation between work that is part of our core contract and needs to be independent, and what is commissioned, Engaging Kent CIC created a ‘trading arm’ project called Engage, which has its own staff and resources, so public money for core work is not used in commissioned work, and Healthwatch Kent can still scrutinise the consultation as a whole, including the engagement work done by Engage.
Engage has already done some bits of commissioned work, for example they worked with East Kent Hospitals in 2015 organising focus groups before the STP came into being, and recently with West Kent Clinical Commissioning Group.
Profits made by Engage go to Engaging Kent CIC, which is then required to reinvest that money into its core objectives. For example, Engaging Kent invested funds into the Rural Coffee Caravan Project, which provides information and reduces social isolation in rural communities. Also, as the funding for Healthwatch Kent has been cut by over 25% in the last two years, it can provide funding for additional engagement carried out by Healthwatch over and above the core contract.
We have found in health and social care there is often potential for conflicts of interest, some of these are unavoidable, but need to be managed effectively. Many Local Healthwatch across the country take on commissioned work and not all of them separate that work as completely as Kent does, but still manage to maintain their independence.
It’s a delicate balance to ensure we manage any potential conflicts of interest effectively. We believe we have given this thorough consideration with the support of our volunteers and advice from our commissioners, stakeholders and our umbrella body, Healthwatch England. We believe we have created a transparent structure that manages our, and your, concerns.
Our aim is always to maintain our independence whilst working in partnership to ensure the voices of patients and public are heard and acted upon.
We are constantly learning, and we welcome any feedback if you are concerned that we are not carrying out our role effectively. You can contact me at firstname.lastname@example.org