Board Meeting5:00 – 7:00 Tuesday 4 October 2016Room 1 Beaumont HouseMile End Hospital, Bancroft Road, E1 4DG (see map page 2)

Agenda Time Lead

1 Welcome and introduction to Healthwatch Tower Hamlets

5:00-5:15 David

2 Getting to know you – a chance for everyone to give some quick background on who they are, why they got involved in Healthwatch and any specific areas of interest.

5:15-5:45 All

Business Items

3Minutes of the meeting of 3 August – there were no formal minutes to the meeting as it was a general discussion on the approach and structure of the Healthwatch tender response. The response is attached for discussion on page 3.

5:45-6:00 Di

4Representation, roles and responsibilities – a quick outline of the structure of Healthwatch and opportunities to get involved.

6:00-6:15 David/Di

5 Your Voice Counts Event and impact – draft report attached for discussion on recommendations 6:15-6:30 Di

6 AGM and any actions 6:30-6:46 Di

7 Agree date for induction and regular meeting dates 6:40-6:50 Di

8 AOB 6:50-7:00 David

Included for information

9 HWTH Access to health and social care report to Health Scrutiny Panel

10 NEL Sustainability and Transformation Plan

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Schedule 10: Quality Statement Response Sheet

Contract: LPG5029

Name of organisation:

Healthwatch Tower Hamlets

Please respond to the Quality Statement questions for contract Healthwatch Tower Hamlets, using the response fields in this document.

If you have additional attachments or documents with your response please state this as part of your response.

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Question A1Criterion: Governance and financial management

Weighting 3%

As the current provider has indicated that TUPE applies, please explain your plans for the staffing of Healthwatch Tower Hamlets, including managing any transfer of existing staff.Word Count: 300 words

Response

As Healthwatch Tower Hamlets is the current provider transfer of staff is not necessary. However in response to the LBTH Healthwatch review the Board undertook to a review of our current staff and organisational structure and has now developed the following:

This structure now places greater emphasis on recruiting, training, and supporting local citizens to manage promote and deliver the outcomes and impacts of Healthwatch Tower Hamlets.

To enable our local citizens(people who live and work in Tower Hamlets) to draw on expertise from data analyses and qualitative and quantitative research reports we will work in closer collaboration with our neighbouring Healthwatch across the Barts and the North Central London Sustainability and Transformation Plan footprint.

Should our tender be successful one member of staff may potentially face redundancy. Two existing part time staff members are on temporary contracts and would need to apply through an open recruitment process for the Community Engagement and Citizen Support roles should they wish.

We would wish to continue the opportunity for positions to be filled on a job share basis as we feel that this provides greater opportunities to local residents with family commitments or health needs and provides wider representation from across the local community.

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Question A2Criterion: Governance and financial management

Weighting 2%

Please set out your proposed structure for Healthwatch Tower Hamlets, including the Board, members, and volunteers you would recruit to successfully deliver its functions.Word Count: 300 words

Response

Our proposed structure is set out below:

Board members are responsible for the business management and performance of the charitable company and for representing the voice of local residents on the Health and Wellbeing Board and the Health Scrutiny Committee. Board positions are publicly advertised and appointments made by Healthwatch members at their AGM following Strategic Advisory Group input.

The Advisory Group has responsibility for developing our strategic direction and priorities and for representing the voice of local residents within commissioning and quality performance processes. The Advisory Group will be self-nominated and include representation from across localities. A regular invite list of 40 people will ensure regular turnout of 14-18 people at meetings.

Our Task Groups lead on the co-production of services with our strategic partners and in developing community led actions.

The Tower Hamlets Together Stakeholder and User Group will incorporate the work of the Strategic Advisory Group and will help us identify priority areas and work alongside us to ensure we deliver and measure outcomes and impacts.

Our experience has shown engagement works better the more local it is and our structure is based on a locality model enabling us to collaborating with our SAG partners to focus on a specific locality each quarter.

Our structure is based on HWTH being run BY rather than for or with local citizens. It depends on attracting, training and retaining a large number of local citizens as volunteers who have diverse skills and backgrounds and who are focused on having an impact on commissioning, delivery and community wellbeing.

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Question A3Criterion: Governance and financial management

Weighting 3%

The service specification sets out the required legal form for Healthwatch Tower Hamlets, and options for achieving this. Please outline the options you would select in setting up Healthwatch Tower Hamlets, and why you believe these would be the most appropriate.Word Count: 300 words

Response

HWTHs is a company limited by guarantee and is registered as a charity in England and Wales. We employ our own staff and manage our own budget and finances. Our model insures that local citizens are genuinely involved in the management and decision making of HWTHs and are accountable to are members (over 1,000) and the local community.

We are managed by a Board of 14 local citizens, half local people, ¼ representing user groups and ¼ representing voluntary organisations. We continue to have two members of the Health and Wellbeing Forum on our board. The Council contract manager is a non-voting member. We would welcome representation from the Health and Wellbeing Board. The SAG has the opportunity to review and comment on applications prior to appointment.

We have recently run a successful recruitment process to appoint new members to the Board which was promoted widely through the Healthwatch membership, the third sector, our strategic partners and governance support organisations. Our Board have a diverse range of skills covering the key areas of

Finance Governance Business Development Market Research and/or social marketing Communications, PR and media Citizen Engagement Public health and primary care management

As far as possible, the Board and Advisory Group aim to fairly reflect the demographic make of the local community and equalities groups. We identified a gap in representation from young people and as a result established a separate Healthwatch Young People’s Panel that reports regularly into the main Board.

The Finance, Personnel & Review Committee provides scrutiny and monitoring of HWTH governance and performance including priority setting, outcome and impact performance and oversight of the enter and view (E&V) programme. They review new projects before presentation to the Board and monitor their performance. They agree budgets, spend and authorise payments.

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Question A4Criterion: Governance and financial management

Weighting 5%

Please set out how you will demonstrate value for money to the council and local residents, and how you would meet any efficiency savings which might be required, with reference to the information you have provided in the Cost Schedule.Word Count: 500 words

Response

We will provide value for money by:

Engaging local citizens to manage and deliver HWTH so the citizen voice can be heard and actioned across wider parts of the system. Staff will focus on supporting citizens to represent and act, rather than acting on their behalf with each member responsible for between 20-40 volunteers. A cascade effect means it is likely that those 20-40 volunteers will reach a minimum of a further 20-40 people.

The benefits of this approach is that local people: take on key representation, enter and view, signposting and awareness raising roles allowing

us to achieve greater outcomes and impacts; identify the health and wellbeing issues that matter to them and work with the insight, energy

and assets of the community to shape actions and activities in response; understand the community and isolated communities better and network across family,

neighbourhood, faith and school networks; have meaningful and constructive roles and the confidence to see themselves as an asset

which has a positive impact on their own wellbeing.

Working collaboratively with Tower Hamlets Together colleagues to ensure that we add value to commissioning plans by clearly identifying where we can influence outcomes and have an impact. Undertaking collaborative engagement to improve and share outcomes through joint investment and demonstrating an integrated approach to the community.

The regular locality based ‘Your Voice Count’ events will allow partners to share engagement activities and costs, it will allow us to demonstrate community voice having a direct impact as partners will have ownership of the outcomes, it will allow all partners to build a critical mass of local residents willing to take part and it will allow the community to build its own networks through regular engagement and joint working. This will allow us to then follow up the Community Intelligence Bursary programme with a community solutions programme that involves partners supporting locality based community groups to develop their own actions to impact on community health needs.

Bringing in additional resources such as the donation of the Hub at the Royal London Hospital, funding from Macmillan, CCG and THT and negotiating with Barts to include patient engagement support as an element of their soft services contract.

We will achieve efficiency savings by:

Working with our neighbouring Local Healthwatch (LHW) to share: expertise in data management, analyses and reporting writing; representational responsibilities across regional structures such as Barts, STP, Transforming

Service Together or specialist areas e.g. transport, cardiovascular, cancer; producing more regional generic communications information together to which we add

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localised information and events; specialist training and development e.g. accessible information.

Reducing our overheads by no longer needing to cover the monitoring costs of the host Urban Inclusion Community; changing the staffing structure to lower level positions with some of those functions going to

LHW and the Chief Executive.

The result will be a genuinely citizen led organisation with a workforce of hundreds working collectively with statutory partners to share resources to have a combined greater impact and in a way that makes sense to local people.

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Question B1Criterion: Embracing equality and diversity

Weighting 3%

Please give examples of how your organisation has embedded equality and diversity in different areas of its work.Word Limit: 400 words

Response

The Board worked with a volunteer consultant to develop our Equality and Diversity Policy. One of its key focuses is to ensure that individuals from disadvantaged groups are not excluded or isolated from their environment because of any of the characteristics protected under the Equality Act 2010 or socio-economic status. To promote social inclusion and build stronger communities we aim to include disadvantaged groups across all our activities rather than through separate targeted activities.

Both the Board and Advisory Group strive to reflect the make of the local community with diverse representation from across equalities groups. Where we have noticeable gaps we have acted to rectify this such as our young people’s panel.

Our prioritisation toolkit allows us to weight potential work areas to focus on equalities groups and we have recently prioritised children and in the past Eastern European, Vietnamese and Chinese, and Gypsy and Traveller communities. Within our Enter & View programme we consider equalities issues as a sub set of patient experience e.g. GP access for visual or hearing impaired, children with a disability or those without English.

As well as going to where people are e.g. markets our outreach programme targets groups less likely to engage such as white working class men (Geezers Club and pubs), people with a learning disability (day centres), children (interactive activities at family events and sports clubs) homeless and dual diagnosis (peer researchers, shelters, faith groups).

We work in partnership with voluntary and community groups who have existing links with and are trusted by target groups, ensuring that issues of language, culture and ethnicity are managed sensitively and appropriately. We provide advice on the kind of information that is likely to have an impact and use their expertise to engage. Our community intelligence bursary work gathered the experience of: Somali and Bangladeshi women carers and older people, people with mental health and substance misuse issues, children, young people, and the deaf and hard of hearing community, Asian lone mothers, and Eastern European community. We have undertaken extensive work with the housebound and people with long-term conditions through VCO subcontracts.

We are working with NCEL Healthwatch to develop guidance on improving access as a result of the introduction of the Accessible Information Standard.

We raised long delays for gender reassignment in London with Healthwatch England they raised with NHS England who have now allocated additional funding to help bring waiting times down.

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Question C1Criterion: Relationships with partners

Weighting 5%

How would you ensure you influenced health and social care commissioners and providers, both challenging and supporting them to take necessary action?Word Limit: 500 Words

Response

To influence we need to build strong: evidence; partnerships; and representatives.

EvidenceOur User Experience Review Panel will review intelligence gathered directly by Healthwatch and from across health and social care sector performance and complaints feedback to identify key user experience and identify citizen concerns to produce regular quarterly highlight reports with practical recommendations for improvements. We will:

make the HWTH data repository available to commissioners and providers in a format that enables them to manipulate the data to meet their own needs;

track responses to our recommendations through bimonthly reports to the Board and where responses are not provided pursued at executive levels.

PartnershipsA Community solutions sub group of the HWB Engagement Group will move forward the Community Intelligence Bursary work through supporting citizens to work in partnership with statutory staff to identify and develop actions most likely to impact on local health outcomes. Healthwatch needs to ensure that statutory partners move away from being service providers and instead support citizens to do what they have identified as important and what they can do themselves and they share power and control with citizens. Actions citizens have already identified:

Older people establishing their own neighbourhood Healthwatch to support each other on estates or within GP practices;

Mums organising ‘stay and play’ after school activities for children and parents; Bangladeshi and Somali carers creating informal support networks.

The Strategic Advisory Group will help agree our work plan and identify how outcomes and impacts can be measured through their own actions and commissioning and quality improvement plans. This worked well with our hospital nutrition project and more recently with the access to GP practices project.

Enter & View programme committee (CCG, CQC, LBTH and Adult Social Care) –our E&V programme influences commissioners and providers both through highlighting quality concerns and suggesting areas for improvement. Partners work together to agree a visit programme with the potential to impact on quality improvements and meet regularly to review the impact of visits and follow up non responses to key recommendations. Where we have continual response problems we escalate to senior levels or the Health Scrutiny Sub Committee.

Task Groups – these function on co-production principles and involve commissioners and providers meeting alongside local people in an equal partnership. The task groups agree priority projects and measures for monitoring outcomes and impacts. They provide opportunities for mutual challenge but

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are solution focused and allow users to see direct impact.

RepresentativesWe already empower citizens to take on representative roles where HWTHs can influence change to improve health. Our representatives need to:

have the skills and evidence to be able to voice why actions should be taken; understand complex commissioning, contract and service delivery requirements and be able to

voice what good quality outcomes and impacts look like; understand the different roles of representatives to both provide challenge on the quality of

services at the Health Scrutiny Sub Committee and to work as partners to develop solutions to health problems on the Health and Wellbeing Board.

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Question C2Criterion: Relationships with partners

Weighting 5%

In setting the work programme for Healthwatch Tower Hamlets, how would you balance evidence from community intelligence with the priorities of partners?Word Limit: 500 Words

Response

Local citizens will set the work programme for Healthwatch under the overriding principle of - can we make a difference to the health and wellbeing of the local community. Within this framework they will balance evidence from community intelligence with the priorities of partners through the following process.

Healthwatch Priority setting process

The Healthwatch Advisory Group (local citizens) identify a long list of potential priorities by reviewing evidence from a wide range of community intelligence sources including our members, our qualitative and quantitative research, the Joint Strategic Needs Assessment, the Health and Wellbeing Strategy and information gathered through the Tower Hamlets Together partnership. The locality events will be used as an opportunity to do grass roots priority setting by doing activities such as ‘Where would you spend the money’. Our aim is not necessarily to keep gathering more information but to make sure that what we already know is being used and the local voice is having an impact.

The Strategic Advisory Group will identify a long list of potential priorities from the Health and Wellbeing Strategy, their commissioning plans and work programmes and regional strategies such as the Sustainability and Transformation Plan and Transforming Services Together. The Tower Hamlets Together User and Stakeholder Group, which includes local citizens, will also have input into the long list of priority areas.

A Prioritisation Panel of members of the Board, Advisory Group, User Experience Review Panel, Strategic Advisory Group patient leaders and task group members.

Before a session, each participant goes through and ranks each issue as low, medium or high against these categories1. Number of people potentially effected;2. Community support;3. Citizens quality of life;4. Priority groups affected;5. Citizen safety;6. Wider impact on the system.To give an overall score out of 24.

We then look at the background factors of1. local work on the issue;2. workplan balance;3. potential to have an impact;4. urgency of issue.To give a score out of 12.

In the session, the group go through each item with support from a member of staff to decide by

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consensus whether the issue should be recommended for inclusion in the work programme. In order to be put forward as a priority issue, the issue needs to score 60% or more on the tool, which is equivalent to 14/24 in the issue prioritisation, and 7/12 in the background factors.

Flexibility needs to remain to respond to issues that may arise during the year and that the Advisory Group feels it is important that we respond to. A project proposal is then developed to go to the Finance, Personnel and Review Committee regarding the details on how the priority area will be tackled and can include a variety of options such as; a community solution project, E&V visits, surveys, qualitative research, patient leaders project, or a combination of approaches.

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Question D1Criterion: Influencing and achieving outcomes

Weighting 3%

How would you ensure that health and social care commissioners and providers, having accepted Healthwatch Tower Hamlets’ findings and recommendations, have subsequently implemented these to deliver tangible outcomes?Word Limit: 400 Words

Response

We follow up findings and recommendations through the Review Programme Committee that was established in October 2015 and includes Enter and View representatives (local citizens), HWTH Review and Monitoring Chair, HWTH Co-Chair (local citizen), commissioners and monitoring officers from the CCG and LBTH Adult Social Care, Care Quality Commission, and relevant providers when required.

The Committee review the E&V Programme on a quarterly basis and reflect on its usefulness (demonstrating that the visit is having an impact). It is an opportunity for

HWTH to hold commissioners/providers to account for service improvement and discussions around key themes (a formal process for engagement and discussion);

HWTH to inform the Care Quality Commission of potential visits they could undertake locally; commissioners and monitoring officers to put forward cases where HWTH can undertake

future visits collaboratively.

They review key recommendations from other intelligence reports and activities of Healthwatch to develop a six month impact report which is then provided to the Board for any further action or escalation.

This report then feeds in to our ‘You said They did’ report and case studies that allow us to go back to the partnerships outlined in C1 and track progress against the outcomes and impacts. We do not monitor all of the recommendations, outcomes and impacts as this is unachievable with our limited resources and staff. Our volunteers can use the You said They did to argue for further actions in their localities. The committee and Board identify the key outcomes that we use as good measures of change and influence.

We seek regular feedback from our Strategic Advisory Group members as to the impact of our engagement and review their commissioning plans and transformation strategies to track implementation of our suggested recommendations. We will report to the Tower Hamlets Together Stakeholder Group to review tangible outcomes.

Our regular formal and informal meetings with partner commissioning and engagement leads ensure that HWTH outcomes and impacts are built into their own reporting processes.We follow up any outstanding issues or concerns through regular meetings with Chief Nurse Royal London, Acting Chief Executive CCG, Director of Adult Services LBTH, the Royal London Hospital Care Quality Review Meeting and ultimately the Health Scrutiny Sub Committee of the Council. Using our critical friend role to provide constructive and sometime challenging input into the commissioning and decision making processes.

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Question D2Criterion: Influencing and achieving outcomes

Weighting 3%

How would you measure and evidence the outcomes of Healthwatch Tower Hamlets’ work?Word Limit: 400 Words

Response

We accept the key outcomes and outcome measures set out in the Service Specification and currently work to an action plan and key performance indicator to evidence similar outcomes effectively. We know it will be a challenge to deliver all outcomes and activities to a high standard across Tower Hamlets at a consistent standard. We may need to focus on different activities or localities at different times of the year to enable staff and volunteers to develop a focused approach.

Following on from the new draft Health & Wellbeing Strategy we will consider developing outcomes and measures for local people:

having a greater role and influence in shaping their local services; taking collective action on issues that impact on their health and wellbeing; feeling in control of their health and wellbeing; supporting each other around their health and wellbeing; noticing partner staff working differently to support them to lead projects and actions rather

than wanting to deliver services.

To do this we might measure the number of: issues that citizens have identified that they want changed in order to have an impact on the

health of the community; citizens supported into leadership roles in local communities to address health and wellbeing

issues; citizen led projects developed in partnership and with support of Tower Hamlets Together

(THT) partners; THT organisation staff reporting that they are working differently to support citizen led

projects; Locality engagement events undertaken in collaboration with THT partners to coincide with

HWB board meeting.

What we are proposing is not a quick fix approach and the measures chosen will need to be seen as effective markers to making progress towards long-term objectives. The temptation is to drive towards focusing on quantitative data that gives us numbers and charts and with detailed methodologies but we are not public health or a research institution. We feel it is more important to work closely with people in the community to find out what they understand the issues to be. This requires a change in organisational culture and approach within statutory organisations; to listen to the people and communities we serve, to start with the things that matter to them, to share power and control with citizens and to move away from the default choice of delivering more services. We will work closely with our THT partners to develop and share accountability for outcome and impact measures in this area.

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Question E1Criterion: Involving the local community

Weighting 4%

Please describe the range of mechanisms you would use to engage and involve local people in the monitoring, commissioning and provision of their health and care services?Word Limit: 500 Words

Response

Healthwatch Tower Hamlets is local people and they are therefore involved in all aspects of our work.

They monitor services by: providing their experience of the quality of services; coding and reviewing data on the User Experience Review Committee, highlighting citizen

concerns and raising issues with commissioners and providers; using the highlighted concerns and the identified HWTH priorities to set the E&V programme,

aims and objectives of visits, undertaking visits, writing reports, agreeing findings and recommendations and monitoring the outcomes through the E&V Review Committee;

voicing citizen concerns at quality assurance meetings such at CCG Primary Care Committee, Royal London Hospital Care Quality Review Meeting and Health Scrutiny.

They engage in commissioning by: providing their experience of services to feed into community intelligence on need and the

JSNA and needs assessment process to suggest improvements; contributing to the development of citizen focused outcomes and impacts; the Advisory Group providing an initial community response to commissioning plans; taking on patient leader/representative roles to work in partnership on a wide range of

strategic commissioning groups such as the THT Stakeholder Group, Integrated Care Board to design actions to improve health;

participating in HWTH Task Groups working in partnership with to develop commissioning strategies, work plans and projects.

They engage in provision by: identifying areas that will impact on the wellbeing of their community and leading on

developing and managing actions to address that need; undertaking peer led research into the needs of local people.

The Patient Leaders programme, that was a developed by Healthwatch in partnership with the CCG, has demonstrated an effective active learning programme can engage local citizens and influence commissioners. It’s important that we continue to utilise their skills and empower them to expand their leadership and work skills. We feel it is important that they take a lead in designing future volunteer programmes in partnership with THT.

We recognise there are a number of bodies looking to develop community volunteering and that by working together we will be able to provide:

A co-ordinated and more effective recruitment campaign; A better resourced and managed training programme that meets the diverse interests and

motivations of volunteers e.g. some people want qualifications or work experience while others want to feel they’ve made a difference or had an impact;

A range of health volunteer training resources.

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We will: Provide ways that people can participate that fit their everyday lives; Manage consultations so that people are asked once for views on a topic; Let citizens know what difference their views have made; Let citizens know what the final decision is; Be clear what type of participation is sought and for what purpose; Develop mentoring and shadowing initiatives within communities and organisations that bring

together experienced volunteers and new volunteers; Ensure people can be involved in a variety of ways, from online and interactive, to paper

questionnaires and hand held devices, to practice based meetings, faith group events, focus groups and making sure we are in the places where people are already.

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Question E2Criterion: Involving the local community

Weighting 3%

Please give examples of how you have worked with local voluntary and community sector organisations to deliver local services, and how you would go about this in Tower Hamlets.Word Limit: 400 Words

Response

Our Community Intelligence Bursary programme worked with 17 local organisations to train community researchers to gather the experience of:

Carers on support and health needs; Older people on future health and social care support needs; Cancer patients on community needs; People with mental health and substance misuse and/or alcohol issues on barriers to access

and more accessible integrated services; Children with ongoing conditions and experience of primary and secondary care; Young people on what good wellbeing is and how to promote it; Local deaf and hard of hearing community and Asian lone mothers who have been through

domestic violence on how GPs could better support health and wellbeing; Eastern European community on their experiences and expectations of the health system; Existing and future support needs of older Somali people and adult Somali men with drug

issues;

It engaged with over 1200 local people, trained 33 volunteers and voluntary sector workers made 137 recommendations and resulted in a Health Conversation event attended by 132 citizens and health professionals. It had a direct impact on enabling communities to lead change and has demonstrably influenced partners commissioning plans for primary, social and integrated care.

We will build on the success of the CIB project to deliver a Community Solutions Programme. to support groups to identify areas that they believe can impact on the wellbeing of their community and enable them to lead on developing and managing actions to address that need. We hope that this will be a strong partnership between Healthwatch and the Tower Hamlets Together partnership structure and Stakeholder and User Group to ensure that all our resources are co-ordinated behind it and that we can support communities by facilitating and enabling their own networks as opposed to stepping in to do things for them.

We will continue to s ub contract to existing voluntary and community and faith organisations as we have done in the past with:

Social Action for Health – Patient Leaders Leaders in Community –Young People’s Health Panel Community Options – Mental Health Task Group Tower Hamlets Citizens – peer researchers training Tower Hamlets Friends and Neighbours –Voices of Housebound residents

We will continue to work closely with the CVS Health & Wellbeing Forum and the Children and Young Peoples Network to hear from them their users’ experience of services and conversely to provide information to them on community needs that they maybe best placed to respond to.

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Question F1Criterion: Representing the views of local people

Weighting 5%

Please give examples of the types of quantitative and qualitative information that you think would be likely to influence commissioners and providers, and how you would you go about gathering this and presenting it clearly.Word Limit: 500 Words

Response

The most influential information that Healthwatch can provide commissioners is information that is not duplicated and which is sourced independently. It is acknowledged that Healthwatch is not a research institution and it lacks the resources and the skills to perform this function to a recognised ‘gold’ research standard.

Instead, Healthwatch aims to be the voice of local residents and the local community as well as the facilitator of that voice. There can be a blurring of the distinction between 'research' and 'community intelligence gathering' and we believe it is and will be essential to clarify the purpose and the objectives of any research and indeed any requested information by commissioners and providers. The methodology of any piece of research has to be dictated by the objectives rather beginning with the methodology such as 'focus groups'.

Although Healthwatch does not itself have professional research skills, it does presently have access to a bespoke network of qualified/experienced researchers who are able to provide support to their volunteers, peer-researchers and community organisations. This is in addition to a number of Healthwatch volunteers who have recently received recognised research methods training. We will also look to our neighbouring LHW to develop this skills pool effectively.

Whether we are undertaking research or gathering community intelligence the following will always be paramount:

Ensuring that the work, either qualitative or quantitative, meets the objectives of the priority that has been agreed by Healthwatch and our partners and is based on the evidence presented in the JSNA or other key background data;

Ensuring the work, either qualitative or quantitative, is independent with no conflict of interests and is based on sound evidence an on an appropriate rigorous methodology;

The need to respond to information gathering and research projects as well as proactively providing commissioners/providers with feedback from local communities;

Ensuring there is opportunity for local residents/communities to identify issues for further research as well as to create and work on their own solutions to be presented to commissioners in an appropriate manner;

The following of ethical protocols at all times; Clear reports that are systematically based on the evidence gathered that should include: A full methodological summary detailing sampling process, methodological notes and

limitations etc.; An executive summary; Tables of data - if quantitative Thematic analysis including direct quotations (if qualitative); Different versions of the main findings so that they are accessible to all involved. Feedback to commissioners/providers as well as those who took part.

Quantitative:

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Healthwatch will produce regular quarterly reports highlighting concerns raised by local residents which is to be part of the Patient Experience Review Panel. The teams clinically code service user experience comments, effectively turning raw feedback into hard trends. The coding will be based on clear, established and consistent criteria so that it is methodologically rigorous. No issues will be overlooked and potential safeguarding incidents are more likely to be identified. This will be triangulated against data from NHS Choices, 'I want great care', PALS and Complaints and other sources.

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Question F2Criterion: Representing the views of local people

Weighting 3%

How would you identify and engage seldom-heard communities in the work of Healthwatch Tower Hamlets?Word Limit: 400 Words

Response

There are existing LBTH population data sets such as those used for the JSNA that identify seldom-heard communities. We would work with THT partners to assess whether there are communities that they do not currently hear from. We know that housebound people, those with mental health issues, new residents, refugees, the Somali community, LGBT residents, young parents and the traveler community are often seen as seldom-heard and over the past 5 years we have engaged with all of these groups effectively. We have found that talking to the interpreting staff at the hospital or GPs can be a good early indicator of new, more hidden or more transient communities coming into the Borough with a growth in Eastern European, south American, Spanish, Portuguese and Italian communities. We have also worked with faith networks to identify and engage new groups.

We often engage the seldom heard through community groups who have a greater expertise or better reach e.g. the Chinese centre to reach the Chinese community, Praxis to reach refugees, Real or Tower Project to reach people with a physical or learning disability. We have accessed the Gypsy and Traveller community through an introduction by their housing officer and visiting them directly on site.

We know from our experience that mental health users and people with dual diagnosis are more effectively engaged through peer led approaches with links to volunteering opportunities and skills development.

We work closely with our existing members to encourage them to engage people from other communities they feel might get involved; particularly the patient leaders and advisory group members.

Our locality based work will use all Tower Hamlets Together partners to undertake outreach and we will use the GP Networks to link into Practice Participation Groups and social prescribing programme. Events outreach will target seldom heard groups within that locality. If we have the capacity and the links we would like to undertake more work across the faith organisations in Tower Hamlets, particularly those that reach new communities, to see if we can set up volunteering programmes within those communities.

We recently piloted an interactive approach to gathering the views of children including games and video at our Your Voice Counts event. We aim to continue to work with partners including the Children in Care Council, forums for children with disabilities and special educational needs, looked-after children, children in need of help or protection.

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Question G1Criterion: Maintaining national links

Weighting 2%

How will you ensure that Healthwatch Tower Hamlets develops effective partnership working with Healthwatch England, Care Quality Commission and other local Healthwatch regionally?Word Limit: 300 Words

Response

Local Healthwatch (LHW)Our new structure proposes working collaboratively with neighbouring LHW both for economies of scale and to develop greater expertise. We have met several times and agreed to work together strategically moving forward under a Memorandum of Understanding and subcontracting model. We have agreement from Redbridge, City, and Waltham Forest. Unfortunately the competitive tendering process has put these plans on hold pending the outcome.

The skills and expertise that we plan to share or bring in from other LHW are: Data analyses and reporting –across the Barts footprint initially; Higher lever communications; Training and development of Board members and volunteers; representational responsibilities across regional structures such as Barts, ST, Transforming

Service Together or in specialist areas e.g. transport or cancer; Delivering joint volunteer training programmes for Barts Health to enable volunteers

undertake monitoring functions.

We have set aside over £30,000 in our budget to support this joint working.

Our partnership with HWE includes: Regularly submitting our community intelligence to influence national campaigns; Receiving online updates, briefings and toolkits. We are currently looking at using their

delays in social care assessments toolkit; Using their communication support to access regional and national media. We appeared on

BBC London Radio four times last year; Contributing to London regional events to work with LHWs on shared priorities e.g. tackling air

pollution. We have a named CQC officer and they regularly attend the E&V Review Committee to add

feedback, identify areas for collaborative working and avoid duplication. We: Review their monthly visit bulletins and upload or link to relevant Tower Hamlets reports on

our website; Notify staff of any serious quality or safety concerns from Enter & View reports or from

community intelligence; Discuss joint visits where we take a stronger focus on gathering patient experience.

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Question H1Criterion: Profile in the local community

Weighting 4%

How will you ensure that a range of local people and community stakeholders are aware of Healthwatch Tower Hamlets, and its purpose and functions?Word Limit: 500 Words

Response

HWTHs is a membership organisation managed and delivered by local citizens and our key mechanism for raising awareness is through word of mouth through our volunteers and members personal networks. To expand our membership and those networks we plan to work through a locality approach.

Our main approach is to go where local people are through a regular outreach programme led by volunteers that visits Ideas Stores, markets and supermarkets, GP Practices, hospitals, children’s centres, community groups, schools and anywhere else that local people gather. We combine promoting Healthwatch with providing information and signposting and intelligence gathering to ensure that citizens get something out of it and that they can see it can make a difference.

We will deliver a collaborative engagement event in one locality each quarter with planned awareness raising and outreach activities leading up to the event. This will involve visiting schools, GP Practices, Ideas Store, community groups, markets, supermarkets and shops. Shortly before the event we will focus on door to door leafleting close to the venue. Our Advisory Group meetings will take place in the same Locality for that quarter and will be open to local people from patient groups etc. Our Tower Hamlets Together partners will work collaboratively to ensure that we can effectively access GPs, schools, housing associations etc. enabling us to have a far wider and deeper reach.

We will also: Further develop our website and social media presence to ensure effective promotion of

information to those who use web-based communication. Work closely with local citizens to further shape the website, manage and contribute to social media channels and to evaluate online feedback systems;

Ensure the development of the Single Point of Access (outlined in I1) promotes HWTH as an independent voice for people to leave feedback or access independent user experience information;

Ensure our role is promoted by Tower Hamlets Together partners including their patients, users and staff. HWTH feedback postcards in service provider premises, promotion with PALS and ICAS. Information included in school newsletters, GP practice websites and newsletters, housing associations, info screens at service sites, libraries, one stop shops, faith institutions etc;

Run a targeted campaign to engage citizens who use home and residential care providers; Produce and disseminate widely a fortnightly ebulletin keeping people up to date with

engagement activities locally and a monthly newsletter ‘You Said, We Did’ to let people know what the impact of their engagement;

Maximise HWE national branding and communication and link to national campaigns.

Work with VCOs: Use the Locality and social prescribing networks to cascade information through to smaller and

informal community groups and to service users; Ensure understanding of HWTH’s role and powers that can be used to help them raise issues

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regarding service improvement for members/users; Piggyback on events including, ESOL classes, luncheon clubs, play groups, fun days, and social

activities; Develop appropriate communications tools for different groups.

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Question H2Criterion: Profile in the local community

Weighting 2%

Please provide details of your planned premises for Healthwatch Tower Hamlets, taking account of the needs set out in the service specification in relation to visibility, compliance with the Disability Discrimination Act, facilities and accessibility of location.Word Limit: 300 Words

Response

We are currently in negotiation with Barts Health to take up the offer of office space in David Hughes House which is directly next to our Healthwatch Hub on the Royal London site. This is a significant benefit to us as:

It has a higher public profile and footfall with opportunities for larger, clearer signage directing people from the hospital site;

It will allow us to run a phone line into the Hub and provide internet access enabling us to fully utilise the Hub as a volunteer centre and the signposting and information hub;

It will reduce the amount of time that we are currently need to user going in between the Mile End and Royal London sites;

We will be able to manage the cancer project more effectively from there; It provides better links to some of our key partners, as well as Barts staff we will be co-located

with the mental health RAID team and LBTH social workers; With patients coming from the neighbouring Healthwatch borough it will provide further

incentives for working collaboratively.

The new site has full disability access is close to good transport links.

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Question I1Criterion: Providing information to local people

Weighting 3%

How will you provide the information and signposting function of Healthwatch Tower Hamlets, and ensure that this adds value to the existing borough-wide and regional information and advocacy services?Word Limit: 400 Words

Response

We are very excited that, following our consistent recommendation for a joint directory of services and a single point of access, planning is now under way for a Single Point of Access which is being set up by Tower Hamlets Together, Health and Wellbeing Hubs (Public Health) and the Patient Portal (Vanguard).

The proposed principles of the SPA are to: - Integrate access to local health and social care; Act as a one stop shop with ‘no wrong front door’; Provide an up to date directory of services for the whole system; Easy to access and responsive with choice of method including telephone and internet; Available on a 24/7 basis with web access for appointments, self-assessment and referral, and

providing supporting information; Support self-management & assessment; Supports different languages.

It will include: - Mental Health Children’s Centres Schools & Colleges Acute Primary Care Community Patients and Carers Social Care Voluntary Sector Ambulance 111 Care Homes/Agencies

With these changes on the way we feel that HWTHs can add value to a signposting and information function by:

involving local people in the design of the SPA, assess whether it is community friendly, providing ongoing monitoring feedback, noting problems as it’s rolled out;

making sure we are driving traffic to the SPA and Health and Wellbeing Hubs. We will develop a pool of skilled citizens that can go out into the community with tablets to actively take people through how to access and make the most of the SPA/website. We will train our volunteers to train other citizens to use the system. This will also allow us to identify any gaps or problems and report back to the providers to improve the system. Residents will also be able to drop into the Hub to access the internet with volunteer and staff support;

Supporting people to access the complaints process and advocacy support where needed and using their feedback to add to our community intelligence;

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Providing a face to face and free phone service for signposting and information that is staffed by skilled staff and volunteers;

Helping patients to make informed choices about the services that they access by producing guides and one to one advice on how to compare GPs, consultants, care homes etc. We may need to gather intelligence as to what patients think is good or important and also visit services that we are getting regular inquiries about e.g. home care providers and care homes.

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Question J1Criterion: Community Benefits

Weighting 5%

The Council works in accordance with the Localism Act and are strong advocates for supporting local businesses and local jobs for local people; please explain your best, previous experience/ examples that demonstrate your ability to support us with our aims.

The Council is committed to improving the local community not only through physical improvements but also through social engagement such as apprentices, new jobs and sponsorships. Please provide specific examples of where you have provided equivalent benefits for your clients and a proposal of how you can deliver this in line with this contract.

PLEASE ALSO COMPLETE SCHEDULE 3 AS PART OF YOUR RESPONSE TO THIS QUESTION.

Word Limit: 500 Words

Response

We pushed for Barts Health to include social investment requirements such as local labour, investment in skills and support of local supply chains within their transport and soft facilities management procurement. On our request they required contractors to set aside a percentage of the contract value for patient education, monitoring and input; probably the first time in the country this has happened. We used this success to influence the Commissioning Support Unit to encourage their contractors to indicate what percentage of the total price they would allocate to patient engagement in association with Healthwatch.

We directly influenced Barts decision to run the transport call desk in-house at Royal London resulting in up to 38 FTE jobs plus apprentices and interns. We have actively lobbied via the CVS for VCOs, like Community Transport, to be subcontracted to the main contractor.

We will continue this work across the local supply chain to maximise local benefits.

60% of our sub-contracting is within Tower Hamlets 50% to local VCOs. We purchase our printing, catering and IT support locally through competitive tendering processes.

Healthwatch is based on the principle that everyone is a potential asset no matter what their age, education or experience and being social engaged with us in itself has a positive impact on citizens’ wellbeing.

We strive to employ local people with three of our five current staff members living locally and the other two coming from local minority communities. Positions will be advertised locally as we know they have the right skills and can bring added value through local knowledge and networks. We will work with Skillsmatch to advertise both paid and volunteer work opportunities.

It is crucial to the local health economy that more local residents are attracted into care professions. HWTHs provides local people tangible work experience to enable them to access job opportunities.

We have: employed graduates developing their skills and understanding of patient experience; taken on apprentices from Barts and from Urban Futures; supported Tower Hamlets College social work trainees work experience placements.

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worked with DWP to support JSA volunteers; provided large numbers of volunteers with short term work experience placements to

support practical experience and CV enhancement; worked with local mothers to re-enter the workforce by developing a work record and

refreshing skills; a comprehensive Volunteer Strategy, Policy and Guidance with systems, insurance and

policies in places.

Participants have gone on to work as health care assistants, public health strategists, GP support staff, health guides, paid researchers, project developers and to education.

We’re interested in offering work experience places via "Working Start" and through the council’s Employment & Skills Service. We’re keen to set up work placements for individuals with learning difficulties as we believe that they have key skills as experts by experience and peer researchers and are happy to work with Tower Project.

It is always our aim to provide staff and our trainees with access to appropriate training and skills development. We will also encourage our sub-contractors to provide traineeships and work placements.

Question K1Criterion: Interview

Weighting 7%

Only the top three (3) bidders submitting the Most Economically Advantageous bid through a combination of the quality criteria and price as outlined here will be invited to the presentation and will be informed of this by 28th September 2016

The presentation must answer the following question:

Commissioners of health and social care services consult residents on savings proposals which include closing or reducing some services. Healthwatch gathers community intelligence indicating that many residents are against these proposals. How would your organisation address these conflicting views to achieve the best outcome?

The time for the presentation will be limited to 15 minutes with another 15 minutes for questions and answers.

PLEASE NOTE: a response to this question is not required in initial bids.

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