Healthwatch Oxfordshire in action – Part two
In part two of her interview, Rachel Coney; Chief Executive of Healthwatch Oxfordshire, discusses the organisational priorities, the measures taken to achieve them and support better health and social care quality in the region, and some of the challenges they have overcome along the way.
Operating on such a high policy level, how do you keep service user involvement consistently embedded? What would you say are the main co-ordination challenges you face, as a public facing organisation?
There are four main ways in which we hear the views of the public:
Independent large scale projects
We are able to identify areas using what we hear from our conversations with the public and the voluntary organisations we work with. From here we set up our own projects and the process begins.
These projects include looking at people’s experiences of access to general practice, being discharged from hospital and we are in the final stages of fieldwork around people’s experiences of dignity in care. This helps us determine whether dignity and care standards in Oxfordshire are actually being met.
This is another powerful channel for us and we have a dedicated outreach events programme. My colleague travels across the country, attending events at least a couple of times a month. The rest of the time, armed with a stall, leaflets and speak-out cards, she goes across Oxfordshire speaking to people in the street about their experiences of care, capturing their stories. We are then tasked with analysing and theming them to decipher the concerns and issues bubbling up across the local service user population.
To support our cause we give professional support to third sector organisations who have solid relationships with the people who would not ordinarily talk to us. For example we work with the local Asian women’s group who may get around 150 Asian women to share their experiences, whereas, because of our capacity restrictions and lack of community links, we would probably only get around five to talk to us. Liaising with and working through organisations who already have trust based relationships with seldom heard communities is key for us.
” Liaising with and working through organisations who already have trust based relationships with seldom heard communities is key for us.”
Partnership networks with voluntary or statutory organisations
Our fourth piece of work for this year is a sensitive subject but something we are keen to build dialogue around: child sexual exploitation. We will be talking to young people at risk, survivors, their families and carers of young people caught up in exploitation in Oxfordshire. It’s an example of a project where we have limited knowledge of the specialism so a strong network partnership is going to be vital.
To be successful we will need to work alongside a local voluntary sector partner who is already embedded in that area of work. We also have a relationship with the National Working Group on child sexual exploitation in Derbyshire. They are providing materials, structured interview guides and questionnaires that will allow us to talk to these people. Partners like this give us a genuine objective outside view and act as consultants for the report writing stage. They are also responsible for training those involved in the project and running focus groups for us. We will absolutely need to be working really closely with them, as we do any voluntary or statutory organisation.
What are your organisational priorities for the coming year?
Our visibility to children and young people and the organisations that support them is very low, but we are tasked by the council in ensuring that children and young people have an effective voice at the children’s trust board in Oxfordshire, so raising and addressing that are key. Over the course of the next 12 months we will be trying to model strong, best practice for other people and organisations to follow.
It’s an interesting one to me as the mother of teenage children, as I think as a society we do not always trust young people enough, nor make the time / have the inclination to communicate with them effectively. That was very clear in the recent national children’s survey results.
16-17 year olds can be enormously empowered and have an incredibly intelligent, valuable amount to say and contribute, we just don’t invest the time and energy in facilitating that conversation so that it works. For example the Children’s Trust Board runs on school days, during school time, but somehow wants to engage young people with its outputs. That’s an immediate barrier- not exactly young people friendly. As we prioritise this area I’ll be encouraging the staff here to go and talk to the children at Pegasus Youth Theatre, where I know their young trustees play a really important and meaningful role in the governance and running of the theatre. And I think we could all learn a lot from organisations like that who do it very well.
“The Children’s Trust Board runs on school days, during school time, but somehow wants to engage young people with its outputs. That’s an immediate barrier- not exactly young people friendly.”
How can organisations like Healthwatch ensure that involvement and addressing public needs, stays embedded in the cycle of rapid change?
This is well illustrated in some of the individual work projects I have mentioned. Part of our work process is to actually say “your consultation processes were not good enough, you did not engage properly and this could have been avoided by..” We are trying to support and encourage local services to improve their consultation processes and use their patient feedback more effectively.
This includes facilitating networking opportunities for providers and commissioners, which is unique to this Healthwatch – at least, I’ve not come across another who takes the same approach. Three times a year I bring together the Directors of Quality and all of the patient experience leads from all the major commissioners and providers in Oxfordshire, and we share the service user and patient experience feedback that we have observed from each of our individual perspectives e.g. public health, social care, CCG, ambulance services etc.
From pooling this intelligence, we are then able to identify common quality issues across the system. Last year these considerations were then written into the refreshed health and wellbeing strategy for Oxfordshire as priorities. We’ve gone some way towards putting impact measures in place for each, though not as far as we would have liked. Aside from the bigger picture, this networking strategy encourages individual trusts to reflect such issues in their organisational quality accounts and forward planning.
“We are trying to support and encourage local services to improve their consultation processes and use their patient feedback more effectively.”
What initiatives and ways do you use to reach local people/engage them in healthcare developments?
We work really closely with the media and we send regular updates to our mailing contacts, however we are yet to make the most of social media, which is something we are working to change. Our partnership networks are our biggest advocates for distribution. When we are organising an event or canvassing for an online survey, foundation trusts and organisations like Age UK will share our news and promote us – as we do for them. Shared intelligence and building strong contacts are a vital part of our process.
Are they any misconceptions or potential barriers that impact public perception of Healthwatch Oxfordshire, if so how do you counter them?
The name of the organisation and the language we use to position ourselves can sometimes be limiting. While we cover healthcare policy, we also cover social care and a lot of people don’t immediately make that connection. Staff also tell us people don’t like the language we have been using for our strap line. We positioned ourselves as being a “champion” for service users and feedback included: “What are you championing? Are you a gym?”
With such literal questions showing us how important it is to think about messages, we are going back to our original stance of positioning ourselves as a public health “watchdog”, which we found people see as a very positive role.
How do you engage service users in your mission and empower them to understand how their feedback will convert into improvements?
It was really difficult at the outset, but now we have been able to produce an annual report that highlights our key achievements, such as mental health in schools, we have evidence! The fact we can now prove it is worth it, is encouraging for people and builds trust. After years of work building our reputation, it is a fantastic position to be in as a progression focused organisation.