Working together for change

Healthwatch Camden is part of the wider Healthwatch network, supported by Healthwatch England. Recently I was invited to attend Healthwatch England’s board meeting to talk about our cross-borough work on urgent and emergency care.

Afterwards the board asked questions about how we planned the work and how we achieved change through it. I’ve been thinking about some of the things that worked well.

Trust: the five local Healthwatch already knew each other, we meet regularly and we share a set of values about how we work. So there was a lot of trust between us, and we could all see the value of working in a collaborative way. Healthwatch Camden took the lead, and each of the local Healthwatch contributed to the project, taking responsibility for different aspects of the work.

Partnership: we tried to work in genuine partnership with people who provide and commission our local urgent and emergency care services. Local Healthwatch is always rooted in the viewpoint of people who use health and social care services, and will always champion their point of view and their interests. It is what we are here for. However, we can find a lot of common ground with people who work in the services. We held a co-design event to talk about developing 7-day community services. We found that patients and carers shared the same frustrations as doctors and therapists about poor co-ordination and communication between services. Together, people could come up with ideas for how to make things better.

Creativity: for our co-design events we drew on experience from other places and used the best ideas from them. We made sure that the events included equal numbers of people who use services and people who work in services, so that there was genuine dialogue.

Flexibility: we used many different methods. For some topics focus groups worked well, for others a telephone survey was more suitable. And for work on the last phase of life we did some in depth interviews.

Inclusivity: Because we are all well-established in our boroughs we were able to bring in the help of local voluntary and community organisations. Our areas are very diverse and we always try to work inclusively, so that the minority voices get heard as well as the majority ones.

Relevance: we focused our reports on topics that were already being considered in the Urgent and Emergency Care programme, so that our findings could be put to immediate use. We also uncovered topics that need more attention, in particular the problem of late diagnosis of cancer. These parts of the report might take longer to achieve change on.  

Follow up: we made sure things got followed up. Our second co-design event looked at a service specification and checked that it took account of all the insight and action points agreed at the first event.

Persistence! Getting involved in large scale change programmes is daunting, there is a lot of bureaucracy. To help us through the process we supported a Citizens’ Reference Group, who have a representative on the Programme Board. They are there to hold the board to account, to make sure that the ideas and insights that Healthwatch is gathering from local people really do get used and make a difference in the way services are planned, and in how they are delivered in future.

There isn’t one way to do engagement and we are always learning about better ways to do it. Our work so far shows that the key thing is to start from some values – we promote equality, we work inclusively, we are honest about what we can and can’t influence, we really do believe that every voice counts.

If you would like to get involved in this work, there are vacancies in the Citizens’ Reference Group. Get in touch if you are interested. You need to be someone who can read through some quite lengthy papers. You will get expenses paid, and a modest fee for attending meetings. Please contact: or telephone 020 7383 2402 for more details.