Recommendation 145

Local Healthwatch structure

Not accepted - agree with principle
There should be a consistent basic structure for Local Healthwatch throughout the country, in accordance with the principles set out in Chapter 6: Patient and public local involvement and scrutiny.

We share the underlying intention behind this recommendation to ensure consistency of outcomes for local communities with each local Healthwatch organisation providing a strong voice for their local population and helping to shape an effective local health and care system.

We believe that local Healthwatch organisations should be set up in a way that best meets the needs and reflects the circumstances of their local communities; taking a top-down approach and imposing a fixed structure would undermine the need for flexibility.

We believe that consistency of outcomes – with each local Healthwatch organisation providing a strong voice for the local population and helping to shape an effective local health and care system – is more important than consistency of form. As every local authority has now commissioned its Healthwatch provider, we also believe that retrospectively imposing a consistent structure at this stage would divert effort and resources from the important work that local Healthwatch organisations should be doing in their role as local consumer champions.

We do, however, fully recognise the concerns about previous arrangements for patient and public involvement in Staffordshire, and the disproportionate – and ultimately damaging – focus on governance and organisational matters at the expense of ensuring the local community’s concerns were heard and acted on. As part of the new arrangements, one of the core roles of Healthwatch England at the national level is to provide support and leadership to local Healthwatch organisations. This year, as local Healthwatch organisations have been establishing themselves, Healthwatch England and the Local Government Association have provided important support to help them put in place clear governance arrangements that will enable them to focus on effective delivery of their local priorities.

It is vital that local Healthwatch organisations continue to be supported and that any early signs that they are struggling to fulfil their role are identified and addressed. Local authorities are responsible for commissioning and performance managing their local Healthwatch provider. Alongside this, Healthwatch England has a crucial role in building capability across the network, and it will ensure that best practice is shared and there are clear standards in place for what a good local Healthwatch should be achieving. We will also work with Healthwatch England to ensure that they can develop and provide targeted support for local Healthwatch organisations that may need it.


Local Healthwatch have been publishing their annual reports for the first year of operation (2013/14), giving examples of the impact that they are having and how they are giving voice to local communities.

Healthwatch England is continuing to provide support to local Healthwatch organisations to enable continuous improvement and sharing of good practice. The Department has continued to provide additional funding to Healthwatch England to boost its capacity to provide targeted support to specific local Healthwatch where needed. Healthwatch England is also enabling a focus on outcomes by developing guidance on what a good local Healthwatch looks like.

Local authorities, as commissioners of local Healthwatch, have a critical role in ensuring that their provider is delivering effectively and meeting the needs of the local population. The Department has continued to provide funding to the Local Government Association to support commissioners of local Healthwatch during 2014/15. The Local Government Association’s work programme is providing important support to local Healthwatch around fulfilling their role as members of health and wellbeing boards.

The Department has also commissioned the King’s Fund to review the impact of local Healthwatch and to identify the factors which contribute to a high-performing local Healthwatch. This is expected to report in Spring 2015.