Thank you for giving up your time to join the event today.I am guessing that we have a relatively broad mix of people –with for varying reasons an interest in Healthwatch..and hopefully many of you have already signed up as members and keen to get more connected.Thanks to colleagues from RAISE who have helped us with sponsoring today
Who are we and how are we involved…the Healthwatch Portsmouth development group have been meeting for several months now ..and are a mix of colleagues from the City Council /Learning Links and the University..and we have been preparing for the Transition to the new arrangements…so they are in place by 1/4/13.The development group was formed as a result of a decision to develop HW outside of the city council – made by the council and other stakeholders invited to a meeting on the 10th January 2012. The process for moving form the transitional to contractual provider of LHW Portsmouth is reaching a conclusion..but not yet ready to make an announcementHOUSEKEEPING?fire procedures etc
Very much hoping to get your input and help..and to have both a productive and enjoyable session this morning .
Insert?May be very useful to mention where HW fits with other organisations and groups as I assume you are trying to do– although not easy to explain and may take a lot of time. I have a diagram but, im’ not sure it helps that much. I have put on the next slide for you to see. – it’s a bit messy though – I can find a sharper version. It may help to illustrate the complicated nature of the system. Its similar to the one you have – just another option for you to consider.
The image came from the Healthwatch Transition Plan - produced by the DoH back in March 2011 - it was one of their first attempts to show where HW fits with the whole system from a public perspective. I have added a better version.
The Big Society context is helpful to understanding how HW could fit in..A successful local Healthwatch could be seen to tick many if not all of of the above boxes ..but as with the more general intent its not just going to happen because a few people say it will happen….It will need a lot of effort to nurture and grow something locally owned and valued….and some will perphaps be already writing it off …I am equally sure though that a lot of the people here today will want it to work…Health and care in out local community is something that will affect us all –I have elderly parents /in laws currently seeing the good and the not so good of the local health system and having been involved with the local health scene in one way or another for many years want to see it genuinely response to and mindful of what the local people want of it.
People from SEAP will be there so I would advise being brief when talking about advocacy as too much talk about that will take us off topic. They would most likely debate what advocacy means in this context, given the chance. I have changed the bullet point to keep it in line with legislation – I can explain more if needed.
This is still a bit of a blank canvass-and indeed it remains to be seen how far the local Healthwatch freedoms will be tempered by the national guidance/requirements –from Healthwatch England/CQC and beyond.To date the signs are quite encouraging in so far as the national guidance documents from the LGA/DoHetc have been useful and informative.
Anyway hopefully thatmay begin to get your creative thinking caps on and/or to start to generate comments /questions etc..We will however at this point move rapidly onto the complementary presentations being given by our guests starting with Lynne Rigby from PDF.
Aims/format of the morning : To begin to build the governance arrangements for the new local Healthwatch Portsmouth……Two part event : initially hearing from other organisations to get us thinking about some of the issues and Asking you to help us with the design.
NHS Organisational landscape post Health and Social Care Act 2012: Its complicated !
Context: The big society Agenda aims: To unleash entrepreneurial spirit Give communities more power Encourage communities to take an active role in their communities Transfer powers from central to local government/open government Support cooperatives, mutuals‟ charities and social enterprise.
Healthwatch: the new local consumer champion for healthand social care Comes into being from 1/4/13 Seeking to involve patients /users/carers and the wider public as stakeholders in in health and social care Working on a firm evidence base –gathering local views on health and social care Engaging with the community and individuals Working with the NHS /LA and all interested others –to improve care pathways. Inspection powers/rights to visit services to monitor service delivery
Local Healthwatch (continued) Individual NHS complaints advocacy Signposting and advice to help make choices in health and social care
Local Healthwatch is still emergent and lots ofunanswered questions e.g.: It‟s a membership body ..but what does this mean? How does it work with other organisations How does it prioritize a potentially huge agenda How does it really engage and involve the local community
How will we establish and appoint to the permanent Board i.e. Chair /membership /constitution etc.? What do we assume are members mandates/roles responsibilities? Who /should we co opt to the Board ?(eg open invites to relevant stakeholders/partners Should we establish sub committees /focus groups etc?..etc?etc..?
PDF is a local User Led non political lobbying and campaigning group recognised by Portsmouth City Council and the Primary Care Trust amongst many others as a Consultative Disability Group. PDF Membership consists of individual members, members nominated by voluntary organisations, statutory organisations (who have no voting rights) and interested individuals.
PDF is a legally constituted registered Charity, with a Memorandum and Articles of Association, including a set of standing orders. PDF is also a Company Limited by Guarantee. PDF also have a non-legal status as a User Led Organisation.
Clarity of purpose and structure Commitment of individuals as Trustees/Company Directors Recognition by others specifically in terms of accessing funding The requirement to operate as a business, professionally and appropriately.
Reporting responsibilities to the Charity Commission and Companies House Requirement to operate under all employment, health and safety laws etc. The impact of government regulations changes to working hours, holiday requirements, pensions and redundancy. The Red Tape environment
PDF CORE STAFF PDF PRINCIPLE OFFICERPDF TRUSTEE PDF PROJECTS BOARD FRANK SORRELL CENTRE
There are two fundamental premises for ULOs’ modelled on Centres for Independent Living:• that their work is underpinned by a social model of disability perspective• that the organisation’s constituents constitute the majority of the governing and other decision making bodies.
provides support to enable people to exercise choice and control is a legally constituted organisation has a minimum of 75 per cent of the voting members on the management board drawn from the organisation’s constituency is able to demonstrate that the organisation’s constituents are effectively supported to play a full and active role in key decision-making has a clear management structure
has robust and rigorous systems for running a sustainable organisation (e.g. financial management/contingency planning) is financially sustainable as there will be no ongoing central government funding has paid employees, many of whom must reflect the organisation’s constituency identifies the diverse needs of the local population and contributes to meeting those needs is accountable to the organisation’s constituents and represents their views at a local level
supports the participation of its constituents in designing, delivering and monitoring of the organisation’s services works with commissioners to improve commissioning and procurement.
Our Aim is to promote the care, welfare, interest, education and advancement of disabled people their families and personal assistants and their independence and inclusion within the community of Portsmouth and the surrounding areas. We work with service providers and other disability organisations to ensure that disabled people get the same rights and facilities as everyone else.
We facilitate consultation with our members We work in partnership with Portsmouth City Council and other Service Providers We provide and promote conferences on disability We inform service providers of preferred delivery of services We identify the lack of or gaps in services We advise on disability access issues
We monitor services for good practice We identify key topics of interest to and for our members in order to incorporate into existing working groups or new groups as required. We signpost individuals and organisations to other relevant services/organisations
At our fully accessible Frank Sorrell Centre, with a conference room, two interview rooms, three accessible toilets, accessible kitchen and ample car park. PDF has been gifted these premises from the Frank Sorrell Trust which in 1983 opened the building as a Disabled Living Centre. PDF has had a very productive partnership with the Trust as the way we use the building is in total accord with their original aims, which is why the building has been given to us.
PDF manages the DIAL (Disability Information Line), which is linked to the national DIAL network. PDF manages the Shopmobility Scheme running from Arundel Street Portsmouth. PDF manages the Portsmouth Parent Voice Coordinator, on behalf of a group of disability organisations, as part of the Aiming High for Disabled Children Agenda. PDF supports the Get Together group which is a version of the Duke of Edinburgh award for people with LDD.
2012 adds to existing duties Duty to hold non-executive directors, individually and collectively, to account for the performance of the Board of Directors Duty to represent the interests of the members of the Trust as a whole and the interests of the public 1/29/2013 Page 31
Public, patient /carer, staff constituency 14yrs age minimum Public meetings Vote Public Benefit Corporation Greater say in how services are provided 1/29/2013 Page 32
One or more Directors to attend, when required, Council meeting for the purpose of providing information about the Trust’s performance of its functions or the director’s performance of their duties; ‘Significant transactions’ must be approved by Governors – description/definition of significant transaction can be included in constitution; Council must approve intention to merge or acquire; Must decide whether the private patient work would significantly interfere with the trust’s principal purpose; Governors must approve any proposed increase in private patient income of 5% or more in any one financial year; Amendments to the constitution must be approved by the Council of Governors Approval needed by at least 50% 1/29/2013 Page 33
A copy of the agenda of each meeting of the Trust Board to be sent to the Council of Governors; After each meeting of the Trust Board, a copy of the minutes must be sent to the Council of Governors. 1/29/2013 Page 34
To act in the best interests of the trust and to adhere to its values and code of conduct; To hold the board of directors collectively to account for performance and ensure that the board of directors acts so that the trust does not breach the terms of its authorisation; To regularly feed back information about the trust, its vision and performance to the constituencies or stakeholder organisations that either elected or appointed them. 1/29/2013 Page 35
At least half of the Board of Directors - Non - Executives Non-Executive Directors to be member of public or patient constituency Non-Executive Directors appoint/remove Chief Executive Register of interests of directors 1/29/2013 Page 36
Council of Governor meetings Joint meetings between governors and directors Subgroups Meeting organisation 1/29/2013 Page 37
Appointment of Chair and NEDs Approval of appointment of CEO Approval of appointment of auditor Setting remuneration of Chair and NEDs Holding Board of Directors to account Communicating with members 1/29/2013 Page 38
• Registered charity that is governed separately to the university• Regulated by the University AND the charity commission• Funded by the University of Portsmouth (c935,000), commercial trading (c100,000) and membership fees (c260,000)• Managed by permanent staff and represented by student officers• Governed by a Board of Trustees – 5 sabbaticals, 3 students, 3 externals, 1 university nominated• Provides representation, sports, societies, student media, volunteering and a small amount of trading activity• Turnover of about £1.7M
Activity 2008/09 2010/11 2011/12Athletic Union memberships 4,128 2,850 2,959Athletic Union clubs 48 34 35Societies memberships 3,178 3,767 3,503Societies 68 90 90Student media volunteers Not measured 1,121 (sign-ups) c250 contributorsCommunity volunteers Not measured 222 384Community volunteer hours Not measured 4,056 4,991RAG money raised Not known 26,031 73,000Election turnout 2,657 4,122 5,027Unique visits to UPSU.net during October Not known 28,798 44,447Student satisfaction 64% N/A 76%
Our vision “A positive impact with every Portsmouth student” Our valuesInclusivity Member Student Honesty Transparency Courage focus leadership Our strategic themes 2011 - 14Innovation & The local Stakeholders Finance & Qualitygrowth community resources
• Student officers are the face and voice of the organisation• Union services managed by permanent staff• Political leadership = President• Operational leadership = Chief Executive• The Board of Trustees set strategy and provide the Chief Executive with work plan and budget• Students set policy via general meetings and student council• The Board of Trustees is the most senior authority
The Trustees are ultimately accountable for everything that happens in the Union; they are responsible for upholding the law and overseeing management. The democratic structures are responsible for setting the policy framework within which the Union operates. The democratic structures inform and The Trustees hold management to guide the operational work of the account, performance manage theUnion, elect the sabbatical officers and Chief Executive, scrutinise thethe Chair of the Board. The democratic operational work of the Union and structures pass policy that provides act as guardians of the Union‟s the boundaries within which the vision and values Union‟s work is carried out. Chief Executive Senior Management Team Managers Coordinators / Front line staff Union Operations
The Board satisfy themselves that they have the right tools to govern effectively. These include: • A defined scope of delegation for operational activities • An annual agenda cycle for Trustees business • A range of sub-committees to scrutinise and oversee high risk areasThe Board also receive information that provides context to decision-making and a better idea of the impact they have. This includes: • An annual cycle of presentations from Union departments / activities • Annual satisfaction survey reports from beneficiaries, funders and staff
• Students influence the Union both formally and informally, to ensure that we remain student ledFormal Informal• 8/12 of our Board are students • Regular satisfaction surveys• Over 5,000 students vote in our • Feedback through our serviceselections to choose our 5 • Participation rates in our activitiessabbatical officers and services• Student Council • Talking to us!• General Meetings• Annual Members Meeting• Referenda• Student CommitteesExamples of „bottom-up‟ change• Creation of the „DCC‟, gender neutral toilets, usinglocally sourced fish within the whole University,
We have sometimes found that a tension can exist between these stakeholders Can funders and beneficiaries objectives be aligned? Can you satisfy both? Are they mutually exclusive or not? ‘Like a partnership between a cat and a mouse’?
Public & Patient Local Involvement HealthwatchCommunity Health Involvement Forums Networks (LINk) Councils “a new system of From April 2013 Local Authority representatives, patient and public A responsibility for nominees from local involvement in NHS health care and Advocacy Third Sector bodies health for England involving social services Signposting and members appointed by the traditionally hard to Facilitate and Advice Minister in response reach groups" influence to advert consultation Health & Wellbeing Co-opt non-voting CPPIH recruited Board members to the members to the Specific Enter & Council. Forums View Powers Right of entry Abolished in 2003 (in England) Represent Abolished in 2008 Abolished April 2013 Empower Inform
Outreach & Evidence &Intelligence Research Governance & Membership
HWP Governance Model (A) Healthwatch HWP Board Portsmouth •Corporate body •Oversees “Enter & View” powers (HWP) •Commissions ad-hoc research groups •Represents HW 1 Re p Health & Signpostin Wellbeing g Board Advocacy 3 Service 4 Elected Public User Governor involveme Groups s nt 3 Delivery Partners Healthwatch Network Members Healthwatch Community Researchers Healthwatch Governors
HWP Governance Model (B) Healthwatch HWP Board Portsmouth •Corporate body •Oversees “Enter & View” powers (HWP) •Commissions ad-hoc research 1 Re Health & groups p Wellbeing •Represents HW Board Signpostin g 7 3 Governor Delivery s Partner Advocacy Advisors Public involveme nt Membership Elects Healthwatch Network Members Healthwatch Community Researchers Healthwatch Governors
HWP Governance Model (C) HWP Board Healthwatch •Corporate body •Oversees “Enter & View” Portsmouth powers 1 (HWP) •Commissions ad-hoc Re p Health & research groups Wellbeing •Represents HW Board Signpostin 5 g Members 3 Advocacy Delivery Partner 2 Reps Public involveme nt Membership “Senate” of 10 Governors Healthwatch Network Members Healthwatch Community Researchers Healthwatch Governors
Community Strategic Direction Public Scrutiny Intelligence CQC Sec. State HWEnglan NHS d NCB Health Local Health & Overview & One Seat Healthwatch Wellbeing Scrutiny Board Panel Enter & View Cross Referral Information & Powers Attendance PowersSignposting Strategic Commissioning Democratic Challenge BoardAdvocacy & Complaints PCC/Public Health/CCG Policy developmentPublic & User Involvement City wide organisations Task group investigation