An engagement & support event for voluntary &
community sector (VCS) and Healthwatch
representatives on Health & Wellbeing Boards or
their sub-groups across London.
19th September 2013
10am – 1 pm
Resource for London
LVSC October 2013
Present
Ann Hayes
Brigid Brennan
Bryan Smith
Donald Roy
Gordon Owen
Kathryn Williamson
Laura Luckhurst
Michael Kerin
Olive Hamilton- Andrews
Pat Kenny
Patricia Turner
Shane Britton
Shepetim Alimeta
Varsha Dodhia
Vivien Giladi
Workers Educational Organisation
Royal Voluntary Service (RVS)
ISS FS Education
Healthwatch Wandsworth
Project @Messrs G Owen & Co
Richmond CVS
Greenwich Action for Voluntary Service
St Joseph Hospice
Redbridge Health & Wellbeing Board
Revolving Doors
Kingston Voluntary Action
Revolving Doors Agency
Refugee Council
Namaste Care
Voluntary Sector Enfield
Speaker
Dr Paul Plant, Public Health England (London Team)
Facilitators /note takers
Alison Blackwood - LVSC
Sandra van der Feen - LVSC
1) Introductions and overview of the two year project
Regional Voices (including LVSC for London) has been awarded funding from
the Department of Health’s Innovation, Excellence and Strategic Development
fund (IESD) to support effective voluntary and community sector (VCS) and
Healthwatch engagement with Health and Wellbeing Boards (HWB), both where
there is a VCS representative on the board and where there isn’t. The
programme, which will run for two years aims to:
 Support effective VCS & Healthwatch engagement on and with Health and
Wellbeing Boards;
 Create a learning exchange network to share good practice that supports
individuals, board structures and government; and
 Develop effective and robust routes for dissemination and collation of
information to support HWBs through support meetings (two per year), online
updates and, where appropriate, resource development
The overheads from the presentation can be found here
1
The 33 Health & Wellbeing Boards in London – all different in
structure and membership – participants share their
experiences in their local areas
2)













Kingston Voluntary Action - Healthwatch and VCS sit on the HWBB and
both have voting rights. Both Healthwatch and KVA sit on JSNA Working
Group. Kingston VCS Strategy in partnership with local authority
Redbridge - Have community representatives and CVS involvement. Two
meetings have taken place. The JSNA is being refreshed
Greenwich CVS - Are delivering Healthwatch. Supports Healthwatch and
VCS representatives. Healthwatch has a place on the HWBBB but there is no
VCS representative
Newham - interest in Homelessness but Newham has scatty information on
the HWBB – not come together
Enfield - elected VCS rep on HWBB. Health lead of Enfield of 50s sits on the
JSNA Strategy Group and writes report for the CVS newsletter which has a
good reach.
Richmond CVS - HWBB only has statutory member (Healthwatch). Is
lobbying for representation. Good relationship and VCS involved to a degree
but want to engage and communicate with Board more.
Hackney - Had good shadow Board. Both Healthwatch member and
designated VCS representation. There is also a Health & Social Care Forum
and VCS members are nominated through that Forum. St Joseph Hospice sits
on HWBB Working Groups at officer level. People feel quite engaged but
integration of services only privately discussed. Question on how effective the
process really is.
Refugee Council Health Befriending Project - Wants closer links with
JSNAs, CCGs and Healthwatch. There are links with the local Healthwatch
but difficult to get issues taken forward. There is little capacity for small
refugee organisations to put into the agenda
Workers Educational Organisation - Deliver community interpreting and
training including people who become reps on Hackney LINk. Would like
greater understanding of the HWBBs and involvement
Revolving Doors Agency - London based: complex needs – links to HWBB
and want to influence. Used group feedback to try and get them involved.
Revolving Doors - member of Camden Healthwatch. Slowly getting there.
Healthwatch Wandsworth - Works quite well allowing individual members,
which is quite unusual. HWBB is quite restricted – Healthwatch members not
allowed a vote. There are no VCS reps. Councillors and Clinical
Commissioning Groups (CCG) reps have voting rights, but officers don’t.
Local Partnership Board is large with up to 60 organisations including VCS.
Harrow Healthwatch - Varshia is Chair. Healthwatch has seat but some
members have voting rights, whilst others don’t (Healthwatch does but officers
don’t). Good shadow Board – which makes big decisions. North West London
“Shaping a Healthier Future”. (involves 8 CCGs and hospitals and 7 local
authorities – have to work closely together
2
Group discussion
Key issue of concern:


Some HWBBs have no voting rights except for clinical members and
councillors (e.g. Wandsworth) – this is a big issue of concern
There are high expectations from the reps – can they be realistically met?
What are the issues for reps and where there is no VCS representation? What
needs to be done to ensure engagement?
 Enfield has good democratic process
 Hackney – not one way into the system – different structure, but well
established Health Forum – organises steering group meetings to facilitate
better engagement
 Priorities are very broad in some areas but more specific in other areas
 Carry out information to groups through mail-outs
 There is engagement in Wandsworth – have a forum but loudest voices
dominate
 Use “soft power” to try and engage
 Signpost to facilitate engagement
 Need accessible information at day centres, homeless centres etc. The places
are there but not the information to facilitate engagement
 Information needed for local people to engage – needs posters and flyers
What are the gaps?
 Range of cultures and groups – different needs
 How accountable? – discussions in public – some opportunities to feed in, but
how/where are the HWBBs held to account?
 Lack of VCS representation
 Hard to reach communities – elderly
 Isolated groups – e.g. BAMER, older people (e.g. housebound) – they have
no access to internet and are therefore hard to reach. Enfield VCS need to
support them
 Loudest members of Forums dominate (see above)
 “Least popular” groups hard to engage
The LVSC Who’s Who guide for London provides contact details of the
representatives on the HWBBs. Please notify us if you can provide us with further
contact details as the guide needs updating regularly
3) Table discussion
1) What is the value of meeting at a London wide level?
 Virtual – look at Pan London initiatives like Mayor London Health Board
 Not sure because of the wide variety of different approaches – except to focus
on specific key issues and for trying to develop a London wide picture of
priorities
3



2)










Helpful to have informative speakers that at borough wide level we may not
have access to
Useful for sharing good practice and encouraging joint working
How is the re configuration across London impacting neighbouring regions?
Might be worth finding out for organisations that cover other regions
What can LVSC do to help HWBB reps?
Sharing resources and information through the 33 boroughs
Sharing information from the Academic Health Networks
Practical things – policy updates (or pointing them out)
Explain the commissioning cycle
Influencing skills training
Continue to engage with VCS
Provide more explanation of terms, of new organisations for the non- health
sector people
Steer for more joint working so that the strategic issues can be addressed
How can LVSC help Londoners feed into the London Health Board?
Development of the Who’s Who guide – create a echelon borough by borough
so we can see connectivity
3) What can LVSC do to help VCS engage with health and care in London?
 Provide more engagement with different HWBBs in London as it seems like
there is a wide gap on representation and equal voice
 Provide comprehensive summaries /briefings of topical information that would
be helpful to the VCS
 Link up with CCGs and Public Health in order to feed in the concerns of the
sector
 Look at issues regarding the pressure on care homes for care and financial
sustainability in terms of local authority purchasing /tariffs
 Workforce development in social care – staff training
4) What should we be lobbying about?
 Lobby for VCS engagement at all levels – citing good examples – e.g. where
they exist
 Lobby for increased and effective representation and involvement of VCS in
HWBBSs and relevant sub groups
 Lobby for increased links between HWBBs especially in same geographical
areas
 Press for greater uniformity (based on good practice) across London
 Specialist commissioned services across London via NHS England, including
cancer services
 Community representation on the London Health Board Living wage /zero
hour contracts
 Living wage /zero hour contracts
 How to influence health policy and investment in London?
4
4) Dr Paul Plant: Deputy Director Health Improvement, Public
Health England (London region):
London Health Board
Paul Plant’s presentation can be downloaded here








Paul’s team: aim: to keep people healthy; helping the new commissioning
landscape and gathering health intelligence
Yvonne Doyle – Advisor to the London Mayor, Regional Director of Public
Health
No direct interaction with VCS directly, but everything in new health and social
care system is done at a local level. VCSs need to connect with their local
Directors of Public Health, HWBBS and CCGs
VCS have good understanding of the wider social determinants of health –
how to get that into the system. We have a strong commitment to work with
VCS – how work with the public?
Priorities for HWBBs – some only on individual websites; some come from the
NHS; others describe the areas differently. Big issue is mental health, also
obesity, mainly focusing on children. Mental health – focus on first 6 months of
life (including mental health of parents); adolescence and resilience. GLA
published business case for: economic investment in early years
Academic Science Networks work on integrated mental health programmes.
There are 15 AHSNs – 3 in London: South London Academic Health Science
Network. North East and North central London (UCL) AHSN and Imperial
College Health Science Centre
JSNA – topic refreshing over time. They are comprehensive but at different
stages of development
London Health Board – London Mayor is the Chair. The Health Science
Networks are involved. Social care is part of its focus – e.g. making the case
for investing in social care in London (see also overheads and website
Questions /issues of concern:
 Where is the connectivity between all the sections and where is the voice of
reality? How to get the work on the ground at a regional level? Answer: the
Boards aims to help to improve the system and make the links and help
improve primary care. However, the Board is not a representative body or
intended to be. It is not a structure like the HWBBs – this Board doesn’t
make decisions. There is no budget associated with the Board and it doesn’t
have a commissioning role
 Children’s budgets are very low as work on safeguarding takes all: Children
& Young People VCS organisations are really struggling. Answer: GLA will
publish international evidence on return on investment on prevention and
early years in November this year. Social justice will feed into the economic
model. This should help with evidence base to present to commissioners
 Figures on homelessness and overcrowding – is that being looked
anywhere? Doesn’t seem to be on any policy agenda because of the
5
economic downturn. It’s becoming a bigger issue and is an inequality issue.
Answer: there is Marmot report on this – Indicators for HWBBS, Hackney
and Lambeth pilots across 4 boroughs. Work with boroughs and use
resources e.g. on London Health Observatory which is part of Public Health
England. See also Government Public Outcomes Framework (2013-2016)
5) Way forward – actions for LVSC and Regional Voices
Regional Voices will:
 Discuss the key issues, concerns and recommendations raised at all
regional events with the regional voices partners, including LVSC, to
ensure effective and appropriate support and resources for VCS and
Healthwatch members of HWBBs in all the regions
 Develop an online network that takes on board the suggestions
/recommendations made at the individual Regional Voices’ events and
produce, share and/or build on resources and good practice where
appropriate
 Publish the results of the recent on-line survey of VCS and Healthwatch
members of the HWBBs
 Lobby for VCS representation and equal voice on all the HWBBs.
 Lobby for voting rights of Healthwatch members of the HWBBs
 Build on the links developed with CCGs, including CCG Support Units as
well as HWBBs
LVSC will:
 Publish and disseminate a short event report to all participants and
through the new monthly Influencing support bulletin
 Share the key issues raised at this event with the Regional Voices’
counterparts to ensure effective support to VCS and Healthwatch
members of HWBBs and their sub groups
 Signpost VCS and Healthwatch representatives to relevant London wide
information/resources/good practice in the monthly e-bulletin – e.g.
information from the 3 London Academic Health Science Networks,
London Health Board, etc
 Signpost VCS and Healthwatch representatives to local HWBB good
practice and case studies where appropriate
 Develop an on-going dialogue with the London Health Board so that
issues, concerns and evidence from VCS and Healthwatch members are
taken forward
 Liaise with Regional Voices to ensure that relevant and accessible
information is produced and disseminated, including posters and leaflets
where relevant
 Lobby for the issues as raised by participants
 Produce /adapt relevant jargon free summaries/briefings where
appropriate which are also relevant for non-health sector organisations
 Signpost reps to influencing skills training
 Coordinate a second engagement & support event for March 2014
6