Decision Making

Healthwatch Wandsworth makes its decisions in an open and transparent way and ensures the interests of the people of Wandsworth are always put first. This policy and associated procedures outline the steps taken to ensure decisions are evidence based and lead to substantive impact in the community. This policy applies to all relevant decisions made by Healthwatch Wandsworth.

The governing regulations and standards are:

  • The NHS Bodies and Local Authorities (Partnership Arrangements, Care Trusts, Public Health and Local Healthwatch) Regulations 2012 – referred to as Regulation 40 throughout this document.
  • Freedom of Information Act 2000.
  • Seven Principles of Public Life (Nolan Principles).

Role of the Healthwatch Committee

The Healthwatch Committee is responsible for setting the priorities for Healthwatch’s activities each year, working with the Healthwatch Manager. The Committee has eight members who participate on a voluntary basis as lay members (persons who are not a health or social care professional): four of these are Trustees of Wandsworth Care Alliance (WCA) and are appointed by the WCA Board, four are elected by members at Healthwatch Wandsworth Assembly events. The Committee is chaired by one of the WCA trustees and the vice chair is one of the elected members. WCA is the host organisation for Healthwatch Wandsworth, meaning that it employs Healthwatch Wandsworth staff and holds the budget for its activities. To ensure the complete independence of the decision-making process, the WCA Board has formally delegated this responsibility to the Healthwatch Committee but WCA retain overarching responsibility as the corporate body delivering Healthwatch Wandsworth. WCA expects the Healthwatch Committee to take account of any relevant guidance on processes and procedures issued by Healthwatch England.

The decision making process is expected to be sufficiently flexible to respond to any major changes in the policy environment. It is used by staff on a regular basis to drive their daily work and is used by the Committee when deciding priorities and the direction of work. The Committee has the power to delegate some of the relevant decision making to the Lead Officer of Healthwatch Wandsworth, for example, being able to make decisions on things that have already been set as priorities that will have already been agreed by the Committee and small pieces of work which do not have a substantive impact on staff or financial resources. There may be some instances where focusing on one priority might make it not possible to focus on another. There also may be new priorities that come up. The Lead Officer reports regularly on activity and the Committee can raise questions as needed and sometimes this may be retrospectively. If the Lead Officer is not able to discuss something with the Committee, they can discuss it with the Chair. When the Committee has made a decision, the staff team is responsible for implementation and delivery and reports back to the Committee. `

The Committee will reconsider a decision where new data has become available, or if circumstances change, which might prompt it to reach a different decision, or where there is evidence that this decision making process was not followed.

How we set our priorities

We prioritise our work based on the following information:

  • Public feedback about services
  • We ask the public what they think our priorities should be in an annual survey and at our events
  • Knowledge about strategies of local or national NHS and public health organisations
  • Local context and issues, such as large providers of services in special measures and the Joint Strategic Needs Assessment.
  • National context and issues, such as the NHS Five Year Forward View or significant inquiries or findings.
  • Availability of our own resources and capacity.

Decision making criteria

We use the following points as a guide for making decisions and prioritising where we focus our work:

  • The issue impacts on a large number of people, or has a very significant impact on a smaller number of people.
  • The issue has been raised by a large number of people.
  • There is potential for Healthwatch to make a significant difference or impact on the issue in question and we will be able to demonstrate outcomes and impact of our work (or is there an organisation better placed to do so who we can work with or approach).
  • The issue fits with Healthwatch priorities or the priorities and timescales of other strategic local commissioners, providers and organisations.
  • The issue has been raised and evidenced by a representative organisation with specialist knowledge of concerns or views of local people, such as the Care Quality Commission (CQC).
  • The issue highlights gaps, such as gaps in service delivery or the voice of local people is not being considered.
  • The issue affects people who are less likely to be heard or highlights the experience of excluded communities on challenging issues that may disproportionately affect people with protected characteristics and create or perpetuate inequality.
  • We have sufficient resources and capacity.

Opportunities for people to inform our work and share their experiences of health and social care include:

  • Attending our Healthwatch Wandsworth Assembly events.
  • Speaking to our community outreach team at local community events, meetings and workshops.
  • Sharing views when our Enter and View team visits services.
  • Sharing views via our website and social media.
  • Contacting our Information and Signposting service.

Healthwatch Wandsworth invites local people to become members to keep up-to-date with our work and to hear from us about opportunities to become involved by signing up to become a member.

Covid-19 addendum

The Covid-19 pandemic had a major impact on the work of Healthwatch, preventing the usual activities involved in outreach and ‘Enter and View’ visits. Clearly, this impact will continue for some time. The Committee will need to continue to take account of the potential risks to its own staff, volunteers and service users when planning how to fulfill Healthwatch’s duty to collect the views of service users and the wider community on the adequacy and quality of health and social services in the Borough.

Staff and the committee have drafted additional decision making questions and a risk assessment template for undertaking face to face work. These documents include consideration of: where the workshop/meeting/forum will meet, which communities we expect to meet, assurance that we are following government regulations, why the engagement has to take place and assessing if the benefits outweigh the risks and measures that can be taken to reduce risks.