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White Paper Stakeholder Briefing

A new people’s voice body for health and social care:

Our proposals

The White Paper: Services fit for the future recognises a need for a strong people’s voice across health and social care in Wales.

CHCs welcome the intention to create a stronger peoples’ voice across health and social care.  We are not convinced however that the proposals as outlined in the White Paper will achieve this and are concerned they will dilute rather than strengthen this voice in the NHS.

We believe a new, strong and meaningful peoples’ voice body should be designed and developed in Wales, for Wales.  We should learn from others’ approaches and experiences and build on what is valued within our own current arrangements.

Over the summer CHCs have asked people what is important to them and looked at the different arrangements across the UK and beyond.  We considered in detail what others have said about the strengths and weaknesses of the different models.

From our analysis we have developed an outline for an alternative proposal that we think is better placed to fulfil the aspirations set out in the White Paper.

We have set out our ideas below and want to seek the views of a broad range of partners so that together we can build a consensus around a new model for the future.

Why do we need a people’s voice body at all?

We agree with the aspiration set out in the White Paper that health and social care bodies should get things right for themselves by continuously engaging with their communities.  We also know that these bodies do not yet get this right every time – and we do not believe that new legislation alone will make this happen.

In Wales, by and large we don’t have a market driven health and care system.  It’s therefore important that our services are created with and for the people that use them.  Not only do services need to engage on the matters they are thinking about, but people must have the opportunity to have a collective voice on the things that matter most to them.

Health and care organisations have the responsibility to respond appropriately when concerns are raised with them.  However, those people in the most vulnerable situations may not be in a position to raise their concerns without independent support.

The purpose of a new people’s voice body in Wales should therefore be to:

“reflect the views and represent the interests of people in their health and social care services”.

What should a people’s voice body do?

Over the summer we have listened to what people in Wales think is important for a new people’s voice body.  We have looked at what other countries do, and what independent reviews have said about their arrangements. We have reflected on what works well in our current arrangements.

We have used what we have learnt to identify what we believe should be the core elements of a new people’s voice body to meet our distinctive needs in Wales.  The following table sets this out:

CHC functions and powers that should be transferred to a new people’s voice body covering health and social care

 

Why?
Promotes, advises and supports providers on engagement and consultation activity Helping health and care bodies to get things right first time is better for individuals and communities

 

Monitor and evaluates effectiveness of providers engagement and consultation

 

To check that people have the opportunity to influence and inform their health and care services – and not to check compliance against standards for engagement.  We think this sits better with others

 

Encourages and supports local community engagement and involvement through others

 

 

 

Learning from Scotland, we believe there is an opportunity to do this differently and better by building an alliance with others so that people and communities have the best possible chance to have their say

Facilitates and  co-ordinates engagement activity undertaken by others

 

 

Engages directly with patients, clients and those who care for and about them whilst accessing services

 

 

 

To hear from people about their experience, see for ourselves and respond in real time

Unannounced access to health and social care wherever care is delivered

 

Engages directly with wider public

 

To hear first-hand from across our communities to gather the widest range of views and experiences

 

 

Signposts and promotes advice and information on health and social care services To help people find the information they need
Right to be heard in health and social care (including on service change)by:

 

–      Policy makers

–      Service providers

–      Scrutiny bodies

 

So that decision makers in health and social care listen and act on the views and experiences of people
Scrutinises health and care policy, plans and performance locally, regionally and nationally

 

So that people’s voices are heard and acted upon in decision making at every level
Right to be involved in design and development of services (including service change proposals)

 

So that people’s voices are heard and acted upon in decision making at every level
Supports and provides assistance to individuals raising concerns

 

So that people, particularly those in vulnerable situations, are able to have their specific concerns heard and addressed

 

Sets standards for governing its activities

 

So that people across Wales know what they can expect from their people’s voice body, and can be sure that the activities carried in their interests are of a high quality

 

Support service improvement through sharing ideas, information and concerns

 

So that decision makers in health and social care listen and act on the views and experiences of people to improve services for everyone

 

 

Additional functions and powers for a new people’s voice body covering health and social care

 

Why?
Right to public response on concerns raised So that decision makers are accountable to individuals and communities and people can see the impact of their voices

 

Right to be heard by:

 

  • Regulators

 

So that regulators in health and social care listen and act on the views and experiences of people

 

 

 

Right to scrutinise the work of health and care regulators, inspectors, etc So that those providing assurance are themselves accountable to individuals and communities
Service providers should have a duty to facilitate hearing directly from patients by forwarding information to existing and former patients

 

So that the people’s voice body can hear about all aspects of people’s care in and out of hospital and across health and social care
Right to challenge policy makers and service providers and report concerns to responsible bodies where there is a breach of any standards or requirements relating to engagement and consultation

 

So that policy makers and service providers account for their actions and decisions

 

We do not believe a new people’s voice body should have the following functions, duties or powers.  Some of these form part of CHCs existing functions whilst others are proposed in the White Paper.

Functions, duties and powers

 

Why shouldn’t these be part of a new people’s voice body?

 

Develop standards and guidance for engagement and consultation

 

Experience in Scotland shows that this responsibility sits better with others.

 

We believe the responsibility for setting standards should sit with the government.

 

The new people’s voice body and others should inform and influence the setting of these standards

 

Provides advice and information on health and social care services We believe the responsibility for this should be with health and social care bodies.

 

The new people’s voice body must have the right to challenge services where the advice and information is not sufficient, clear, accessible or accurate.

Inspect premises We believe this responsibility should sit with expert bodies.

 

Responsibility to develop alternative models to service change proposals where agreement cannot be reached We believe any lay organisation would not be equipped to meet this responsibility.
Right of referral to Ministers on service change proposals

 

We believe a new people’s voice body should not be the decision making body for a proposed service change.  All service change proposals should be subject to public scrutiny.

 

We believe that the kind of engagement/consultation on service change should match the type of change being proposed.

 

The arrangements for service changes should ensure a proportionate and consistent approach across health and social care. We do not consider that the determination of a service change as substantial or otherwise is helpful.

 

Where decisions are not considered to be in the public interest, the appropriate challenge is through judicial review

 

 

What should a new people’s voice body look like?

So that a new people’s voice body is, and is seen to be, independent, we believe that it should be established as a single legal entity on a stand-alone basis.

We believe the organisational design of a new people’s voice body must:

We believe that volunteers should:

A new people’s voice body must be free to determine how it recruits its volunteers.

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