To provide the committee with an overview of Healthwatch Herefordshire and its work, Government proposals to abolish Healthwatch England and Local Healthwatch, and principles for future delivery of Healthwatch’s functions.

The committee received an overview from Christine Price, Chief Officer of Healthwatch Herefordshire, covering the organisation’s statutory role, current areas of work, and the national proposals arising from the Dash review.

The principal points of the discussion are summarised below:

1. The report included in the agenda papers provides background information on Healthwatch since its establishment in 2013, along with an overview of its statutory duties.

2. There are Government proposals to abolish Healthwatch England and local Healthwatch bodies, replacing them with a national ‘patient experience’ function and locally assigned duties for ICBs and local authorities.

3. A forthcoming white paper is expected to provide further detail in the new year. It would take approximately a year for this to progress into legislation, during which time Herefordshire Council will remain responsible for commissioning Healthwatch in its current form. A transition period is also anticipated ahead of any potential changes set out in an eventual Act of Parliament.

4. There is uncertainty over a number of areas, including funding arrangements, staffing implications, and clarity on the scope of future functions until there is more detail from the Government.

5. Healthwatch England’s development of five principles for future patient voice models, with concerns raised about potential loss of independence, in particular.

6. Key Local Healthwatch activities include:

7. The council continues to monitor developments closely, despite the uncertainty surrounding future arrangements. As a general principle, the council remains committed to supporting whatever structure is needed to ensure residents’ voices are heard.

8. Alongside the role of Healthwatch, many parts of the health and care system involve people and groups who engage with service users and patients in different ways. Currently, the collective insight from these sources is not being fully utilised, which presents an opportunity for the future model to bring this feedback together.

9. In relation to the development of Patient Participation Groups (PPGs) across the county, particular reference was made to Hereford Medical Group (HMG), where the PPG is now operating as an autonomous body rather than one managed by the practice. This was highlighted as a positive example demonstrating how independent patient voice can support constructive collaboration with a General Practice (GP). Committee members noted that this could provide a template for other practices seeking to enhance the effectiveness of their PPGs.

10. In response to a question about using Enter and View powers to visit care homes, it was noted that securing a care home’s participation can be bureaucratic and that the process is still often perceived as inspectorial, despite the intention being to engage with residents and families. It was further commented that the visits are highly managed, with care homes presenting themselves in a particular way, and that the significant time and resource required often yields limited tangible feedback.

11. Committee members discussed the importance of safeguarding independence in any future model, risks to community intelligence if statutory functions are fragmented, and the need for strong local mechanisms to ensure patient voice influences decision?making.

12. The Director of Public Health noted that connecting quantitative data across the system remains a significant challenge, even within a single organisation, and even more so across multiple ones. It was further highlighted that integrating qualitative data is even more complex, given the varied ways it is collected, the different platforms used, and the difficulty of bringing it together cohesively. The aspiration is to develop a Joint Strategic Needs Assessment that incorporates both quantitative and qualitative data, using this combined insight to better understand patient experiences and inform what matters most for communities.

13. In response to a question about whether there are plans for a joint local plan between the ICB, the council, and Healthwatch that outlines transition protections for the next twelve months, it was noted that no such plan exists at this stage, as there is still limited information about what will be happening.

14. In response to a question about what would be lost if Healthwatch were abolished, it was noted that Healthwatch provides a valuable “helicopter view,” offering independent information and advice to individuals, particularly those who may feel overwhelmed. This broad perspective helps address a range of issues that span both health and social care. It was added that work is also carried out with specific communities, where trust is built over long periods of time to understand their unique challenges, often relating to inequalities affecting different groups, including the learning disability community.

15. The committee agreed that the Chairperson should write to the Secretary of State for Health and Social Care, emphasising that any future proposals should be centred on the five principles set out by Healthwatch in their report.