By Tony Okotie, Chief Executive, Community and Voluntary Action Tameside (which includes Healthwatch Tameside) and a non-executive director of an NHS Provider Trust.

Margaret McLeod raised a number of interesting points about the role of Healthwatch in her recent blog, Public Engagement in the new NHS – where does Healthwatch fit?, and I tend to agree with many of the issues she raises. However, I believe the debate about whose responsibility it is for engagement and dealing with complaints requires further consideration.

Is there anything wrong with every NHS organisation having someone identified as leading the public engagement? We would say it is vitally important. They all have a statutory duty to engage with patients and the public. By just expecting Healthwatch to have the responsibility, they miss this opportunity to work with the public and patients. The NHS has to move to a sense of ‘working with’ rather than ‘doing to’. That said, the different roles of the National Citizens Assembly and Healthwatch England are not clear – it is muddled and confusing.

I think that we also have to be careful about Healthwatch locally becoming ‘the ‘go to’ organisation when the NHS wants to know what people think about services – I think Healthwatch should be one of a number of ‘must look at’ routes to gaining intelligence but not the only one. They are not funded to do the work for NHS organisations – but to add to it from the perspective of a consumer champion. It’s about partnership working, data sharing and triangulation.

It is probably okay for people to have choice in the way they raise concerns or give feedback about services. What’s important is for the data to be used locally, regionally and nationally in a co-ordinated and meaningful way. For me, this is about cascading detail down to a local level (from whatever source) then having mechanisms to escalate trends and significant concerns up to regional and national level. It is the local contextual knowledge that enables raw data to be interpreted and transfigured into meaningful key messages.

We know from our work with Patient Opinion that service improvements are most likely to happen from complaints and comments when they are responded to as close to source as possible. So by ‘centralising’ this work into Healthwatch, you remove the direct link from the patient to the NHS organisation, and hence the imperative for that NHS organisation to ‘own’, and want to learn from, that feedback.

That is not to say NHS organisations can’t or shouldn’t improve the way that they respond to feedback and complaints. The recently published Clwyd Hart report about the NHS Complaints Service clearly highlights that. We have to make it easier for people to complain and NHS organisations have to see complaints as a positive thing, and an opportunity to improve. Simply moving complaints to Healthwatch is overly simplistic and will remove the ownership of the problem from the NHS.

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