A HealthWatch focus group

Warwickshire LINkWarwickshire LINk ran a focus group on Friday 24th June to gather opinions about how local HealthWatch in Warwickshire should be organized. Local HealthWatch is the body that the government proposes will take over the functions of the LINk, along with additional functions, from October 2012.

I found it useful to participate in the group and hear other points of view. I think it helped me a great deal to clarify my own views about what local HealthWatch should be.

Unfortunately the way the group itself was run was not ideal, and that raises interesting questions about local HealthWatch if it is likely to be run in the same kind of way.

Like the previous Warwickshire LINk event that I attended, this one had been made deliberately difficult to find. We were told the venue was the Masonic Hall in Church Walk, CV21 3AT, but there is no Masonic hall to be found there. The real venue turned out to be half a mile away at The Arnold House, Elsee Road, CV21 3BA. (I know the explanation, but the explanation is not an excuse.) We were told there would be free parking, but the car park was full so I had to park on the street and move my car after a while.

After a good buffet lunch, all twenty-two of us tried to get into a room that had been prepared for about fifteen participants. An enthusiastic facilitator ran a 2½-hour discussion around five broad topics relating to HealthWatch.

The facilitator, and her Teller-like silent sidekick keeping notes on a flipchart, had been hired by the LINk (at considerable expense, I learned from a committee member). She boasted that her company, PPI Solutions, had worked with fifty LINks.

Overview

The meeting began with an overview of what local HealthWatch is, to ensure that all the participants knew the basics. It was based on this Q&A, with the date July 2012 corrected to October. I am hoping to publish my own overview here shortly, so I’ll not cover it in detail. I know from the work I’ve already done on it that it is not easy to pick through all the documents and create a clear picture.

The overview given at the meeting missed out some important points, many of which I pointed out during the meeting:

  • As far as anyone can tell in advance of detailed advice on branding, the Department of Health intends the organization that will evolve from Warwickshire LINk to be named HealthWatch Warwickshire.
  • HealthWatch Warwickshire will have a legal duty to be representative of local service users, including carers.
  • HealthWatch Warwickshire’s exact role in providing the public with advice is not clear yet.
  • HealthWatch Warwickshire will be able to employ its own staff.
  • Warwickshire’s Health and Wellbeing Board will have a duty to promote public involvement, in addition to HealthWatch Warwickshire’s role in public involvement.
  • Commissioners and providers will have a legal duty to have due regard to findings from HealthWatch Warwickshire, which means HealthWatch Warwickshire could take the council, the clinical commissioning group, any NHS trust, or any other care provider to court as a last resort.

Discussion

I took part fully in the discussion, rather than spending a lot of time taking notes. So I’m relying on PPI Solutions’ report for detailed information about what was said.

I’m not confident, though, that the report will accurately capture the views of participants. When I review the report, I’ll be comparing it with the few notes that I did take as a sanity check on its conclusions.

The reason I’m not confident is that while the facilitator was professional in the sense that she was being paid, she did not seem to me to be very professional in the sense of being skilled as a facilitator. I had five particular concerns.

The focus group was not focussed — A focus group should not just be a rambling discussion. This one allowed participants to make speeches that sometimes bore little relation to the questions being asked. As a result, some participants soon felt there was nothing more to be said, and a third of us left early.

The facilitator did not elicit detail — The facilitator did not seem to follow up on what people said to draw out what they really meant and clarify her own understanding. It seemed to me that people sometimes did not feel heard after they had said their piece, so they would say the same thing again later.

The facilitator did not delineate differences of opinion — When opinions differed around the table, the facilitator did not try to clarify the difference and bring it out into the open. If anything, she tended to smooth over differences of opinion and focus on common ground. This meant that some of the points LINk members feel the most strongly about are unlikely to have been captured, though they are precisely the things that will cause the LINk trouble later.

The facilitator’s own opinions were very evident — The facilitator sometimes had to give factual information to participants who had misunderstood something, but this often strayed into giving her own opinion. Also, when a participant said something that was difficult to understand, the facilitator often paraphrased it in terms of her own point of view, instead of going back to the participant to clarify their point of view.

The contents of the flipchart were not checked — The facilitator never referred to the flipchart to ensure that an opinion had been captured accurately. I kept an eye on the flipchart from time to time, and I felt that points were sometimes written there too briefly to indicate what had really been said.

Questions

Finally, it seemed to me that the five questions forming the basis for the discussion were LINk-based questions, not HealthWatch-based questions. Local HealthWatch will come into being as part of a reorganization of health and social care that has clearly-defined objectives, but the questions were not aligned to those objectives.

Instead, the questions were based on the LINk’s existing work, asking about what it means to be a consumer champion, about access, representation and staffing, and how to influence decision-makers. Only the first of those looked beyond the LINk’s present remit, and that only a little beyond because the LINk already has a very similar role.

If and when the report from PPI Solutions is available, I’ll probably review it here. I say “if” because I have not yet seen any report from the previous Warwickshire LINk event that I took part in. My guess is that PPI Solutions will pick out from the discussion those opinions that confirm their own view of HealthWatch. I would be delighted to be proved wrong.

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About Rod

Chairman of the Gloucestershire charity Suicide Crisis, Vice Chair of Relate Gloucestershire & Swindon, and an enthusiast for public involvement in the NHS.
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