Healthwatch Lincolnshire Annual Report 2016/17

1 Message from our Chair ………………………… 3 Message from our Chief Executive ……… 4 Highlights from our year ………………………. 5 Who we are …………………………………………… 7 Your views on health and care ……………. 10 Helping you find the answers ………………. 19 Making a difference together ……………… 23 It starts with you ………………………………… 30 Our plans for next year ……………………… 34 Our people ………………………………………… 36 Our finance ………………………………………… 40 Contact us …………………………………………. 42

2 Message from our Chair On behalf of the HWL Board of Directors/Trustees I am pleased to present our fourth annual report for April 2016 to March 2017.

This has been a challenging but very I am also very proud of us achieving Finally, I would like to thank all of our staff, productive year for us as an the ‘Investing in Volunteers’ award volunteers and Board. All of you are organisation, and I am delighted to this year and of our new monthly responsible for our success and impact; it is report that our reputation continues to reporting system which is excellent in a privilege to be Chair of HWL and I grow both locally and nationally due to enabling us to provide clear evidence commend this report to you. the hard work and dedication of all of of the intelligence we receive from Healthwatch Lincolnshire Chair those who work for us as staff and the public and of course in supporting volunteers. the positive impact we are making on John Bains health and social care for the residents of Lincolnshire.

Healthwatch Lincolnshire Annual Report 16/17 Page 3 3 Message from our Chief Executive

“During the past year, the challenges facing health and care services in Lincolnshire have sometimes felt overwhelming”.

An example of this is the closure of 5 GP surgeries in West and East Lincolnshire and the effect this will have How do we do this? on patients. “Through the sheer dedication of our staff, volunteers and trustees, without them Healthwatch Lincolnshire would not be Whilst we would commend the neighbouring GP practices who the organisation it is today. I would like to take this stepped in to provide their services to the new patients, opportunity to personally but publically thank them all”. concerns about the impact increased patient list sizes is having on already stretched services has been raised with us. Finally from me, I am very proud to be able to share our Investors in Volunteers Award success this year. This We would like to reassure everyone in our county that achievement demonstrates a real commitment to our Healthwatch Lincolnshire continues to work hard to volunteers and we now plan to build on this success ensure we are sharing your health and care experiences throughout our organisation. with the people that pay for or deliver your healthcare services.

Healthwatch Lincolnshire Annual Report 16/17 4 Highlights from our year

Our website and Our Information We have raised 353 feedback centre Signposting Team questions, helped 1,570 patients, recommendations, has received an carers and service impressive users find their way observations and 53,952 hits through the suggestions complicated health and social care system

This year we've Our reports have tackled Healthwatch volunteers have issues ranging from NHS Health contributed a staggering 1,732 reached 7,778 Checks to Neurology hours of support from April ‘16 people on social to March ’17 media

Healthwatch Lincolnshire Annual Report 16/17 5 Highlights from our year – Where our 353 questions, recommendations, suggestions and observations have been raised

197 questions 101 recommendations 11 recommendations, were raised were shared as a result observations and directly with of our Enter and View suggestions were activities health and made from our Learning Disability care provider NHS Health Check organisations project activities

10 recommendations, Our Public Experience Committee PEC has produced observations and (PEC) has raised: escalation reports suggestions were made for neurology and 16 questions with EMAS following our NHS Transitional Care 8 questions with community health, pathways, both of Immunisation and acute and adult social care, for Screening project delayed transfers of care which asked activities 8 questions about cancer services questions of the service providers

Healthwatch Lincolnshire Annual Report 16/17 6 Who we are

Healthwatch Lincolnshire exists to make health and social care services work for the people who use them. We believe that asking people more about their experiences can identify Everything we say and do is informed by our issues that, if addressed, will make services better. connections to local people. Our sole focus is on understanding the needs, experiences and concerns of people of all ages who use services and to speak out on their behalf.

We are uniquely placed as a national network, with a local Healthwatch in every local authority area in England.

7 Our Vision, Mission and Core Functions

Our vision is for everyone in Lincolnshire to access and receive Vision outstanding health and social care services.

Our mission is to be the consumer champion for all health and social Mission care services for everyone in Lincolnshire.

• Influencing – helping to shape the planning of health and social care. • Signposting – providing information, helping 3 Core people access and make choices about available Functions services. • Watchdog – being a critical, supportive and accountable friend to everyone in Lincolnshire.

Healthwatch Lincolnshire Annual Report 16/17 8 Our 5 Strategic Priorities 2014-2019 (refreshed August 2016)

1. Influencing Health and Social Care services through the delivery of our 3 core functions.

2. Raising awareness on a local and national level of HWL and its impact.

3. Making HWL sustainable for the future.

4. Working in partnership to support improvements in health and social care.

5. Participation and involvement in all aspects of health and social care.

Healthwatch Lincolnshire Annual Report 16/17 9 Your views on health and care

10 Listening to local people’s views

Public Facing Engagement continues to be effective in raising awareness of Healthwatch Lincolnshire amongst Lincolnshire residents and also encouraging people to share their health and care experiences.

Our Volunteer and Staff Team continue to make a huge contribution to this type of engagement. Between October and December 2016, our volunteers visited 68 GP Surgeries across the county. November 2016 and March 2017 were our busiest months for volunteer hours giving their time to Healthwatch Lincolnshire activities. Our Volunteers have supported us in activities ranging from public engagement, training, administration and reader panel support. We have estimated that a minimum of 1,730 hours in 2016/2017.

These hours equate to over 140 hours per month, with a team that varies (because of their other commitments) between 25-35 active volunteers at any one time.

Healthwatch Lincolnshire Annual Report 16/17 11 Listening to local people’s views

• People with Learning Disabilities, this work focused on experiences of NHS Annual Health Checks (which has prompted a commissioned project) • LGBT conference, Healthwatch were a partner in a countywide annual conference • Rurality – all our project work asks specific questions of patients, carers and service users as to what impact living in rural communities has on their health and care • Food and Fitness lifestyle choices for children in years 5 & 6

Healthwatch Lincolnshire Annual Report 16/17 12 Listening to local people’s views – ‘how we collect your voice’

• Through 97 Healthwatch Hubs • Feedback Centre • Quick Polls • Surveys – usually for project and targeted work • Emails • Telephone enquiries • General engagement across Lincolnshire which gathers feedback forms • Provider Network Meetings

Listening to local people’s views – ‘What we do with your voice’

• Record all experiences shared on our database

• Check all identifiers are removed from each recorded case

• Produce a monthly report which is distributed to organisations such as NHS England, CQC, 4 Lincolnshire CCGs, Lincolnshire Health and Wellbeing Board and Health Scrutiny. We ask providers to respond to our questions within 20 working days. We also produce thematic reports from our project activities.

Healthwatch Lincolnshire Annual Report 16/17 13 Listening to local people’s views – ‘examples of questions we have raised on your behalf’

We have asked 197 direct questions of service providers during the past year, below provides a small example of these:

Concerns were raised about the impact on services due to the numbers of holiday makers on the East coast.

We asked: how long does someone have the status of temporary resident before they have to register? Does local services get paid extra for treating temporary residents?

Patient had made a complaint to a GP surgery and not received a response (after a year).

Action: As well as contacting the surgery we escalated this to the CQC as part of their inspection process.

Healthwatch Lincolnshire Annual Report 16/17 14 Listening to local peoples views – ‘examples of questions we have raised on your behalf’

Patient had concerns about hospital discharge due to personal experience (lengthy delays)

We asked: Do you keep a record of how many patients are unable to go home due to delays in home care provision or care home placements?

Patient observed some very poor practices during their stay in hospital.

We asked: the Trust to note the experiences shared by the patient, we would expect this to provide learning and improvement on the ward.

Provider response: This experience was simply not acceptable and we would ask that the patient please contacts PALS so that we can find out some more and address directly with the ward and with the nurses on duty. Please pass on my sincere apologies.

Healthwatch Lincolnshire Annual Report 16/17 15 Once we have visited a premises or provider we will provide an overview of what we found during that visit and when published this will include any Enter and View as a feedback the care givers have provided, it will also include any areas Statutory Duty where the visit has prompted a change to the service. Carrying out these visits as an independent organisation can provide a new and different perspective for providers, commissioners and the public. The purpose of Enter and View is to utilise the local They can also feed into much broader information gathering for those Healthwatch volunteers (Authorised Representatives) to go originations set up to monitor and inspect the health and care services we into local health and care premises to look at the services receive such as the Care Quality Commission. they provide. Once we have completed our finding we inform the following Enter and View is part of our statutory “Duty to Enter & organisations. View”. This means we have a legal right to visit places that provide publicly funded health or care services. • The Care Quality Commission • Lincolnshire County Council Enter and View is ‘one’ of the means we have to observe, • Clinical Commissioning Groups review and listen to the views of patients, families, carers • NHS England and those that work within the environment. • Healthwatch England

Healthwatch Lincolnshire Annual Report 16/17 Page 3 16 • Our rationale for visiting the Acute Hospital and Mental Health Trust What we’ve learnt was on the basis of patient feedback. In the case of A&E work, this was a continuation of a previous Enter and View to follow-up what from visiting services actions had been taken. • Our visits to primary care were based on our programme of work with the Care Quality Commission. The development of concurrent visits Reasons for carrying out Enter & View visits 2016/17 looked at a different way of working with our colleagues across the sectors. During this year we have carried out visits to Care Homes, Acute Hospital Trusts, GP’s and Hospice Care. • Our visits to the Care Home sectors are planned in conjunction with All our thematic areas are directed by our Enter and Lincolnshire County Council, working with them to build a more robust View Working Group and overseen by our Public way of identifying and carrying out work with homes across Experience Committee. Lincolnshire.

• The work undertaken around day therapies was determined by the need to finalise our work around Hospice work in the community.

Healthwatch Lincolnshire Annual Report 16/17 Page 3 17 What we’ve learnt from visiting services

Almost all our reports identified areas where we felt the provider needed to consider a response, in addition where good practice was identified this was also included.

In all reports where providers have chosen to respond to the suggestions made, we included these within any final documentation in the public interest.

One area which was notable across the care homes we visited was the lack of provision for male resident activities, by signposting homes to the local Men’s Shed* more opportunities are being created for recreational activities specific to men within the care home sector.

Our Enter and View representatives continue to provide a well experienced team for this function and the following members have been instrumental in this year’s Enter and View Activity:

Sally Wilson, Carol Lintin, Clive Green, Maureen Stevens, Gill Allen, Michael Cassidy, Maureen Cassidy and Shelia Wraith.

Healthwatch Lincolnshire Annual Report 16/17 18 Helping you find the answers

19 How we have helped the Case study community access the care they need

• Julie our Information Signpost Officer and Chris who supported Julie in this service has signposted 1,570 people to a wide range of health and care services during the year. • Information and Signposting provides individual Family member was concerned about patients, carers, service users, their families and carers ‘mum’ who was living alone and had with a wide range of support. From a listening ear multiple falls. Julie was asked to help and managed to secure local respite. After through to practical information and advice with how to mum passed away the family contacted us make a complaint or where to go for local help and to say: support. “We take comfort in the fact that she was • Our website has contact details of around 1,000 health settled and happy in the care home for and care providers in Lincolnshire as well as a lot of the few months she was there and we would never have achieved this without other useful information and signposting. your help” Healthwatch Lincolnshire Annual Report 16/17 20 Listening to local peoples views

Case study Patient with breathing difficulties from Lincolnshire had the need to attend a Walk in Centre (April 16) which was situated outside of Lincolnshire. They were triaged and told they had no problems at all, in fact the doctor cleared them as having good health and no need for any medical intervention. A few days later patient was admitted to the local hospital in Lincolnshire with Heart failure.

HWL – obtained consent to release patient details and followed this up on behalf of the patient. HWL liaised with the Walk in Centre Manager to get some explanations for the patient. A formal letter of apology from the Walk in Centre was sent to the patient along with a detailed response. The patient was told that the Doctor was of the impression that it was a ‘flu like illness’ and felt it was a viral infection.

As a result of this case the Doctor raised the experience with colleagues at a meeting for lessons learned.

Patient happy with the response and encouraged that lessons had been learnt so no-one else will go through the same thing they did.

Healthwatch Lincolnshire Annual Report 16/17 21 How we have helped the community access the care they need

Patient needed to access specialist services and were unable to get through on the telephone number provided. They contacted Healthwatch to ask for help, we made contact with the clinic and asked them to contact the patient direct as they had outstanding results.

Patient told us “I have now got my results, thank you so much for your help”

Patient with significant family history of colon cancer was refused treatment by provider as they were over the BMI criteria. Patient contacted Healthwatch as they were very concerned that the referral and procedure would be delayed resulting in possible late diagnosis.

Healthwatch on patient’s approval contacted the relevant hospital department to ask why the patient could not continue due to family concerns, as a result the patient was dealt with within 4 weeks.

Patient came back to us and said “thanks again for your help, I am sure I would still be waiting without your input. Your help was invaluable at the time when I didn’t know where to turn”.

Healthwatch Lincolnshire Annual Report 16/17 22 Making a difference together

23 How your experiences are helping influence change – reports and recommendations

• LD Annual Health Checks – listening to the experiences • Immunisation and screening – our county wide project of adults with a learning disability when accessing their resulted in 10 recommendations and a report which was Annual Health Check, we were able to provide 11 presented to the Lincolnshire Health and Wellbeing Board. recommendations to GPs and other specialist health care As a result of the findings it was agreed that Lincolnshire advisors. This work culminated in a workshop session Public Health would take responsibility for assessing current with pledges from local organisations as to how they can public messages. NHS England Immunisation team also improve understanding and most importantly ‘take up’ agreed to complete background checks on whether some of this important work. As a result Healthwatch patients had not been invited to receive screening. Lincolnshire have now been asked to complete a year long project to bring together all relevant agencies and • Transitional Care Pathways – as part of our Public service users. Experience Committee work we raised an escalation paper with regards to Transitional Care Services in the county as • 197 questions raised directly with providers – this has concerns had been raised by GPs in the county. As a result seen recognition from providers that areas such as of our escalation Community Health, CCGs and Lincolnshire access to their services needs to be improved. County Council have agreed various aspects of the service should be improved.

Healthwatch Lincolnshire Annual Report 16/17 24 Working with other organisations

• During the past year Healthwatch Lincolnshire has built on our already successful partnership working. Examples of this include a ‘Living with and Beyond’ cancer project with Macmillan and West CCG. Our role was to gather the patients’ perspective and report on these experiences. • Our Immunisation and Screening work enabled us to work closely with NHS and Public Health colleagues • Patients Medication project included close working with Lincolnshire Pharmacy Committee and Public Health • Distribution of reports • All our monthly and themed reports are shared with Healthwatch England, CQC, NHS England, 4 Lincolnshire Clinical Commissioning Groups, Lincolnshire Public Health, Health Scrutiny, Health and Wellbeing Board, NHS Trusts, service providers and commissioners

Healthwatch Lincolnshire Annual Report 16/17 25 Working with other organisations- Pilot project with Care Quality Commission (CQC)

Our work with the Care Quality Commission (CQC) has been in 3 ways: • Monthly reporting and sharing of information, all Healthwatch Lincolnshire reports are shared with CQC Concurrent Visits • We also provide themed reports and receive reports Healthwatch Lincolnshire have been working closely with from CQC CQC on a pilot project for our 2 organisations to complete • New pilot project which partnered our two concurrent visits. organisations with ‘concurrent visits’ This work enables us to work closely but independently with provider visits and has demonstrated real benefits to CQC, “CQC are pleased to be participating in a ‘concurrent visits pilot’ with Healthwatch Lincolnshire for GP surgeries. The aim being to Healthwatch Lincolnshire, provider and most importantly improve working and communication between our organisations, patients and service users. increase patient feedback and lessen the regulatory burden. Our role has focused on gathering the patient voice at GP Evaluation to date has been very positive and the pilot will surgeries during concurrent visits a role that CQC have continue throughout the next six months”. acknowledged is challenging for them due to lack of time Michele Hurst - Inspection Manager Primary Medical Services and available during visits. Integrated Care Care Quality Commission - Central Region

Healthwatch Lincolnshire Annual Report 16/17 26 How we’ve worked with our community

Staff and volunteers are out and about every week promoting Healthwatch Lincolnshire. For instance we attended over 50 community and voluntary groups from Skegness to Grantham; Spalding to Gainsborough.

Through our network of 97 Healthwatch Hubs, our Hubs play an important role in gathering health and care experiences

During the year over 150 people have attended 12 Provider Network Meetings across the county. These meetings have been a great opportunity for very small health and care providers to network with much larger statutory organisations (and vice versa).

Healthwatch Lincolnshire Annual Report 16/17 27 How we’ve worked with our community – involvement of local people

From 2014 we have been reporting every health and care Providers and commissioners are asked to respond to our experience that has been shared with us and whilst this has reports within 20 working days, we are pleased to share with been an enormous task, we have invested a great deal of time you that in most cases this happens. These responses are also into getting this area of our work right. shared with patients, carers and service users which gives them We are very pleased to report that in January 2017, we were with some much needed answers. able to finalise the introduction of a new data collection and reporting system which has enabled our reporting to be much Representative on Health and Wellbeing Board more accurate, flexible and faster. Our current representative on the Lincolnshire Health and Using our new system, all information received by Healthwatch Wellbeing Board is Sarah Fletcher our Chief Executive Officer. Lincolnshire is shared on a monthly basis with the 4 Lincolnshire Sarah is supported in this role by our Board Chairman, John CCGs; Lincolnshire Health and Wellbeing Board and Health Bains. Through Sarah, Healthwatch plays an active role within Scrutiny Committee, Care Quality Commission, Lincolnshire the Health and Wellbeing Board due to her operational and County Council, NHS England, and Healthwatch England as well strategic involvement in our organisation. as all the GP surgeries, care homes, dentists, 4 NHS Trusts etc.

Healthwatch Lincolnshire Annual Report 16/17 28 How we’ve worked with our community – involving volunteers with statutory activities

Healthwatch Lincolnshire is committed to including volunteers  Our Public Experience Committee includes trustees, staff, and lay people in our work, whether this is through a more CCG Patient Involvement representative and a volunteer. formal role such as Enter and View Authorised Representative or This committee is heavily involved in ‘deep dives’ into health the more informal role of Every Voice Counts, volunteers are at and care services and during the last year has looked into the heart of our work. neurology, transitional care pathways, cancer services and The link from operational volunteer to strategic work can be EMAS. demonstrated through our Board, Committee and representational work.  Our Trustees hold formal (but non-voting) representation roles on all 4 of the CCGs in Lincolnshire, Health Scrutiny and NHS Trust.  Through our Local Community Champions, Mystery Shoppers and Promotion and Engagement Volunteering we are  As a Registered Charity and Company Limited by Guarantee gathering local voices. Over 140 volunteering hours are our organisation must have a Board of Directors/Trustees completed each month. who are all volunteers, other than any out of pocket expenses they all give their time completely free.

Healthwatch Lincolnshire Annual Report 16/17 29 #ItStartsWithYou

30 #ItStartsWithYou What did people tell us about an issue?

Neurology The Lincolnshire Neurological Alliance raised serious concerns with us about the cessation of the Neurology service in Lincolnshire and subsequent impact this has on a significant number of patients (in excess of 3,000 people).

What we did? Prepared an escalation paper that was sent to Lincolnshire Health and Wellbeing Board and Lincolnshire Health Scrutiny Committee to ask for their support to investigate this matter in more depth.

The paper was also sent to United Lincolnshire Hospital Trust and the 4 Lincolnshire Clinical Commissioning Groups, for response as to their actions in place to improve the situation.

The next slide provides an update as to what has changed as a result……….

Healthwatch Lincolnshire Annual Report 16/17 31 #ItStartsWithYou

What has changed as a result? – Neurology Escalating this issue resulted in a response from United  Open referrals have been geographically reviewed: Lincolnshire Hospital Trust as follows: o LCH patients have been reviewed – cohort of 35 patients The list below is actions which the United Lincolnshire living near Gainsborough identified – 6 alternate week Hospital Trust have taken since January to address this clinics at John Coupland have been set up to see these situation: patients due to room availability at LCH. o GKH patients who are equidistant to PHB have been  Held an additional 32 clinics at weekend, creating a offered a referral at PHB where the current wait is 19 total of 297 new patient slots, and 410 follow ups. weeks (39 open referrals)  Have taken on a locum at PHB to replace the departed  Pathway review has been started: NUH consultants. This has provided us with: o Headache – started and currently being reviewed by o Monday – clinic at PHB consultants o Tuesday – alternate week clinic at LCH o Parkinson’s – started and a patient participation event has o Wednesday – clinic at PHB (+evening extra clinic) been held to scope pathway with CCG / ULH. o Thursday- clinic at PHB  Epilepsy nurses have started with the Trust o Friday – PHB (currently, but due to cease as of end  Business case for 4th substantive consultant being finalised March – capacity will be maintained through evening clinics / Mondays)

Healthwatch Lincolnshire Annual Report 16/17 32 #ItStartsWithYou

Transitional Care Pathways –  Changes to the next round of procurement which will address In February 2017 we were asked to meet 4 GPs from a surgery many of the capacity issues faced by this service located in East Lincolnshire as they had serious concerns about this service. From the information they shared with us it was very  Improving communications with Primary Care partners (they apparent that the service was potentially failing patients. As a have asked Healthwatch advice on how this should be best result we contacted all 96 GP surgeries in Lincolnshire and done) received responses from several of them, all confirming similar  Telephones in the LCHS Operations Centre and the lack of serious problems. coordinated response by the staff was a significant issue. This is being addressed by LCHS as a matter of urgency with a What we did next? Prepared an escalation paper that was sent to number of key actions taking place over the next 2 months Lincolnshire County Council, Lincolnshire Community Health  An interim solution being put in to improve the telephone Service and 4 Lincolnshire CCGs. system now What has changed as a result?  A full solution to the telephone system being implemented We have received a very detailed response from the main provider during June 2017 of this service who have recognised and apologised for any  The appointment to a full time duty manager to oversee the problems encountered by organisations using this service. As a day to day operational delivery of the Operational centre. result they have acknowledged that lessons have been learnt and  A refocus of roles in the Operational Centre to ensure there are implementing the following: are clinical floor walkers available for support, advice and further discussion with call handlers and referrers should that  Additional support for care homes be required. Healthwatch Lincolnshire Annual Report 16/17 33 Our plans for next year

34 What next? Our Board and Public Experience Committee has agreed the following themed plans for 2017/18

• Completion of access to NHS dental services for • Project to focus on statutory organisations people in care homes implementation of Accessible Information Standards • Completion of Child and Adolescent Mental Health • Background work and ongoing support for STP Self-Care Services (CAMHS) experiences messages • Support the further take up of NHS Health Checks • Retrace Young People Lifestyle choices project – 3 years for adults with a learning disability on has anything improved • Promotion and Engagement activities – wide range • Social Care – focusing on Direct Payments, home care of weekly activities planned throughout the year services etc • Neighbourhood Teams – looking at how we can • Falls – scoping exercise and system discussions to better support the development of the teams through understand the impact of falls on patients, families and work such as our Information and Signposting services in Lincolnshire (potentially around 23,000 service. annually require service intervention) • Engage with Sustainability and transformation partnerships (STPs) consultation.

Healthwatch Lincolnshire Annual Report 16/17 35 Our people

36 Our People

Board of Directors/Trustees John Bains, Brian Wookey, Paul Martin, Pauline Mountain, Mike Hill, David Carmichael, Lyndy Moulder, Clive Green, Simon Sandland-Taylor, David Gaskell

Sarah Fletcher Chief Executive Officer

Nicola Tallent Julie Evans Dean Odell Chris Bayly Jayne Thomas Tim Barzycki Oonagh Quinn Partnership & Information Research, Data & Board Secretary, Volunteer Project Stakeholder Development Signposting & Communications PA and Officer Officer Engagement Manager Safeguarding Officer Officer Administrator Officer

Volunteers: Margie Allday, Jillian Austin, Jane Brigginshaw, Kate Brophy, Michael Cassidy, Maureen Cassidy, Anthony Cronin, Barbara Dempster, Nigel Fear, David Gaskell, Clive Green, Eleanor Green, Gillian Haydon, Merrill Hayes, Michael Hill, Mary Hubbert, Charmian Hutson, Charlotte Irvine, Julie Judd, Eilene Keeling, Christina Leggett, Katie Lewis, Carol Lintin, Barrie Luck, Lyndy Moulder, Helen Nicholls, Anna Pastuszko, Maria Prior, Paul Rhodes, Judith Riley, Peter Smith, Keith Spurr, Maureen Stevens, Melvin Taylor, Nicholas Unsworth, James Ward, Elizabeth White, Michael White, Sally Wilson and Sheila Wraith

Healthwatch Lincolnshire Annual Report 16/17 37 Decision making

One of the most important aspects of how Healthwatch Lincolnshire operates is through our decision making, particularly in relation to our Healthwatch activities.

With so many possible health and social care services to focus on, it is important that we have clear lines of decision making, which include:

 Healthwatch Lincolnshire Board of Trustees – recruited from communities across Lincolnshire. Our Trustees are all unpaid volunteers and bring a wealth of experience to the organisation, they are a ‘critical friend’.

 4 permanent committees – these are devolved board committees that work in more detail on our Finances, HR, Governance and Public Experience (PEC). PEC is responsible for agreeing and recommending our annual project plans and looking in more depth at areas of health and care that are causing concern to many across Lincolnshire.

 Working groups – including Enter & View, Communication, and Sustainability.

 Annually a third of our Trustees are required to step down (by rotation) from our Board, they are invited to re-stand if they so wish. The Board also has a proactive approach to recruiting new Additional Trustees which is, open to anyone in Lincolnshire. 38 How we involve the public and volunteers

• Our Board of Trustees are all volunteers, they are • We have engaged with over 21,500 Lincolnshire residents responsible for ensuring Healthwatch Lincolnshire is during the year, giving them an opportunity to learn about working strategically and devolving operationally to Healthwatch and recognise our role in the county, how through our CEO and staff team, adhering to legal statutory us, they can have a voice and at the same time giving them requirements and working within Charity opportunities to share their voice. Commission and Company Laws. Our Board is involved in decision making through our various • 4,557 Lincolnshire people have completed our surveys and committees and attendance as a non-voting quick polls observer at Lincolnshire Clinical Commissioning Groups, Health Scrutiny and other relevant boards. • 4067 patients, carers and service users have shared their experiences with us through our website feedback centre and • We have 452 Healthwatch Lincolnshire members, it direct contact with us. These experiences have been in turn is our members who vote to elect Trustees to shared with the organisations delivering and paying for health represent them on our Board and care services.

• Volunteers are involved as trained Enter and View Visitors, help to carry out community engagement activities, are involved in readers panels and a host of other support activities. Without our team of volunteers we would never be able to reach out across Lincolnshire as well as we do.

Healthwatch Lincolnshire Annual Report 16/17 39 Our finances

40 Our finances

A complete set of financial statements and Trustees Annual The following table provides a summary of the annual finances of Healthwatch Report will be available on request by contacting our head Lincolnshire for the year ending 31 March 2017. The figures provided have been office on 01205 820892. taken from our draft accounts which at the time of completing this report had not We would like to take this opportunity to thank been finalised and approved by the Healthwatch Lincolnshire Board (this will be Lincolnshire County Council for their continued support in in August 2017). respect to their award of grant funding. Tracey Richardson BSc (Hons) FCA, Chartered Accountant has completed an At the end of our financial year we are showing a deficit Independent Examiner’s Report in accordance with general directions given by the figure of £47,761 which can be attributed to redundancy Charity Commission. and settlement agreement of staff, these additional costs An Independent Examination includes a review of the accounting records kept by had not been anticipated at the beginning of our financial the charity and a comparison of the accounts presented with those records. year.

Income £ Funding received from local authority to deliver local Healthwatch statutory activities 363,181 Additional income 1,636 Total income 364,817

Expenditure Operational costs 29,217 Staffing costs 328,497 Office costs 54,864 Total expenditure 412,578 Balance brought forward -47,761 41 Contact Us Address: Healthwatch Lincolnshire Unit 12, 1 – 2 North End Swineshead Boston Lincolnshire PE20 3LR

Phone number: 01205 820892

Email: [email protected]

Website: www.healthwatchlincolnshire.co.uk

Twitter: @healthwatchlincs

Facebook: www.facebook.com/healthwatchlincolnshire

We will be making this annual report publicly available by 30th June 2017 by publishing it on our website and circulating it to Healthwatch England, CQC, NHS England, Clinical Commissioning Group/s, Overview and Scrutiny Committee/s and our local authority.

We confirm that we are using the Healthwatch Trademark (which covers the logo and Healthwatch brand) when undertaking work on our statutory activities as covered by the licence agreement. If you require this report in an alternative format please contact us at the address above.

© Copyright Healthwatch Lincolnshire 2017

Healthwatch Lincolnshire is a registered charity number: 1154835 and Company Limited by Guarantee number: 08336116 42