<p> The Wider Voluntary Sector on engagement with Health and Wellbeing Boards- Free text input into survey, September 2013</p><p>This document contacts the free text that survey respondents inputted to the survey about engagement with health and wellbeing boards. The recommendations derived from this input can be found on the survey report which can be accessed on http://www.regionalvoices.org/hwb-reps/survey </p><p>Regional Voices is also following up on specific case studies brought to our attention through this survey. Thanks to all who shared their experience with us through this survey.</p><p>The Wider Voluntary Sector- support wanted...... 1 Support where there is no VCS rep...... 1 Where there is a rep on the board...... 2 Representation...... 3 Engagement with board...... 4 Listening...... 6 Practicalities...... 6 Awareness raising/training...... 8 Communication/publicity...... 10 Clearer/more accountable routes in...... 11 Effectiveness...... 12 Networking with other VCOs/meetings to share experience...... 12 Examples...... 13 Particular interests...... 13 Wider determinants...... 14 Research/evidence...... 14 Challenges Faced by Wider VCS...... 15</p><p>The Wider Voluntary Sector- support wanted</p><p>Support where there is no VCS rep</p><p>A more direct involvement with the voluntary sector would be beneficial to all concerned.</p><p>I am the CEO for a carers organisation and am frustrated at the lack of communication from the Health & Wellbeing Board. Yes, there is a place for our local HealthWatch rep, but this is far from enough and despite local lobbying they are still refusing to make any more places available for other Vol Sector reps. Our local Vol Sector network, has been allowed to send its Chair to a working group (not the main Board) and again they have been frustrated in attempts to get more Vol Sector reps on the H&WB Board.</p><p>If Healthwatch is to be the voluntary sector representation - I would like a robust organisation in place. It is unclear how mature they are at this stage. I do not feel that they are capturing the issues regarding the organisation which I work for.</p><p>We are well briefed as a sector but need more than just the Healthwatch rep on the board- I feel they miss some key information influencing the plan for the future by not having 3rd sector representation at board level</p><p>That Healthwatch reps are skilled up in communicating important messages/decisions.</p><p>Help Healthwatch with their structure and communications to small community groups, If you are in receipt of clinical treatment - there is support until such time as the individual has recovered. There are other instances of poor health and social care but they are not on any radar as they are not on anyone's "register" and don't know how to ask.</p><p>The active recruitment of non Local Authority members.</p><p>No representation at all at the moment</p><p>We need wider voluntary representation on H & W Board not just Healthwatch representation.</p><p>Significant input at HWB from VCS a rep on the board</p><p>A place on the H&WBB VCS representation</p><p>Representation on the health and wellbeing board for the sector Funding for a VCS network to feed into above having a representative on the board</p><p>A place on it! Or representatives that actually have an understanding of what representation is</p><p>The first step would be to have voluntary sector representation on the HWB. Healthwatch is on the Board but is a VCS organisation only in structure governance. It is a QUANGO that is not representative of the voluntary sector generally.</p><p>Where there is a rep on the board</p><p>Better contact with the Voluntary Sector Representative on the Health and Well-being Board in our area. I know of the structure but am not actively involved in influencing what goes on nor receive feedback directly. Their contact details. Right now I would just google them. They have not approached me.</p><p>Ensure that the voluntary sector rep holds regular briefings easy access to volunteer reps. early consultation opportunities good communication from health and wellbeing boards</p><p>A regular meeting with the rep and other VSO's to share rising initiatives, concerns etc and to have a pathway of influence within the H &WB boards Opportunity to be involved, ability to feed into the meeting and get feed back from them in an easy way for those Vol Sector reps to actually represent the voluntary sector - i.e. actually ask me for my views and represent them regular updates from the voluntary sector representative</p><p>It would appear that 1 representative (often with a biased attitude) is allowed to sit on this board but that means the necessary statistics which prevail in an area do not get reflected.</p><p>Information about how to do this - who are the reps - when are the meetings etc.</p><p>A properly resourced, functioning voice for the voluntary sector on the HWB. </p><p>Representation I am very concerned that our 'Representatives' do not engage with us and therefore cannot be representative. I am concerned that Healthwatch have a seat at the boards - how can they represent the views of all heath and social care communities? </p><p>It is early days for us, but a more local group of interested individuals in the town, who could have a known voice to influence the members of the HWB which is in the main town of the District.</p><p>Voluntary Sector Rep sitting on the Board. The rep should not be involved in service delivery, however should support and regularly engage with a large number of health related voluntary sector groups and organisations.</p><p>A VCS representative who wishes to take on a representative role. The representative in our area has been very clear that, whilst they did want a place on the Board, they did not want a representative role, they wanted to influence the agenda from his organisations perspective and had no idea they was being presented as a nomination for this role, particularly as a democratic process had taken place resulting in a different nomination.</p><p>Within a two tier authority area we have one rep at the county level, who does not really understand the issues facing service delivery VCF organisations and only reports retrospectively. At a local level we need to have a nominated and duly elected representative who is allowed to share papers and discussions both in advance and after the meetings. Not being told who our rep is and that they cannot discuss things are they are confidential. Our rep also needs to be given an opportunity to raise items at the board. Having direct access when the area of strategy or commissioning directly affects our service users not going through an infrastructure group who "think" they know the issues</p><p>The representative on the HWB is Healthwatch still in its infancy with little experience of health or the voluntary sector. The make-up of the HWB is half commissioners and half councillors one Lay rep. hardly influential. I am aware of the problem but cannot see a way to change the status quo. I have written to both Healthwatch and HWB without getting a positive response. The CCG are setting up a lay forum which may eventually have some influence on commissioning.</p><p>For the voluntary sector representative to be someone, with relevant expertise, who was elected by their peers to be the representative rather than the self selected, disconnected person we have at present</p><p>Neither the third sector nor Healthwatch are a statutory partner on the local CCG if they were this would be of great benefit support from central government wouldn't change this. infrastructure organisations don't always reflect the perspectives of the sector.</p><p>Engagement with board</p><p>We are involved only because of our tenacity. this is difficult given we are a very small local charity with very limited funds. We raise issues that affect the people we support and represent locally and can often influence policy and practice but it has taken an enormous amount of energy.</p><p>Ensure that the board provides very local opportunities for the general public to meet with and discuss issues with the board</p><p>I am finding it very difficult to influence and find out information about the activities of the health and wellbeing board. despite requesting info and a meeting, these have not been followed up.</p><p>Ensure there are sub groups that we can attend to contribute </p><p>The Health and Wellbeing Board staff making themselves known and engaging with organisations in the Voluntary and Community sectors. Responding to feedback sent into the H&W-B Board. Being part of the joint strategic needs assessment process</p><p>More access to the Board and more information about what they are already doing Contact with members of the Board. Funding and commitment from the Board to tackle problems in the local area. Existing knowledge built up through SHA, PCTs, specialist Commissioners and RDA has gone.</p><p>To be involved</p><p>Opportunities to be involved</p><p>Engaging with us and calling on us for our opinions would be a good start</p><p>Potentially training days or opportunities to network with members of the board and have strategy days</p><p>Help and support to engage and influence the HWB. I have attended meetings in the past re the joint strategic needs assessment. I am keen to ensure that vulnerable women with complex needs (our service user group) are included and that we are able to ensure their needs are understood by commissioners. As a small/ medium voluntary sector organisation it is important that our work is recognized and funded by the appropriate commissioners.</p><p>Funding to resource local consultation with groups on housing estates and engagement with the hard to reach groups.</p><p>To be invited to contribute our statistics on the health impacts we provide for our clients</p><p>Clear communication about the present work and where the voluntary sector can input and influence. There seems to be little direct communication to understand the present position</p><p>Being included </p><p>Being consulted about changes that impact on our sustainability however indirectly they may be.</p><p>An open mind on the Health & Well Being Board. new health landscape, build up relationships with the public sector partners required for effective engagement and VCFS to influence.</p><p>I have a local network of young people passionate about having their say to improve mental health services for future young people. Is there a way of them feeding into the decision making through our organisation rather than just a small minority being expected to sit on boards which is neither representative nor reaching out to the most vulnerable?</p><p>We have a Lead Engagement Officer, employed by the VCS and funded by the Local Authority. This works reasonably well, but perhaps more of the same thing would improve matters. I feel that the majority of the general public are not aware of the set-up and they need to be better educated to ensure there is true consultation. The local Healthwatch are really trying to address this issue.</p><p>If they did genuine as distinct from superficial tokenistic consultation e.g their first demographic survey did not include sexual orientation</p><p>We cover a sub-regional footprint so very hard for us to engage with individual health and wellbeing boards.</p><p>More knowledge of their processes for engaging listening at taking evidence</p><p>Clear structure and plan for engagement and involvement</p><p>I think there should be a proven (and well publicised) pathway to allow the Voluntary Sector to inform advise and train those people on the Health & Wellbeing Boards.</p><p>Ensure there are sub groups that we can attend to contribute </p><p>The Health and Wellbeing Boards need to actually want and value the input from the voluntary sector before we engage with them. It is pointless trying to influence a board that only wants feed in from Healthwatch and not the wider voluntary sector. It appears to have gone full circle and we are not back at the point where the medical model is now commonly used, in other words leave it to the professionals to run things as they know best</p><p>Listening... I feel that the Health and Wellbeing Board needs to be more prepared to listen rather than dismiss representations from outside itself. Our main opportunities for influence come through established relationship with commissioner and other council officials rather than the Health and Wellbeing Board itself which feels remote and unapproachable</p><p>I have approached the lead on a few occasions through a number of routes and have had no response.</p><p>The belief that your opinion is being heard and if appropriate, acted upon. </p><p>Practicalities Information prior to board meetings (e.g. agenda topics) Formal opportunity to comment on relevant items Report back from board meetings</p><p>Being invited to provide input with sufficient time to provide any data required or attend any focus groups/ workshops that may be planned, which historically are called at very short notice.</p><p>We have a staff member that is jointly funded by the CCGs and Public health to ensure that the VCS is able to feed into the JSNA. This has been funded for 2 years but we aren't sure if this will be continued. National recognition for this kind of involvement would support our case for future funding.</p><p>Funding for the time it takes up</p><p>Funding to resource local consultation with groups on housing estates and engagement with the hard to reach groups.</p><p>Timing - parents need to be given time to drop off and pick up children from school, so best times are usually between 10am and 2/2.30pm. </p><p>Childcare costs to be provided or else childcare from a local specialist sitting service that looks after disabled children. </p><p>More Time !!!!! more time in my role to allow me to spend more time.</p><p>We need more time so we would support if we had more manpower</p><p>My understanding, for the organisation I work for, is influencing the health and wellbeing board is about the investment of time, building relationships and being available for the opportunities. I believe as an organisation we have a good understanding of the role and current status of the health and wellbeing board and are up to date on the role of the third sector in the region.</p><p>Being paid for being on board - all other members of the board are paid for being there apart from voluntary sector members who are taking time out from their day job if they participate I any statutory board like a LSCB etc</p><p>Agendas and plenty of notice of cut-off dates.</p><p>Advance agendas so that meetings are attended that are relevent to the attendees.</p><p>Given more time to provide feedback in a variety of ways; understanding the relevance to my organisation; knowing that views are listened to; clear edited versions of all papers/reports/documents that summarise know who is on it and how to contact them more resources and therefore more capacity - it's time that is needed to read and absorb the complex information of eg JSNA, learn the structure of the system</p><p>Early planned discussion of health & well being needs which takes into account voluntary sector knowledge (I am the officer, working for an infrastructure organisation, who supports the third sector HWB rep to engage with the wider sector) Better planning - more time, more willingness to engage with third sector - on behalf of County Council officers supporting the HWB. For example, only since the last meeting have agendas and papers for the HWB meetings been made publically available a week before the meeting. There's also a Working Group that meets before and after main board meetings, and it seems likely this is where the bulk of the work will be done (it's largely made up of public health staff and other officers). We do have a third sector representative on this group, and are just working out how we can support them to be effective and linked to the representative on the HWB.</p><p>Awareness raising/training</p><p>More information on how to engage - jargon free and not using acronyms. </p><p>Clearly identify who our local contact is and how to get hold of them. Be more specific about what we can influence - its not enough to say 'have your say'. Health and wellbeing is a massive area and generic surveys don't make you feel you have made a difference. If you have a problem, most people want to know there is an actual person they can talk to or place they can go where there issues will be listened to. If that's already happening, then its not been made clear.</p><p>Knowing who is on the board where they meet what they do how do they feed back how do we get involved etc</p><p>I would support the JSNAs but have no idea how to go about this. General support and training would be very useful.</p><p>Receiving information from them directly.</p><p>Understanding the route to the board. I don't understand it because the people that I ask can't seem to give an answer! easy access to information i have no experience or knowledge of the health and well being board I need to know more about the board and they need to actively give us information. So far I have heard nothing from the board despite being a large charity.</p><p>I think knowing a little more about it would motivate me to get involved.</p><p>Far more information easily found and understood.</p><p>More transparency around the vision and aims of the board within the broader community, and a clear pathway to access and influence within the board. Clarity to enable support is essential</p><p>My role wouldn't place me in a position to become involved with these boards. However, I would be interested to know how staff in our local 'branches' get involved and what support they would need to do so.</p><p>Knowledge of the mechanisms by which this can happen.</p><p>Training, Conferences, Consultation, Networking opportunities</p><p>Training</p><p>Someone to listen and talk to.</p><p>We have no information on these matters to decide whether we should engage with them</p><p>Knowing about it and being given an opportunity to understand it and interact with it</p><p>Information</p><p>More information</p><p>Basic information from the CCG, the local authority (JSNA plus social care) and the Chair of the Health & Wellbeing Board about dates of public meetings, and also it would be good to have an invitation to respond to any engagement or consultation exercises they may be carrying out. It feels that because we are fulfil a very specialist area (brain injury support), we get forgotten. I've already received one email today from a local authority apologising for leaving us off a request for information from providers in our area. They have deferred the cut-off date by one week to allow us to respond - I'm not sure that's very satisfactory!! training about the strategy & health & wellbeing boards would be good invitation to local board</p><p>Training for The health & wellbeing board in understanding of the third sector. A place on the board for third sector - currently although we have campaigned for one we don't have a place. Examples from other areas may support our case about involving the sector.</p><p>To understand how the system works. Our organisation is just started and I need to find out.</p><p>More to the voluntary sector information being made available</p><p>Information about what is happening re the local Health & Wellbeing Board. I was previously a member of the Health & Wellbeing Board and have many years experience as a former CEO in the NHS. Translating the CCG notices into colloquial English, avoid abbreviations please.</p><p>The process needs to be clearer. People need to be able to meet with each other and understand where everyone fits in the process.</p><p>Definitely funded events as my organisation doesn't always have funding to put these on. </p><p>Communication/publicity</p><p>Clarity and communication are asked for from health and wellbeing boards- what the processes and priorities are. </p><p>It would be good to know what achievements the health and well being board have made. More publicity about this would be welcomed and this would ensure greater cooperation of a wider section of people. Everything seems to be held close to chest! I have attended two meetings but do not know when the next one is.</p><p>Less talking, meetings, repetition, indecision & lack of direction & more positive action.</p><p>I would support to influence the communication, good clear communication channel is essential to wide range of people. I would also include the needs of people with hearing loss and respecting each communication requirements. Deaf Awareness is essential tool to be more aware of understanding deaf people.</p><p>A clear strategy about health priorities.</p><p>More written but simplified information to be made available - our local presentation was many pages long and was overloaded with information which even some of the professionals and commissioners have difficulty in understanding. </p><p>Also need simplified information for those with Learning Disabilities.</p><p>Clarify around HWBs and their prioritisation of children and young people - it is still very unclear as to how HWBs in general will incorporate the needs of this key group.</p><p>Open lines of communication from the H&W Boards. They are closed shops. clearer, simpler communications. I have some hope that local Healthwatch may make a difference. Main issues are about the confused agenda for HWB - too big a canvas in some ways, and too parochial in others. Not clear about the extent to which the health issues that really worry people - eg will the local hospital neglect my elderly parent - are the ones that they are invited to get involved with</p><p>A clear and simple flow chart showing how and who to send info to and a year planner of events / consultations etc.</p><p>I am from a small community health and well-being group. We promote active ageing and healthy living to anyone who wants to change lifestyle. I the dates of Healthwatch [sic]* meetings coincide with our groups sessions we are unable to participate. I would suggest more opportunity for interactive online communication and webinars. </p><p>Clearer/more accountable routes in More and clearer information. One single point of contact.</p><p>Feedback from the health and wellbeing board and a means of feeding into it.</p><p>Constitutional inclusion of voluntary sector representatives on the health and wellbeing board through the local CVSs. At the moment we rely on the good will of the public sector and personal contacts.</p><p>Clear reporting routes with voluntary sector representative - knowing who that person is. Additionally it is almost impossible for one representative to be the voice of the whole voluntary sector Better information of the role of the health and wellbeing boards Clear information regarding when they meet and agenda items to be discussed,</p><p>Just being aware and having feedback on what the board does, who are involved etc a legal right for our views to legally influence H&WB boards, and for them to legally demonstrate where local views have been taken account of (hmmm... what if it was the EDL? JW)</p><p>Legislation! The JSNA is almost wholly clinical health focused, not about wellbeing and not about prevention</p><p>A clear route to do this - a contact name or group</p><p>It would be helpful to have a clear line of communication with the above - I have not had any information about the HWB or been involved in any consultation with it in any way. I have had limited input to local reviews regarding commissioning with the local authority but this is not clearly associated with the HWB</p><p>Clearer pathways into influencing</p><p>I think that processes need to be more open and it should be made clear where voluntary groups can have an influence. then there need to be forums for this that are more than talking shops clear and coherent pathway of engagement</p><p>Clear guidance as to how and who to approach</p><p>Voluntary sector involvement was a tick box exercise - with no impact on outcome</p><p>Effectiveness</p><p>Greater independence for the H&WB. It is technical a committee of the local authority and as such it is debatable what influence they will have. It is also a question of how they work with the local CCG which is a great unknown</p><p>Belief that it would actually achieve something and be truly representative of the sector and that there was some sort of open selection process. It is seen by 90% of the voluntary sector who even know of its existence (and that is only probably only 10% of whole sector) as being another bureaucratic structure that achieves nothing. Possibly calling the odd meeting and setting up another yet web site.</p><p>Networking with other VCOs/meetings to share experience Communication between groups and forums to share ideas</p><p>Use my/our skills and experience to persuade the third sector to work together.</p><p>Examples of good practice from similar organisations to mine It would be very useful to learn how other CABx around the country engage with their health and wellbeing boards</p><p>Coordination of voluntary groups regular meetings at sub regional / regional level to share ideas and experiences and raise concerns.</p><p>Examples from other areas of how JSNAs are developed with input from wider stakeholders. Support (eg. training, research, publications) about how the Health & Welllbeing agenda can be influenced to encompass wider social welfare issues that impact on it but are not traditionally part of Health & Wellbeing e.g. debt</p><p>Through hard work and determination I was able to influence the JSNA to include sexual violence in the doc. However I have no contact with the Health and Well Being Board and to my knowledge there is voluntary sector representation on the board. training on how to influence and also examples of how people from other areas have achieved engagement with local health & wellbeing boards/CCGs etc</p><p>Examples Examples of how this is working in other parts of the northwest.</p><p>There is an intention locally to involve the VCS in influencing the HWB but the practicalities of how it is done are not clear yet. Examples of good practice from other areas that are similar to ours are always useful. we're quite well linked into all of the above- however it would be good to find out what other areas have done to get a seat on their H&WB Board.</p><p>Research of best practice</p><p>Training and examples from other areas.</p><p>All the above examples would help! (training, examples from other areas, research)</p><p>Particular interests</p><p>Would like to influence more collaborative working. Integration, less of a health is one thing, social care is another. How can we integrate more and work together.</p><p>Acknowledgement of equality diversity inclusion and human rights would be a good starting point. This would help influence all of the above. It would also influence the Strategic plans on mental health and suicide prevention, to name just two. If decision makers across the spectrum were up to speed on these areas rather than being totally out of their comfort zone the equality outcome may be improved.</p><p>We work with Deaf people who use sign language: a tiny minority of the population who need specialist accessible services. Our problem is that as commissioning become more local, it is harder for us to engage with the growing number of bodies in every area - we don't have the capacity or resources. Localism is all very well but our service users have more in common with someone on the other side of the country than someone living next door (with whom they do not communicate). We are invited to take part in various feedback and consultation exercises but I could probably spend all my time filling in forms and going to meetings, with little if any benefit for us or our clients.</p><p>Stop ignoring education especially SEN (D) Just being involved and recognised would be nice. Like many VCS organisations our focus is one part of the bigger health and wellbeing picture. Being involved in a general way is a waste of our time, however, we have considerable expertise and knowledge in our specific area. I feel the statutory organisations need to come looking for VCS organisations with experience and a track record.</p><p>I am concerned that there is no specific representation for mental health. I believe mental health is a unique area of healthcare that needs to be represented directly as it is the only area of health care where an adult can be treated against their will. This situation creates a huge power imbalance that is not found in any other adult health or social care setting.</p><p>Mental Health Watch</p><p>For marginalised groups there needs to be a strong steer in guidance issues from DH. We are still waiting for it!!!</p><p>Wider determinants As a representative of a older people residents association of 220 older people in one retirement village, there is lack of knowledge of the new NHS structure and there is no understanding on where to go in advice on this with the users of the social care and health service. New publicity strategies are need is older and disabled people are to contribute to services. VCS rep on HWB</p><p>Just an opportunity to feed into the board would be a start and a willingness from the board to listen and not assume it knows everything. A lot of those on the local board have no idea of what is happening to Joe Public by the impact of cuts to services and reduction/changes to benefits. This is a timebomb waiting to go off so any savings now will be insignificant when people's health deteriorates en masse!</p><p>All of these things, plus a focus on anti-poverty work which has a key role to play in addressing citizen health and well being</p><p>It is difficult for us (see below) as we are not really classed as being within the health & social care sector.</p><p>Research/evidence In depth research that adds to the JSNA which is currently too broad brush</p><p>Recognition of the role we play in trying to support mental health carers. expenses and a monetary recognition for the time we give up to attend meetings...support with getting help for a sitting service so we can attend meetings.</p><p>More strategic involvement in JSNAs - at moment seems like a statistical and tick-box exercise to confirm central Govt policies rather than truly looking at local needs. A willingness to include qualitative as well as quantitative information</p><p>Challenges Faced by Wider VCS i was the LINK rep for 18 months during interim period. as i do not wish to be part of Heathwatch i am now not a member of the H&WBB. my professional experience was essential in having an understanding of what the 'Board' and its workings were about. Without my previous knowledge and skills i think participation at the Board would have been difficult.</p><p>Our local priorities do not appear to represent parent carers however they have listened and started to engage with our local carers' centre Cares. They do put on Patient Summits for patients and carers to find out information and ask questions - however this is often at short notice for carers, is at the wrong time eg from 1.30pm to 4.30pm just when parents need to pick up children from school(s) and if alternative times are arranged eg evenings they are not aware that parents have childcare needs, with that childcare often costing 3 or 4 times more than normal childcare. We are working on raising these issues through different avenues so that HWB are more aware.</p><p>No clear mechanism for getting items on the agenda - the representative has asked what the procedure is for getting items on the HWB agenda, but there doesn't seem to be one.... Also, HWB tends to focus on the really big picture, so priorities are fairly clearly defined and have been static for the 10 years or so I've been invovled in health inequalities work locally - it's fairly unlikely the third sector is going to identify a massive new issue, it's more more likely to be a view on how the sector, or it's users, see an existing priority. But does mean a single representative may be speaking on issues of which they have little personal knowledge - indeed, on issues of which no one at the board meeting has particular expertise.</p><p>What can the H&WB board actually do, how does it influence the money flow, how does the commissioning process work to favour the sector.</p><p>The Council has rejected the voluntary sector representative's nomination in favour of a representative chosen by the Council. How can the voluntary sector have a voice? Democracy is dead here.</p><p>The representation of the voluntary sector in terms of numbers on the H and WB Board does not reflect the huge role the sector plays in delivering services and enabling the voices of local communities to be heard.</p><p>Possible narrow interest groups that view their sector as more important than others. Establishing clear objectives so that people know why they are attending and what the desired outcomes are local government ignores, overrules local communities</p><p>Lack of direct involvement Appropriate representation</p><p>So many voluntary sector organisations but no one is really feeding information in a co-ordinated way. However, as there is no representation on the HWB it is difficult to get views in to the chain. The sector tend to be told what the board issues are and then try and support that work within whatever services they are providing.</p><p>I don't know who the rep is or how to contact. It feels as though the board is very city-centric and wider county, whilst I'm sure they are involved, one recieves very little feedback. vol sector very strapped for time and money - infrastructure has been decimated. No-one has the time/resource to try to fight to get into meetings/answer surveys that are not connected to our everyday work.</p><p>The VCS representative does not want to take on this role and freely admits they do not have the wider knowledge of the sector, or the issues the sector works with, the challenge is how we support the inclusion of the wider sector in an effective way.</p><p>S . I . C Silence - Indifference - Complancey- The equality perspective of the different protected characteristics are not included or appear not to be taken into account from start to finish with thew HWB.</p><p>There is still a tendency not to recognise the professionalism of the voluntary sector.</p><p>Getting these onto the agenda! The structure is such that third sector representation is minimal and the links in the sector are poor at coordinating a response from the sector</p><p>It would help if the Health and wellbeing board was more open to it's communities and it's non-elected members i.e. voluntary sector and local council members challenge it's commissioning partners for the better good of the communities .</p><p>Its so public sector no one else has a look in, indeed |I suspect event not tier 1 local authorities are littel engaged in reality.</p><p>How to reach vulnerable older and disabled people with physical, mental and sensory disabilities and those who wish to know about their options for end of life care.</p><p>Despite discussion I understand that our local Health & Wellbeing Board decided not to have a third sector representative on the Board, despite delivering heavily subsidised (by charitable donations) health and social care services, and enabling the local authority to meet its 'efficiency savings' last year. Education being recognized as a major issue in well being. Failure to use our expertise in the field</p><p>The issue for the HWB working alongside so many organisations. CVSs should be utilised in the strategic discussions at the beginning and not invited once statutory partners have the outline of the strategy, it is important that VSO are treated as equal partners.</p><p>Meeting such diverse representation as usual and have a representative that is knowledgeable and credible aut health and not serving own organisations need</p><p>It is not possible to do so. The board is made up of all the usual suspects</p><p>Consistent channels of communication are needed</p><p>The usual of one vol. sector representative somehow trying to cover the views of such a wide stakeholder base - an almost impossible job! Being seen as an equal and valid partner in sitting around the table.</p><p>Health & wellbeing board is in its infancy stages</p><p>There seems to be one route only through Healthwatch representation on the Health & Wellbeing Board and therefore there is little opportunity to have direct influence in the sphere of work we engage in. the assumption that we do not know what we are talking about lack of real representation at board level no clear route</p><p>See above</p><p>Other more wealthy organisations that bully the smaller independent organisations</p><p>I am sure the voluntary sector is give space and time to say things .</p><p>Inclusion</p><p>You have to work very hard to find out who might be the right person to contact and influence and go to as many meetings as possible some of which aren't useful for the sake of the contacts that need to be made. It would be much more helpful and cost effective if we have clear pathways for discussion and reporting.</p><p>Lack of knowledge of issues - people on the Boards are not patients or service users themselves. Being listened to time not expereinced any to date time to find out what is happening</p><p>In our county we have representation on the board and so no real barrier there</p><p>We are not aware properly how, through whom, we think the Voluntary rep for the area but as yet we have had no briefings therefore how do we get the issues though to the H and W board and be aware of what items will be discussed at future meetings so that we can make a active contribution.</p><p>A lack of robust evidence bases around the impact of non-health interventions on health outcomes.</p><p>Unsure what the process for this is</p><p>The reason why the HWBB does not want the third sector representation is that they feel we are all service providers and there is a conflict of interest.</p><p>Being taken seriously and to be listened to with conviction.</p><p>Members of Irish in Britain have luncheon club services within social clubs which are predominantly run by elder volunteers who may not have the capacity to engage with HWB's. Whilst more established Irish welfare system's will have the capacity to engage and influence we found they and not been consulted with despite the large numbers of elder Irish within local areas. We also feel that the categorisation of Irish under 'white other' keeps the Irish health needs somewhat hidden. We have an ageing population. There are so many specialised issues. A general CVS rep is not likely to know the specifics of issues that chronically excluded people face, such as Gypsies and Travellers, and even where we are able to brief them it is unlikely to be a priority. getting past the self interest of the voluntary sector representative making sure that everyone gets a fair shout rather than a few organisation's voices being heard above others as above everyone expects infrastructure organisations like mine to have this involvement but it needs funding attached</p><p>Ensuring that the VCS are represented and that the community is also represented Not being seen as the 'poor relative' - tokenism - are they really interested? - are we seen as being influential? - not to be seen to be 'rocking the boat'. lack of engagement</p><p>Who to go to and how to go about influencing the board. I believe organisations need to help commissioners to understand the needs of their clients. We need to provide clear information about what we do, how it makes a difference, how the work can be measured and evaluated, what the costs are and the savings to society etc. Face to face meetings would be better than e-mail, letters etc. How can we achieve this?</p><p>Taking the edit from central government that it is solely the responsibility of public bodies - when it suits. The county council view is that Heatlhwatch will be the voice of the VCS hence they are the only non public agency on H&WB Board. But they are a "quango" set up and council are holding the purse strings as it was not put out to tender as in other counties!</p><p>Time</p><p>As stated above, there are no real direct routes in. HealthWatch, in our opinion, are NOT representatives of the Vol Sector as a whole and carry no mandate for such.</p><p>There are to many issues (sometimes conflicting) across the spectrum of health and social care for 1 or 2 people to represent. I am also concerned that the people who are supposed to represent do not have to evidence their engagement with the constituency they are supposed to be representing.</p><p>See above There is not a clear pathway for information no proper process of engagement that I am aware of</p><p>Who do I raise them with. What issues are relevant to the board etc. So far there has been little or no involvement in our area. lack of strategic focus by HWB as a whole n/a</p><p>Most Voluntary organisations are small and its difficult to organise a system whereby they have a meaningful voice. we had a very good local consultation event in the county. unfortunately teh weatehr was atrocious when this took place in the winter and representation was not as good as it might have been but this seems to have been a one off and there wasn;t much follow up afterwards</p><p>ACCESS to the people on the Boards and ensuring they fully understand the issues that need to be communicated Getting the message across all over the board and ensure that the channel of communication stay open.</p><p>Getting representation. Trusts - community and acute can be influential but I am really unsure how we can ensure that our organisations issues are fully represented. This is the area of greatest concern given that they are very influencial with regards to setting local strategic priorities and developing the jsna.</p><p>You have to have representatives who have the time to attend their meetings At present Healthwatch represent the views of the Voluntary Sector and the board is interested in wider determinents not individual issues Lack of communication</p><p>Lack of information. Lack of interest from the Centre re anyone elses views, particularly with regards to the Third Sector.</p><p>Lack of information/communication Resources provided to voluntary sector rep to allow for wider engagement Resources available to voluntary sector to allow time for engagement and input (there seems to be a perception that we can just fund staff time for engagement from existing resources, but severe funding cuts across the board do not allow for that). If Health & Wellbeing Boards genuinely want to engage with the wider voluntary sector then they must be prepared to provide some funding to allow this to happen.</p><p>We are new to working within the health & wellbeing sector and our primary aim is to engage people in the natural environment which in turn has huge benefits for people's physical and mental wellbeing. I feel that currently we have difficulty tapping into the right places as we are not primarily a health & social care sector organisation and there are few local examples of the ways in which environmental projects can impact on health. It would be good to know who the best person would be to start some of these discussions</p><p>Known sources of information being regularly dispatched to local people, eg HWB agendas, minutes, reports etc being in the local libraries or being publicised as being online.</p><p>Don't know how or throuh whom</p><p>To whom should one write or address emails? There is no clear line of communication.</p><p>There does not appear to be a clear channel of communication - or if there is it is not communicated to the wider voluntary sector</p><p>Who's listening? Do they claim to represent the voluntary sector? They don't leave their ivory towers!</p><p>Not aware of anything Who knows? If front line groups like ours don't get told anything about the boards and how to access them then surely the key challenge is becoming engaged in the first place. who and where are they how do we raise issues</p><p>Channels through which this can happen are not widely known. There is also still a tendency not to treat the VCS as equal partners.</p><p>No requirement for health and wellbeing boards to involve/consult/listen to the local voluntary sector No structure for local representation, e.g. there is no local health and wellbeing partnership in the district where my charity is based</p><p>Closed or unadvertised meetings, and lack of contact with specific officer Accessibility</p><p>Restructuring of health sector. Lack of understanding of the VCS within health.</p><p>The hierarchy is very confusing and can be barrier. Lack of 'real' people rather than faceless 'boards'. People know that something exists but don't know how to access it.</p><p>Public sector tend to make the decisions on priorities etc before they involve the VCFS. VCFS often not seen as equal partners public sector has inadequate knowledge of the number and range of VCFS services, and the resources our sector brings to the table.</p><p>I have had quite a lot of contact with the local board but I have not been asked what issues affect us as a local voluntary organisation.</p><p>Lack of knowledge and information around who is on the board when and where the board sits and I suspect the Boards lack of knowledge of what is on offer from the voluntary sector. professionals paying lip service to seeking service users views and getting a straight answer to questions about future services,</p><p>Our social club currently trying to get new members, and I am currently trying to contact every FT and trust in the region to get this publicised. The hospital has not even responded. These are challenges we face.</p><p>As above. The views and experience of the sector are not respected or listened to by the H&W boards being listened too as an equal contributor</p><p>Knowing when and where to meet, also resource as we are often focussed on front line provision and it is hard to split our time effectively Difficulty getting engagement with the members due to their busyness.</p><p>I know nothing about these health and well being Boards. How do they fit into all the other organisations ? Who are they answerable to , what influence do they have ? As carers we have lack of time for attending meetings or writing reports or answering surveys. the size of the area and our distance from centre makes us feel isolated and unimportant to them.</p><p>The Board is largely composed of professionals who inevitably see issues through their professional perspectives</p><p>They do not seem to understand the breath of work we do especially aroung the public health and preventative side. They say the right things but often not backed up by action.</p><p>CREDIBILITY</p><p>Getting HWB to engager with VCS</p><p>Knowing more about the board</p><p>LA don't take voluntary sector serious. Almost an add on service.</p><p>Being included rather than excluded Understanding there is considerable expertise held in specialist third sector organisations that umbrella organisations cannot represent. We are very busy already fulling the gaps in statutory services</p><p>The means in which to get your opinion to the people that can really bring about and influence change. The fact that our H&W Board has no voluntary sector members and the only means in order to "reach" the people on the Board itself, is through Healthwatch, which also does not have a member to champion disability, is a concern. we do not know who is running it now as we are not getting any feedback from it to our organisation</p><p>Lack of representation</p><p>Simply engagement - currently there is no interaction</p><p>The challenge is to get the board to recognize that the voluntary sector actually knows useful things and can feed into strategy in a constructive and meaningful way</p><p>Disparate groups who go about their own jobs with no idea that other groups exist. Tokenistic inclusion of patients and public even though we are assured that the NHS is patient Centred.</p><p>See above- knowing how to find them.</p><p>The profile of the HWB is not very high at the moment, it is as though they are still in 'shadow form' and it is not clear how the HWB will receive info from any sub-groups or how existing groups feed into the HWB. About four weeks ago, I have raised this with the Director of Adult Services who sits on the HWB and they agreed more clarity was need and she would follow it up.</p><p>It would be good in the first instance to know how to approach the Board, who to talk to, how to get representation on the Board.</p><p>More open opportunites to present issues to them on an organisational basis rather filtred by a represetative.</p><p>Don't know</p><p>Get into any of the meetings funding/ resources</p><p>I have had little direct contact but through the menatl health provider forum in our area, we are trying to make links. lack of feed back/involvement from the VCFS rep on the local health & wellbeing partnership who in turn report to the wider county health & wellbeing board. Need to have the 'right' person on the board who properly represents the whole of the sector in our area.</p><p>Knowing where to begin.</p><p>Its actually a secondary issue. The real issue is the relationship between the hospital trust and the coterminus CCGs in which the prime driver is the preservation of the hospital trusts financial standing in oredr to ensure its foundation status.</p><p>I went to the launch of a health and Wellbeing Board and they asked us to write on a flip chart how we could impact on the board. The launch didn't contain ANY information as to how that would be possible. The full list of members was not circulated, a diagram showing how groups feed into the Board was not circulated. My answer was that if they want the VCS to impact on their work, they need to be able to show us how to actually get through to them. I believe I may be on a working group that feeds into the Board - but I don't know because nobody, despite my requests has been able to explain if it is so or not!</p><p>Over-individualistic bodies who fail to cooperative. WE are supposed to make representation through elected members!</p><p>No VCS representation status</p><p>Communication. I have never found DMBC very forward at communicating with people in this area. This is a barrier that must be overcome otherwise there will be no accurate feedback from the public.</p><p>Being involved in the development of the Joint Health and wellbeing Strategy. </p><p>They are still developing their structures and the only rep that we currently have is Healthwatch and they are still forming their own processes.</p><p>We have no contact information for this board.</p><p>The diversity of issues and addressing them effectively can be the greatest challenge for boards. Having the resources to address local need is also one of the greatest challanges.</p><p>Life is too short.</p><p>Reps do not communicate effectively. At a county level one lay representative cannot possible have sufficient knowledge to represent the sector so it is clearly only tokenism.</p><p>Not sure of the routes. Although lots of introduction meetings. It has become less clear who is doing what where and how to get involved. I had registered to be involved in as much as possible. but other than say you have been registered we havent heard how to become further involved.</p><p>Our organisation spent over 12 months lobbying for a VCS rep at the HWB. The responsibility of sourcing this rep has gone to a different organisation and they haven't even told the sector that there is a VCS place at the HWB let alone come out and engaged with us. it feels like gate keeping and i am going to be challenging this very soon.</p><p>Getting onto the boards.</p>