Healthcare on a low income

Healthcare on a low income

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Healthwatch England’s latest research shows that people on lower incomes find it harder to access NHS services than people who are financially more comfortable.

In 2023, it reported that people were increasingly avoiding NHS appointments and prescriptions due to the cost-of-living crisis.

Two years on, rising costs, poor service availability, and a lack of support are still common themes in the experiences people share with Healthwatch across the country.

While the NHS is free at the point of delivery, people’s income and where they live can affect their care experience. Research by the King’s Fund in 2024 found people living in poverty had worse care than those with higher incomes.

Several factors contributed to this, including the cost of technology to access services online, like smartphones and broadband internet, and the costs of travelling to get care, like bus fares and parking expenses.

Healthwatch England looked at seven areas that affect those on low incomes. These are:

Living on a low income shouldn’t be a barrier to healthcare access. Find out what better support for people on low incomes could look like.

Read Healthwatch England’s recommendations for making care more accessible for people on low incomes.

If you are looking for support with the cost of living visit our website.

Your feedback May 2025

Your feedback May 2025

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Your NHS and social care feedback for May 2025

Top issues

You told us that long distances to travel to audiology and radiology appointments in hospitals were an issue. There was also feedback around difficulty getting a face-to-face GP appointment and issues with the online booking systems. Half of the feedback about GP services praised the good service patients received by staff.

This month’s focus

We took our Here to Hear drop-ins to place in Ashington, Hexham, Bedlington, Hadston, and Morpeth, plus we were at the Bell View wellbeing event in Belford.
We completed an Enter and View visit to Hartford Court Care Home, and held focus groups in Hexham and Alnwick on audiology services.
Our online session from Parkinson’s UK had 18 attendees who really enjoyed the talk.
The Persistent Physical Symptoms project has been re-establishing contact with groups in Ashington, Blyth, and Newbiggin-by-the-sea to recruit research participants.
We asked for experiences of applying for or renewing a Blue Badge and heard that the process is lengthy and slow.

Positive feedback example

A person told us that they are happy with the care they received at their GP surgery, with a sensible booking process, being guided to ring on a Monday for non-urgent medical appointments available that week (although they did say that patients do have to ring early).

Having not needed to see a GP in over ten years, the person said they were pleased to be offered full blood testing, finding it reassuring that they were taken seriously. They were also pleased to be offered a wellness check for added reassurance.

Castle Morpeth resident

Negative feedback example

“This was a Blue Badge renewal but I had to give all the information again including ID, doctor’s original letters of my conditions etc. – why?? As it was a renewal I was expecting a simple form i.e. giving any changes to my conditions.

It’s a very long-winded procedure, photocopying everything a second time. I sent it well in advance but they came back with more questions last month. I had thought I’d been turned down and was getting anxious but I’ve just heard they will renew it. I know they advised of a large number of applications and a backlog but surely renewals should be much easier for all concerned.”

Ashington and Blyth resident

Impact

Our team produced a simplified version of a Volunteer Agreement handbook for Thriving Together, to be shared with users of the new volunteering management system including Healthwatch Northumberland and other local organisations and services. ”Many thanks to the team for updating the Volunteer Handbook to an easier read version.”

Thriving Together Project Manager

Information and Signposting Service

We helped people find information on a number services including patient transport, talking therapies, social prescribing, hearing loss and mental health.

Read more in our feedback summary for May 2025

Volunteers’ Week 2025

Volunteers’ Week 2025

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ADHD diagnosis research

ADHD diagnosis research

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In its latest report, Healthwatch England has found that people with ADHD find a diagnosis life-changing, but long waits on the NHS need urgent action.

ADHD is a neurodevelopmental condition, characterised by difficulties with concentration, energy levels, impulsiveness, or a person’s ability to manage their time.

Healthwatch England commissioned a poll of 2,579 adults living in England to explore people’s experiences and impacts of possible ADHD and of getting an ADHD diagnosis. All respondents were either diagnosed with ADHD or thought they had it.

The survey was conducted following concerns about access to ADHD services raised by local Healthwatch and the public.

Findings

The report highlights ADHD diagnosis can change people’s lives, giving them a better understanding of themselves, improving their wellbeing and self-esteem, and concentration at work.

Yet long waits for assessments put people with suspected ADHD off seeking professional care, and almost two-thirds (64%) of people with an ADHD diagnosis said they received either no information or poor information whilst waiting for their assessment.

Of the people who responded to the poll and who are currently waiting for an assessment, nearly half, had been waiting for over a year, and 10 per cent of these for three years or more.

Healthwatch England’s report, “Recognising ADHD: How to improve support for people who need it” highlights that long waits for an ADHD assessment on the NHS put people off seeking any support.

Of all respondents, 41% said they didn’t seek a formal ADHD diagnosis, with 20% of this group giving long waits as a reason.

There is no official data on how many people are waiting for ADHD assessments. A recent BBC investigation suggested that at least 196,000 adults were on NHS waiting lists for ADHD assessments.

Recommendations

Healthwatch England warns there is an urgent need for quicker access to NHS support for ADHD and has set out four priorities for the Department for Health and Social Care, NHS England and other stakeholders. These are:

  • collecting data on waiting times to understand demand
  • shifting more ADHD care to community care to reduce waiting times
  • better training for staff in both primary and community care
  • and tailored information and support for people on waiting lists.

Healthwatch England sits on and supports the work of the NHS ADHD taskforce, which was set up in 2024 to address the challenges people face in getting the right support.

Read the full report

If you would like to tell us about your experience of ADHD diagnosis or treatment, please get in touch.

Hearing what matters

Hearing what matters

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Experiences of audiology services in Northumberland

What people told us about NHS audiology services in Northumberland

We asked local people to tell us about their experiences using NHS audiology services in the region, including what’s working well and what needs to improve. We also wanted to understand any barriers to using the service and how this impacted people, and the reasons some people had made the move to private audiology services.

Many praised the kind and helpful staff, and said that getting hearing aids or repairs to hearing aids had made a big difference to their quality of life and wellbeing. People also appreciated the convenience of the postal service for batteries and parts.

However, most of the feedback we had was negative. People told us they were unhappy with recent changes to the service, especially the lack of local provision and the need to travel, in some cases very long distances, to access help and support. Many mentioned age, inability to travel and health concerns as being additional barriers. This is unsurprising given most audiology users are likely to be older adults. Many mentioned long waiting times to receive support and care and some told us about the negative impact that had on their wellbeing.

Confusion about the audiology service is also evident including people not having a full understanding of what clinics are available and what services are provided in those clinics, as well as a lack of awareness of changes to the service and how to access help at various stages of hearing loss or receive follow on care.

Some communities were more dissatisfied with the changes including those in North Northumberland and Morpeth, those aged 80 plus and those with sight loss and physical mobility issues. We are also aware that hearing loss is more likely to negatively impact certain groups of people, such as those with dementia or with sight loss.

We’ll be sharing these findings to help improve access and support across the county. Read more about this work online or download at the link below.

Hearing what matters – experiences of audiology services in Northumberland

Share your experiences of audiology services, or any other NHS and social care service you have used recently.

Your feedback: April 2025

Your feedback: April 2025

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Your NHS and social care feedback for April 2025

Top issues

In April you told us it was difficult getting an appointment for both GP services and NHS dentists. We did however, hear a lot of positive feedback about the quality of care patients received from GP services, dentists and hospitals outpatients departments.

This month’s focus

This month we have been out at our usual Here to Hear sessions as well as attending additional sessions at Hexham auction mart, a Seafit event at Amble hosted by the Fishermen’s Mission and the west locality’s dementia event organised by the Locality Coordinator.

We have started work on the Persistent Physical Symptoms project, a joint research project in partnership with Northumbria Healthcare NHS FoundationTrust, Northumbria University, and residents of Blyth, Ashington and Newbiggin-by- the-Sea.

Positive feedback example

“I was referred to musculoskeletal clinic re. lumbar pain and sciatica. Physio diagnosed prolapsed lumbar disc and referred me for a MRI scan. I explained I had claustrophobia. She chose an open scanner at a private facility using NHS funding. She was honest about the 4-6 week waiting list but my scan was allocated at week three. I am now waiting for a steroid injection in the affected disc space.

This has been a very positive experience with experienced therapists who provided quick and appropriate investigations and treatment. I have been very pleasantly surprised.”

Blyth and Ashington resident

Negative feedback example

A person told us they dislike the Anima appointment booking service used by their GP surgery, as it is only open between around 7am-7pm, when they are out at work. The system also won’t allow them to book an appointment in advance for routine care. They say there should be choice over methods to book appointments and that GPs have found systems that are more convenient to THEM but not to patients.

They think online and telephone appointments might mean GPs miss out on spotting body language and other cues suggesting someone needs additional support.

The patient has received an email to say GPs will now be triaging their appointments through Anima – they feel this is doubling up the processes. When they visit the surgery they find a lack of privacy at reception due to large screens and desks. They generally find it to be an unhelpful, unwelcoming atmosphere and feel that the service has gone downhill since the COVID-19 pandemic.

Castle Morpeth resident

Impact

A young volunteer with us who has led on a schools-based project contacted us to say he had been offered a place to study Medicine at both York and Sheffield Universities. He said “I’m almost certain that I couldn’t have secured these offers without my role in this project (the interviewers seemed to really enjoy hearing about it!), so thank you for giving me the opportunity to lead it”.

Information and Signposting Service

This month we were asked for help finding mental health support, cancer patient transport, information around Covid-19 vaccinations, and diabetes, amongst several other issues.

Read more in our short report for April 2025

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What did you tell us in our Annual Survey 2025?

Every year we ask people living in Northumberland to tell us what they think of the NHS and social care services they have used over the last 12 months, in our Annual Survey.

We compare the results year on year.

The aims of this year’s Annual Survey are to:

• Gain an overview of experiences and views of health and social care services in the last year

• Get clear direction from people in Northumberland as to which services we should prioritise in our work for the next year, and why

Summary

Our Annual Survey was open during February and March 2025. It was available online, as a printed document and in easy read. It was promoted on our website, social media platforms, newsletters, through our network of contacts and at our 12 in-person events during that time.

We received 377 responses to the survey from all parts of the county. This is more than last year, where we received 229 responses.

Generally, people felt that NHS healthcare in the previous 12 months had been good and had largely stayed at the same level of service, getting neither better or worse. People didn’t think as highly of adult social care services, but said they had largely stayed the same over the year.

We heard from more than twice the number of females (60%) to males (23%). Adults of all ages shared their views, but the majority of people were aged 65 or above.

As reflects the demographics of the county, 2% of the respondents were non-white.

Our work priorities for next year

As part of the survey, we asked people to choose one service from a list of 22 health and social care services (plus ‘other’ option), that we should focus on in the coming 12 months. 320 people answered this question.

The top three services chosen were:

1. GP services (28%)
2. Dentists (13%)
3. Adult social care services (12%)

These three choices made up over half of the responses (53%).

 

Read more in our Annual Survey 2025 report

 

The Big Conversation on women’s health

The Big Conversation on women’s health

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Thank you to everyone who took the time to share their views on women’s healthcare in The Big Conversation last year.

Thousands of women across the North East and North Cumbria had their say about NHS healthcare by taking part in an online survey and focus groups targeting specific groups of women, such as those who have additional health inequalities or barriers to accessing health care.

The report has now been published identifying key themes and recommendations.

Background

Women, making up 51% of the national population, live longer than men but spend more time in ill health and living with disabilities. There is not enough focus on women specific conditions or how conditions, that affect both men and women, impact on women differently.

In 2022, the UK Government published their first strategy focusing on women’s health inequalities. The 10-year ‘Women’s Health Strategy for England’ set out commitments to improve the health and wellbeing of women and girls and deliver better health outcomes.

In our region, the North East and North Cumbria Integrated Care Board (NENC ICB) is committed to driving forward the Women’s Health Strategy and making changes that will benefit local people and future generations.

During the ICB’s second annual Women’s Health Conference in July 2024, the ‘The Big Conversation’ was launched in partnership with the North East and North Cumbria Healthwatch network.

Headline findings

  • 61% of women said they feel confident to speak with a healthcare professional about their women’s health issues. However, many went on to say they aren’t confident they will be heard or get the help they need.
  • GPs have a critical role as the ‘gatekeepers to support’ for most women. We heard that many women are concerned that their GP does not listen to them, act on what they are told or doesn’t have up to date knowledge about many women’s health issues. Improving experiences in primary care will significantly improve confidence in women’s health care.
  • Women want the choice to have a female healthcare professional; this is a strong message from general engagement but particularly important in targeted work with underrepresented groups.
  • The GP (75%) and NHS website (75%) were selected as the most common place to find information on women’s health. A session with underrepresented groups highlighted the need for targeted accessible communications and the importance of peers in their communities and community support organisations.
  • It is important to women that their health records are easily accessible by healthcare professionals and kept up to date.
  • Women would like more research into women’s health concerns.

Top priorities

Overall, women said their top 5 priorities in relation to women’s health are:

  1. Mental health and wellbeing: including depression, anxiety and eating disorders.
  2. Healthy ageing and long-term conditions: including falls, heart disease, stroke, diabetes, dementia, bone, joint and muscle health, and bladder/urinary.
  3. Menopause, perimenopause and hormone replacement therapy (HRT).
  4. Screening services: including cancer screenings for cervical, breast and bowel.
  5. Menstrual and gynaecological health.

Read the full report and recommendations

If you would like to tell us about your experience of women’s health services please get in touch.

Eye care costs

Eye care costs

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New research from Healthwatch England reveals costs of additional eye care services are likely to deter some people from visiting opticians altogether.

An estimated 50% of sight loss is avoidable. That’s why it’s vital that people can have their eyesight tested regularly and get the help they need if there is a problem. Yet new research from Healthwatch England found that costs associated with visiting opticians are deterring those on the lowest incomes from getting regular eye tests.

An online survey was carried out asking about people’s eye care experiences between July and September 2024. 14% of people who responded to the survey had avoided eye care due to cost in the last two years.

People who described themselves as ‘not at all comfortable financially’ were much more likely to say they avoided going to opticians than those who were financially very comfortable (39% vs 3%). Lack of awareness of the financial support available may also contribute to the high rate of people avoiding eye care.

Additional costs may put off patients

As people face rising eye care costs and lack of financial support, many high street opticians, which are private businesses, increasingly rely on generating income through offering services in addition to eye tests.

The survey found that of those who had attended an eye test in the last two years, 72% had experienced staff offering additional services at a cost. This practice has made some people reluctant to visit optician services at all. Those who said that opticians had offered them additional paid services were twice as likely to say they had avoided getting eye care in the last two years compared to those who had not experienced this.

84% of the respondents to the survey were eligible for free eye tests. However, as the results of the survey show, many people eligible for financial support for their eye care may find it difficult to afford additional costs. They may put off getting eye care because they are concerned about being pushed into paying for products or services they can’t afford.

Healthwatch England set out the following steps to protect people from the rising impact of eye care costs:

  • The Department of Health and Social Care should review support for the costs of NHS eye care for those on the lowest incomes.
  • The Government and the NHS should consider a targeted communications campaign through direct channels to low-income eye care patients.
  • The primary eye care sector should have clear guidelines for how staff should assist those on lower incomes without affecting their confidence in seeking care.

If you would like to tell us about your experiences of accessing eye care, please get in touch.

Your feedback: March 2025

Your feedback: March 2025

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Your NHS and social care feedback from March 2025

Top issues

During March you told us you continue to have difficulty getting an appointment with your GP. This was due to feeling forced to go online to do this, or because of poor communication with and from the practice. Around one in five comments about GP services were in praise of the service received at the practice.

Feedback around A&E departments at hospitals was that the quality of care had been poor.

You also told us that waiting lists for mental health services were long, plus the quality care was inconsistent.

This month’s focus

We attended many events hosted by other organisations this month including Allendale Meet and Eat and Berwick dementia café, as well as events in Cramlington, Seahouses, Blyth Family Hub’s Step into Spring event and Vision Northumberland’s equipment day. This is in addition to our usual Here to Hear events in Bedlington, Hexham and Morpeth.

Our Annual Survey had 377 responses and we will share what you told us shortly.

Our online talk for this month was from Northumberland’s Domestic Abuse Service.

Positive feedback example

A patient got in touch to leave positive feedback about their experience of a hip operation at Wansbeck General Hospital.

They said “To help alleviate the fears and concerns regarding a hip operation, Wansbeck Hospital are getting it right. A whole team of people descended on me, helping me (literally) every step of the way. I felt well looked after and completely informed. Well done Wansbeck.”

Cramlington, Bedlington and Seaton Valley resident

Negative feedback example

An elderly person told us they had to call an ambulance during the night as they had been unwell, their condition was deteriorating and they lived alone. They were taken to the RVI and waited four hours to be seen/assessed. They were then placed on a trolley bed in a corridor where they remained for nine hours without being given any water (or food) and too weak to call out for someone’s attention.

Eventually a member of nursing staff commented they looked dehydrated and brought a tiny cup of water. The staff member promised to bring more but never did. On discharge from hospital staff said ”don’t hesitate to come back if you have any more problems”. The person said they’d rather stay at home and face the consequences because at least they’d have access to water.

Tynedale resident

Impact

“The JobCentres are feeding back saying that the Mental Health Support in Northumberland booklets are good and offer clear options of support for customers. They issue them to so many customers who are saying they need support with their mental health.” Partnership Manager, DWP

Information and Signposting Service

We were able to give information or point people in the direction of support for a number of issues including benefits/housing advice, NHS complaints advocacy, patient transport, volunteering activities, and weight loss support.

Read more in our short report.