Cervical screening my way

Cervical screening my way

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In 2023, NHS England set a target to eliminate cervical cancer by 2040. It’s an admirable but challenging goal, set against declining levels of uptake by women of cervical screening over the past 20 years.

In response, Healthwatch England launched research to investigate why some women are hesitant to go for screening, to make recommendations to policymakers on how to improve uptake and to help meet the elimination goal.

Key findings

  • The top reasons for hesitancy among respondents were worries about physical discomfort, embarrassment at undressing in front of healthcare professionals and a belief they didn’t have to go because they weren’t currently sexually active.
  • Women felt NHS information describing the purpose of cervical screening was good/clear (78%), but fewer (58%) said it explained Human Papillomavirus (HPV) the leading cause of cervical cancer.
  • Some women didn’t receive accessible or translated information to enable them to understand the invitations and make an informed decision about attending screening.
  • Most women (81%) who’d attended screening previously said staff treated them with respect. However, only a third (33%) felt they’d been able to ask staff for practical changes that could make them feel comfortable in appointments.
  • There was strong support (73%) for home testing – currently being considered as an option by screening experts – if it was offered free on the NHS.
  • There are major gaps in national data on the diversity of women who attend cervical screening.
  • In-depth interviews with women provide examples of innovative practices that improve uptake among diverse women.

Recommendations at a glance

Recommendations to policymakers include calls for:

  1. NHS England to investigate solutions to ensure that disability and ethnicity data about people attending screening can be captured, analysed, and published alongside regional and age uptake data in the future. This would allow for a more comprehensive picture of uptake among diverse groups.
  2. NHS England to address the gap left by the closure of Jo’s Cervical Cancer Trust (the only charity and national helpline dedicated solely to cervical cancer), with high-profile promotion of alternative, trusted sources of direct support and information for women.
  3. Screening providers to ensure they train and enable admin and screening staff to meet their responsibilities regarding accessible information and adjustments to care.
  4. Screening providers, working with local Healthwatch, to seek feedback from their local communities to understand views on booking methods, appointment times and preferred locations for drop-in clinics. Services should adapt access accordingly to help increase uptake.
  5. NHS England to introduce an NHS-branded Trauma Card, based on a Healthwatch Essex initiative for affected women to bring to appointments.
  6. Subject to the results of NHS-commissioned research on the safety and effectiveness of self-screening, the NHS should adopt self-screening as an alternative option offered to all women nationally who would prefer it. Instructions for their use should be co-designed with women.

Read the full report and recommendations

If you would like to leave feedback about cervical screening or another health or care service please get in touch.

Share your views on North East Ambulance Service

Share your views on North East Ambulance Service

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We’re working with North East Ambulance Service (NEAS) and other local Healthwatch to understand people’s experiences and expectations of the services. This includes:

  • Ambulances and paramedics
  • Patient transport
  • 999 call handling
  • NHS111

While people think about NEAS as ambulances responding to 999 calls, nearly two-thirds of its work is answering calls to NHS111. From life-threatening emergencies to general health advice, NEAS plays a key role in the North East healthcare system.

Your views on how it delivers its services, and how it supports those who contact the service will help shape future planning and delivery.

We are interested in hearing your views whether you have contacted the ambulance service recently or not. The survey is short and your responses will be anonymous.

Have your say before Monday 21 October 2024.

This survey is now closed.

As a thank you for your time and contribution, at the end of the survey you will have the opportunity to take part in a prize draw to win £100 of Love2Shop vouchers.

You can get in touch with us at any time for more information or if you would prefer the survey in a different format.

Feedback from August 2024

Feedback from August 2024

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Health and social care feedback August 2024

We heard from 148 this month. Hospitals and GP services were the services we heard the most about. The quality of care or service received in hospitals was a concern for people, and also communication issues.

Patients feeling pressured to access GP services online continues to be something we hear about. Half of the comments were received about GP services were highly complimentary about the quality of service received.

This month’s focus

As well as our usual Here to Hear sessions, we spoke to people at Magic Memories cafe in Blyth, Cramlington Warm Hub, Blyth Central Family Hub Pride event and Hexham Farmers’ Mart.

We carried out three ‘Enter and View’ visits at care homes in Hexham, Ashington and Morpeth. The findings of these visits will be published soon.

Our resource ‘How to get the most from your GP appointment’ was published this month along with our health visiting services report.

We continued to promote the Big Conversation women’s health campaign, with over 500 responses to date.

The online session was from NSPCC, giving information on the new Building Connections service to help tackle loneliness in children. See ‘Impact’ section below for more details.

Impact

At our online talk by NSPCC’s Building Connections service, a representative of Harrogate and District Foundation Trust introduced herself to the speakers and said “This is an amazing and sadly well needed service for young people so well done! I represent the NHS 0-19 Service and would like to share this
presentation with our 5-19 workforce (School Nurses). Could I share this recording with them to raise awareness and support the referrals into your service?”. NSPCC were happy to work with her.

Positive feedback

A patient told us they had recently attended their local Urgent Care Centre.

They reported “I attended at 9.00am and was seen by a nurse by 9.10am. I was very well looked after. The nurse established the situation and organised for me to be seen by a doctor who attended within minutes.
“They gave me a thorough examination, identified the situation and provided advice and medication. I left the centre at 9.25am feeling a lot better. The staff were great: caring, warm and professional – a very good example of excellence. Thank you.”

Negative feedback

A patient reported witnessing an elderly man in their GP surgery experiencing breathlessness and dizziness, trying to make an appointment to see a GP. The receptionist asked if he had a smartphone and told him to use the NHS App to book his appointment. The man said he had a phone but didn’t know if it was a smartphone. Another receptionist asked to see the man’s phone and said ‘yes, it’s capable’. When the man told them that he didn’t know how to use the App, the receptionist suggested he asked a family member or friend to help him.

Service providers and number of enquiries

Royal Victoria Infirmary – 6
Newcastle Hospitals – audiology – 4
Valens Medical Group – 3
Burn Brae Medical Group – 3
Northumbria Healthcare NHS Foundation Trust – 2
Alnwick Medical Group – 2
Railway Medical Group – 2
Greystoke Surgery – 2
Hexham General Hospital – 2
Adult Social Care – 2

Download our August 2024 summary as a pdf

 

Annual Event – Delivering in Berwick!

Annual Event – Delivering in Berwick!

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Your feedback July 2024

Your feedback July 2024

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The services you gave us feedback about the most this month were hospitals and GP services. Access to hospitals was the main concern, specifically the length of time patients had to wait to get an appointment, followed by communication issues. Feedback around GP services was to do with people feeling pressured to go online to make an appointment or access other services, and poor service generally.

This month’s focus

Our Here to Hear drop-in sessions took place in Alnwick, Morpeth, Hexham, Prudhoe, Bedlington, and Ashington. We also attended the SeaFit event for fishermen in Amble, a North Northumberland Autistic Society support group in Chatton, and Choppington Disability Group’s coffee morning.

Due to high demand an extra 2500 copies of our cost of living booklet were printed and distributed across the county. Plans to produce this resource in six other languages and in easy read are underway.

The Big Conversation launched this month. This is a joint initiative between local Healthwatch and the NHS in the North East and Cumbria, and aims to better understand experiences of women’s health and healthcare.

Our online talk was from Northumberland Joint Musculoskeletal and Pain Service (JMAPS).

Read more in our short report

Join the Big Conversation

Join the Big Conversation

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Join the Big Conversation about women’s health

The NHS Integrated Care Board for the North East and North Cumbria is working with local Healthwatch to better understand experiences of women’s health and healthcare. We want to know what’s working well and what could be improved.

The Big Conversation aims to find out what matters most to women and girls when it comes to their health. As part of this you are invited to share your views about women’s health issues and accessing health services.

Join the Big Conversation by completing this short survey and tell us:

  • What matters to you about your health?
  • What is important when you use women’s health services?
  • How comfortable are you talking to doctors about women’s health issues?
  • What are your top health concerns?
  • Where do you find information about women’s health?

The survey will only take around 10 minutes and your answers will help create better health plans for women and girls in our region.

If you fill in the survey, you can take part in a prize draw to win a £100 Love to Shop voucher.

This survey has now closed.

How easy is it to give feedback to your GP?

How easy is it to give feedback to your GP?

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In October 2023 we undertook a ‘health check’ of all GP practice websites in Northumberland across seven primary care networks (PCNs). There are 36 practice websites representing 45 individual surgeries. This was to see how easy it was to find information about how to raise a concern or give positive feedback and to see if signposting information for support in raising a concern was up-to-date and factually correct.

Why we did it

Patient feedback is an important part of improving patient experiences and outcomes, enabling the service provider to identify potential problem areas. Having clear processes also gives the opportunity for concerns to be dealt with swiftly to prevent escalation and to avoid undue confrontation with practice reception staff.

In most GP services complaint situations, the appropriate course of action is for a patient to initiate a complaint directly with their GP practice. Patient feedback to Healthwatch Northumberland has shown that many people seem unaware of how to resolve a complaint or concern through their GP surgery and what support options are available to them.

There have been recent changes to advocacy support in Northumberland, with VoiceAbility taking on the NHS Independent Complaints Advocacy Northumberland (ICAN) service, as well as national changes, with Integrated Care Boards(ICBs) now handling NHS primary care complaints – these were previously dealt with by NHS England.

We wanted to explore if these changes had been reflected on GP practice websites. We also wanted to gather evidence of the need for consistent messaging in order to ensure that the process of raising a concern is easy from a user’s point of view, and that signposting information is factually correct, so that patients have a clear understanding of their rights and options.

How we did it

Our staff and volunteers carried out research by visiting each GP practice website to review its complaints information. All of the websites were accessed via desktop computers and, where possible, using smartphones (29 out of the 36 websites) to ensure equal accessibility.

We are aware of other accessibility issues, for example, language barriers, and will carry out further research on this.

What we found

  • Nearly 60% of GP websites were found to be equally accessible from both desktop computer and smartphone.
  • There was a 50:50 split on whether or not information and support for raising a concern was easy to find on the websites – some information was found under different headings on the websites rather than on the main complaints page.
  • Complaints information, support options and signposting information was very muddled. Even where correct support organisation details were given, they weren’t always accompanied by the correct contact details or explanations of how the service could help.
  • In some cases, there were additional steps that needed to be taken when making a complaint online, for example, having to download forms, which could be a barrier to patients making the complaint.
  • There was a lot of variation in information and processes even between practices within the same PCN, for example, within one PCN, two practices have almost identical looking websites, but one practice directs patients to send complaints to NHS England, whereas the other directs them to the ICB.
  • Within another PCN, again, four practices have very similar looking websites, but two of them require the patient to attend the surgery in person to collect a complaint pack, one requires the patient to put a complaint in writing by post and only one practice offers the option of making a complaint online via email.

Read our full findings and recommendations

Have your say on eye care services

Have your say on eye care services

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Have your say on eye care services

We would like to know if you are getting the eye care you need.

Healthy vision is something many of us take for granted – until there is a problem. An estimated 50% of sight loss is avoidable. That is why people need access to regular eye tests and, if there is a problem, get the help they need.

Tell us about your experiences and help improve eye care services for everyone.

This survey is now closed

Disabled people could be missing out on social care support

Disabled people could be missing out on social care support

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Up to 1.5 million working-age disabled people in England could need social care support but are not accessing it. This means they are likely to be missing out on help with daily activities such as washing, cleaning, socialising, and going to the shops. Healthwatch England polled 1504 working-age disabled adults in England and found one in four, 28%, could be eligible for support under Care Act criteria but have never had a social care needs assessment. You can read about the poll and the results below.

Why people don’t receive social care

The people who took part in the poll had unmet social care needs— they said they are eligible for social care under the Care Act but had never received social care due to multiple factors:

  • They didn’t think they could get any support (65%); 
  • They didn’t know where to go for support (34%); 
  • They were unable to afford to pay for care or contributions (26%); 
  • They found it too difficult to get support from councils or the NHS (14%);
  • Their local service closed (2%).

People who were excluded from the estimate include:  those who are waiting for a social care assessment, have been told they are ineligible for social care support, are supported by unpaid carers, access state benefits, or simply do not want any support. 

Also excluded were those who currently access care, which according to NHS figures is around 300,000 working-age disabled adults receiving publicly funded care and an unknown number of people funding their own care.

When people receive social care, they report positive experiences

Out of 20% of respondents who said they currently receive social care, over three quarters, 78%, agreed that the care they receive helps them live the life they want, compared to only nine per cent who disagreed with the statement. 

Two-thirds (62%) of the respondents who receive social care said it helps them stay healthy, while over half, 51%, said it helps them do the activities they enjoy. 

Just under half, 47%, said that their care enables them to keep themselves and their home clean, and the same number said it supports them to eat and drink properly. Just over one in five, 22%, of people said that their care supports them in working, studying, or volunteering.  

Eligibility issue

Under the Care Act, people may be eligible for social care support if their needs arise from a physical impairment or illness that negatively affects their ability to perform tasks quickly, independently, and safely, while also affecting their wellbeing. 

However, the research shows the extent to which eligibility might apply to more disabled people will remain unknown until people can easily interact with social care services or access assessments.

Annanya’s story: I struggle with routine household tasks

Annanya, 21, is a part-time student and ambulance call centre worker from Liverpool. She has several health conditions, including mental health problems, dyslexia, ADHD, suspected autism and diabetes. Together, these conditions make it difficult for Annanya to maintain her home and to run chores, and she needs support with daily tasks.

Annanya reached out to her local social care provider for support. However, the council told her that her needs were a medical issue.

“They kept me on a waiting list for six months just to get an assessment, then they called me to say they can’t help me”, she explained. “The assessment was also done remotely – nobody visited me at home. I live alone and struggle with household tasks and planning. Having some extra support could really help me manage these challenging aspects of my life”.

Louise Ansari, Chief Executive at Healthwatch England, said: 

“Social care can be transformative and change people’s lives. Our research highlights a really positive message, that for so many people care has helped them live independently, leading the lives they want to live, how they want to live them.

“Yet, social care in England is under financial strain, facing a workforce crisis, and requires major reform.  Our findings clarify those challenges, showing that the hidden demand for support could be as high as 1.5 million working-age adults in England. Not all these people will be eligible for publicly funded care, but far too many clearly live with some form of unmet need and don’t know where to turn for support. 

“We need to make sure there is more support for disabled people, and that this support is easy to understand and to access. Not only will this help people with their emotional and physical needs, but it will also help people who have told us they’d like more support to get into work, and it will contribute to taking pressure off NHS services.” 

We need to make sure there is more support for disabled people, and that this support is easy to understand and to access.

Call for reform

Healthwatch is calling for a fully funded and long-term reform plan for social care that will address workforce issues, offer more support for unpaid carers, and a focus on early prevention.

As part of the reform plan, Healthwatch England has set out three recommendations:

  • The Government should fund local authorities to raise public awareness of social care and find potentially eligible individuals through proactive outreach to disabled people.
  • Government should also dedicate funding to boost capacity and support councils in addressing existing care assessments and care package backlogs. 
  • There needs to be greater investment to ensure all disabled people accessing social care assessments are offered a Care Act advocate who can help them understand the assessment process and their rights.

Read the report in full

Tell us your experiences of accessing social care support at home

Trends in feedback January to June 2024

Trends in feedback January to June 2024

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Between January and June 2024, we received feedback from 417 individuals from talking to people at face-to-face events, telephone calls, emails, our website, social media and other sources. This is approximately the same as the previous six months (we heard from 422 individuals between July and December 2023). Between January and June 2024, we signposted 65 people to different organisations for further support. This is up slightly from 59 during the previous six months. Our social media content had a reach of 110,000 and almost 7000 engagements, and our website had 23,000 views, compared to a social media reach of 77,000, over 7,000 engagements and 16,000 website views between July and December 2023.

The feedback we have had for the past six months has mainly been around three service areas:

GP services

29% of all feedback received in January to June 2024 was to do with GP services (roughly the same proportion as July to December 2023). The main issues we received feedback on were difficulty getting an appointment and poor service. However, approximately one in four comments we received about GP services were positive which is an increase on the previous six months (one in five comments were positive between July and December 2023).

Hospitals
25% of all feedback received during the six months was about hospital services. The biggest concerns were around the distance to travel and lengthy waiting lists. There were also concerns raised about poor communication and poor quality of care when people got to hospital. However, just under one in three of the comments we received about hospitals were positive.

Dentists

Dentists were mentioned in 7% of all the comments we received. The vast majority of feedback was to do with the difficulties getting an NHS appointment. About 10% of respondents who fed back about dentists reported that the dentists they had spoken to were only accepting private patients. Approximately one in ten of the comments we received about dentists were positive.

These three categories made up almost two thirds (just over 61%) of the feedback we received in January to June 2024. This is up from the previous six months when these categories amounted to less than half of the feedback received (48% in July to December 2023).

Over a quarter of the feedback for GP services was about three particular GP practices. We will contact these practices individually to discuss the themes that have been raised in the feedback.

Signposting/requests for information

16% of the contacts we received in January to June 2024 were requests for information or signposting support. The top three areas were:

  • Adult social care – enquiries were mainly about getting care in the home and care assessments
  • Cost of living support – this included requests for information around benefits advice
  • COVID-19 vaccinations – enquiries were around eligibility and vaccination sites

Read more in feedback trends for January to June 2024 report.