In his first annual report to Parliament as Chair of Healthwatch, Sir Robert Francis looks beyond health and social care performance statistics to explore how people are experiencing care day-to-day across England.
Drawing on evidence from 406,567 people, over the last year Healthwatch has looked at what people are saying about GPs and community services, hospitals, social care services and mental health support, as well as issues that are common to all four areas of care (see below).
Over the course of the year, our network shared 2,053 reports with local services and decision makers about the improvements people would like to see.
The collective findings of these stories and reports show a real mix of views, with people continuing to receive outstanding care, much of which people say is down to the dedication shown by the extraordinary staff who keep things running.
However, it is also becoming clear that others struggle to access the support they need, with services not getting the basics of care right. Examples Healthwatch has worked on over the last year include care home residents not being able to see an NHS dentist and hospitals not providing the right information to help prevent patients having to return unnecessarily.
Issues like these require the NHS and social care system to be looked at as a whole rather than focusing on the headline targets for individual parts of the service.
Yet as it stands, services are not always able to spot the gaps between them and the impact this is having on the people they care for.
With the NHS Long Term Plan imminent, and the government’s plans for social care due in the New Year, listening effectively to people needs to become “part of the DNA” of health and care in England. From the beginning of the planning process to the provision of services to individual patients, insight from people need to be used to shape decisions and better track performance.
Healthwatch is doing its part. Since 2014 we have created the health and social care sector’s single biggest source of user insight, gathering more than 1.4 million experiences and views. We have also set a clear goal to step this up further, by reaching a million people a year by 2023.
Encouragingly, those working in health and social care are also using our insight more than ever before, drawing on our evidence and calling on our expertise to engage with communities up and down the country.
The government’s commitment to invest billions more in the NHS provides a rare opportunity to invest for the long-term in a building a culture where staff at all levels work in equal partnership with communities to shape the way services run.
Chair of Healthwatch England, Sir Robert Francis, says,
“The government’s investment of extra billions in our health service gives us a great opportunity to think about how that money should be spent, and how we can track the impact of any changes to ensure they deliver the help people want and need.
“To do this, we want to see people’s experiences of care become part of the very DNA of the decision-making processes throughout the NHS and social care sector.
“I have seen first-hand how a purely target driven culture within the NHS can actually be bad for people’s health, both patients and staff. To focus exclusively on performance measures can leave services with a false belief they are succeeding without any real idea whether people’s care and support needs are being met or where things might need to change.
“Listening to people and learning from their stories is the best way to get the balance right, and to ensure services have the evidence they need to shape care around the real-life needs of those they serve.
“The outstanding efforts of our local Healthwatch teams, supported by more than 5,000 volunteers, have created an evidence base of people’s experiences that is simply unparalleled. What’s more, we can see this insight being used to shape some of the biggest debates in health and care.
“For me, this is just the beginning. Over the next five years, we are looking to create a movement that puts people at the very heart of health and social care. To do this we need people to keep coming forward, keep sharing and help services hear what really matters to them.”
Four common themes
From the hundreds of thousands of stories gathered by Healthwatch in the last year, we have identified four themes which people commonly experience across all services.
- Better information to make the right choices
With the right information, the public is not only empowered to make better decisions about their health and care, but know where to go for help when they need it. However, this information isn’t always available, and when it is, it can be too technical, confusing or difficult to find.
- Easier access to support
Quicker and easier access to health and care services is essential. It can take a long time for people to get the support they need. Many experience delays at every step – from getting an initial appointment, in waiting rooms, and to see a specialist for further treatment. Repeated cancellations also indicate that the NHS doesn’t value people’s time. Technology used correctly offers the potential to alleviate these barriers and provides easier access to services, and to earlier diagnosis.
- Improved conversations
We know people want to be involved in decisions about their treatment and care. Good communication between professionals and the public helps people to be more informed, understand their choices, and manage their expectations. This is particularly important for people with disabilities or people who don’t speak English as a first language.
- Well-coordinated services
Navigating health and social care can be complicated. People want a seamless experience across different services. When services work well together, it not only makes things easier for people but also reduces the risk of serious issues being missed.