A Picture of Health for South East London

1
A Picture of Health for South East London Topline
findings from pre-consultation engagement
2nd March 2007
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Presentation structure

• Background objectives
• Our approach
• Main findings
• Current experiences of healthcare
• Healthcare priorities
• Response to the case for change
• Peoples principles for change
• Moving forward

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Background

• Aims of research were
• To gauge reactions to the case for change
• To establish the publics principles for change
  to inform future options
• 4 Deliberative one-day workshops across SE
  London, each with
• c. 50 members of the public recruited to be
  representative of the area
• c. 20 engaged public
• Structure of the events
• Majority of the day spent in table discussions
  led by PCT facilitator capturing discussions on
  laptop
• Presentations on the policy and clinical cases
  for change

4
Main Findings
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Partial knowledge and varied experiences

• Good knowledge of traditional health services
• Gaps in knowledge of other primary care services
• Such as Walk-In centres, minor injuries units,
  NHS Direct, out-of-hours GP services
• People call for more information and better
  promotion of these services
• Particularly where they provide alternatives to
  AE
• Table discussions reveal inconsistencies in
  services, e.g.
• Some have to travel out-of-area for Walk-In
  centres
• Variability in access to GP, quality of care and
  range of services available at GP

6
Accessibility a strong theme in current
experiences

• People raise accessibility as an issue in current
  experiences
• Some find access to GPs limited
• Restrictive opening hours and appointment booking
  systems
• Many frustrated by waiting times throughout the
  system
• Diagnosis, tests, referrals, AE
• Perceived loss of services in some areas
• Accessibility also a reason for positive
  experiences of services
• Local pharmacist easily accessible no
  appointments, longer opening hours
• Positive reports of alternatives to GPs and AE
  (Walk-In centres, NHS Direct) where experienced

7
Relationships with health professionals
instrumental in perceptions of services

• Examples of good and poor experiences often down
  to how people have been treated
• Many reports of negative experiences
• Lack of sympathy, respect and time
• Unable to see own GP/ same GP
• However, some participants report good
  experiences of services as a result of their
  interaction with healthcare professionals, e.g.
• Some have built a strong relationship with GP
• Pharmacists frequently praised for being helpful,
  caring and respectful

8
Communication and information a widespread issue

• Majority of participants believe there is poor
  information on services
• Not proactively promoted, even to those in
  greater need (e.g. support available to carers,
  aftercare, support for long-term conditions)
• Hard to navigate the system
• Limited awareness of additional services provided
  by GPs and pharmacists, though positively
  received where experienced
• There are also criticisms of communication
• Between health professionals and patients, e.g.
  informing of test results
• Between different health professionals, e.g.
  between primary and secondary care

9
Mixed experiences of hospitals

• Many instances of good experiences of secondary
  care
• However, there are some concerns over conditions
  in hospitals
• Cleanliness
• Food
• Unpleasant atmosphere noisy, hectic

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Healthcare priorities based on experiences

• Accessibility
• What I need, when and where I need it
• Regardless of disabilities, language

Expertise Reassurance that health professional is
competent and skilled to deal with condition

• Communication
• Promoting services
• Good communication between patients and health
  professionals

Priorities
Empathy Time and attention going beyond treatment
needs
Continuity of care Join up between services
Range of services Attention to full range of needs
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Response to case for change generally positive

• Greater sympathy and understanding from the
  general public
• Engaged public more cynical just another
  reworking of long-term problems
• Clinical case for change more compelling than
  policy case
• Helps redress assumptions about where care should
  happen, especially
• Role of paramedics vs. proximity of AE
• Services at/ closer to home for those with
  long-term conditions
• Being treated by a specialist centre, rather than
  at the nearest hospital (e.g. for a heart attack)

12
Response to case for change generally positive,
though some reservations

• Despite supporting central principles of change,
  many have reservations
• Case for change does not address some of their
  big questions
• How has all the money invested in the NHS been
  spent?
• Why are there cuts in services/ staff?
• How will you tackle waiting lists?
• Some are not convinced that it can happen in
  practice based on their experience of current
  shortcomings in the service
• Some doubts over capability and competency of GPs
  to take on more

13
Peoples principles marry their priorities with
the case for change

• People want any options for South East London to
  be designed with the following principles in
  mind
• Accessibility
• Especially to out-of-hours and more urgent care
• Closer to home, especially for long-term care
• Greater access to specialists, more quickly
• No gaps in provision during the process of change
• Patient focus
• Personal, polite, respectful interactions with
  health professionals
• Join-up between services
• Intermediate support where needed

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Peoples principles marry their priorities with
the case for change

• Information and promotion
• Raising awareness of services available
• Information on changes to services
• Information on how to use services
• Standards of care
• Maintaining high standards of care, especially
  for AE
• Increased focus on prevention
• Especially through education
• Increased focus on mental health
• More explicitly referenced in communications

15
Moving forward

• We are in the process of in-depth analysis, but
  clear direction on communication of the options
  is emerging
• Clinical case for change is more compelling than
  the policy drivers
• Critical to stress how transition process will be
  managed to address concerns about loss of
  services
• Should emphasise how peoples healthcare services
  will improve
• Should highlight how changes will address
  perceived capacity issues
• Communications should make explicit reference to
  the peoples principles for change to reduce
  resistance
• There is an opportunity to highlight what new
  services are already available (such as Walk-In
  centres and minor injuries units)

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Contact us

• Liz Owen
• Research Director
• lowen_at_opinionleader.co.uk
• 020 7861 3267
• Lucy Devereux
• Research Consultant
• ldevereux_at_opinionleader.co.uk
• 020 7861 3266

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London WC2A 1AHTel 020 7861 3266Fax [phone]
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