Planned care is the term that the NHS uses for any treatment which isn’t an emergency. This includes pre-arranged appointments at the hospital or within the community, which usually start with a referral from a GP. Planned care covers almost all NHS services, from minor operations and routine tests for treatment and other care pathways which had a definite end such as a cure or improvement.
The challenge
The NHS has recently published a “long-term plan”. This plan sets out how, over the next ten years, the NHS will use extra funding to focus on things that can make a real difference to the health and wellbeing of our population.
In order to do this, we need to make sure that planned care services being delivered across Coventry and Warwickshire are the best they can be; high quality, safe, effective and delivered in the right place by the right health professional.
We need to recognise what we’re doing well, celebrate and share success and look for ways to improve to make sure we have a good quality of care being delivered to everyone.
What we did
Between April and July 2019, the local Clinical Commissioning Groups went out and spoke to hundreds of local people, frontline NHS staff and community and voluntary sector workers and asked them:
- What do you think is working well?
- What would you like to see? Is there anything you think could be improved?
- Have you ever faced any barriers or difficulties to accessing healthcare?
- What could you do differently to improve your own health and wellbeing?
We spoke with hundreds of people across Coventry and Warwickshire, with a particular focus on those who might typically find it difficult to access health services or have less opportunity to give their feedback on their experiences.
Key audiences we engaged with included:
- Youth audiences
- Elderly
- BAME audiences
- Homeless and vulnerably housed
- Gypsy and Traveller community
- Carers
- LGBT+ audiences
- Those with disabilities/long-term health conditions
- Those with mental health issues
- Employed people
- Community and voluntary sector groups representing all of the above
- General practice
- A wide range of health professionals from a number of roles and departments working in hospital planned care services across GEH, SWFT and UHCW
In addition to the questions above, those working in hospital planned care services were also asked:
- What are your thoughts and ideas generally around the topic of Planned Care to gain a better understanding of what ‘good’ Planned Care looks like and areas that could be built upon in the future
- How can the NHS provide the best Planned Care experiences for patients?
- How staff see their role in influencing and providing the best experiences for patients?
- Looking at referrals for appointments – what works now, and is there anything that could be improved or built upon?
- Thinking about information included in referrals received, what works? And is there anything that could be improved?
- If referring onwards…What works well? Is there anything that could be built upon or improved?
- What do staff hear about that is perceived positively by patients and service users?
- Which aspects of the service do patients feel could be improved?
- What outcomes should be aimed for in terms of providing the best Planned Care services for patients? What do staff think patients would be looking for to create a positive experience / positive journey through the care pathway?
After analysing all the feedback received, a number of key themes were identified as being the most important to people and would work well as the key outcome framework domains:
| Access |
Easier access to services where access means the ease of making and booking appointments, the availability of appointments, the types of appointments available, the convenience of appointments, the ease of getting to and from services; getting the right information, advice and guidance to help make choices about care; consideration of how travel and transport can impact access.
|
| Communication |
Communication with and between patients, families and between organisations, departments and staff. |
| Empowered and supported workforce |
Getting the best staff to support patients, good customer service; every contact counts; access to the best services no matter where a person lives or their personal history; services which react and develop to provide the best possible outcomes for patients and their families. |
| Patient journey |
A seamless patient journey through all treatments and interventions, underpinned by joined up working between teams. |
| Person-centred care |
Services which understand a person’s needs, wishes and history; services delivered with compassion, empathy and understanding; feel listened to and respected; involved in decisions about care; services delivered closer to home; don’t always want to go to hospital for routine appointments |
| Prevention |
Support to help people manage a healthy lifestyle and improve wellbeing; support to avoid getting ill in the first place; education and awareness raising of key health topics; how to better manage a long-term condition when required.
|
In addition to the more general feedback, we also gathered a range of feedback specific to certain groups or communities including the elderly, young people, BAME communities, homeless and vulnerably housed; gypsy and traveller communities, carers, LGBT+ and those with mental health or additional needs. This feedback does fit into the key themes above, but it is important to note that it is feedback that needs to be given due consideration to ensure services are planned, prioritised and delivered to reach our whole population, reduce inequalities and improve outcomes for all.
Who we worked with
|
University Hospitals Coventry and Warwickshire NHS Trust
Hospital of St Cross, Rugby
George Eliot Hospital NHS Trust
South Warwickshire NHS Foundation Trust (via earlier engagement, Summer-Autumn 2018)
Hill Street Over 50’s Club, Rugby
Bedworth Older Peoples Club (and Food Bank)
The Roma Project, Coventry
Hope in Unity, Coventry
Edward Street Elder Asian Group, Nuneaton
Nepalese Community, Nuneaton
ESOL class, Sydni Centre, Leamington
Baitul Ehsan Mosque, Leamington
The Jesus Centre, Coventry
Salvation Army, Nuneaton
Helping Hands, Leamington
Woodside Traveller Site, Rugby
Corley View Traveller Site, North Warwickshire
|
Carers Trust, Wellesbourne
Carers Trust, Hartshill
Carers Trust, Coventry
The Gap Community Centre, Warwick
Coventry Pride (Trans and Gender Variant Group)
Warwickshire Pride
Coventry and Warwickshire MIND, Rugby
Coventry and Warwickshire MIND, Mancetter
Springfield MIND, Leamington Spa
Coventry railway station
Nuneaton railway station
Leamington Spa railway station
Coventry College
Rugby College
North Warwickshire College (Nuneaton Campus)
Warwickshire College (Leamington Campus)
|
The outcome
Overall we received some fantastic feedback. Taking the opportunity to go out and speak with those who might traditionally struggle to have their voices heard was a really valuable experience and helped us build stronger links with these communities and groups.
Getting an idea of what our population wants and needs from planned care services will really support us in how we plan, prioritise and deliver those services to improve health outcomes.
Next steps
We will continue to analyse the feedback we received and group it into the common themes above (creating additional ones, if necessary). We have used this information to draf desirable criteria and outcomes, which we will take back out to these audiences to check and challenge as part of further engagement.
Once complete, we will present the findings to our providers to help them start thinking about the future of planned care services, continuing to involve patients and the public every step of the way.