The COVID-19 pandemic has changed the way NHS and social care services work for the foreseeable future. The public is grateful to NHS staff and understands the challenges faced by health services during the crisis, but some people have also felt left in the lurch.
Although 76% of people polled said that feedback is an important way to improve services, many felt barriers remain. People are reluctant to provide negative feedback in case it increases pressure on services or staff.
We know that NHS and social care services won’t bounce back overnight - there will be problems to tackle - but also opportunities to make care better. However, this begins with services learning important lessons from people’s experiences of care to make improvements, especially in preparation for a possible second COVID-19 wave.
The Health and Care Select Committee is already looking into the delivery of core NHS and care services during the COVID-19 pandemic. Thanks to thousands of people telling us their stories of care during the pandemic, I was able to share our evidence, which highlights the persistent issues people have faced over the past few months.
Five lessons for the future
Interruptions to care should be minimised
There are significant levels of fear and stress amongst people who have had appointments cancelled or their treatment paused. Some patients have also been afraid to visit services for fear of catching COVID-19.
This has resulted in widespread interruptions to everyday care, with significant impact on people with cancer awaiting potentially lifesaving treatment, as well as those needing important routine examinations, such as cervical screening. The main concern is that people were not sufficiently involved when their care was postponed and received no medical support to explain the implications of this.
We have also heard about the difficulties people face accessing B12 injections, which is concerning for individuals with pernicious anaemia – an autoimmune condition, which affects the body’s ability to produce fully functioning red blood cells - who cannot absorb B12 in tablet form. GP practices are inconsistent in how they provide these injections. Some have falsely cited government instructions as a reason to stop injections, whilst others have referred to out of date guidance. Services must provide accurate information to the public and listen to the valid worries their patients have about not receiving treatment.
Invest in good communication and accessible information
Communication to explain changes to care has been lacking, which is why many people have been left confused and in a state of limbo about what happens next.
Services can help deal with these problems by investing in clearly telling people what support is available and how to access it, and making sure individuals understand where they are on a waiting list as services deal with the backlog that has built up.
Information also needs to be accessible. All too often during the pandemic people contacted our services because they could not get hold of advice in a format they could understand. In the rush to issue each wave of new guidance, the needs of people with a disability, impairment or sensory loss, or those whose first language is not English were often overlooked.
Services can help prevent future issues by meeting the Accessible Information Standard, which already requires NHS or social care services to communicate in a way that meets people's individual needs.
Join the campaign: #BecauseWeAllCare
Our new campaign aims to help services identify and, more importantly, address issues and support people experience by encouraging feedback of health and social care services across England.
Contact your local Healthwatch by phone or by email to share your experience, or for information about local services and support
Safety test any changes to the process
The coronavirus pandemic has led to services adapting the way they usually run. Sometimes these changes are for the better but in other cases, this has affected patient safety. For example, hospitals have discharged patients too soon, without the appropriate care or medication in place, leaving families to intervene.
For example, Sharon’s* family had no communication from doctors while she was ill in hospital and experiencing delirium. They did not at first test Sharon for COVID-19, but she then tested positively on readmission 24 hours later. Staff were about to send Sharon to a care home that was not expecting her arrival until her family stepped-in to prevent this.
The NHS has done much to improve the process of discharging people from the hospital so that this is done safely, and people are given the correct medication and care information.
We all need to understand if the changes the NHS made to this, and other processes, in response to COVID-19 caused unintended or unexpected harm so that we can prevent this from happening again.
Make sure dentistry is more prepared to provide care
Finding up-to-date information about how to access an NHS dentist was an issue before COVID-19. However, during the pandemic, this problem only became serious, with the public struggling to get up-to-date information and many being left uncertain about how to access emergency support.
For example, David* told us he tried contacting local dentists without success and then turned to NHS111. He was referred to different places for treatment, which was frustrating, the information he was given was inconsistent, and he was eventually referred back to his original dentist to wait for treatment.
While many dental practices have reopened, people still tell us that they are struggling to find an NHS dentist and that there is inconsistency in what practices are offering and how they are working, with some charging extra for PPE.
Go digital but not by default
There has been a reluctance across the NHS to embrace new technology up until now. The coronavirus pandemic has resulted in more services offering online appointments. For example, around 85% of GP appointments now happen via phone or video chat.
For many people this change brings benefits, such as not requiring people in rural areas to travel long distances for appointments, but technology should not be the solution to everything.
People have praised better online access to services but some have also felt left out because they are either uncomfortable not talking to someone in person or are unable to use digital health services
Joanne did not think online appointments would work but was pleasantly surprised by her experience.
Share your experience of care
We all appreciate the hard work of health and care staff during the pandemic. Healthcare services are now working to bounce back from COVID-19 - but they need our help.
Please take a few moments to share your experience in our short online survey.