Integration Health and Care Experience Profile 5

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Summary of report content

Healthwatch Ealing and Healthwatch Hounslow produced a Health and Care Experience profile about a woman with multiple health conditions, including recent experience of care for a cardiovascular condition.

This was part of a project led by Healthwatch England and NHS England to develop a qualitative methodology as part of the Local Integration Index. Eight local Healthwatch piloted this methodology by focussing on particular local groups with experiences of care across several health and care services. This methodology can be used to ensure people’s experiences of integration are used by local systems to track how services are working together locally.

A literature review was conducted alongside a comprehensive data analysis, a series of focus groups and semi-structured interviews, and a meta-analysis to capture the theoretical pathways of integrated care for women suffering from cardiovascular issues as well as how these pathways are being realised and experienced. The data shows that women in Ealing and Hounslow with this complex health status were frequent users of a large range of different emergency and elective secondary care services.

 In conjunction with the views and experiences of women that shared similarities with this experience profile, the evidence suggests that holistic care pathways must be effectively structured with accessible prevention and management strategies in place, in order to improve the health and wellbeing of these women. Although a lack of communication, poor service provider coordination and a lack of holistic care were regularly cited by individuals, Ealing residents were notably more satisfied with the level of care that they had received.

The analysis also uncovered health inequalities with high rates of emergency admissions coming from those living in the most deprived areas, significantly higher rates of Hypertension and Coronary Heart Disease in of women of a BAME ethnicity and disproportionately more women of a BAME ethnicity with 5 or more long-term health conditions including a heart condition.

Local policy around cardiac pathways and integrated pathways of care was limited and should therefore be built upon. However, the evidence from this research points toward initial inaccessibility to services and a lack of prevention and management support as significant contributory factors to the complexities of this cohorts' health and wellbeing and not necessarily the acute and chronic care services.

This paper outlines the visions and ambitions of the NW London region as well as each local borough pertaining to the improvement of care for this experience profile, alongside recommendations on how to both further develop the methodology of this research for future use focused on tracking whether the improvements in process or planned in these boroughs are having a positive impact on patient’s perceptions and experiences of their treatment, and how the level of integration and coordination of the health and social care systems in Ealing and Hounslow could further support women with multiple long-term health conditions including a heart condition.

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General details

Report title 
Integration Health and Care Experience Profile 5
Local Healthwatch 
Healthwatch Ealing
Healthwatch Hounslow
Date of publication 
Friday, 11 June, 2021
Date evidence capture began 
Tuesday, 15 December, 2020
Date evidence capture finished 
Wednesday, 31 March, 2021
Key themes 
Communication between staff and patients
Health inequalities
Integration of services
Service delivery organisation and staffing

Methodology and approach

Was the work undertaken at the request of another organisation? 
Yes
What type of organisation requested the work 
Other government body
If this work has been done in partnership, who is the partner? 
NHS England and Healthwatch England
Primary research method used 
Focus group
Structured interview
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
GP practice
Secondary care services 
Cardiology
Diabetic medicine

Details about conditions and diseases

Conditions or diseases 
Cardiovascular conditions
Diabetes and other endocrinal, nutriotional and metabolic conditions
What type of pregnancy or maternity themes are included in the report 
N/A

Details of people who shared their views

Number of people who shared their views 
19
Age group 
Not known
Gender 
Not known
Ethnicity 
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Not known
Does the information include staff's views? 
Yes
Types of health and care professionals engaged 
All care professionals
What was the main sentiment of the people who shared their views? 
Mixed

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
No
Does the information contain a response from a provider? 
Not applicable
Is there evidence of impact in the report? 
Not applicable
Is there evidence of impact external to the report? 
Not applicable

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.