Shaping The Future: The Importance of Public Engagement

Imelda Redmond is National Director of Healthwatch England, the independent champion for people who use health and social care services. Imelda has 20 years’ experience working in senior roles in the not-for-profit sector. She was previously CEO of the charity 4children, Director of Policy and Public Affairs at Marie Curie Cancer Care, and Chief Executive of Carers UK where she received a CBE for her services to disadvantaged people in 2009.

Changing policy and practice in health and social care can take a very long time.

But in recent months we’ve seen this doesn’t have to be the case. Faced with an unprecedented crisis, services have adapted with remarkable speed.

As the lockdown eases, we need to take stock.

In the heat of the moment it’s been hard for the public to have their say, to tell NHS and social care leaders whether the changes were working for them or not.

As the country adjusts to a “new normal”, and decides what we want to keep from the new ways of working, we need those in charge to hear from patients and care users who have experienced the changes first-hand.

After all, it is only through people’s experiences that we can look beyond the facts and figures and really understand the impact of this pandemic.

What people have been saying

Right from the start of the crisis we knew that at Healthwatch we would have to roll up our sleeves and do our bit to help the response. Indeed, across the country we have seen our network shift focus, mobilising thousands of community volunteers to get help out to those who were shielding and others who needed it.

But whilst we are doing things slightly differently, we have continued our core work of gathering the views and experiences of people from a huge variety of communities.

At national level we’ve already analysed over 7,500 of the stories shared with us.

These cover not just people with COVID-19, but also those with a range of other conditions who have seen their treatment and support affected too.

Many have spoken very highly of the dedication and empathy of the health and care staff involved in their treatment and ongoing care.

Where praise has been forthcoming it’s because staff and services were seen to be looking after people with dignity and respect despite the pressures.

We have also heard consistent messages from across the country about NHS and local authorities needing to step up efforts around communication.

This is both at community level, in terms of getting information and advice out to people, and on an individual level helping people understand what any changes might mean for their care.

In recent months we have also seen the NHS hail a number of achievements. The mass adoption of digital and telephone appointments in primary care is perhaps the best example: before the crisis 95% of appointments were done face-to-face despite huge change programmes over many years to introduce more digital ways of working. Yet this has now flipped almost entirely, with 85% of consultations happening remotely.

However, there is an inherent danger in assuming that mass take up is the same as positive support from users.

In many cases people have not had a choice about using this service. We know from previous research that people want the NHS to make better use of technology to make care more convenient, but are the recent changes working for them? Are there existing and new groups of patients who are being excluded from care as a result of the growing reliance on technology?

We have been listening intently to what patients have been telling us about these new services. We have also been carrying out specific research to find out about people’s direct experiences. But this is an area where significant further engagement is needed before the NHS simply adopts digital approaches as the default option going forward.

Making longer-term changes focused on the user

In these difficult times for all our public services, people’s perspectives must be seen as a priceless contribution. They provide services and policy-makers with information they might not otherwise be able to access.

Precisely because Healthwatch has continued to engage and gather people’s views in the midst of a crisis, we have a hugely valuable evidence base that we will be using to provide health and care services with vital insight.

We do not and cannot speak for everyone.

So I would urge health and care services to also take this opportunity, build on the public’s willing.