As lockdown continues into a fourth week, we’re starting to see data emerging about the knock-on effects of coronavirus on healthcare, from excess deaths reported in the FT, to concerns from Cancer Research about delayed diagnosis. Last week we interviewed a small sample of people whose healthcare had been disrupted to understand more about how the experience affected them. We spoke to people who had chosen not to seek care as well as people whose appointments had been cancelled or postponed, with a wide range of conditions. We’ll be discussing the findings in a joint webinar with National Voices Chief Executive Charlotte Augst, who’ll be sharing views from their Our Covid Voices series, David McNally, Head of Experience of Care at NHS England and NHS Improvement, and Martin Marshall, Chair of the Royal College of GPs.
You can sign up for the webinar here.
Across the board we found that people were patient, grateful and understanding of the pressures on the NHS, but also evidence that people were avoiding seeking necessary treatment both because of concerns about their own safety, and more often because of a reluctance to further burden the health service. We found some recurring themes around uncertainty, anxiety and gaps in communication for people whose care was disrupted, and worries about the long term impact for mental health service users and pregnant women in particular. You can read more about our findings in the report here.
Based on this initial evidence we make four key recommendations for consideration, which we’ll discuss in next week’s webinar:
- Setting expectations about the right level of demand for the NHS
Our research, and the population level data, tells us that people are avoiding or being prevented from accessing the care that they normally would. Some of this disruption will be harmful and have negative long term consequences for physical and emotional wellbeing. On the other hand we also find that some interactions work well remotely, and some appointments may not be necessary. At the individual level people need enough information to make confident decisions for themselves about their care. At a societal level a meaningful public conversation is essential to balance the level of demand the NHS can meet with the expectations of the citizens.
- Understanding the consequences of messaging
Messaging from the NHS has a significant impact both on behaviour and on people’s experience of care, from the macro level of advertising campaigns to the micro level of answerphone messages which set the tone for an experience. Our research shows that some people are hearing that the NHS is on hold, and not asking for help is the best way they can contribute. Not everyone has the tools to interpret these messages in a way that keeps them safe and well, and we need to understand this inequality and how it can lead to actions that are ultimately harmful.
- Focus on person-centred care, clear communications and managing uncertainty
All our participants gave us the same message about what makes a positive care experience, and it’s not a surprise. In a time of uncertainty people just want to know what to expect and when, to be treated as an individual, and have space to be heard. This message may not be new, but understanding how to achieve this in a time of resource constraints is more of a challenge.
- Health is more than a set of symptoms, and care is more than a series of interventions
Some of the most distressing accounts we heard were from people with existing mental health conditions, and pregnant women. For these groups continuity of care was crucial to their wellbeing, and was the aspect most disrupted by covid-19. Their care didn’t feel unsafe because the infrastructure was in place to manage crisis, but it didn’t meet their longer term health needs.
This research aims to add to the evidence base around the knock-on effects of coronavirus for health and wellbeing in the UK by understanding the experiences of people whose care has been disrupted.
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