The Patient Experience Library

Barriers to Accessing Mental Health Support in Tower Hamlets

Due to the effects of the COVID-19 pandemic and the cost-of-living crisis, there has been an increase in mental ill health. As a result, it is now more important than ever to understand people's experiences of mental health services in Tower Hamlets, and how services can better meet the local population's needs. Healthwatch Tower Hamlets set out to carry out a project that specifically targeted people over the age of 65 and people from minoritised ethnic communities who based on current data from mental health services in the borough, are less likely to access mental health services when needed.

East Harling and Kenninghall Surgery Feedback

In April 2024 we visited East Harling Surgery to speak with patients about their experiences with local health and social care services. We were also invited by Kenninghall Parish Council Luncheon Club to speak with their attendees about their experiences. In this report we have also included feedback for the surgery received in April online and through our helpdesk from those who were unable to attend our visits

To increase public satisfaction in the NHS, we need a new conversation about how to improve it

As satisfaction with the NHS reaches a new low, we should embrace the power of citizens and society to restore public confidence, argue these authors

Socio-economic disadvantage and utilisation of labour epidural analgesia in Scotland, a population-based study

Socio-economic deprivation is associated with adverse maternal and childhood outcomes. Epidural analgesia, the gold standard for labour analgesia, may improve maternal well-being. We assessed the association of socio- economic status with utilisation of epidural analgesia and whether this differed when epidural analgesia was advisable for maternal safety. This was a population-based study of NHS data for all women in labour in Scotland between 1 January 2007 and 23 October 2020, excluding elective caesarean sections. Socio- economic status deciles were defined using the Scottish Index of Multiple Deprivation. Medical conditions for which epidural analgesia is advisable for maternal safety (medical indications) and contraindications were defined according to national guidelines. Of 593,230 patients in labour, 131,521 (22.2%) received epidural analgesia. Those from the most deprived areas were 16% less likely to receive epidural analgesia than the most affluent (relative risk 0.84 [95%CI 0.82-0.85]), with the inter-decile mean change in receiving epidural analgesia estimated at -2% ([95%CI -2.2% to -1.7%]). Among the 21,219 deliveries with a documented medical indication for epidural analgesia, the socio-economic gradient persisted (relative risk 0.79 [95%CI 0.75-0.84], inter-decile mean change in receiving epidural analgesia -2.5% [95%CI -3.1% to -2.0%]). Women in the most deprived areas with a medical indication for epidural analgesia were still less likely (absolute risk 0.23 [95%CI 0.22-0.24]) to receive epidural analgesia than women from the most advantaged decile without a medical indication (absolute risk 0.25 [95%CI 0.24-0.25]). Socio-economic deprivation is associated with lower utilisation of epidural analgesia, even when epidural analgesia is advisable for maternal safety. Ensuring equitable access to an intervention that alleviates pain and potentially reduces adverse outcomes is crucial.

What are the strengths and limitations to utilising creative methods in public and patient involvement in health and social care research? A qualitative systematic review

It is important that patients and public are included in the research process from initial brainstorming, through design to delivery. This is known as public and patient involvement (PPI). Their input means that research closely aligns with their wants and needs. Traditionally to get this input, interviews and group discussions are held, but this can exclude people who find these activities non-engaging or inaccessible, for example those with language challenges, learning disabilities or memory issues. Creative methods of PPI can overcome this. This is a broad term describing different (non-traditional) ways of engaging patients and public in research, such as through the use or art, animation or performance. This review investigated the reasons why creative approaches to PPI could be difficult (limitations) or helpful (strengths) in health and social care research. After searching 5 online databases, 12 studies were included in the review. PPI groups included adults, children and people with language and memory impairments. Creative methods included songs, poems, drawings, the use of photos and drama, visualisations, Facebook, creating prototypes, personas and card sorting. Limitations included the time, cost and effort associated with creative methods, the lack of application to other populations, ethical issues and buy-in from the wider research community. Strengths included the feeling of equality between academics and the public, creation of a safe space for people to express themselves, inclusivity, and that creative PPI can be cost and time efficient. Overall, this review suggests that creative PPI is worthwhile, however each method has its own strengths and limitations and the choice of which will depend on the research project, PPI group characteristics and other practical limitations, such as time and financial constraints.

Extent, transparency and impact of industry funding for pelvic mesh research, a review of the literature

Conflicts of interest inherent in industry funding can bias medical research methods, outcomes, report ing and clinical applications. This study explored the extent of funding provided to American physician researchers studying surgical mesh used to treat uterine prolapse or stress urinary incontinence, and whether that funding was declared by researchers or influenced the ethical integrity of resulting publications in peer reviewed journals.

Negotiating pace, focus and identities, Patient/ public involvement/engagement in a palliative care study

Patient and public involvement and engagement (PPIE) is an increasingly important component of research conduct to enhance processes and potential for impact, yet is rarely critically interrogated. This paper draws on Foucauldian analysis to highlight the disciplinary powers and tensions arising in PPIE. The paper draws on a nested evaluation interview study with three PPIE members and eight academics, who had been involved in an implementation science study focused on pallia- tive care. PPIE members were involved in the whole study and are coauthors of this article. Through shared values and commitments to the study, a team culture of equality was developed. Yet while power was dispersed and takenup by all team members, in so doing a self governance approach within the team was developed. The pace and focus of discussions was at times more subjugating than coproduction. Identities and posi- tions were porous; the simplistic division of 'academic' and 'PPIE' did not stand up to scrutiny, with an increasing blurring of boundaries as people's experi- ences and insights changed over time. Continual, sub- tle, negotiations of roles, inputs and identities were manifest throughout the project. PPIE in research in- volves subtle, complex and ongoing disciplinary prac- tices enacted by all members of the team.

The impact of unpaid caring on mental health in Northern Ireland

Carers NI, The impact of unpaid caring on mental health in Northern Ireland, May 2024

POLICIES FOR BETTER MENTAL HEALTH, THE CASE FOR A MENTAL HEALTH POLICY TEST

This briefing makes the case for a cross-government mental health policy test, to ensure a net-positive impact of all policies on mental health

Harbottle mobile health unit proposal - Engagement report

The North East and North Cumbria Integrated Care Board (NENC-ICB) and Northumbria Primary Care (NPC) are undertaking a feasibility study to enhance GP Services currently delivered from Harbottle Village Hall by the potential use of a van-based Mobile Health Unit (MHU). A survey was designed and distributed by NPC in December 2023 seeking the opinions of local residents and a wide range of other stakeholders. Patients who were registered with The Rothbury Practice (regardless of which surgery they accessed care from), received either a hard copy of or text message with a website link to a letter, survey, and a frequently asked questions (FAQs)document.