The Patient Experience Library

Prevention, population health and prosperity, a new era in devolution

In spring 2023, the NHS Confederation and the Local Government Association jointly established a Health and Devolution Working Group to understand the priorities, opportunities and challenges in bringing together health and local government devolution. This report builds on the rich learning from the working group and sets out why integrated care systems and devolved administrations should work together to jointly improve health and support economic prosperity, how they can maximise their collective impact for their shared populations, and what government needs to do to support and accelerate the health and devolution agenda in future.

Monthly Feedback Report

We heard from 173 Greenwich residents about their experience of health and care services.

Q4 Patient Experience Report

Every three months we produce this report to raise awareness about patient experience and share recommendations on how services could be improved

PPIE in a technical research study, Using public involvement to refine the concept and understanding and move towards a multidimensional concept of disability

Disability is often an essentialised and oversimplified concept. We propose refining this while incorporating the multidimensional nature of disability by increasing the use of existing survey questions and their corresponding data to enrich, broaden and inform understandings of disability.

Using FLO text-messages to enhance health behaviours and self-management of long-term conditions in South-Asian patients

Cultural and communication differences faced by South-Asian (SA) ethnic minority groups have led to challenges in the delivery of health care and complex management of long-term conditions (LTCs). We aim to explore the use of text- messaging in SA communities, through the Florence (FLO) health messaging system utilised within U.K. health sectors, to enhance positive health behaviours and self-management.

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.