Accessing health and care services when you live alone
Over eight million people in the UK live alone. Healthwatch England looked at the experiences people have shared and identified several challenges they face if they are ill and don't have enough support. These include:
- Issues with accessing transport and travelling to a hospital
- Assumptions being made about their health and care
- Needing to advocate for themselves
Travelling to Hospital
A primary concern was how to get to health appointments. One person spoke about the multiple barriers they faced:
"I'm old, disabled and live alone. There are no buses to my surgery, which is less than a mile away. It costs me a minimum of five pounds if I have to go there, more if my lift has to come further. With the cost of living crisis, nobody can afford to be out of pocket.
"A "volunteer" car service, last used before the pandemic, charged me five pounds too, and it must have gone up by now. Local surgery seems to feel that if you're too sick to get to the surgery, you should call an ambulance."
One solution for people facing similar issues is to use a local patient transport service to get to the hospital. However, this is not always available or convenient:
"I’m old and disabled and have not driven for eight years. I’m on my own and constantly on hold to book transport. You’re not even allowed to book in advance anyway, and I can’t get through to my area – ever.
"I was given another number outside my area, but they won’t do it. So I must go to the back of the queue every time for procedures I desperately need. It’s not good enough. I need more eye surgery. I'm diabetic. I have had two previous brain surgeries, which left me deaf, blind and unable to walk.
"It’s getting worse, and I’m scared. When I do manage to get transport, my time slot for appointments is always longer. Then I am forgotten about and can’t get transport home. It’s always that I may be picked up at 7.30 AM, and I don’t get home till 7.30 PM! You work it out how many hours that is? It’s shocking!”
Healthwatch England have set our their call to action on patient transport
The wrong assumptions are made
Despite people who are living alone often telling services about the issues they face, this may not always filter through to everyone they meet.
There may be assumptions about the nature and availability of help people have, when this is only sometimes the case.
"The pharmacy doesn’t answer the phone. My dosset box is delivered weekly and I always get that, but if the doctor puts a prescription through it just sits in the pharmacy until I can find someone to collect it.
"Sometimes I need that prescription to start taking it the next day. If I try to call them to ask if it can go on the delivery van next day, it is a waste of time. They either don’t answer or pick up the phone and replace it without answering. It can take hours to speak to someone there."
Because the individual could not go to the pharmacy themselves, they could not get new prescriptions on time.
Advocating for themselves
People also spoke about how they often have to advocate for themselves, which places an extra burden on them when managing their health and care.
“My GP referred me twice to visit A&E for emergency treatment. I felt I was eventually listened to, if only to get rid of me. That's how I felt. Consequently, I was diagnosed with cancer. My lesson is to be my own advocate while with medics.
"It takes a lot of energy to do this when you're sick and on your own. My perseverance in understanding my own body and insisting that further tests were done [meant] the cancer was caught at an early stage, and the surgery was successful in removing the tumour.
"Ideally, I think training for medics should be provided to treat patients who live alone, who are independent and are listened to when they voice their fears. Maybe an advocate or intermediary could be provided for those on their own.”
The suggestion is for some kind of advocate to be available for those on their own to help them get the care they need.
How can those who live alone get better support?
Despite individual services providing the care and support people need, there might not be a joined-up understanding of the implications of living alone with limited or no support.
- The nature of 'lack of support' needs to be clearly understood. For example, while taxis and buses exist, they may not be suitable for everyone; the key question is are they right for the individual concerned? A single journey may seem relatively inexpensive on the surface, but many health conditions require frequent trips to a distant location. When finances are being carefully managed, this can be a problem. We also know that local cuts mean fewer local transport services to some hospitals.
- Appropriate signposting to available support might be one way to address this need. This information should be clear about any limitations and practices of working, such as patient transport only working within set hours, to certain services, and only for people who are eligible. If the expectation does not meet the reality for people, they may choose not to engage with aspects of the health system or support in place.
- Signposting should also be given to local voluntary and statutory advocacy groups, which can help people living alone understand their rights and communicate with services. And where people living alone have been referred for treatment, are on a waiting list, or have been discharged from the hospital, clear single points of contact should be provided so they can stay in contact with services about their care.
