Recommendations from Healthwatch report, "The public's perspective"

The Healthwatch network across England want to see teams across the health and care system get the support they need to deliver services that work for everyone.

And together, we’re calling for more to be done to help services create better listening cultures, and to understand access barriers, health inequalities, and people’s experiences of care.

You can read the full report, or just read our recommendations below.

We are calling for improvements in:

1. Getting a GP appointment  

Healthwatch England (HWE) are calling for:

1. All GP surgeries to move to digital phone systems by the end of March 2024, so patients spend less time waiting on hold.
2. Greater public awareness of, and sign-ups to, the NHS app, through the promised national communications campaign.
3. Most patients able to benefit from full NHS app functionalities by the end of March 2024.
4. Evidence that Integrated Care Boards plan to tackle health inequalities around GP access, especially in deprived areas.
5. All GP practices offering free phone numbers.
6. All GP practices sign up for the Register with a GP Surgery Service, which makes registering with a surgery easier for patients, particularly those with no fixed address or ID.

Read our report into your experiences of accessing a GP in Milton Keynes. 

2. Getting dental treatment  

The upcoming dental recovery plan must:

1. Set out a clear vision for improving patient access to a local NHS dentist that provides preventative and emergency care.
2. Incentivise dentists to provide more NHS work, through major changes to the contract introduced in 2006.
3. Conduct a national assessment of the needs and gaps in oral healthcare for diverse populations.
4. Ensure Integrated Care Boards listen to local communities, include dental representatives in their decision-making, and use all opportunities to join up dental care with other local NHS and public health services.
5. Mandate collection of specific data to track the access and experience of people facing the worst barriers to care.

3. Getting mental health support  

Healthwatch are calling for:

1. Provision of early or ongoing support through additional staff roles at every available opportunity. This includes through mental health practitioners, peer support workers, and school-based teams.
2. A 'parity of esteem definition' that puts mental and physical health services on equal footing. The government must publish this as soon as possible.
3. The Major Conditions Strategy to include a roadmap that:
   1. Reduces mental health waiting times for assessments, treatment, and crisis support.
   2. Improves transitions from child to adult mental health services, based on need, not just age.
4. The Draft Mental Health Bill to be amended and pushed through without delay. The bill aims to ensure patients get more say over their treatment, improve access to advocates, and place a duty on doctors to consider patients’ wishes before deciding on compulsory treatment. It also aims to reduce the disproportionate number of Black people who are sectioned.
5. Bespoke training for NHS staff, to equip them to better understand the needs of young people with learning disabilities and autism.

4. Cancer care

People need:

1. First appointments that meet their preferences and needs, including longer appointments where necessary.
2. Improvements to online referral trackers, so they can understand what is happening with their care.
3. Personalised aftercare support, including post-treatment plans, appropriate home adaptations, and a single point of contact with care teams.

5. Waiting for elective care 

We’re calling for:

1. More proactive NHS communications with patients while they wait for treatment.
2. Single points of contact, either in person, over the phone, or via the NHS App, so patients waiting for care can give feedback about issues or changes in their condition.
3. More personalised support for those waiting, such as access to pain management, physiotherapy, and mental health support.
4. Transport and accommodation costs to be covered by the NHS where patients choose to travel for quicker treatment at another NHS setting.
5. Better use of all available data sources, to reduce last-minute cancellations and understand what drives non-clinical, clinical, and patient-led reasons for NHS delays.

6. Social care     

We want to see:

1. A renewed focus on implementing previously announced reforms to cap the amount people can spend on social care costs over their lifetime.
2. Further reform announcements to boost investment in services, address workforce challenges, and support councils to provide proactive social care information and advice services which cover both pre- and post-assessment.
3. People in health and care settings given a legal right to a Care Supporter – a person important to them, like a relative or friend – who can visit to provide emotional support, advocacy, and essential human contact.

7. Hospital discharge

We’re calling for:

1. An urgent focus on workforce and capacity solutions in secondary care and social care.
2. More consistent implementation of latest hospital discharge guidance, including:
   1. Support to help people make informed choices, by providing contact information and advice, and asking about transport home.
   2. Better signposting to support services, such as voluntary organisations and services that support unpaid carers.
   3. Clear responsibility for who will arrange people’s transport home, with dedicated staff to make travel arrangements.
   4. Single points of contact for people to use if their condition gets worse.
   5. Greater involvement of family and carers in decisions about discharge.

8. Cost of living

We’re calling for:

1. Over-the-counter medications to be offered on prescription for patients eligible for free prescriptions, and for those struggling financially who pre-pay for prescriptions.
2. Clearer information about annual and pre-pay prescription options.
3. NHS England to restart their review of the health travel costs scheme and introduce a reimbursement scheme that covers travel to primary care appointments.
4. Inclusion of GP phone numbers in the freephone service.
5. Healthcare benefits that keep pace with inflation in real terms.
6. Extended Statutory Sick Pay for those on NHS waiting lists.

9. Digital transformation

As services move towards more digital ways of working, we want to see:

1. Traditional models of access and care to remain alongside digital methods.
2. Patients involved in designing new technological solutions.
3. Built-in patient education (tutorials, how-to guides, digital community champions) with any new digital healthcare rollouts.
4. Funded, accessible community courses or training for those with low digital literacy.
5. A universal right to internet access, with cross-government action to work towards this.

10. Accessible information   

Following our Your Care, Your way campaign, we’re calling for:

1. Action by Integrated Care Boards to ensure providers implement the Accessible Information Standard (AIS).
2. Routine checks of AIS compliance during Care Quality Commission inspections.
3. All health and adult social care providers to undertake the new voluntary self-assessment of AIS compliance, and work with local Healthwatch and people with extra communication needs on ways to improve accessible information.