Change NHS: What Local People Told Us
About Change NHS
Change NHS was launched in October 2024 as the largest public consultation in the NHS's 76-year history. It aims to involve patients, NHS staff, and community organisations in a nationwide conversation to shape a new 10-Year Health Plan for England.
The plan will set out how we create a truly modern health service designed to meet the changing needs of our changing population. This will be focused on the three shifts that the Government, health service, and experts agree need to happen. This includes:
- moving care from hospitals to communities
- making better use of technology
- focussing on preventing sickness, not just treating it
What Local People Told Us
As the local health and social care champion for people living in the Royal Borough of Kingston, we listen to people's experiences of health and social care services. We find out what's working for them, what needs to be improved and their ideas for change.
We collected some recent feedback we have heard from local people and submitted them to Change NHS to make sure local voices were being heard about the 'three shifts'.
Hopes and Fears About Technology in the NHS
Hopes
Residents see potential in AI for improving translation services, especially in emergencies when accessing interpreters is difficult. Suggestions included AI detecting languages on calls and a dedicated NHS number that connects to a translator before transferring the call. Some also highlighted the need for better systems, as current translation services don’t always work as expected:
"You tick the button for a translator for your appointment, but you get to the appointment and there is no translator."
Appointment reminders were another priority, particularly for people with ADHD:
"We do not get reminders often enough. We need reminders a week before and a day before our appointments."
Concerns
Many fear being forced to use digital tools they struggle with or prefer not to use:
"I do not want to use a computer. I do not want anyone to force me to use one."
Data privacy and security were also major worries, with some losing confidence in online systems after personal experiences:
"After my online account was hacked, I lost confidence in online systems being able to protect my personal details."
A lack of face-to-face GP appointments was another frustration:
"There is no face-to-face (GP) offered and it’s making me lose heart with doctors. How can you check ears, nose, and throat over the phone?"
Additionally, concerns were raised about online services excluding those with learning disabilities, neurodiversity, and English as a second language. Residents stressed the importance of keeping non-digital options available so no one is left behind.
Virtual Wards
Healthwatch Kingston have held two workshops to help residents understand what a Virtual Ward is.
- September 2022 Event: This virtual session aimed to introduce the concept of virtual wards and answer questions around what people wanted to know
- November 2023 Event: At this session guests from the community were invited to listen and ask questions after the hospital's presentation which provided an update on the success, challenges and future plans of the Virtual Ward implementation.
Residents and care staff initially had concerns about alarm systems in case a patient’s health deteriorated at home, the training required to use the technology, the cost of running equipment, the need for personal Wi-Fi, the option to opt out, and whether friends and family would need to take time off to provide support.
Staff from Kingston Hospital addressed all these questions, leaving attendees reassured.
Ambulance Triage
We told Change NHS that the idea of ambulance triage would be very welcome to local Kingston residents who have concerns about the current workload for frontline staff,
"London Ambulance Service seems to have sensible plans such as increasing the proportion of people who can be treated in their own home rather than conveyed, but at present these plans are swamped by issues elsewhere in the system- primarily social care- so that the ambulances are tied up outside the hospitals. Apart from the risks to patients, this must be demoralising for staff.’’
Preventing sickness, not just treating it
Empowering People to Manage Their Health:
"More education of the public on what an emergency is and when to self-care.’’
Residents want better public education on when to seek emergency care and how to self-manage minor health issues, with calls for free emergency training for unpaid carers to better manage accidents and concerns out of hospital.
"Free emergency training to unpaid carers - particularly parent carers - for things like anaphylaxis, seizure, burns, falls, signs of infection etc.’’
Fairness and Accessibility in Support Services:
Concerns have been raise about fairness and flexibility in accessing support services. Attendees felt that when they need to cancel due to their mental health, it is seen as a lack of engagement, whereas cancellations or rescheduling by professionals are more readily accepted.
"When we cancel it is seen as not engaging, but when they [health and care professionals] cancel or rearrange it is fine.”
Strict attendance policies were also criticised, as being dismissed from services after missing two appointments does not account for the realities of living with mental health conditions:
"We get dismissed from the support service if we do not attend twice in a row, this is because of our mental health and this is not taken into consideration.”
Making Prevention Services More Inclusive:
"It is exhausting being pushed from one service to the other. We get penalised for non-attendance when the group is not right for us, or we struggle with our mental health and can not attend.”
Residents want more tailored services for people with neurodiversity, as being repeatedly referred to unsuitable groups can be frustrating and overwhelming:
"Being sent to the wrong groups is draining and it can be overwhelming and traumatic to be sent to another wrong group again.”
Where do these insights come from?
The information that we provided to Change NHS was drawn from a range of recent projects that we undertook to help champion local voices on their health and social care needs.
Healthwatch Kingston Including Communities: Engagement Report March 2022 to October 2023
Between March 2022 and October 2023, Healthwatch Kingston attended health and wellbeing events and community groups (28 in total) across our borough and engaged with attendees from seldom heard from communities and the most vulnerable in our society. Our work solicited 334 responses that have informed this Including Communities report. We wanted to hear people’s views and experiences of NHS and social care services to ensure commissioners, providers and other system leaders responded appropriately to local population health and care needs. Local people we engaged with across this 20-month period included:
- People experiencing homelessness
- Young people (16-18 years)
- Refugees, asylum seekers and other migrants (RASM)
- People with learning disabilities
- Neurodiverse people
- People from areas in Kingston with high deprivation
- People with English as a second language
- People with limited mobility to leave their home, through community libraries
- People with physical and mental disabilities.
Read the Including Communities Engagement report here
Healthwatch Kingston Including Digitally Excluded Communities: Engagement Report July to October 2023
To build upon our Including Communities work, Healthwatch Kingston ran a further series of face-to-face “we’ll come to you” focus groups with digitally excluded local residents, to find out how Healthwatch Kingston could better engage people who were digitally excluded in our work and, how they might better access information about health and social care services.
Healthwatch Kingston listened to 137 people (95 digitally excluded and 42 young people) who contributed their views and experiences as part of this community engagement in different ways.
Our Including Digitally Excluded Communities engagement took place at:
- Kingston Migrant Advocacy Service (twice) the ‘Welcome café’ (migrants from Hong Kong) and the ‘Lunch Club’
- Kingston Eco-op (twice) a local community project that promotes physical and mental wellbeing for adults with additional support needs (including people with a Learning Disability)
- Fastminds – ADHD Support Group
- Kingston Association for the Blind
- Cambridge Road Estate Community Group Foodbank ‘Tuesday Lunch Club’ at Queen Mary
Hall.
Read the Including Digitally Excluded Communities report here
London Ambulance Service Strategy 2023–2028
Along with other local Healthwatch across London, Healthwatch Kingston were invited by the London Ambulance Service NHS Trust as part of a pan-London consultation to inform a refreshed London Ambulance Service strategy for the next five years.
Read the London Ambulance Service Strategy 2023-2028 report here
