CONSULTATION Findings could lead to local campaigns and better training for primary care staff

Published: 06/10/2005 Volume 115 No. 5976 Page 9

Better information on accessing the NHS has emerged as a key issue in the Your Health, Your Care, Your Say consultation.

Ministers are promising to take a close look at the issue as they write the healthcare outside hospitals white paper.

Speaking to the 50 participants at an event in London last week, health minister Lord Warner said: 'I have taken away a real concern about information and how you make your way through the system. It can be really bewildering - something I've learned from personal experience of using the NHS.

'We will do our very best to come up with a set of proposals which do respond to the points that come out of this consultation.' Later, Lord Warner told HSJ: 'I think there is a lot being said here that will change policy in the future , but I would not want to pre-empt the process.

'But there is a theme coming across about information about how they access services. There is clearly something we should be doing in that area.

'I always knew it would be an issue, but I didn't know it would be such a widespread one.' He added: 'What people seem to be saying is It is not that they do not like the service when they get it; It is getting into it that is a major problem.' Caroline Brook, Department of Health lead on the white paper listening exercise, said she was 'very surprised about how much the issue of information was being brought up'.

She said the revelation could manifest itself in the form of better training for GPs and receptionists, local publicity campaigns, and better use of libraries, digital TV and NHS Direct to publicise services.

'This consultation will help us prioritise what the department does first, ' she said.

The 50 participants spent a day discussing the future of primary and social care at the event, organised by Opinion Leader Research.

The group was divided between five tables, each of which was headed by a facilitator.

One of the participants said: 'Information is power. If you do not have the information, you do not know what you can do.' Another agreed: 'There is very little information and you have to find it out for yourself, ' she said. 'To get it you have to go on and on and on about it. If There is no information at the first point of contact, then There is no point in doing any of it. Everything comes back to the GP.' 'Information should be handed out everywhere, ' said another. 'They should be bending over backwards to increase the standard of people's health.' Sue Gower, whose son has muscular dystrophy, said: 'When you are diagnosed there should be more information about what is available in the local area; local support groups and parents who have been through the same thing. It would be empowering.' Ms Gower called for greater joined-up working between health and social care, and said the children's centre model should be widened to adult care, with GPs on the same site as social workers, dentists and other healthcare providers such as chiropodists and chiropractors. 'I hate being passed on to another person, especially if they do not have the medical history in front of them. All the information should be in a central place.' And she called for longer GP practice opening times. 'The principles of information and accessibility are underlying what everyone is saying.' Yvonne I'Anson, one of those participating, rejected the idea of specialised primary care services for different demographic groups. 'It is not about creating services for different groups, It is about services being sensitive to these groups, ' she said.

The London day was the third out of four regional events, which will culminate in a national consultation day in Birmingham at the end of the month. Last week HSJ revealed that the process was costing taxpayers more than£900,000 (news, page 7, 29 September).

A report by Opinion Leader Research on the London event said that getting into services was one of the things that consultees found worked least well. They said it was hard to get past receptionists and through to a GP, and appointment times were only available during working hours. Too often leaflets with important information were behind the reception desk.

Participants also said it was difficult to get advance appointments, and there was a feeling that care was too reactive rather than proactive: patients have to push for what they need.

And there was criticism of the 'rudeness' of GPs' receptionists. One participant said they were 'powerhappy fat controllers' because they could decide who got to see the doctor and who didn't. Another said: 'One look at a medical receptionist is enough to make you ill.' Finding the way through the service was a problem, and continuity and communications between the NHS and social care was raised by a number of people.

The people's priorities

Those attending the consultation event were asked to prioritise a variety of services the government could offer.

When asked where they wanted to get their services, Londoners seemed most interested in evening and weekend GP opening hours (28 per cent) and more services such as blood tests and minor surgery provided in the community rather than in hospitals (26 per cent). These were favoured over allowing multiple GP registration and walk-in centres (17 per cent) and better services for specific groups.

Asked how their care could be made more joined up, 29 per cent were most impressed with the idea of case managers planning care at a single needs assessment meeting, while 27 per cent called for better information and the same number wanted more respite care. Only 22 per cent said there was an overriding need for improving the quality of care for those with longterm conditions.

Participants were also asked how the government could help them take care of themselves. Twentynine per cent said they wanted routine check-ups and health advice, while a quarter called for more action to tackle poverty and poor housing.