Health Management and Policy Alert

Caring in a complex world: perspectives from unpaid carers and the organisations that support them

The King's Fund -
Unpaid carers – anyone who provides care, unpaid, for a friend or family member who due to illness, disability, a mental health problem or an addiction and cannot cope without their support – play a key role in the health and care system. Caring can be a big commitment and carers themselves also need support with their own health and wellbeing. Yet, it’s also clear that carers are not always able to access the support they need. We set out to understand the current picture of local support available for unpaid carers in England. We looked at what evidence is available for different types of support, what carers and professionals involved in commissioning and delivering services for carers prioritise, and what are the barriers and facilitators of access to these different types of support.

• Report
• The King's Fund - publications

Specialist perinatal mental health care in the UK 2023

Maternal Mental Health Alliance -
This report on specialist perinatal mental health community services in the UK highlights the progress made in all four nations since 2013. However, it finds that access to life-saving mental health care for pregnant women and new mothers remains uneven, with many regions still lacking the necessary resources. Mental health-related deaths during pregnancy or up to six weeks after birth are increasing, emphasising the urgency of addressing this issue.

• Report
• Maternal Mental Health Alliance - news

Waiting for NHS hospital care: the role of the independent sector in delivering orthopaedic and ophthalmic care

The Health Foundation -
This analysis looks at the use of independent sector providers in the delivery of NHS-funded ophthalmic (treatment for eye disorders) and orthopaedic care (hip, knee and hand procedures), two areas where the independent sector’s share of care has grown most. The report concludes that greater use of the independent sector, while having an important role to play, will only have a limited impact on the NHS backlog and is no substitute for addressing wider issues such as staff shortages, social care and underfunding.

• Report
• The Health Foundation - press release

Removing barriers to shared decision-making

Patient Information Forum (PIF) - 

PIF and the Patients Association worked with NHS Nottingham and Nottinghamshire Integrated Care Board (ICB) to look at ways of making it easier for patients to take part in shared decision-making. They delivered a co-production programme with the My Life Choices panel of local people and the NHS Nottingham and Nottinghamshire personalised care team and developed and implemented patient information to support people with hip, knee, and joint pain to make treatment decisions. This report, developed with input from My Life Choices, outlines the key findings and recommendations. It also shares the co-produced resources developed throughout the project.

• Report
• More detail

GP referrals: part 2 – the hidden waiting list

Healthwatch England - 

HealthWatch commissioned Panelbase to carry out an online survey covering two distinct groups who had an appointment with their GP practice in the past 12 months. Firstly, those who either expected or requested a referral for tests, diagnosis, or treatment, but didn't get one, and secondly, those who were referred for tests, diagnosis or treatment. Panelbase heard from 2,144 people overall. The figures quoted in this briefing are based on the 1,518 patients who fall into the second group - those who were referred for tests, diagnosis, or treatment. The survey was also shared via the Healthwatch network (1,825 respondents overall of which 1,458 respondents were in the “referred group”) and comments from both surveys are used to support the analysis and provide quotes for this briefing. Considering how long it can take for a patient to be told they are being referred, combined with the time it takes to get onto a waiting list, the total time the patient has been suffering from their symptoms or condition can be much longer than official waiting time statistics would suggest. There are gaps in measurement for some parts of the referrals process – creating a dangerous blind spot. This briefing shares people’s experiences and the impact behind these figures.

• Briefing
• Press release

GP referrals: part 1 – the referrals black hole

Healthwatch England - 

HealthWatch commissioned Panelbase to carry out an online survey covering two distinct groups who had an appointment with their GP practice in the past 12 months. Firstly, those who either expected or requested a referral for tests, diagnosis, or treatment, but didn't get one, and secondly, those who were referred for tests, diagnosis or treatment. Panelbase heard from 2,144 people overall. The figures quoted in this briefing are based on the 626 patients who fall into the first group. Fieldwork was completed October 2022. The survey was also shared via the Healthwatch network (1,825 respondents overall, of which 357 respondents were in the “not referred group”) and comments from both surveys are used to support the analysis and provide quotes for this briefing. The briefing shares people’s experiences and the impact behind these figures.

• Briefing
• Press release

Offline and isolated: the impact of digital exclusion on access to healthcare for people seeking asylum in England

British Red Cross - 

This report finds that people seeking asylum in England are at risk of missing out on basic healthcare services because they have limited access to the internet and digital tools. Using a peer research approach, where refugees who have been through the asylum process interviewed people seeking asylum, the report provides a detailed picture of the barriers to online healthcare services. It highlights several barriers, including the affordability of devices and mobile data, a lack of Wi-Fi in asylum accommodation, and a lack of confidence in using technology and navigating websites in English.

• Report
• More detail

Parliamentary and Health Service Ombudsman scrutiny 2021–22

Public Administration and Constitutional Affairs Committee - 

This report of the annual scrutiny inquiry into the work of the Parliamentary and Health Service Ombudsman (PHSO) raised concerns with the PHSO continuing its policy of not considering less serious health complaints, introduced to reduce the backlog of cases resulting from the Covid-19 pandemic. The Committee also noted that it received written evidence that expressed dissatisfaction with the PHSO’s handling of complaints, and that the organisation failed to meet its targets for time taken to close cases, as reported in its annual report and accounts.

• Report
• More detail

Continuing to pay the price: the impact of prescription charges on people living with long term conditions

Parkinson's UK -
This report contains details of a survey of over 4,000 people with long-term conditions, including those with Parkinson’s, on prescription charges. It finds that the charge is a barrier to accessing medicine. The survey shows that people with long-term health conditions that cannot afford their medication are seeing an increase in GP visits, trips to accident and emergency, and hospital stays. Some survey respondents reported they had to stay in hospital for up to six weeks. Not being able to afford medicine has also led to mental health issues and increased time off work.

• Report
• Parkinson's UK - news