You said, we did.
Local people’s views are at the heart of decisions One Devon makes.
We engage with thousands of people every year to help inform and shape plans for local services.
Below are some of key projects from the past year including what you told us and what we did in response.
Better for you, Better for Devon
Over 5,700 people across Devon helped shape the future for health and care in the county by sharing their views as part of a major engagement programme last summer.
Outpatient appointments
You said:
Many people still feel more confident having person to person contact in a hospital setting, but this could be due to understanding, education or long-term behaviour patterns. Where people have little or no experience of health services, they are more open to new approaches if the level of care is not diminished.
We did:
We are undertaking further investigation into the development of community-based resources and the infrastructure required to support alternative out of hospital clinical care as a key part of the Long Term Plan for Devon.
Travel
You said:
Non-emergency, specialist care should be available in Devon and Cornwall as a default position. Whilst some people indicated they were willing to travel for over an hour, there is still more that needs to be understood around the opportunities and challenges that exist.
We did:
Devon is working collaboratively with the Heart of the South West Local Enterprise Partnership and the Community and Voluntary Sector to establish a Devon travel working group to review and explore investment to increase community and alternative transport services across Devon.
Where services are best provided
You said:
People are attending A&E because they report it is easier to access than other services, for reasons such as availability of GP appointments and lack of understanding of alternative services. 45% of people highlighted the need to raise the awareness of alternative services, as currently attending A&E means a wait, but they will be seen and treated.
Almost 20% of people suggested the need to enhance and improve the pharmacy service, by offering better and more private consultation opportunities and building confidence in the medical knowledge as an alternative to A&E/GP.
We did:
We are undertaking clearer communication about what alternative services there are to A&E for urgent medical treatment. We are building public awareness and confidence by developing a primary care campaign that promotes digital services, for example online GP consultations, NHS App, NHS 111. This could also include minor injury services and pharmacies.
Supporting parents around childbirth and new babies
You said:
As supported by the previous Better Births engagement, people want to see more local services available to them during and after pregnancy.
We did:
We are working with the Devon Maternity Voices Partnership through co-creation with parents in local communities to understand what services they want and where.
Holsworthy Community Involvement Group (HCIG)
More than 1,000 people living in Holsworthy and the surrounding areas responded to the local survey in 2018. This survey was independently analysed by Healthwatch Devon, in the Holsworthy healthier and happier lives report, gave a set of recommendations which focused the HCIG on the areas for further qualitative engagement.
In 2019, almost 100 more people engaged with the NHS through qualitative face to face focus groups. Contributing their views to the health and social care needs, resulting in a full set of recommendations based solely on what people had told us in the survey and in the focus groups.
Priority issues
You said:
90% said that the services at Holsworthy hospital are important to them, although only 50% considered ‘Health information and healthy lifestyles’ a priority. The second ranked priority was End of Life Care with 79%. Of the people who highlighted End of Life Care 75% put care in their own home as their first choice with the next most popular being care in a community hospital at 16%.
Holsworthy Hospital
You said:
90% of respondents said that Holsworthy hospital services are a priority. However, of that 90% a significant number 16%, said they did not know that, following the temporary closure of the in-patient beds in 2017, Holsworthy hospital is still open and offering a wide range of services.
Services in your Home
You said:
Although based on a limited sample it appears that services provided by the Private Sector have a higher incidence of not meeting needs or meeting needs only poorly (44%) nevertheless care within other sectors (Family Members, NHS, Voluntary Sector, Social Services) still shows 25% poor or failed to meet needs.
Loneliness or social isolation
You said:
13% said that they had a feeling of loneliness or isolation and not surprisingly 94% of these considered ‘Loneliness and social isolation’ a priority issue for them. Over 60% said community activities in their area and help with transport to community activities would be most helpful to them.
Feeling safe
You said:
People told us that while recognising statutory services were limited in the area, they were generally seen as available when needed, but did give examples of times when out of hours medical services were not accessible. People felt less safe if they had an urgent medical need or no GP appointment was available. There was a lack of knowledge of what services were available to them or who to contact if they needed (non-urgent) help. People told us that there is a strong reliance on friends, family and neighbours in times of need.
Travel and transport
You said:
People told us that public transport is every limited in frequency from and to the area. Journeys of up to nearly 3 hours each way, across multiple buses and changes are not uncommon to access district hospitals. Car parking and cost of private travel is also an issue. Community transport, whilst available is not as well know as it could be and there is a strong reliance on family friends and neighbours for transportation support.
What good end of life care looks like
You said:
Many people made clear wishes to die at home, or close to home (but no specific venue cited), as this would allow them to be with (or close) to family and friends, but with the right support in place. However, respondents commented that there is little in the way of respite for caring for people at end of life. Whilst there were some reports of bad experiences of end of life in acute hospitals, People gave accounts of how good the EOL service at Holsworthy hospital was and the comfort of being in a local setting was to the patient and the family. More support and training for end of life drugs was seen as a key requirement. Communication between GPs and hospices was seen as very positive.
Carer feedback
You said:
People reported many examples of mental health issues and (or perceived) lack of support. Carers also recognise that there is a huge stigma attached to mental health and so isn’t spoken about as much as it needed. More joined up planning of appointments, and closer to home, is key as it affects the carers as well and the patients. Whilst a strong sense of community caring exists through friends and family, there is a perceived lack of support for carers who are carrying out more and more complex caring. Some carers reported knowing about respite care (some also reported of not knowing), the high cost was a huge barrier to access
Virtual Voices
Over 500 Devon Virtual Voices members completed online surveys and telephone interviews on two key topics; outpatients’ appointments and mental health, to inform the Long Term Plan.
Outpatient appointments
You said:
- 47% of respondents still prefer a face to face appointments with a suitable clinician for serious conditions
- 50% of respondents are open to using technology as an alternative to face to face, recognising the following:
- The most important thing is receiving the right care that is most appropriate.
- There is a strong preference to receiving care locally (whilst maintaining the same level of care)
- Whilst recognising the barriers to follow up appointments (parking, time, childcare) using technology to deliver care must place clinical confidence over convenience.
- When asked, the majority of respondents think email, phone calls and text messaging are the easiest ways to communicate with clinicians about appointments.
We did:
We are undertaking further investigation into the development of community-based resources and the infrastructure required to support alternative out of hospital clinical care as a key part of the Long Term Plan for Devon
Mental Health
You said:
Lots of great mental health support services were highlighted. There is a strong feeling that physical exercise helps to maintain good mental health. Followed closely by engagement in a wide range of social activities, which bring people together for social interactions. Being connected to nature or being around animals helped some people whilst other just needed someone to talk to.
We did:
We are undertaking the development of a central database that identify mental health support and services available from recognised practitioners across Devon to right and timely access to mental health support, to bring it in line with physical health. This will build stronger links between social prescribers and Primary Care Networks to support mental health Signposting as a key part of the Long Term Plan for Devon.
