Listening and learning from our patients and local communities during Covid-19
What has been the impact of Covid-19 on you and your family? How has your life changed over the past six months? How has your health and access to healthcare been affected?
These were some of the big questions that we have been grappling with over the summer. As part of the Trust’s Learning & Insights programme, we have been working together to understand the extent of the impact of Covid-19 on our patients, our citizens and our local communities. Thanks to the willingness and openness of our patients and local citizens we have been able to listen and learn in a way that we hadn’t done before. We’re now using what we learned and working with teams across the Trust to help improve patient care and experience for the anticipated second wave of the pandemic. Here’s a taste of what we found.It sadly won’t come as a surprise that the impact on the North West London population has been profound. Across the boroughs we serve, we have witnessed higher than UK average rates of Covid-19 infection and mortality. The direct impact of Covid-19 has not been evenly distributed - our BAME communities and those from more disadvantaged backgrounds have borne the brunt of this pandemic. We have learnt from many different people and community groups the extent to which mental health, education and employment has been affected.
We have heard about many positive experiences within our Trust, of feeling safe, protected and cared for even in a time of great uncertainty. Our patients have valued the efforts of our staff to create a sense of security through Covid-protected spaces and to forge trusting relationships when communication is restricted due to PPE. We have been overwhelmed with the generosity of volunteers and donations which were appreciated by our patients and staff during the difficult times.
The impact of visitors not being permitted on site was deeply felt and resulted in challenging times for our patients and their families. We have learnt lessons on how we can adapt to improve the experiences for our patients even with the restrictions in place. The improved WiFi connectivity and role of family liaison officers has helped bridge those gaps and increase connection between our patients and their loved ones. Some maternity patients even described an increased closeness and bond with their midwife teams as well as gratitude for the continued face-to-face care.
The shift to remote consultations has been both celebrated and challenged. The speed at which changes were made to ensure patients could receive care virtually was appreciated. For many, not having to travel or spend time in clinical environments, whilst still receiving quality care and time with their clinicians, was gratefully received. However, as with many new changes, there were issues, particularly for those who are digitally disadvantaged for access, language or disability reasons. There were also inconsistencies of care with some patients having virtual consultations but having to visit our sites for tests or to pick up prescriptions. We have received a lot of feedback on how to improve these services which will be critical to improving patient experience for all.
The pandemic highlighted many challenges around communication. It is clear that whilst there was plenty of information available, it wasn’t all helpful, accessible or clear. News media drove up levels of anxiety and some patients ended up not knowing what the changing context meant for them personally or how it would impact their care or what they would need to do if they were to fall ill. These levels of confusion seemed to increase as time went on and rumours gained momentum to the extent that some people were scared to come to hospital for urgent care. This was particularly true in some BAME communities. We learned the value of direct, open conversations for dispelling rumours and building trust. It highlighted the responsibility we have to provide clear and concise communication and to keep open to conversations with local population so they understand how we can help them.
This work has been both important and eye opening. Whilst it has been valuable to learn about the impact on our populations as whole, to understand the scale and breadth of the impact of Covid-19, the individual stories and experiences have been absolutely vital in providing specific feedback on what we need to do better going forward. We are hugely grateful to everyone who gave us their time and shared so openly with us and we will now work with the wider Learning & Insights team to reflect and plan the way forward.
This work is just the beginning of what we need to do, not just to ensure that we are best equipped to address the further Covid-19 challenges we face but to ensure we have the strongest connection with our patients, citizens and local communities. We need to keep listening and we need to keep improving.
We will be updating on progress about this work from all five Learnings and Insights working groups over the coming months. If anyone would like to discuss this work further, please don’t hesitate to get in touch with me (hannah.fontana@nhs.net).
