Survey summary
Patient and Carer Conversations for Nottinghamshire Healthcare
The survey collected responses to identify the key areas where Nottinghamshire Healthcare can improve its care and support for people. Over 30 surveys have been completed.
The following question was asked:
Please tell us up to three things that you think are most important for Nottinghamshire Healthcare to improve upon so that we provide the right care and support for people. If possible, please be specific about which service area these improvements relate to.
Participants highlighted important issues across various service areas. The recurring themes and suggestions have been summarised below.
1. Crisis Services
- Crisis Support: More regular check-ins for those in crisis, preferably by staff with counselling experience.
- Access Line Issues: Concerns about unqualified staff handling the access line and giving inadequate advice to patients in distress.
2. Autism and ADHD
- Staff Training: Need for better staff training to support autistic individuals and provide autism-informed care.
- Crisis Services: A crisis service that is suitable for autistic individuals, with continuity of staff and autism-trained professional's
- Gaps: Limited support for adults with ADHD beyond medication, and long waiting times (2-3 years) for assessments.
- Care Coordination: Poor coordination for autistic individuals, with services lacking trauma and autism informed approaches.
3. Safety and Risk
- Patient and Carer Safety: Concerns about the safety of both patients and carers at home.
- Inconsistent Care: Risk assessments and care plans are inconsistent.
- Discharge Support: Limited support upon discharge, leading to risks for patients.
- Off-Rolling to GPs: Issues with patients being discharged to GP care without adequate support.
4. Staffing
- Doctor and Staff Shortages: Calls for more NHS doctors and better staffing levels. Less reliance on bank staff.
- Staff Training and Development: Need for upskilling, emotional support, and career development for staff.
- Management Issues: Concerns about excessive management roles and wasted resources, with a focus on improving staff morale.
- Valuing Staff: A need to make staff feel more valued, with suggestions for more visible management on wards and appreciation of staff contributions.
5. Services
- Access to Services: Limited access to Community Psychiatric Nurses (CPNs) and community support, with no assertive outreach team.
- Inpatient Support: Lack of adequate inpatient accommodation and care coordination post Care Programme Approach (CPA) ending.
- Trauma-Informed Care: Need for investment in trauma informed care and training.
- Joined-Up Services: Gaps in service integration, suggesting more joined up processes across mental health, housing, and community services.
6. Listening to and Involving Patients
- Diverse Engagement: Involve a more diverse range of patients and carers, offering paid involvement to acknowledge their expertise.
- Feedback: Need for a system that responds to feedback and shares resulting changes.
- Patient Involvement: Greater involvement of patients in decision-making processes, especially those with lived experience.
7. Appointments
- Convenient Scheduling: Patients report that appointments are made for the service's convenience, not the patients, and suggest creating a more flexible system for mutually convenient scheduling.
- Wait Times: Waiting lists for appointments are too long, with a need for better systems to provide timely assessments and follow-ups.
- Signposting: Improved signposting to support resources to help patients "wait well" while waiting for appointments.
8. Resources
- Community Resources: More community-based resources, especially upon discharge, to prevent relapses.
- Inpatient Care: Better access to inpatient care, reducing reliance on crisis services and out-of-area hospitals.
- Practical Support: Resources to help people access benefits and services, along with upgraded facilities for patient comfort.
9. Communication
- Health Information: Patients want to be better informed about their health status, test results, and follow-up procedures.
- Translation Services: Improved translation services, including for British Sign Language (BSL), with better booking systems for interpreters.
- Medical Records: Calls for better sharing of medical records between GPs, community services, and social care to improve communication and patient safety.
- Simplified Communication: Less use of acronyms and clearer communication across all levels of care.
10. Carers
- Family Support: Faster response and improved communication with families and carers, along with culturally sensitive care.
- Carer Training: More training and resources for families and carers to better support patients at home.
11. Reputation
- Public Perception: Negative press coverage has created anxiety among patients and carers about the quality of care being provided.
- Learning from Inquests: Better learning from inquests to prevent avoidable deaths and improve accountability.
- Staff Attitudes: Addressing staff who display negative, neglectful, or prejudiced behaviour towards patients.
Conclusion
The feedback from patients and carers suggests that Nottinghamshire Healthcare has several key areas for improvement, especially around care for neurodivergent individuals, patient safety, staffing, communication, and crisis support. Strengthening staff morale, ensuring better care coordination, and involving patients and carers in decision-making processes are seen as critical steps towards improving the Trust’s services.
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