The patient experience: Evaluation report, One Hackney and City

Healthwatch Hackney carried out an evaluation of the One Hackney and City (OHC) Programme between January and February 2017. This was to identify the patient experience of care. OHC is also the name of the care programme provider, which is a group of several providers.

This work was done as part of an evaluation that was commissioned by OHC to evaluate their programme.

The report identifies a number of key issues: patients, who receive care through the programme, tend to have both health and social care needs; many patients were concerned about living in poor housing conditions which affected their physical and mental health; unpaid carers of patients experienced isolation, exhaustion and deprivation, and had a strong sense of duty to look after relatives who needed their support; paid carers of patients had issues with time-keeping and the number of hours allocated for care; patients were not clear whether the programme was a new service or a new way of providing a service, or whether it was a social service rather than a health service; patients also felt frustrated that the programme was not able to offer them housing support or advice; the referral process was not clear with many patients thought it was their GP who had referred them to the programme; the quality of care provided by the programme is generally well-received by patients; staff were seen as non-judgemental and supportive to increase patients’ confidence and reduce their isolation.

The report made the following recommendations:

• There should be clear and consistent information about the role and remit of any provision. In particular there should be clarity as to whether it is a new body of provision, a vehicle for faster access to regular and acknowledged mainstream provision or a vehicle through which alternative provision can be accessed such as the voluntary sector.

• During discussions, the tension between OHC being a 'new service' and a 'new way of working' seemed evident and appeared to be reflected in the perceptions of those interviewed. Transparency as to the nature of any new developments is likely in turn to enable greater clarity for patients/clients.

• There should be greater alignment and clear pathways between mainstream and additional provision in terms of access and transition from one to the other and timescales should be adjusted accordingly.

• Access to the voluntary sector provision should be maintained.

• Attention should be paid to recording the more intangible outcomes such as reduction in loneliness, isolation and sense of wellbeing. It seemed apparent that when this had happened it tended to remain unacknowledged unless prompted. Instead, interviewees spontaneously talked of physical or health improvements alongside any physical changes to their environment.