Get to know where to go when choosing healthcare

This report presents the findings from Phase II of Healthwatch Bolton's "Get to Know Where to Go" project, which aimed to improve public understanding of local health and care services and encourage appropriate use of alternatives to A&E. The project focused on residents in the Bolton neighbourhoods of Breightmet, Little Lever, Farnworth and Kearsley, areas identified as having high levels of deprivation and high A&E attendance rates. Information was provided about NHS 111, pharmacies and the Pharmacy First scheme, urgent dental care, urgent treatment centres (UTCs), out-of-hours GP services (BARDOC), A&E, and the NHS App. 

Healthwatch Bolton and Bolton CVS delivered information through focus groups, community events, printed materials, social media, newsletters, videos and translated resources in Urdu, Punjabi and Gujarati. The project reached more than 108,000 people, including 203 focus-group participants and over 1,100 recipients of printed information. Participants generally reported feeling better informed about healthcare services after attending the sessions, particularly pharmacy services, NHS 111, urgent treatment centres and urgent dental care. 

The feedback highlighted significant challenges in accessing healthcare. Many people reported difficulty obtaining GP appointments, especially through 8am booking systems, and expressed frustration about receptionist gatekeeping and increasing reliance on online systems. Digital exclusion was a major issue for older people and those without smartphones, internet access or digital skills. Some participants reported turning to non-clinical sources for medication because they could not access appointments. 

Experiences of urgent and emergency care were mixed. While some users found NHS 111 helpful, others described long waits, repetitive questioning and uncertainty about language support. Many people felt that limited GP access was contributing to overcrowding in A&E departments. Participants also raised concerns about long ambulance waiting times and poor coordination between services, with some feeling passed from one service to another without clear guidance. 

Pharmacy services received both praise and criticism. Some participants valued services such as Pharmacy First, but many were unaware of the range of support available through pharmacies. Concerns were also raised about medicine shortages, communication problems and the loss of blister-pack medication support.

Dental care was identified as a major area of concern. Participants reported difficulties registering with NHS dentists, travelling long distances for urgent treatment and facing affordability issues where NHS and private services were mixed. They also felt there was insufficient information about how to access urgent dental care. 

Mental health services attracted particularly negative feedback. Many participants felt support was difficult to access, especially during crises and outside normal working hours. Some reported feeling dismissed or not taken seriously. However, local voluntary organisations such as Bolton Listening Lounge and Transforming Lives were praised for providing valuable support. 

Cross-cutting themes included confusion about healthcare pathways, poor communication from healthcare providers, transport difficulties, inequalities in access and a strong preference for face-to-face services. Many participants said they wanted the return of a walk-in centre in Bolton and felt the healthcare system had become too complex and dependent on digital technology. 

The report recommends improving GP access, simplifying urgent care pathways, increasing awareness of pharmacy services, expanding NHS dental provision, strengthening mental health support, tackling digital exclusion, reducing access inequalities and providing more support for carers. It also calls for better communication between services, wider distribution of healthcare information resources and stronger use of community feedback to shape services. 

Overall, the project found that while residents valued receiving information about healthcare services, many continue to experience barriers related to access, communication, digital exclusion and service navigation. The report concludes that clearer information, more inclusive service design and improved coordination across health and care services are needed to help people access the right care at the right time.