Health inequalities in Croydon - a public discussion

As part of Healthwatch Croydon’s Annual Meeting on 6 November 2024 at the Clocktower Café in central Croydon, there was a public discussion, section under the title: Your views on health inequalities. Residents had the opportunity to share their views on health inequalities in Croydon to help inform the borough’s new Health and Care Plan. 

This session was focused on hearing experiences as residents and as people and organisations supporting people living in Croydon who are dealing with the impact of health inequalities on their lives, their health (physical and mental) and their wellbeing. There were ten tables of discussions. Each were given the NHS definition of health inequalities and the core aspects of Croydon’s Health and Wellbeing Strategy 2024-2029 to inform the discussion.

Residents have different experiences of accessing services. They said that information needs to be local, relevant and easy to understand. Digital developments like apps and online interactions need to align with residents’ access to them, their knowledge needs and abilities. Residents want to see the right person first time.

Residents and the people that support them experience variable levels of care between services and disconnects between different parts of the system. Some experiences are with staff who are not suitably qualified (e.g. not qualified as a prescriber resulting in delayed access to treatment), or do not seem interested enough in the resident. Other concerns included working with processes which do not support them, such as two-ring call backs from GPs that tick a box in responding but do not allow for the time to answer the call. This extends the process causing residents unnecessary stress, when they just wanted to be listened to and helped.

How the system views a resident can impact their approaches to care provided. The focus is on identifying deficits and problems rather than on the whole person. This can create a culture of dependency rather than empowerment. There is with insufficient co-production of individual care plans designed around individual and specific needs.

The recognition of, and response to, residents’ life experience is central to building trust in services. Residents have experienced not being seen or heard, as well as being judged and experiencing discrimination that leads to a mistrust in services and systems. Experience of using some services, for example of NHS111 can affect confidence in using this service and therefore deciding to go to other places such as accident and emergency care. The impact of the social determinants of health such as education, malnourishment, poverty and poverty of opportunity need to be considered as they can make a difference on how people perceive and use services.

The role that communities can have in reducing inequalities. Residents see a distinct role for community groups to empower communities not usually heard and support the need for more communal and collaborative approaches.

Residents are also keen to see resident experience and views used to inform policy and make changes to services. Are there the resources and political will to change services?