New dialogue data review

Healthwatch Kingston upon Thames undertook a review of engagement reports over five years to examine common themes in relation to health inequalities.

While the breadth of Healthwatch Kingston’s insight reports demonstrate significant local efforts from service commissioners and providers to listen to the lived experience of patients and service users, the findings consistently show that barriers rooted in language, cultural understanding, digital exclusion, mistrust, stigma, accessibility, and fragmented services continue to restrict equitable access to health and social care in the Royal Borough of Kingston upon Thames. 

Across settings, including residential care, hospitals, early years services, mental health, bereavement support, community services, and digital access—people describe challenges in navigating systems, securing appropriate information, receiving culturally responsive care, and experiencing joined-up communication. 

Evidence highlights universal issues such as limited translation availability, inconsistent application of the Accessible Information Standard, lack of culturally relevant food and activities, long waits, poor transport accessibility, unclear pathways, low awareness of entitlements, and administrative complexity disproportionately affect minoritised communities, particularly those with low English proficiency or limited digital skills. 

At the same time, the evidence also illustrates what works: compassionate staff, strong community and faith-based/life philosophy networks, accessible pharmacies, co-production, meaningful face to face outreach-based engagement, and a local willingness to improve. Importantly, the review underscores the value of centring lived experience in service design and the necessity of intersectional approaches to understanding need. 

Taken together, the findings in this 5-year review report highlight a clear opportunity for Kingston’s health and social care system to strengthen culturally competent, accessible, and inclusive services, supported by better communication infrastructure, consistent translation support, and ongoing monitoring of health and social care inequalities.