Patient and service user engagement and evaluation around integrated care in Wakefield District

Healthwatch Wakefield wanted to assess patient and service users’ views and experiences of New Models of Care initiatives locally. They undertook 680 interviews with people who experienced the Connecting care service, 53 interviews with unpaid carers and patients who have received services from the West Wakefield MCP Vanguard.

• People are generally positive about integrated care services being delivered through Connecting Care.
• Good health and care co-ordination as a specific function, both within Connecting Care and in the integration of Connecting Care with wider health and care services, was seen as vital in improving people’s experience of the service.
• People who reported a lack of social contact also had poorer self-reported outcomes.
• Unpaid carers reported very mixed experiences within their role as carer, but all described significant impacts on their own health and wellbeing.
• The research identified a clear need for better support, more information and clearer communication and liaison with carers.
• In almost all cases, without the support and input of the unpaid carer, it was patently clear that the patient/ service user would be unable to live in their own homes and would need much more intensive support from health or care services.
• Care home residents interviewed reported generally favourable experiences of health and care services, although the selection sample was biased towards those who had the cognitive and physical ability to engage.
• Potential areas for improvement included care planning and liaison between care homes and other health settings.
• Most residents reported fairly high levels of personal wellbeing.
• Quality of life of those people who were able to engage (only 30% on average of the population of the care homes) seemed to be relatively good.
• People mostly thought that the direction of travel towards shared delivery of health and care services was the right one.
• There was a more mixed picture around whether or not proceeding to full merging and contracting out of an integrated service was a good idea.
• There was general agreement around the question of whether self-help in relation to health and wellbeing was a good thing, but there was less conviction when we asked how likely people would be themselves to take advantage of health support provision, e.g. exercise, healthy eating or low level mental health initiatives.
• There was an almost unanimous agreement that unpaid carers should be supported through the new model of care.
• Overall, most people said that they were willing to share their health and care information more widely in order to improve the effectiveness of care provision, although there were concerns about the level of and extent to which information is shared.