Report on feedback from integrated community services prototype patients

In August 2014 Healthwatch Shropshire was commissioned to undertake an evaluation of the patient / service user experience of the Integrated Community Services (ICS) prototype. The ICS prototype was set up in November 2013 and provided a new model of service provision to support discharge from the Royal Shrewsbury Hospital (RSH), contributing to a wider programme of work focusing on improving flow through the hospital. The prototype was specifically targeted at people living within the Shrewsbury and Atcham locality. During the 8 month period of the prototype 271 people received support from the service. A key driver of the evaluation was to gather patient feedback in order to inform future service delivery as part of a roll-out of ICS across Shropshire. Telephone interviews were conducted with a sample of 122 patients1 who had directly experienced ICS following their discharge from the RSH. This represents 45% of the total number of patients that went through the prototype.

Overall the majority of patients were highly satisfied with the service they received from ICS and felt this was the best way of meeting their needs on leaving hospital. Patients were generally very complementary about the ICS staff they came into contact with and acknowledged the professionalism and high quality of the care they received through ICS. The most common issues raised in relation to the care received were the timing of support workers visits, the short duration of their visits and inconsistency in terms of patients being allocated regular carers. Most people were clear about the service’s focus on regaining independence however for some with on-going care needs this had less resonance. Whilst many patients felt they had been involved in decisions regarding their support plan there were high levels of uncertainty and confusion regarding the specific tasks contained within their plan. Whilst most patients were clear that ICS was a short-term service many said that they weren’t clear about when the help would finish or were informed of the service coming to an end at short notice. A significant number of patients stated that they were not clear about what was going to happen once ICS came to an end. Anecdotally the most common issues raised in relation to post ICS care were difficulties in getting the support needed which when raised frequently related to the affordability of on-going care and a perceived reduction in the quality of the care received.