Agenda item
Covid-19 in Tower Hamlets - resident perspective (Healthwatch)
Minutes:
The Board received a presentation from Healthwatch providing a resident’s perspective on the health and wellbeing in the COVID-19 pandemic A summary of the discussions is outlined below:
The Board noted that:
- Healthwatch was in the process of carrying out a survey online and on the phone. They have also analyzed comments received from local people via telephone and email, NHS Choices, patient opinion, and social media.
- The internet plays a crucial role in how local people cope with the pandemic. Relatively few of those Healthwatch spoke to are digitally excluded; they tend to be older, more deprived, non-White and in poorer health.
- More than half of survey respondents used the internet to stay informed about keeping themselves safe during the pandemic.
- The Government website, the NHS website, BBC News, and social media were important sources of information. While most respondents found it easy to stay informed, some did voice concerns about contradictory or unclear advice.
- Online support groups represent a useful resource for local people to organise and offer advice.
- Access to food (including supermarket shopping among neighbours and support for vulnerable people struggling to afford food) is one of their main areas of concern.
- Patients hospitalised with Covid-19 reported a good standard of care. Although there were apparently reports of inpatients with other issues being discharged prematurely to free up beds for Covid-19 patients.
- Residents had found pharmacy staff to be helpful and supportive, but admin and communications problems happen, particularly in relation to repeat prescriptions and third parties picking up medicine.
- Primary care professionals, including GPs and 111 dispatchers, are not always able to answer patients' queries about Covid-19, as it is a new phenomenon and many aspects are unknown to the scientific community. This causes further worry to patients.
- Some community psychotherapy/mental health support services continue remotely via telephone while others are subject to cancellations. Patient opinion of telephone psychotherapy sessions vary. Complex patients under the care of Community Mental Health Teams can feel particularly unsupported.
- New and expecting parents are apparently experiencing disruptions to maternity and neonatal services, including some cancellations to antenatal and postnatal appointments, and delays in registering babies with a General Practitioner.
- Younger people living with a mental health issue, living alone or with housemates were more likely to experience social isolation.
- Those living with relatives other than their spouse and those experiencing financial precarity were more likely to have tense or unpleasant relations with members of their household.
- Most of the survey respondents who were in work worked from home. Some adapted without issues, while for others it was more challenging; particularly for those with childcare or adult care responsibilities and those who struggled with mental health issues.
- Affording their housing was a major concern for those experiencing loss of jobs or income; the economic downturn increased the risk of homelessness, which in turn meant higher vulnerability to Covid-19
- Consideration should be given to organizing neighbourhood-level grassroots groups to act as digital guides for the digitally excluded individuals who are shielding (including collection and donation of devices and dongles).
- People want professionals to be honest about what they do and do not know or what the science is currently able to tell us. There is the potential for the Board to take a lead on this and counteract some of the confusion coming from central government, in terms of providing clearer, better tailored information on topics such as masks and social distancing.
- Neighbourhood-level online support groups have organised efficiently to provide help for their neighbours, on an informal level. Social prescribers, providers of primary care and the Communities Driving Change programme should work with them to support the local community, making use of the networks they have created.
- Healthwatch had drafted the following recommendations:
1. More proactive communication from GP Practices is needed on the best way to access GP services for different needs and groups; reassure residents that’s it’s ok to see a doctor including reassurance around social distancing, mask wearing and staff testing.
2. Provide additional triage training to practices that need it.
3. Undertake more work to investigate what some of the challenges are for patients with remote appointments, including privacy for those sharing living spaces and the impact of health literacy on how people communicate about their symptoms.
4. A lot of services have been put on hold that might have serious repercussions for patients, including cancer diagnosis, pain management, IVF, bone marrow transplant patient and post-surgery check-ups. Patients need honest communication about when, how, and how gradually services will resume, as well on when and why it is safe to attend hospital appointments.
5. Increase the promotion of mental health self-help apps and support, including the possibility of counselling and therapy via online chat (with text, audio, and video options)
6. Maintain a strong integrated care approach for those with severe mental health, substance misuse and housing problems.
7. Support residents to access therapy and bereavement counselling reflecting religious and cultural diversity, particularly in relation to BAME communities.
8. Patients, family, and unpaid carers have taken on more responsibility for caring over the lockdown. With the right support and training some may want to continue, elements of this where it improves their quality of life. This should be clearly offered as a personal choice and integrated with other forms of care support.
9. Access to Covid-19 testing for care worker needs to be improved.
10.Consider separate times for runners and cyclists at Victoria, Mile End, and the tow paths. People who need to socially distance find it exceedingly difficult to do so with runners and are therefore not going out to exercise as much as they want or need to.
11.Health and Wellbeing Board partners should consider the provision of socially distanced workspace for residents who find it difficult to work from home.
12.Employers need to invest in appropriate home working equipment for those who are being asked to stay at home for longer.
13.Provide information on how to manage stress related to working from home, such as dealing with video engagement overload or distractions.
14. Increase access to financial, employment and housing advice and information.
Supporting documents: