Contact: Rhiannon Worrall, Population Health Fellow, Shropshire Council

The Population Health Fellow for Shropshire Council gave a presentation following a qualitative review of patient experiences of services in the Shropshire, Telford and Wrekin area – copy of slides attached the signed Minutes – and which covered the following areas:

·         Definitions of severe mental illness and complex need

·         Project roll out

·         Survey Results and emerging themes

·         Semi structured interview results and emerging themes

·         Overview

·         Key recommendations and questions

The Population Health Fellow drew attention to the survey results.  When asked how easy or difficult it was to get help, 48% felt it was difficult or extremely difficult to get help due to a number of reasons, including a poor understanding of the help that was available, long waiting lists, lack of trust and poor communication.  It was felt that unless someone was very sick, they would be bounced around a lot of different services and would not get the help needed.

Other themes that emerged from the project included the inappropriate use of services that did not meet the needs of service users, connections between services whereby voluntary organisations and GP services had slightly more positive feedback, whereas the feedback for mental health services ranged from very positive to less positive and the crisis emergency services flagged up more negative experiences.  The same trend emerged when asked to consider how their treatment had been tailored to their individual needs. 

It was felt that people’s negative experiences were in part due to service delivery concerns and that the system was over capacity with long waiting lists and inappropriate services for their needs.  Staff concerns were also picked up and it was felt that if these concerns were addressed this would naturally translate to better patient experiences.  The Population Health Fellow then drew attention to the real-life stories set out in the slides, in particular the respondent who needed help with managing their finances and taking public transport which highlighted a theme around gaps in life and/or social skills.

Turning to the semi-structured interview results, a lot of similar themes arose including long waiting lists, lack of support in between treatments, which was where the voluntary sector came in with more positive feedback.  Some of the things that it was felt would improve patient experience of care for their particular needs included more patience, more professional and more access. 

As a whole it was felt that there was generally a lot of good work happening, but they were not as connected or as streamlined as maybe the physical health services were. The Population Health Fellow drew attention to the recommendations set out in the slides.

The Chairman thanked the Population Health Fellow for her presentation which really brought the slides to life and highlighted the need for integration and better connectivity of services.  He felt there was a role here for the NHS around integration and how to bring physical health services and mental health services together in a more equitable way, along with a role for the NHS and its broader partners e.g. social care, local authorities, voluntary/community sector in order to get a better outcome for the population that was served.

A brief discussion ensued in relation to the work currently ongoing in relation to the issues raised.  It was agreed for the work that has been done to be fed through into the structures already in place and have conversations around the transformation programme that was in place across the mental health services and connect those parts of the conversation.  The Head of Joint Partnerships drew attention to social prescribers who were available in all GP practices and had a wealth of knowledge around what was happening in those communities along with care coordinators whom GPs could refer patients.  She informed the Board of an awareness raising event on 10 October in Shrewsbury Abbey, which would have all kinds of voluntary sector organisations as a marketplace for all staff across all services, to see what all those organisations were doing and the connections between those organisations. 

The Head of Joint Partnerships thanked the Population Health Fellow for her work which was part of a national programme funded by Health Education England, part of which involved taking part in workshops around population health and what that means and how to analyse population health.  The work undertaken would be a good launch pad to really do something about improving work around integration and the work that was already being done.