As ever, healthcare continues to offer challenges and opportunities.
The Government’s 10-year plan for the NHS is taking shape with a call for three major strategic shifts:
- More community-based care
- Prevention rather than cure
- Better use of technology.
We also have our eyes set firmly on the future as we develop our long-term plans for 2025 and beyond.
In line with our Patient Experience and Engagement Strategy, we are consulting widely with patients and the public to ensure we take full account of their needs, as well as reflecting our ambition to be a lead partner, innovating and collaborating across the health and care system.
Locally and nationally, success will depend on how we address health inequalities and make access to care more equitable. Our new Health Inequalities Framework sets out how we will prevent, and respond to, health inequalities within our communities.
Working with colleagues within CityCare, we have refreshed our values and behaviours to reflect our ambition to play a leading role in shaping care in Nottingham.
Working with experts from Forever Consulting, we also asked our communities what they think of the care and services provided by CityCare and the wider NHS.
An online survey received 349 responses. Meanwhile, 70 people, reflecting our diverse communities, took part in six focus groups. We attended two public pop-up events, during which more than 65 meaningful conversations took place.
The feedback received indicates that most people who have accessed health services in the community have had a positive experience due to our professionalism, feeling listened to and involved in decision-making.
Negative experiences tend to stem from long waits for care, difficulty accessing services, and feeling services are poorly co-ordinated.
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What patients want
Patients want better information about services offered by providers. What does CityCare offer and how do they access our services? Can they self-refer?
Many would like to see the same clinician throughout their treatment but this would be less important if they were sure their up-to-date medical records could be accessed by all organisations involved in their care.
Cultural awareness – patients want to be cared for by clinicians who are familiar with how conditions and treatments might affect people from different heritages and cultural backgrounds.
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Accessing our services
Most people want familiarity, using health services in ways they’re used to – for example, booking appointments over the phone.
They prefer personal care, such as in-person appointments with many worrying about accurately and fully describing their symptoms or conditions in writing or explaining them to someone who isn’t a healthcare professional.
Online services are most popular among people who became confident using them during the Covid-19 pandemic and those who appreciate the convenience of fitting appointments around other commitments.
Patients are happier with online appointments if they feel the issue isn’t serious or they don’t need a physical examination. They are also more confident about online consultations if they feel they were properly assessed during an initial face-to-face appointment.
Most of the people we spoke to prefer to receive test results verbally – over the phone or in-person – so they can ask questions. They would also like to receive them in writing, so they have a record. Results should be explained clearly, in plain, jargon-free language.
Accessing care in a single, community-based location is preferred. Different services in the same place (co-location) is also important.
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Digital and online technology in healthcare
While many patients are already using online and digital services to access and monitor conditions, there is a divide – some think digital services and using technology in healthcare is the future, while others believe the personal touch is always required.
We must reflect this mix of patients and their needs, catering for the digitally-savvy and those who use technology comfortably, alongside those who either can’t or won’t use it for healthcare. We must ensure no-one is excluded, especially the most vulnerable.
Although there may be resistance from some, we have an exciting opportunity to help people become more comfortable with online, digital and tech-based healthcare, so it becomes a normal part of their care.
Digital tools are appreciated for speed and convenience but there are concerns about what happens if it doesn’t work.
Also, switching to these tools is often perceived as a way to save money, rather than making people’s lives better, so the benefits need explaining effectively.
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Self-care and managing conditions
Most people we spoke to are willing to take steps to look after their own health, as long as there is someone qualified and trustworthy to teach and guide them.
While there was broad support for self-care, it can be deeply personal and there is no “one size fits all”.
Some patients will prefer the face-to-face approach, others prefer leaflets or short videos on social media.
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How will this help shape CityCare?
The findings indicate that there is strong support for the shift away from hospitals and acute care towards more community-based services, nearer our patients’ homes.
We need to keep listening to our patients, ensuring the voices of the under-represented are heard and care is culturally appropriate.
Technology will offer us the tools to work more effectively and efficiently in this way but we must offer an equitable service – ensuring no one is excluded.
As new ways of working develop, we must ensure we play a leading role in their design and implementation, and we continue to make a difference to the health and wellbeing of our communities.
Click here to read Nottingham CityCare's Community Insight Report
Date published: 20 March 2025
