We wanted to ensure the voices of children and young people were heard as we plan for how paediatric care could be delivered in the future.
Earlier in the year we undertook an extensive engagement activity called What Matters to You however, participation from children and young people was low.
To ensure that the voices of children and young people were heard, from November 2021 to January 2022 we launched a targeted engagement exercise with children and young people across the Humber to hear what they like and don't like about coming into hospital.
This is also included listening to parents, carers and guardians experiences of accessing paediatric services.
63 responses were received from children and young people aged between 2-18 years old.
Feeling cared for and safe was most important to you
The children and young people taking part in the engagement were provided with six simplified statements and asked to pick their top three in order of importance. Feeling cared for and safe came out top. This is consistent with what parents, carers and guardians said was most important, however different to our other What Matters to You engagement where I am seen and treated as quickly as possible was ranked as the most important.
You also said it was very important that:
- you don't have to wait too long
- there are enough doctors and nurses
- the building is nice and has everything you need
Children and young people ranked the building is nice and has everything I need (Estates and Infrastructure) comparatively higher than all the other (adult) stakeholder groups we engaged with, where it was consistently ranked eighth out of nine. This suggests that buildings and the equipment inside of them are more important to children and young people than adult stakeholder groups.
What's good about coming into hospital
Using a variety of different methods including drawings, lists, stories or poems. Young people taking part in the engagement were encouraged to tell us what the best thing about coming into hospital was.
What's rubbish about coming into hospital
Using the same methods described above, young people were then asked to tell us what the worst thing about coming into hospital was.
If you were poorly and had 3 magic wishes to make you feel better you would wish for...
Wish 1 - Nice food and drink - e.g. chocolate and ice cream
Wish 2 - Home comforts - e.g. your own bed and cuddles
Wish 3 - Tech and toys - e.g. being able to watch a film or play with toys
To read the full feedback report and executive summary, please click the document links below.
Next, we will:
Use the feedback to inform our evaluation of potential clinical models for paediatric services
Continue to provide opportunities for children and young people to share their thoughts and ask questions relating to the Humber Acute Services Programme
Reflect and learn from this engagement, and use that learning to inform our engagement approach to formal public consultation, ensuring we are able to talk to more children and young people, their parents, carers and guardians.
What was important to you when thinking about your care in hospital.
Throughout April and May 2021 we asked patients, public, staff members and Local Councillors what matters most to them. Whilst we received nearly 4000 responses to our survey, the number of responses from some groups and communities was relatively low.
We therefore wanted to provide a further opportunity for feedback so reopened the survey between August and December 2021. A further 148 responses were received.
That being 'seen and treated as quickly as possible" was most important.
In the questionnaire, participants were asked to rank nine statements in order of importance with the option to add any further comments at the end. I am seen and treated as quickly as possible came out top in both rounds of our What Matters to You engagement.
You also said it was important that:
- You are kept safe and well looked after.
- There are enough staff with the right skills and experience.
- Things go well for you, and you are satisfied with your care.
The order of preference varied between different groups; however these three statements were prioritised most highly when averaged across the board. The three things that were consistently ranked lowest were: I know services will be there when I need them, I am looked after in good quality buildings and the latest equipment and services are good value for money. This again is consistent with the results from the first round of engagement.
It is important to note that participants were forced to rank the statements in order of importance, so it does not mean these factors were not important at all, just less important than the others. Some comments noted that it was difficult to rank these statements and that they were all important factors to be considered.
We asked about what matters most because we want to pay particular attention to the things people have told us are most important when we look at how we might provide services differently in the future.
When we compare the different ways of organising our services (known as the options appraisal stage of our change process), we will look to prioritise those options which make the biggest improvements to those areas you told us were most important to you.
You said that being “seen and treated as quickly as possible” was most important.
The feedback so far tells us that we need to pay particular attention to the current challenge of long waiting lists, particularly in those services most adversely affected by the Covid-19 pandemic. We also need our longer-term plans to ensure patients are seen and treated quickly in all services and that we design them in a way that means they can withstand any future shocks.
You said that compassionate and caring staff meant you were happy with your care.
The most common reason given for a positive experience was linked to the staff providing the care. When planning how we provide services in the future, we need to ensure staff have time to care. We need to make sure our plans for the future make the best use of the skills, talents and experience of our workforce, including those who will make up the workforce of the future. To do this effectively we also need to make sure we involve our existing staff in the planning process so that we can capture their ideas and aspirations in what we do. This was also a key theme from our first round of engagement in Spring 2021.
You said that social distancing measures implemented due to the Covid-19 pandemic had a negative impact on your overall experience.
Participants told us that social distancing measures such as telephone appointments and restrictions on being able to accompany family members or loved ones to appointments had impacted negatively on their overall experience of accessing hospital care. In line with Government guidance, many of the restrictions imposed as result of the Covid-19 pandemic have now been lifted or relaxed, mitigating any future negative impact on patient experience.
You told us that different people have different priorities.
Whilst overall there was a high degree of consistency in prioritisation across all groups and cohorts of the population, there were some differences when we compared results by age or by role (for example, staff did not rank being seen and treated as quickly as possible as highly as members of the public or parents/carers or relatives).
Next we will:
Use the feedback captured from all our What Matters to You
engagement activities to ensure that our decision-making process is fully informed by a range of views and opinions and truly reflects the priorities and preferences of local people.
We will reflect on what went well and what could be improved and embed that learning into how we plan for formal consultation to ensure our engagement is accessible and inclusive.
The next step is to gather feedback from a range of stakeholders around travel and accessibility, to better understand how people travelling to receive care and treatment may be impacted should changes be made to the location of services in the future.
We asked you what was most important to you when accessing paediatric care with your child or young person.
277 parents, carers, guardians, or support workers took part in this engagement exercise by filling in a questionnaire and sharing their experiences, views and perspectives of accessing paediatric care with their child or young person.
At the same time we also listened to children and young people about what they liked and didn't like about coming into hospital. Click here to read what they told us.
You said that being “kept safe and well looked after” was most important.
In the questionnaire participants were asked to rank nine statements in order of importance with the option to add any further comments at the end. I am kept safe and well looked after came out top. This is different to our other What Matters to You engagement where I am seen and treated as quickly as possible was ranked as the most important.
You also said it was very important that:
The three things that were consistently ranked lowest were:
This is consistent with how respondents ranked these criteria throughout our other What Matters to You engagement exercises.
It is important to note that participants were forced to rank the statements in order of importance, so it does not mean these factors were not important at all, just less important than the others.
We asked about what matters most because we want to pay particular attention to the things people have told us are most important when we look at how we might provide services differently in the future.
When we compare the different ways of organising our services (known as the options appraisal stage of our change process), we will look to prioritise those options which make the biggest improvements to those areas you told us were most important to you.
Next, we will:
Use the feedback captured from all our What Matters to You engagement activities to ensure that our decision-making process is fully informed by a range of views and opinions and truly reflects the priorities and preferences of local people.
Reflect on what went well and what could be improved and embed that learning into how we plan for formal consultation to ensure our engagement is accessible, inclusive and reaches communities and groups we didn’t hear from during our pre-consultation engagement phase.
Gather feedback from a range of stakeholders around travel and accessibility, to better understand how people travelling to receive care and treatment may be impacted should changes be made to the location of services in the future.
The Your Birthing Choices engagement exercise was undertaken to understand what was important to women & birthing people, birthing partners and support people when choosing where to give birth.
The questionnaire was open between June and July and 1,133 responses were received.
An Alongside Midwifery-Led unit is your preferred place to give birth
Participants were presented with four birthing locations and asked to rank in order of preference which one they would prefer to give birth at. An Alongside Midwifery-Led Unit came out top, a Hospital Maternity Unit was second, a Standalone Midwifery-Led unit third and a Home Birth was ranked last.
85.6% of participants also said that if they were able, they would choose to give birth at an Alongside Midwifery-Led Unit, describing this as the safer and more ideal option as it is close to specialist care if complications arise, yet more relaxed and less clinical than a hospital birth.
Overall, you would prefer to not give birth at home
72.3% of participants said that they would not choose to give birth at home, with the biggest concerns being around safety should any complications arise during labour.
27.7% of respondents however, would choose to birth at home saying they feel more comfortable at home and it's a much more family centered experience.
Standalone Midwifery-Led Units are not your preferred place to give birth at
55.3% of participants said that they would not choose to give birth at a Standalone Midwifery-Led unit, with the biggest concerns relating to safety and the risks associated with not being being on a near a hospital site.
However, 44.7% of respondents said that they would choose to birth at a Standalone Midwifery-Led Unit as it is an excellent alternative for women and birthing people wanting a non-clinical birthing experience.
There are other factors that would influence your decision on where to give birth
Participants were provided with a long list of statements and asked to rank the top five most important to them that would influence their decision on where to give birth:
1 - Facilities for birthing partners to stay in the same room
2 - Access to neonatal care
3 - Access to an operating theatre
4 - Access to a birthing pool
5 - Close to specialist care
Not having neonatal care on the same site would influence where you choose to give birth
70.5% of participants said that if there was no neonatal unit available on site, this would potentially influence where they would choose to birth at. The main reasons provided said that they would prefer to have the peace of mind that care neonatal was instantly accessible in an emergency situation.
However, others felt this was not a concern so long as they had experienced a normal pregnancy and a neonatal unit was within a reasonable distance.
Your biggest concern when considering a midwife-led birth is the risk to yourself and your baby if complications arise during labour.
Your biggest concern when considering giving birth in a hospital/labour ward is that partners are unable to stay overnight
Next we will:
Reflect and learn from this engagement exercise and use that learning to inform our engagement approach with this group of stakeholders as we progress to formal public consultation, ensuring we are able to talk to more of our population and hard to reach communities.
Use the feedback captured during this engagement to inform the evaluation of potential clinical models for maternity and neonatal services.
Listen to more parents and birthing people from health inclusion groups, groups with protected characteristics and from areas of high deprivation about their experiences of accessing maternity or neonatal services, how they feel any future potential changes may impact them and listen to any ideas they have on how services could be improved in the future.
Between June and July 2021, questionnaires were posted to 746 patients who had been identified as being impacted by the temporary changes made to Haematology in-patient services throughout July -October 2021.
Participants were encouraged to share their experiences so we could understand if the temporary changes had a positive or negative impact on their patient journey, quality of care and outcomes.
110 responses were received.
You were happy with the care you received..
The majority of respondents, including those impacted by the change of location of their first face-to-face appointment to Castle Hill Hospital, rated the quality of care provided as either good or excellent. Several respondents spoke highly of the kind, compassionate and hardworking staff at Castle Hill Hospital.
The new location and extra travelling did cause some inconvenience...
The feedback shows the majority of patients who travelled to the new location by car, either as a driver or a passenger, said it was easy to get to their appointment. These respondents appreciated the clear directions that were provided and/or noted it was easy to get to Castle Hill Hospital because the journey time was shorter due to where they live.
More negative responses to this question were given from those who
needed to travel further, had problems with parking and/or had to rely on family and friends to help, saying the change in location had caused some inconvenience both time and financially.
The changes have had a financial impact...
Some respondents told us that the changes had impacted them financially, with some needing to now pay for taxis to their appointments or parking costs, when before they could have walked or used public transport.
You don't want technology to replace face-to-face appointments...
With regards to follow up appointments, there was a clear preference from respondents for these to be delivered face-to-face as they favour the personal aspect of being able to see and speak to the consultant in person not through a screen or down a telephone.
There appears to be a wariness to adopt and embrace digital appointments and a number of respondents said they would not feel confident taking part in a video call or using apps - despite the majority of respondents owning the technology needed to take part in these methods of communication
You would like appointments to run on time...
A key area of improvement is around appointments running on time. A large number of respondents expressed frustration around this and some told us they had experienced delays of up to 7 hours.
You would like to be communicated with better...
The feedback also expressed a need for clear and timely communication, especially from those respondents with audio impairments. The individual needs of patients should be taken into account when contacting patients and/or when calling patients through for appointments.
A number of respondents also noted the importance of regular updates with regards to appointment waiting times and/or clear communication when discussing a diagnosis, test or treatment plan.
Next, we will:
The feedback captured during this engagement exercise from both staff and patients will, will be reviewed and considered by the service teams colleagues at both HUTH and NLaG.
The findings of this feedback will be discussed at the joint HUTH and NLaG Haematology Operational meeting, Humber Cancer Board, and shared with the wider workforce in the form of an analysis report.
The feedback captured during this engagement exercise will be reviewed and considered against our evaluation criteria to help inform any proposal(s) for service redesign/reconfiguration, including whether these temporary changes are to be made permanent.
Please click the document links below to read the feedback reports from both staff and patients.
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