Community conversations to help shape the future of health and care services

Community Conversations engagement

Every integrated care board (ICB) is required to involve local people and communities in the formation of their 10-year integrated care strategy and draft 5-year forward plan.

To ensure we involved local people in shaping our long term plans for health and care service, we delivered an inclusive period of engagement titled ‘community conversations’ which ran from May 2023 until January 2024.

With the help and support of our partners, we engaged with over 10,000 people using a variety of engagement methods, that included face to face conversations. Some were recorded on audio, completing online surveys, filling in our question posters at events to creative methods to suit the people we were speaking with.

Summary of our engagement

• Face to face conversations with at least 2,705 people as part of main community conversation programme across 3 integrated care areas with attendance at 26 events across the region to carry out face to face engagement with people which ranged from completing an online survey to commenting on our integrated care system strategy priority posters.
• Running an online survey which was completed by 2,621 people between 1 May and 30 September 2023 hosted on Cornwall Council’s Let’s Talk Cornwall website, which was promoted by 15 GP surgeries to their patients.
• Including a strategy-related question in Royal Cornwall Hospitals NHS Trust’s friends and family test survey which received 2,252 responses.
• Visiting 21 community groups, including peer support groups, and activities in the region and asking what matters most to them in a semi structured format, with a particular focus on reaching our Core20+5 audiences, approximately 2,000 people.
• Having a stall in 3 community hospitals and 10 GP practices and talking to patients and their families in reception areas, sometimes completing an online survey with people who gave their permission for us to do so. Carrying out unstructured but purposeful 1 to 1 face to face interviews with the public at all these locations, events, and activities across the region regarding the 3 key themes in the draft integrated care strategy which are Start Well, Live Well and Age Well, speaking to an estimated 200 people.
• A visit to the Isles of Scilly to speak with local residents in May 2023, around 100 people were engaged with, supported by Healthwatch Isles of Scilly.
• Bespoke engagement activity planned with system partners including Cornwall Neighbourhoods for Change (CN4C), Hearing Loss Cornwall and Young People Cornwall asking what matters most to groups of people who experience health inequalities, this included:
  • 2 events (July 2023 and January 2024) to engage with d/Deaf people and people with hearing loss arranged with Hearing Loss Cornwall to understand experiences of our health and care services (approximately 40 people at each event).
  • CN4C researchers spoke to approximately 105 people using innovative engagement tools and approaches.
  • Young People Cornwall surveyed 173 young people.

Films from our engagement

Alongside our engagement, when people were happy to, we also filmed their experiences as part of our ‘your story, shapes our future’ and shared the films with our integrated care board. This included film clips of our engagement at GP surgeries and from our visit to the Isles of Scilly where a lady explained the long journey taken to receive cancer care. Watch the full set of films.

Read the findings in our Community Conversations reports

The Community Conversations full report.

The Community Conversations overview report which shows feedback by theme and audience.

Community Conversations CN4C report details engagement with diverse groups in partnership with the ICB.

Summary of findings of what people told us

You said: People want health and care services that:​

• they can consistently access, regardless of where they live or who they are (age, location, ethnicity)
• are easily accessible 24/7 (including being locally available, in person where needed and quickly when its urgent)
• are flexible and easier to access for those who need extra support, due to digital exclusion, employment restrictions (fishing and farming), caring responsibilities. affordability of calls or internet, literacy or disability
• are equal in the way care is offered for physical and mental health
• empower professionals to ‘dig deeper’ into a person’s health problems to find out the root cause and offer holistic advice
• offer kinder care: our staff are more compassionate, understanding and listen to the needs of people and their families
• enable people to look after their health and wellbeing with choices and information provided, tailored to their need or medical condition (on diagnoses and throughout)
• provide personalised care based on what people need and not assumptions, offer choices rather than medication
• provide information and communicate in ways people understand. This includes the way we talk, send information and promote our services

You said: Start well

We asked people about what was important to them for the services we provided to children, families and young people aged 0 to 24 years. They told us:

• more help to support some families (parents, carers) who may need a little extra help after their children reach 2½ years and before school age
• promote self-care and child and family health to families so they can be empowered to look after their child
• support families and carers to get GP appointments for young children aged between 0 and 5 years
• being able to raise a concern about the health of my child and being listened to. Parents wanted to be listened to about what may be wrong and what their child needs
• quicker access to educational psychological assessments for children and young people. We were told waiting was the cause of much anxiety in parents and affecting young children’s education or progress
• more mental health facilities and services for young people, especially child adolescent mental health services (CAMHS)
• ensure children and young people can access mental health services designed around their specific needs
• greater access to NHS dentists. Many adults were deeply concerned about how the lack of NHS dentists were affecting children’s teeth, possibly for their whole lives
• provide information about services that meet the different needs of children and young people reflecting neurodiverse, ethnicities, gender throughout the ‘start well’ services, including signposting, advice and ongoing information throughout the child to teen years (as it will change depending on age).
• More awareness raising on risks associated with smoking and vaping.

You said: Live well

We asked people about what was important to them for the services we provided to people of working age (24 to 65) to help them thrive. They told us:

• provide support for people transitioning between young people’s services and adult services
• more responsive mental health services that prevent people reaching crisis
• provide easier access to services offered at GP services, we need flexibility in booking and attending appointment (evenings, weekends) and for longer durations for serious concerns, for example, cancer symptoms or for reviews for long term conditions
• more access to NHS dental services
• more efficient prescribing practices and making it easier to obtain medications for people with long term conditions or work commitments who require it
• reduce waiting lists for treatment, both physical and mental health
• provide more support for people with long term conditions and complex medical needs. People want to understand the options and solutions to help them live healthier lives
• affordable access to activities to improve our own health and wellbeing
• better access to gender affirming care and services and kind care for transgender people
• offer and promote health checks throughout life, screening to age related checks
• health and care that are person-centred and go further than ‘medical’ solutions offered

You said: Age well

We asked people about what was important to them for the services we provided to older people (65+) to help them age well. They told us:

• more joined support provided from initial diagnosis of dementia and throughout living with this condition
• support for people caring for others with health problems
• people want to be at home and feared going into hospital (to die)
• more support to enable a person to be discharged from hospital
• more paid carers with the right skills to deal with the people they care for. Dementia carers were specially highlighted in people’s feedback
• opportunities for socialising to combat isolation and ‘buddy’ to help older people to try new things. Hesitancy and being too ‘proud’ or ‘not old enough’ were reasons given
• ensuring services are flexible to access for those who need extra help or support, due to digital exclusion

The age well feedback is shorter, however that is because the thematic analysis in the overall and live well sections cover the same areas that were highlighted. The above points are provided in addition and just for the age well life stage.