Moving Forward with the NHS Long Term Plan No-one Left Behind
In taking forward the NHS Long Term Plan we wanted to engage with representatives of seldom heard and marginalised communities. These communities often present with the most significant health inequalities, with poorer access to services and poorer outcomes, and if we can get it right for them, we will get it right for everyone.
Given the number of different communities represented, there were significant overlaps in community and individual experience of using health services. For many of the communities represented there was significant overlap and the likelihood of an individual self-identifying as being part of more than one community was highlighted. For example, an individual who had lived experience of being street homeless could have experience of childhood sexual abuse or sexual exploitation, domestic violence, substance use, sex working, the criminal justice system and sexual assault as an adult. No attempt has been made in this report to look at the correlation or causes of this, but it should be noted that Adverse Childhood Events (ACEs) were mentioned more than once.
In general, the communities and individuals represented at the event felt that they did not receive the same service as other communities and all highlighted similar barriers. It should be highlighted that many felt a poor initial engagement with a healthcare provider, was a significant barrier to further engagement with services. It was felt that even if community members did not have a poor experience personally, that they would know someone else who did and that this was a barrier to accessing services. This highlights the need for initial contact to be positive.
As well as many of the barriers to engagement being similar across communities, there were a large number of suggested solutions that were the same regardless of the community or the topic under discussion. The need for involving community members in the co-design and co-delivery of staff training was considered essential. The use of community members as health champions and peer supporters was repeatedly mentioned and the use of targeted accurate co-produced information for each community was highlighted.