Agenda item

To receive and NOTE the Healthwatch Oxfordshire Report on patient views and experiences of Oxfordshire health and care services.

Barbara Shaw (Chair of Healthwatch Oxfordshire) presented the Healthwatch Oxfordshire update. Members were advised that the report provided an overview of recent engagement activity undertaken by Healthwatch Oxfordshire and highlighted findings from a number of pieces of work completed since the Board had last received an update.

A significant amount of community engagement work had been undertaken in recent months. Healthwatch Oxfordshire had been working closely with partners on engagement activities relating to health inequalities and community experiences across Oxfordshire. Particular reference was made to recent work undertaken with residents living in rural communities, which had been delivered in partnership with Community First Oxfordshire as part of the county’s broader Marmot Place programme. Members heard that Healthwatch had engaged with 851 residents across fourteen rural settlements, providing valuable insight into the experiences of people living in those communities and helping to strengthen understanding of the challenges affecting access to services and wider wellbeing. The Board was advised that more detailed findings from this work would be presented to a future meeting.

The Board then received an update on a newly published Healthwatch Oxfordshire report examining people’s experiences of palliative care and end-of-life care across Oxfordshire. The report had been published during the week of the meeting and represented one of the organisation’s most recent pieces of engagement work. The findings offered important insights into public attitudes, experiences and concerns surrounding palliative and end-of-life care and highlighted a number of themes which Healthwatch considered relevant to both service providers and system leaders.

Members heard that individuals overwhelmingly expressed a preference to spend their final days at home or within a hospice setting rather than in hospital or residential care. The reasons cited by participants included the comfort of familiar surroundings, the opportunity to remain close to family and loved ones, and perceptions that home or hospice settings would provide greater dignity and personal control during the final stages of life.

The report also identified a degree of uncertainty amongst some respondents regarding the services available to support people approaching the end of life, including hospice-at-home and hospital-to-home services. This suggested that further work might be required to improve public awareness of the options available. The Board was informed that participants consistently highlighted the importance of receiving the right care and support at the right time. Themes emerging from engagement included the importance of symptom management, receiving clear information, maintaining dignity and respect, feeling safe and supported, and remaining connected to family members and friends. Emotional support and companionship were frequently described as being just as important as clinical or medical interventions. Participants had emphasised the value of compassionate care and the importance of professionals communicating openly and sensitively with patients and their families during what could be a particularly difficult period.

The update also highlighted concerns expressed by some communities regarding cultural sensitivity and the extent to which services consistently met diverse cultural and faith requirements. Members heard that some respondents, including individuals from Muslim communities, had raised concerns regarding whether their wishes and cultural needs would be fully understood and respected during end-of-life care. The Board noted the importance of ensuring that services were sufficiently flexible and culturally competent to meet the needs of Oxfordshire’s diverse population.

The discussion then focused on advance care planning and awareness of the RESPECT process. A significant proportion of participants had not made any plans regarding end-of-life care. Reasons cited included not wanting to think about the subject, uncertainty regarding when or how such conversations should begin, and a lack of awareness about the options available. Members heard that only a minority of respondents had heard of the RESPECT process and very few had completed a RESPECT plan. Concern was expressed that awareness remained relatively low despite the implementation of RESPECT arrangements across Oxfordshire. Healthwatch's findings suggested that greater public information and earlier conversations about end-of-life planning could help ensure that individuals’ wishes were understood and documented before a medical crisis occurred.

The Board heard that participants had spoken positively about many aspects of palliative and end-of-life care. Respondents frequently praised compassionate professionals, responsive services, effective communication and the involvement of families in decision-making. However, the report also identified challenges relating to continuity of care and coordination between organisations. Some individuals reported difficulties when moving between health and social care services, while others described inconsistencies in support arrangements and communication. Concerns had been raised, particularly in relation to people with dementia and those relying heavily upon social care services, regarding continuity and consistency of care. 

Members noted that the findings reflected broader themes that had emerged elsewhere within the health and care system, including the importance of integrated service delivery and person-centred care. The discussion recognised the significance of effective communication between professionals, providers and families, particularly where multiple organisations were involved in supporting individuals nearing the end of life.

The Board RESOLVED to:

NOTE the Healthwatch Oxfordshire update.