How is Healthwatch Westminster addressing challenges to high quality intermediate care provision?

Overview

The NHS defines intermediate care as short-term intensive support provided to patients to maximise their independence. Intermediate care support can either be provided to a patient after being hospitalised and discharged (i.e., step-down care), or to prevent hospitalisation (i.e., step-up care).

In partnership with North West London Networked Data Lab (a collaboration between Imperial College Health Partners, Imperial College London, and the North West London Integrated Care System, funded by The Health Foundation), we conducted this project to provide qualitative context to their report on quantitative patient and care data. The video above was produced by their Patient & Carer Advisory Group to showcase their project findings. 

How did we carry out this project?

For this project, we reached out to organisations that provide support to carers and patients with long-term conditions. Participants were referred to us by local organisations such as Carers Network, Age UK Westminster and Kensington & Chelsea, Open Age, and the British Red Cross.

We collected the data by conducting interviews with 15 respondents, including patients and carers with experience of using step down care. Questions focused on the impact of environmental assessments; involvement of patients and unpaid carers; trust, continuity and quality of care; and communication.

What did we find?

In most cases, respondents deemed the quality of step-down care services to be good. However, interviewees highlighted that the lack of information about the timeline or mode of discharge, the difficulty of understanding care packages provided by medical providers, the low-quality post-discharge equipment and the delay in receiving home assessments were among the key issues they faced.

Another major theme that came up was the involvement of patients and carers in decision making. Some carers shared that they took an advocacy role to better navigate the post-discharge care system and help set comprehensive care directives. This negatively affected their physical and mental health. The report delves further into these findings. 

Our recommendations

Our recommendations address the feedback shared by the 15 participants during the interview discussions. We emphasise on the need to improve communication between medical providers and carers to ensure that sufficient information is provided about what intermediate care services will entail. 

It is also vital to involve patients and carers in decision-making processes, particularly in relation to the care setting and discharge procedures. Finally, adequately training health and social care staff to deliver intermediate care will enable them to better support those who are most vulnerable. You can read more about our recommendations in the report.

What’s next?

We plan to continue gathering insights by engaging with carers and patients at local community centres and hospitals to monitor changes in the planning and delivery of intermediate care across Westminster and Kensington & Chelsea. The findings of this report will also be shared with the Northwest London Networked Data Lab, our key stakeholder networks and local authorities. 

Finally, we are seeking residents with lived experiences of health and social challenges in the bi-borough to join our Advisory Board and help to shape the work of the local Healthwatch teams. If you are interested in supporting our work, being active in Young Healthwatch, joining our Advisory Board as a member, or staying updated on our ongoing projects, please email info@healthwatchwestminster.org.uk