Our position on the COVID-19 Inquiry
Due to start formal hearings in June 2023, the inquiry is also a chance to learn how health and care services could provide better support to people still suffering from the physical or mental health impacts of COVID-19 and lockdowns. The legal hearings will involve testimony from ‘Core Participants’ such as politicians, NHS leaders, scientists, healthcare staff and bereaved families, among others.
Listening to people’s first-hand experiences is vital for any learning and the inquiry is also planning a UK-wide listening exercise called ‘Every Story Matters’ to run in parallel with the legal inquiry hearings, to gather testimonies from the public.
We have submitted to the inquiry a summary of our national findings (see below) about people’s experiences of health and social care services during the pandemic. We have also urged the inquiry to consider the hundreds of reports published by local Healthwatch in real time as the pandemic progressed.
Our evidence
Since the start of the pandemic, we have published 10 key reports or briefings based on our national research and evidence collated from the network of 152 local Healthwatch across England.
The public has consistently praised health and care staff for their efforts during the COVID-19 pandemic, especially in light of the personal risks they faced. However, for many people, access to services health and care services has worsened, and many people felt that national and local level communications about changes were not as effective and accessible as they should have been.
Key themes
Confusion as the pandemic first hit
Many people were unable to find information about changes to routine care, experienced prescription delays and felt unsupported as shielding measures were introduced.
Problems accessing GPs
People described inadequate communication from their surgeries about changes, long phone waits and problems getting appointments for ongoing conditions.
Issues around hospital discharge
Promised follow-ups (after hastily arranged discharges) didn’t happen for most people we heard from, and pre-discharge planning or testing didn’t always occur.
Problems accessing dental care
People struggled to access urgent dental care and resorted to DIY dentistry as dental practices closed down. People then found it impossible to get NHS dental care when practices reopened.
Innovation, but not for everyone
The shift to remote phone or video appointments offered convenience for some, but not for people with serious symptoms, people who had low digital literacy or did not have access to technology (digital exclusion).
Mixed confidence on vaccination
Some people felt ethnic minority groups were being unfairly targeted over vaccine hesitancy due to cultural factors, while others called for logistical improvements like more accessible vaccination centre locations.
Left in limbo on hospital waits
People were left with little support on how to cope with pain and symptoms, and were not given information on when appointments would be rescheduled.
Long Covid
Some people said GPs didn’t know of, or dismissed Long Covid symptoms, while others said they face long waits for specialist treatments.
Our work
Our role in the initial stages of the pandemic included:
- Supporting government public health campaigns by sharing key messages via our national channels, and with the local Healthwatch network.
- Issuing guidance to local Healthwatch in March 2020 to pause some statutory activity, such as visits to health and social care premises, and adopting new engagement methods such as online focus groups.
- Sharing real-time public feedback to NHS England and the Department of Health – including concerns about blanket ‘do not attempt cardiopulmonary resuscitation’ orders on certain patients, which led to a letter from NHSE in April 2020 to the system warning against this practice.
- Rapidly producing patient-focused guidance on remote appointments, followed by an in-depth investigation into the experiences of people at greater risk of digital exclusion. This led to a letter from NHS England clarifying that all GPs should offer patients a choice of face-to-face or remote appointments.
- Conducting in-depth research among groups with lower COVID-19 vaccine take-up and feeding this into DHSC’s vaccine roll-out campaign. This contributed to a shift away from awareness campaigns involving celebrities to a focus on engagement with trusted community leaders.
- Our then chair, Sir Robert Francis, also gave evidence to the House of Commons Health and Social Care Committee’s inquiry, Delivering core NHS and care services during the pandemic and beyond, on changes to appointments, communication to patients, hospital discharge and digital exclusion.
Local Healthwatch
More than 360 reports about people’s experiences of health and social care were published by local Healthwatch in the first year of the pandemic. These and many more can be found via our National Reports Library. Other key activities of local Healthwatch during the peak of the pandemic included:
- Sharing government public health messages with communities (and in many cases, putting these into more accessible formats).
- Coordinating local volunteer efforts to get food, prescriptions and other support to vulnerable residents.
- Arranging virtual forums between the public and local clinicians and public health teams to give opportunities for discussions on issues like vaccines.
- Sharing findings with local commissioners, providers, Care Quality Commission regional teams and Healthwatch England.
What we're calling for
Our recommendations for future public health emergencies.
Public health messages: People need clear, accurate and accessible information delivered in different formats to take account of literacy, communication and disability needs.
Virtual appointments: Recognise that these don’t work for everyone due to factors like digital exclusion and give people the choice to book face-to-face appointments.
Hospital discharge: Ensure people leave safely, with medication, care packages, essentials (like food and heating) in place at home, support getting transported home at night and a named contact for further support.
Care homes: Care homes should allow at least one named person to visit residents to ensure they don’t become socially isolated.
Waiting lists: People should be offered timely, accessible information on the length of their wait for treatment and any pain relief or other support they need to manage their condition.
Vaccination: Avoid stigmatising people for refusing vaccinations and educate them instead, using trusted local clinicians to hold talks with communities and enabling people to make informed choices.
Listening to people: Gather real-time experiences from people via organisations like Healthwatch to inform any changes needed to access, information and other service delivery.
