It’s often said that information is power. But it is with the custodians of information that power ultimately resides. Nowhere is this more true than in the health and social care sectors, where providing service users with the right information is becoming increasingly important in enabling them to make decisions about the shape of the care they receive. This process could range from simply passing on contact details for a local support charity to explaining complex service eligibility criteria in an easy-to-understand manner.
With so much information now available in one form or another, NHS and council employees need to be adept in providing people – many of whom will be vulnerable – with the right information when and how they need it. But research carried out recently by the Picker Institute, an independent charity working on behalf of patients, suggests that many are struggling to do this.
Using “mystery shoppers” to test pathways to information in the health, social care and voluntary sectors, the charity found professionals failed to systematically provide their clients with information about accessing local services. They also reported a lack of effective signposting to where information was held, and insufficient co-ordination between information providers across geographical, sectoral and organisational boundaries.
However, most worryingly, researchers said many health and social care staff failed to anticipate service users’ information needs, reflecting a fundamental flaw in the way enquiries were handled.
“Information about services was not offered proactively as a matter of routine. Instead, it had to be extracted by asking the right questions of the right people at the right time. You have to know what services might be available in order to know what questions to ask. But this is beyond the ken of many service users,” researchers said.
As part of the “mystery shopping” exercise, service users were asked to telephone council departments and NHS organisations requesting simple information about services available in a certain area (see ‘Mystery Shopper’ Case Studies). The service users were then interviewed by researchers to identify the barriers to getting the information they encountered.
Complaints included organisations failing to respond to messages, failing to keep promises to return calls, and giving out incorrect contact details.
The report makes several suggestions for improvements. These include:
● The creation of information co-ordinators or “brokers” who understand the service user’s perspective and are tasked with streamlining procedures to access information across agencies.
● A greater recognition by organisations and their staff of the importance of information.
● An organisation or person to act as a central contact point for information.
● Better training for staff to enable them to better understand users’ information needs.
● Improved promotion of services provided by voluntary groups.
Perhaps one of the reasons for these failings is that there is little research or guidance on what good practice in this area looks like. While giving information seems to be accepted as something that health and social care organisations do, it is not necessarily seen as part of their core function.
But all this could be about to change. With an increased emphasis on the quality of information – the Commission for Social Care Inspection plans to carry out research of its own in this area later in the year – imparting information is likely to become a key part of organisations’ and professionals’ remit.
‘Mystery Shopper Case Studies’ (back to top)
CLIVE ARUP – Multiple sclerosis sufferer
‘I didn’t know whether the voicemail message was just going into the ether’
Clive Arup was “shopping” for information about services available for people with multiple sclerosis in Southport before deciding whether it would be suitable to move to the area:
“I called twice, and both times was directed by receptionists towards the MS nurses for the area. They are the conduit by which people get into the system, and provide a degree of continuity. They were well-informed, and gave me much of the information I would have needed.
“I was given information about drug trials that were either happening or were in the pipeline, and the contact details for the hospitals running them. The next thing that would have happened would have been to make direct contact with neurology departments. The services were pretty comparable to what’s offered in my own area of Oxford.
“One criticism I have of the system is about the voicemail for the MS nurses. One was on holiday and I didn’t get a call back for a week. I left a message several times, but I didn’t know whether it was going into the ether or whether it was being checked. A more thorough message would be better rather than one simply saying ‘I’m out of the office’.
“Another criticism is that nobody asked me if I knew about therapy centres. In Oxford, I’m a chairman of a therapy centre and am reasonably well informed about the system. In our area we have an arrangement with MS nurses where they come to the centre and see a number of people at one go. They can check a person’s bladder control. But when I phoned Southport, I had to enquire at the end of conversations about the centres. Even then, they didn’t have contact details for them. I would have expected the nurses to have that information to hand.
“The nurses also failed to mention the MS Society, which in many areas is very active and organises physiotherapy days.”
ANNE SPENCER – Parent of two autistic children
‘It’s a maze trying to find information that is almost certainly there ‘
Anne Spencer was “shopping” for information about what activities were available for her autistic children during school holidays in West Cornwall before deciding whether to move to the area:
“I wanted to assess how difficult it would be to get the information. I spoke to Cornwall’s social services and the education departments, the primary care trust and a family support centre.
“The receptionists who originally dealt with my enquiries were polite. But they tended to pass me on quickly to someone in the department who was more prepared to tease out what I wanted.
“However, when I got through to the departments I was disappointed with the information – or lack of it. I found out little about services, and got the impression they didn’t understand what I was asking for. I never got anything I could use there was nothing substantial given.
“Several times I had to leave a message on voicemail, but didn’t get calls back. It makes you wonder whether it’s the right person. I was also directed towards particular services that weren’t always appropriate, so ended up being bounced back and forth between different departments. At one point I felt I was going round in circles.
“It made me think this was a big organisation that wasn’t good at joining up its different parts.
“It’s a maze trying to find information that is almost certainly there. If there was a point of contact that could send you to the right places, it would save a lot of time and frustration. Parents have limited time and energy.”
● Citizens Advice Bureau
A link on CAB’s homepage takes you to a separate website offering advice on a range of issues that would be of interest to health and social care clients. Detailed advice is presented under four headings – money, family, daily life and rights – with information about specific problems included in each. Links to frequently asked questions and downloadable fact sheets are prominent on the site, as is an alternative language facility.
This easy-to-navigate and simply presented website offers carers information on the types of benefits potentially available to them, a practical 10-step guide on what to do when you first become a carer, and what type of support and respite care is available. There is also information on how to balance work and caring commitments and a search facility to help identify what services and organisations operate in different parts of the country.
Advice on claiming benefits is given real prominence on this site. It takes you to a section outlining benefits available to older people, including a downloadable guide on these. It also provides information on how Age Concern can help people claim benefits, gives links to local support groups, and explains why older people should make claims. Its national telephone advice line is promoted on most of the pages on the site.
Accessing Information about Health and Social Care Services
This article appeared in the 14 June issue under the headline “Someone might get back to you”