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Report finds rural residents in Derbyshire are struggling to access healthcare

Monday, September 23rd, 2019 3:52pm

By Eddie Bisknell- Local Democracy Reporter @EddieBisk

Watchdogs in Derbyshire have found that many rural residents found gaps in services and were often isolated from accessing care due to a lack of public transport.

Healthwatch Derbyshire, the patient watchdog for the county, has also found that patients often face long waiting times for mental health services.

In a report it has compiled after surveying hundreds of patients, the watchdog also found that there were differences in care across the county.

While the watchdog did find that many patients gave testimony about how much they appreciated the services in the area, the report highlights the main areas which require improvements, as raised by patients themselves.

Loneliness and isolation were key themes, particularly in farming communities in the High Peak.

A patient said: “There have been three suicides in the Tideswell area in the last two years, there is a need for people to have a key worker or be followed-up on a regular basis.

“Loneliness in this area is very high and there is a high rate of suicide in the farming community.”

The watchdog says: “There was a real sense of loneliness and isolation in some of the comments from Amber Valley, Derbyshire Dales, High Peak, Erewash and South Derbyshire especially from older people and carers. 

“People explained their concerns around the cost and limited availability of transport and how this can create a sense of isolation.

“Likewise, many people felt it was ‘essential’ to have access to their own car to be able to access a range of services, including health appointments. 

“This seemed to be a concerning issue for people, as not everyone has access to a car and with a lack of transport it could make it more difficult for vulnerable people to attend health appointments.”

Some of those who responded to Healthwatch Derbyshire’s consultation said that they had concerns for family members being sent directly home from hospital instead of to a community hospital or rehab facility.

One respondent was a nurse from Erewash, who called for a need to improve training for health professionals visiting people in their own homes.

They said: “In my role as a nurse, I see many people that if they had been receiving better care from the home carers then they would not get so ill that they then need to come to the hospital.”

The watchdog said that: “People express concern that patients will not manage safely back at home once discharged – explaining that sometimes discharge feels premature without sufficient support in place.”

It also said: “There was a common theme within Amber Valley, South Derbyshire, Chesterfield and High Peak around difficulties in booking a GP appointment with most people waiting two or three weeks for an appointment. 

“Working people found it particularly difficult to get an appointment to fit around work commitments.”

However, the watchdog did find testimony from a patient in the Derbsyhire Dales who says that a doctor drove out to their house to see them because they could not travel to the GP surgery.

Another person gave praise to the “amazing support” they had received from their GP in reference to their late husband’s medical needs.

The watchdog says: “There was a real sense of loneliness and isolation in some of the comments from Amber Valley, Derbyshire Dales, High Peak, Erewash and South Derbyshire especially so, from older people and carers. 

“People explained their concerns around the cost and limited availability of transport and how this can create a sense of isolation.

“Likewise, many people felt it was ‘essential’ to have access to their own car to be able to access a range of services, including health appointments. 

“This seemed to be a concerning issue for people, as not everyone has access to a car and with a lack of transport it could make it more difficult for vulnerable people to attend health appointments.”

One patient highlighted issues with coordination and duplication – saying that they ended up having MRI scans in both Derby and Burton for suspected appendicitis because the doctors at each hospital could not access the notes from the other site.

Another patient raised a similar issue, with blood tests being taken at both Derby and Burton and sent to each other.

One patient said that they had experienced a six-month wait for mental health services after being discharged from both the Radbourne Unit and Trevayler House, both in Derby.

Another patient in Amber Valley said: “I was suicidal so I visited my GP practice and was offered an appointment but my GP wasn’t very sympathetic and didn’t offer any support, I said that I couldn’t cope but I was just told that I’m already having counselling and there would be no other services for me at the moment.”

One patient from the High Peak said that their mental health nurse changed every three months which they say hinders consistent care and quality communication.

Healtwatch Derbyshire said in its report regarding social care in Amber Valley: “People raised a concern around the lack of continuity with social workers, regular changes of staff and it was felt that this lack of relationship and continuity was unhelpful. 

“There seemed to be a particular issue in regards to children and young people’s social workers with five young people raising very similar issues.”

On services in the Derbyshire Dales, the report says: “Many people spoke of the services offered at St Oswald’s hospital as being a real asset to the local area and were very positive about the services offered there.”

However, respondents did comment that more regular services should be offered at the hospital to keep it viable and prevent more people from having to travel to the Derby area for care.

One patient said: “When I had my second child I had a caesarean. I wanted to breastfeed and I was having some problems. 

“When I rang the nurses they said that the only way I could get help was to go to Etwall clinic. 

“However, as I had had the operation, I could not drive and no one would come out to see me at my home. Because of this, I had to go to bottle feeding my child.” 

Another patient said: “People can be isolated and not always have friends and family locally to support them.”

Patients in the High Peak, specifically in Glossop, raised numerous issues about access to healthcare, with one saying that the town needs its own hospital.

This is due to many residents having to cross the border to Tameside in Greater Manchester or further afield to access care.

One patient said: “Glossop is treated like a second-class citizen in comparison to Tameside, there are many people that don’t have access to transport to get them to services in Tameside.”

Helen Henderson-Spoors, chief executive of Healthwatch Derbyshire, said: “At Healthwatch Derbyshire we conducted engagement work to gain insight into the experiences of people using health and social care services in Derbyshire. 

“Issues identified included long waiting times to access mental health services across the County with people often finding themselves uncertain as to how to cope and stay well in the meantime. 

“Due to the geographical spread of the county, which includes many rural areas, loneliness was also highlighted as a key issue. 

“Transport issues and a lack of awareness of available services were both key factors cited by people feeling isolated or cut off from services. 

“The full report, which can be found on the Healthwatch Derbyshire website, also highlights instances of gaps in services; particularly in the more rural parts of areas in the districts of the High Peak and Derbyshire Dales. 

“Patient feedback in the report was well received by the Place Board and will be used as part of a joined-up strategy to improve care. 

“The strategy involves commissioners, community services providers, local authorities, primary care, the voluntary and community sector, and the public working together to meet the needs of local people.”

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