3.11 Involving people: Making sure IP is accessible to people from seldom-heard groups in general

People from seldom-heard groups may need additional support in order that they can access services and understand information.  It is important to consider what support can be provided to:

• deliver information prescriptions in a format that meets their needs e.g. through telephone information lines;
• explain the IP process - knowing where and whom to go to for both the prescription and the information itself; and,
• offer information in a ‘supported’ way, i.e. have someone available to talk through their particular needs and the information provided.

The pilot sites found that the following factors typically influence the choice of IP format used:

• age of the user
• reading ability and levels of ‘health literacy’
• access to the internet and email
• disabilities – hearing, visual impairment and learning
• language skills.

 

Learning from the pilots

• Consider mapping local need in respect of: access to information; user profiles; and, deprivation and exclusion.

Although the pilot sites did not use any data analysis techniques or formal needs mapping, most agreed that, with more time, more comprehensive 'mapping of local user profiles' will be essential to ensure that information is tailored properly for those with the most complex needs. Hammersmith and Fulham PCT, for example, intend to use Mosaic profiling to establish the profile of the local population and their favoured approaches to accessing information.

• Identify which of your users are likely to need more intensive support, and which are more 'self-managing'.

Recent research tells us that certain seldom-heard groups will need to be more intensively supported if they are to become active participants in their healthcare. These groups include elderly people, those from lower socioeconomic groups, those with less education and those with chronic illnesses. Such groups will benefit from help that is designed to improve their capacity for self-management, such as through improving their knowledge of health issues and building their self-confidence.

• Consider the range of mechanisms for information delivery available through the organisations in your IP partnership, and the implications of these for user access.

If your organisation relies on the internet to deliver much of your information, you are likely to reach younger people and people in higher socioeconomic groups, but probably fewer from other groups. Try to build in face-to-face, telephone, DVDs, podcasts and other methods as well, to ensure that information is communicated to everyone. Don't risk widening the health inequalities gap.

• Recognise the value of face-to-face interaction

Research continues to support the view that users prefer to receive information through a face to face engagement with a care professional, and preferably a doctor, although other mechanisms are welcome. The Picker Institute, for example, found that, when asked about their preferred sources of information, 73% mentioned their doctor.^[1]

Most sites in the pilot developed processes that enable users to receive IPs through face to face contact with professionals or appropriate intermediaries (e.g Expert Patients). This was achieved through a range of engagement activity between services and users, including, for example: standard clinical consultations, outpatient visits, tests and screening sessions, annual health checks, care planning sessions, social care assessments, drop in surgeries and health visits. While a range of mechanisms were adopted in order to maximise accessibility, face-to-face interaction with service users was central to many pilots.

 

Information brokers and advocates

Many pilot sites supported the idea of creating a new type of support worker who would work with seldom-heard groups and ensure the high uptake and use of IPs. Some have brought this role into being, either by building it into an existing worker’s responsibilities or, in some cases, creating it as a result of the IP pilot. The exact nature of the work has varied but common features include:

• Providing support, advice and advocacy to users who have complex information or access needs
• Signposting users to appropriate information sources
• Assisting users in using web-based information sites and help-lines
• Informing local managers of IP systems about any gaps in services arising from local demands and needs.

On the next page: meeting the accessibility needs of disabled users