This report, compiled by Mabadiliko CIC , a community-based research and social justice organisation, offers an in-depth cross-thematic analysis of community insight and views gathered between 2020 and 2023 for a number of health programmes across south east London. It focuses on health-related experiences and perspectives of Black African and Caribbean, South Asian, and economically disadvantaged communities based in south east London.

Key areas covered:

• Obesity: Exploring cultural factors and barriers to maintaining a healthy weight
• Mental health: Examining access to services and cultural attitudes towards mental wellbeing
• Diabetes: Investigating awareness, management, and community-specific challenges
• Heart valve disease: Assessing knowledge and treatment acceptability
• Hypertension: Evaluating prevention strategies and blood pressure management
• The Vital 5 Check: Analysing the acceptability and effectiveness of this health check initiative

The report synthesises findings from seven distinct programmes, conducted by Mabadiliko CIC to inform other health programmes, and it identifies recurring themes and unique insights across three key dimensions:

• Individual and community factors: Including health knowledge, personal beliefs, and the impact of social circles on health behaviours
• Relationships with healthcare professionals and local services: Exploring trust, communication, and experiences of care
• Impact of wider system and societal influences: Examining systemic issues, including racism in healthcare and the effects of service digitalisation

This analysis complements ongoing efforts to understand and address the diverse needs of the population. Mabadiliko CIC has included evidence-based recommendations in the report which aim to improve health service design and delivery, address racial inequalities in healthcare, and foster more inclusive and effective community engagement strategies. By amplifying seldom-heard voices, this report provides guidance for creating a more equitable and responsive health system in south east London.

You can read the cross-thematic analysis of community insights gathered by Mabadiliko CIC between 2020 and 2023 here. 

Third survey 

The third survey was carried out between November 2023 – January 2024 to understand people’s views and experiences of NHS 111 and determine how to improve patient access to care through this service. A total of 194 responses were received, representing a response rate of 18.5%. In addition to SEL People’s panel the survey was promoted to members of the public and we received 213 additional responses. The report includes combined finding and recommendations.

Key findings

The findings shows that although people generally have a good understanding of the role of the NHS 111 service, more promotion is needed around the service’s capabilities. More than 50% of respondents reported having used the service within the past year, with the majority choosing to access the service via telephone.

The primary reasons for accessing the NHS 111 service included seeking clarity on the urgency of their conditions (34%), utilising it as an alternative to the GP service during out-of-hours periods (30%), or when unable to secure a timely appointment (19%).

80% of respondents prefer telephone (rather than online) access to NHS 111 services, finding it more accessible, easier to explain their concerns, and more reassuring to speak directly with a person.

Language barriers, digital exclusion, and accessibility challenges for individuals with physical and sensory impairments, as well as socioeconomic deprivation, were identified as the most common barriers to using the service or limiting access to it.

Over 80% (326) of respondents said that they value the service, considering NHS 111 an essential resource. They expressed their desire to continue having access to the service in the future.

Next steps

The findings will support the redesign of the NHS 111 service by informing the specification, as well as performance targets that we will set for the new service. This report will inform our plans to improve patient experience of using the service and identify ways to overcome barriers that people are facing when using the service. We will continue to collect feedback on our proposals and adapt to respond to the needs of our people and communities in south east London.

Read and download the full report here.  You can read a summary of the findings here.

Second survey 

The second South East London People’s Panel survey took place for two weeks in September and October 2023 with a response rate of 23% from a sample of 1050. We wanted to understand how people are getting health and care help, advice and information when they need it.

Key findings

83% of respondents said they feel healthy and 82% feel happy with 79% feeling in control of their lives.  However, 29% report feeling lonely.

When in need of help and / or advice when unwell, the most common action was self-care and using one’s own medicine cabinet (41%), followed by local pharmacy (34%) and using the internet (34%).  Over two thirds (68%) of respondents had never used NHS 111 on line with 10% of respondents not knowing that this was an option.

Survey responses show that people are generally confident in knowing where to go for different medical conditions and symptoms, based on the urgency and severity of the condition. There are a range of different factors which influence this decision with the risk and severity of symptoms being an important factor (for 56% of people), positive/negative personal experience, ease of access, the need for reassurance – professional advice for children, barriers of accessing other services (e.g. GP, NHS 111).

Respondents reported that their preferred ways of receiving/finding information are from the NHS website (43%), text message (39%), a leaflet through the letter box (21%), poster leaflet at NHS services (20%).  They also reported that their preferred places to get information about health and care are from local pharmacies (80%) as well as other places in the community such as local libraries (50%), supermarkets (43%).

Next steps

This insight will inform our year-round campaign to help people navigate the NHS. This will be centred around the needs of the public and the benefit to the individual when using different services.

Read and download the full report here.   You can read a summary of the findings here.

First survey

The first South East London People’s Panel survey took place January – August 2023 with a representative sample of 1083 residents across all six boroughs.  Participants were asked what is important to them and their families and what actions they need to take to keep themselves healthy and well.

Key findings

Over 75% of panel members said that they feel health, happy and in control of their life. However, over 31% reported that they are currently feeling lonely and 36%, of young people between 16-24 years reported feelings of loneliness.

Financial stability, better access to healthcare, improved mental health services, improved local housing situation and friends/family/community support are cited as the areas of support most needed by south east London residents to live a happier and healthier life. Healthier personal finances were identified as top of the list of all measures and changes that panellists feel would be most effective in keeping themselves healthy and well.

51% of panellists reported that they would find it difficult to make the changes they feel are necessary to keep themselves healthy and well. People feel that the following issues are much less within their control: financial stability, access to healthcare, the local housing situation and, to a degree, their employment situations.

The complete report with the combined results from both periods of recruitment to the South East London People’s Panel (January – August 2023) can be read here.

You can read a summary of the findings here.

Insight from engaged members of the public

We ran the same survey with other members of the public in south east London during March and April 2023 to provide further insight.

Over half of the respondents highlighted NHS healthcare as important to them and at the forefront of their mind. Access to primary care, cost of living and environment were also highlighted as important issues.

Although 72% respondents said that they would find it difficult to make changes happen for themselves, participants have identified a number of measures that can help them to improve health and wellbeing: accessing healthcare including group support for people with similar conditions, mindset behaviour change such as being positive, being more confident and happier, having better motivation and more willpower.

Full report presenting the results for south east Londoners who have responded and told us about things that matters to them right now can be read and downloaded here. 

Next steps

These insights along with feedback from other engagement activities (focus groups, listening sessions, outreach, etc.) will help inform the work we are doing as part of the Anchor programme in partnership with Citizens UK to understand what actions different institutions such as: NHS, local councils, universities, etc. can take to support people and communities to thrive.

Read more about Anchor Programme Listening Campaign and next steps.

The six local Healthwatch organisations (SELHW) in south east London function as independent advocates for public and patient voices within health and care services. SELHW focus on reducing inequalities, tackling health challenges and aiding in service transformation across various sectors, including general practice, hospitals, dental care, pharmacies, optometry, ophthalmology and home-based services.

Healthwatch gathers insights on health inequalities by direct contact with patients and carers from various communities to collect their experiences through focused engagement on services and pathways, through a range of methods including ‘Enter and View’ exercises within services, individual feedback, running focus groups and workshops and surveys. They share these with the NHS, local authorities and other ICS partners to shape and enhance the care provided and inform service development. Healthwatch are sometimes commissioned by specific programmes to gain the views and experiences of particular communities. They have also produced reports for the CQC (Trans Health) and Local Maternity and Neonatal Service (LMNS)(Maternity).

The South East London Healthwatch Insights Reports page is in three  sections: quarterly SEL reports offering aggregated insights from recent Healthwatch publications, focused reports on specific communities facing significant health inequalities such as LGBTQ+ people or the Latin American community or services spanning multiple boroughs e.g. maternity services; or ophthalmology and combined annual reports detailing each year’s activities and impact.

Recurring themes during 2023 were accessibility, communication between services and patients and carers; communication across providers and between services; lack of person-centred interactions during episodes of care; issues of trust and bias; and patient disempowerment. The main health service areas from which insight was gathered from were general practice, dentistry, maternity services, continuing healthcare and community pharmacies.

You can read the reports from SEL Healthwatch here.

A key area of work during 2022 was to work and engage with people and communities to inform the development of the ICS strategic priorities.  This work also involved gaining insight  from voluntary and community sector organisations working with marginalised communities.  Themes raised include  trust and cultural awareness, access issues, mental health and wellbeing, maternity and early years, children and young people, living with long term conditions and complex needs, wider societal issues, partnership working and coproduction with local people.

You can read the report of insight from April – December 2022 here.

We commissioned community engagement as part of our development of  the working with people and communities strategic framework.  This work also informed the ICS strategy development process.

Themes raised included access to services and that face to face appointments are key to enabling access to services and support for people whose first language is not English, which is also important for establishing relationships and building trust. We also heard we need to develop more trauma-informed support and treatment for local people.

You can read the Act for Change report about the views of young people from Afro-Caribbean communities in Bexley and Greenwich here.

You can read the Creating Ground report about the views of migrant women in Greenwich and Lewisham here.

You can read the East African Association report about views from Somali women from Lambeth, Southwark and Greenwich here.

You can read the Lambeth Links report about views from the LGBTQ+ community here.

You can read the Panjshir Aid report about views form the Afghani community in Southwark here.

You can read the South East Islamic and Cultural Centre report from the Bengali community in Greenwich here.

The Joint Programme for Patient, Carer and Public Involvement in Covid Recovery is a partnership between Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust. The programme was funded over two years, by the trusts’ charities to ensure the involvement of patients, carers, and the public in the changes and development of services necessitated by the Covid pandemic.

Year 1: 2020-21

Working with Ipsos MORI, a telephone survey of 1,500 people explored patient, carer and public attitudes and behaviours to accessing care and services during the Covid pandemic.

Insights included:

• Experiences of using hospital services face-to-face during the pandemic were largely positive – the majority said they felt comfortable using these services. But parents and carers, responding on behalf of a child or adult, were less positive.
• Views on restrictions on visitors and carers or family members accompanying patients to appointments were very divided.

For more insights, visit Ipsos MORI’s website.

Year 2: 2021-22

Working with London South Bank University, the programme brought together 180 patients, carers and healthcare professionals to focus on three topics. Through a series of workshops, people shared knowledge and insights, co-developed tools and tested potential solutions and improvements.

Examples of insights, including access to multimedia reports and tools and further information on each theme please click on the project heading links below.

Virtual access to care

• Virtual means visual. Patients need choice about having cameras switched on or off for online appointments.
• Apply more of current best practice guidance about virtual appointments.

Waiting for treatment and self-management

• A ‘safe waiting care plan’ for patients could include information about what is coming next, what to look out for and who to contact when things change.
• ‘Care navigators’ could guide people whilst they wait and advocate on their behalf.

Long Covid

• The range of symptoms people experience is vast and complicated. Services need to recognise the whole person and their individual needs.
• More information and education are needed for healthcare professionals, employers, family members and friends – about what Long COVID is and how to help

Next steps

Work is underway to ensure that the projects’ recommendations influence and drive changes that can improve patients’ care and experiences across south east London and beyond.

For more information about the Joint Programme, please get in touch with: Philippa Yeeles

The report includes key themes collated in November 2021 of insight gained during the pandemic.   Themes raised include  trust and cultural awareness, access issues, mental health and wellbeing, maternity and early years, children and young people, living with long term conditions and complex needs, wider societal issues, partnership working and coproduction with local people.

You can read the analysis of insight gained during the pandemic and collated in November 2021 here.

South London Listens programme is a collaboration of the three south London mental health trusts, south London local authorities and over 150 community organisations working to prevent a mental health crisis as a result of Covid-19 and support community recovery. With a strategic partner Citizens UK, the programme listened to over 6,000 people to develop four key priorities and a range of co-created solutions.

You can read more on the priorities and actions being taken forward in the South London Listens Action Plan and key themes that were identified by local people below.

Social Isolation, loneliness, and digital exclusion

Social isolation was the highest ranked theme in our listening campaign, with a third of responses citing the negative impact it has had on their mental health. Many respondents to our survey experienced feelings of powerlessness (81%), isolation (78%) and loneliness (76%) since the start of the pandemic. These feelings were particularly prominent among respondents aged 18-34, with more than 90 percent experiencing some degree of loneliness, isolation and powerlessness.

This echoes national trends showing that the mental health toll of missed contact with family, friends and colleagues. The pandemic has exacerbated existing feelings of loneliness and isolation especially for parents, carers, older people and those who have been bereaved.

This is important because social isolation and loneliness are often linked to mental health problems including depression, anxiety, and low self-esteem. They can also be barriers to accessing care.

The impact on well-being from people at risk of loneliness is likely to be compounded by other economic and social impacts experienced by the same people, such as those experiencing job losses and health anxieties.

Work and Wages

Work and mental health are inextricably linked. Work is good for our mental health, but being unemployed, or in a challenging work environment, can have a significant negative impact on our well-being. Likewise, being on low or insecure wages causes stress and anxiety that can undermine our mental health.

Since the Covid-19 pandemic began, the proportion of adults in Great Britain who found it difficult or very difficult to pay usual household bills doubled from 5% to 11%.

These developments exacerbate significant challenges in London, where poverty is already higher than in any other region or country in the UK. Through the community listening campaign, we heard about the huge impact on work and wages because of the pandemic. We heard from people in minimum wage jobs of how their hours had been cut leaving them unable to provide for their families.

Our survey found that one-in-three people have been affected by job insecurity (38%) and a similar proportion are struggling to pay the bills (34%). As well as financial insecurity, income loss, and unemployment we also heard about the stress and anxiety caused by increased workloads and trying to manage a work/life balance in new working environments

Children, young people and parental mental health

The pandemic put immense pressure on the mental health of children, young people, parents and caregivers. Rates of mental ill-health, which were already increasing in young people, have been exacerbated as children and young people have struggled with missed education, fear and anxiety.

From our listening, we heard caregivers expressing feelings of guilt and grappling with the stigma of ‘not coping’. Many parents wanted mental health support but did not know where to get it. Around a third of parents in our survey were not confident that they are able to cope and were experiencing symptoms of depression and anxiety.

Access to mental health services for migrant, refugee and diaspora communities

For many people in south London, Covid-19 has brought on new mental health challenges – or made existing challenges worse.

This increased need is particularly felt by those who already experience disadvantage in our society, particularly people from Black, African, Caribbean and mixed heritage communities, and migrants, refugees, and diaspora groups.

Our survey found that 48% of people do not know where to go for support. This rises to 54% for Black, African, and Caribbean community members, of whom 39% face a lack of mental health services. Community leaders from migrant, refugee and diaspora communities highlight specific issues blocking access including language and cultural barriers, lack of trust in the NHS, complicated forms, not understanding the system and fear of personal data being shared beyond the service.

You can read about progress and impacts from the first year of the work, including the findings of the South London Listens digital survey here.

More information on our evaluation approach and outputs is included here.