Your reflections from the accessible information research project
The first phase involved undertaking an initial research project with six local Healthwatch who interviewed people from ethnic minority communities with either limited or no English about their experience accessing health and care services.
Local Healthwatch shared their reflections from the project, including their experience working closely with us on a national campaign and engaging with diverse, hard-to-reach communities.
Background to the project
We funded six local Healthwatch to interview people from ethnic minority communities with limited or no English.
The six local Healthwatch were:
- Healthwatch Camden
- Healthwatch Croydon
- Healthwatch Hackney
- Healthwatch Liverpool
- Healthwatch Norfolk
- Healthwatch Reading
Local Healthwatch engaged 109 people from diverse ethnic minority communities, including people who identify as Arab, Bangladeshi, Chinese, Polish, Ukrainian, Somalian and Honduran.
Additionally, 38 staff members working in different healthcare settings took part in the research to share their experiences.
Find out more about the findings from the research project.
What worked well?
Local Healthwatch reflected that a key strategy was to work with local organisations with existing contacts in hard-to-reach communities.
The project created a need to build strong relationships with new organisations. These relationships were cemented as local Healthwatch worked closely with local organisations.
Local Healthwatch reflected that a powerful aspect of the project was that local organisations felt they were part of a national campaign. As a result, organisations were motivated to maintain good communication with local Healthwatch. In turn, this expanded the reach of Healthwatch to new and broader audiences.
Monetary incentives were helpful and, at times, were used to pay for administration for other organisations. Local Healthwatch felt it worked well to be given the authority to use funding as they thought necessary to establish community contacts.
Local Healthwatch also felt that this project helped them become more aware of existing communities in their local area and their challenges. We heard how Healthwatch was the 'talk of the town' amongst some local communities who recognised that Healthwatch allowed them to amplify their voices at a national level. This project helped to establish a trusting connection with this community.
Outcomes from taking part in the AIS primary research project
- Healthwatch Hackney is working with their local council, which currently has no policy around interpretation, and there is no consistency with using interpretation services. Healthwatch Hackney feels its findings will be helpful in this context.
- Healthwatch Liverpool reported that Liverpool Trusts had been spurred to review Accessible Information Standard (AIS) policies. They also felt the issue is much more on the radar now locally.
What didn't work so well?
It was challenging to find professional interpreters. Local Healthwatch had to work with multiple agencies, experienced cancellations and lost money when interpreters did not show up. The cost of professional agencies is high and would not be feasible within the budget if Healthwatch had required professional agencies for all participants.
Finding interpreters for specific languages, such as Ukrainian and Tamil, was also challenging which could be more costly. Community contacts were vital here, as they were willing to provide interpretation at a low cost or even for free.
Local Healthwatch would have liked to have recruited a more representative sample and found it easier to speak to people women from specific communities.
Key learnings for Healthwatch England
Local Healthwatch provided feedback to us, praising the materials, guidance and support they received. Key learning
· Enjoyable experience. Working with other local Healthwatch was an enjoyable part of the project experience, and regular meetings to share experiences during the research process were helpful.
· Support could have been better. There were some limitations to the methodology, such as that interview questions were lengthy and complex. This was further complicated by low literacy or health literacy levels amongst interpreters.
· Holding focus groups was challenging. Focus groups were a challenging aspect of the research, mainly due to the role of interpreters. Local Healthwatch felt that participants did not necessarily understand the purpose of a focus group. These challenges were further complicated as focus groups had to take place online.
· Better planning. Local Healthwatch thought that there could have been better consideration of timelines. Taking on the accessible information campaign had a knock-on effect on other projects and priorities. The relationship between Healthwatch England and local Healthwatch should be followed up right to publication.
· Outputs at a local level. It would have been helpful for local Healthwatch to have a toolkit helping them to think through how to utilise findings at a local level. Discussions between local Healthwatch could have carried on beyond the research to consider how to produce something useful at a local level.
Reflections from Healthwatch England
We were impressed by the strength of the community contacts and the ability of local Healthwatch to recruit such a diverse sample in a short timeframe.
In future projects, we will aim to improve the support provided to local Healthwatch to deliver successful projects, including greater consideration of the following:
- Provide more one-to-one support and training. For example, more thorough testing of questions and role-play activities with Local Healthwatch to establish greater confidence in qualitative interviewing techniques and familiarity with materials.
- Provide greater support around unique project challenges. For example, how to deal with the additional challenges of working with interpreters.
- Better time management of the project and ensuring local Healthwatch have enough time to prepare with minimal impact on existing projects and priorities.
- Better support for local Healthwatch around how to share data with us to minimise the risk of sharing personal data and ensure data is cleaned and in a usable format.
- Provide more guidance around how to develop and utilise findings at a local level.