National Care Service: Health and Social Care Standards - Co-design Partnership Programme report

What we learned

The Health and Social Care Standards are valued and seen as a helpful tool.

People said they thought the standards were useful. Some said that, with improvements and better implementation, they had potential to improve people’s experiences of health and social care services.

Other things people told us:

• people told us the standards help them understand what good care looks like and what they should expect from services
• some people had used the standards as a practical tool to support conversations, raise concerns, and understand their rights
• the standards being written in the first person and aligned with other national frameworks was positive as it reinforced consistent values

Here are some specific things people said during our discussions:

• GDA members told us they supported the spirit of the standards and their ‘rights-based’ principles
• GDA members told us that the standards are a useful instrument at every stage of people’s engagement with their health and social care services
• people at the MECOPP session said they agreed with the standards Principles, with much of the discussion focusing on the need to ensure that these work in practice

How we will use this

This will help inform the continued review of the standards by keeping elements that people value and find meaningful. It will also support more consistency in how the standards are used. It will help make sure the standards remain accessible and practical for people and organisations to use.

People felt that the implementation of the Health and Social Care Standards is inconsistent and that this limits their impact.

People agreed that the standards on their own are not enough to improve experiences of care. People described an implementation gap between what the standards set out and what actually happens in practice.

Other points raised in this discussion included:

• people felt there were other barriers to practical use of the standards, such as staffing pressures and inflexible service delivery which reduces choice and control
• people shared that the standards did not always reflect their experience of accessing health and social care support
• people described differences in how consistently the standards are used across health, social care and social work settings
• people said it would be helpful to raise awareness of the standards to help people to use them to advocate for better support

Here are some specific things people said during our discussions:

• someone at the Carr Gomm session said they generally viewed the standards positively. However, they felt that lived experience does not always match the Standards’ intentions
• GDA members were clear that there needed to be stronger mechanisms to implement the Standards

How we will use this

These findings will inform a stronger focus on how the standards are used in practice. They will also inform any changes to the standards themselves. The findings will support work to identify practical actions, guidance and tools needed to address barriers to using the standards. They will also inform approaches to improving awareness and helping people use the standards to advocate for better care and support.

People felt the Health and Social Care Standards reflect human rights, but that this could be made more explicit.

People felt that the standards can be a useful way to help them understand their rights. However, some people said that the connection between the standards and rights could be made clearer to better support people to advocate for themselves.

Other points around this included:

• people felt the standards could more clearly explain how they can be used to support and assert people’s rights
• people being supported to make decisions and live independently were highlighted as important areas people felt could be improved
• people shared experiences of limitations in accessing some of the rights described in the standards
• the importance of recognising cultural sensitivities when applying principles such as dignity and respect was highlighted.

Here are some specific things people said during our discussions:

• one person said, “I know my rights under the Human Rights Act, but these are not being upheld by many health and social care services.”
• someone said, “Compassion would ideally be showed throughout the process. It means looking at everyone individually, rather than making general decisions.”

How we will use this

We will use this information to build a stronger connection between the standards and people’s rights, including how people can use the standards. We will also use this information to think about any extra tools and guidance that could support this with the reviewed set of standards.

People found the some of the language and accessibility of the Health and Social Care Standards difficult to navigate.

People told us that the language, structure and number of standard statements can be confusing and overwhelming. There was a strong sense that clearer, more accessible language would help people better understand the standards and what they mean for their own care and support.

Other points raised in this discussion:

• people felt the number of standards and frameworks across health and social care support to be confusing
• some people found the number of standard statements in the standards to be overwhelming and suggested the standards could be streamlined
• people said they felt that the standards could be written in a clearer way – for example, wording such as ‘responsive care and support’ was too complicated
• people liked the idea of the standards being available in different and more accessible formats including translations and clearer guidance for staff

Here are some specific things people said during our discussions:

• “It’s crucial that I have information available to me about the support that is available to me.”
• GDA members told us that it is important that the outcome of the review must include actions to better share accessible, inclusive information on the standards
• GDA members noted the lack of support to understand what the standards mean and how they apply to people’s everyday health and social care supports and services

How we will use this

This finding will inform work to improve the accessibility and clarity of the standards. It will support us in our thinking of how we structure the reviewed set of standards. It will also help us develop clearer guidance and alternative formats to help people understand the standards and what they mean for them.

People thought there was low awareness of the Health and Social Care Standards.

People told us they felt awareness of the standards was limited among people who use health and social care support services as well as those who work in them. People shared that the crowded landscape of guidance makes it difficult to understand what the standards are, how they relate to care and support, and how they could be used if something goes wrong.

Other points raised in this discussion included:

• people were unclear about how they would use the standards if they had a concern about their care and support
• participants felt staff do not consistently reference the standards in person-centred planning or review conversations
• people suggested sharing information on the standards through community settings, local organisations and trusted sources
• people supported digital access to information, while recognising this should not be the only option
• at one session, all but one of the participants said they had never heard of the standards

This is a specific suggestion we heard during our sessions:

• that sharing information about the standards in community-based settings would help spread awareness. Participants suggested community centres, places of worship, shopping centres and libraries

How we will use this

This finding will inform work to improve awareness and understanding of the standards among people who use services and staff. This will also help us as we think about how we share information about the reviewed standards.