Development of our integrated care strategy

In September 2022, partners across Lancashire and South Cumbria discussed the need to develop an integrated care strategy which builds upon evidence, insight and engagement which had been captured through partnership working across health and care organisations for a number of years.

From an early stage, partners recognised the importance of ongoing involvement and engagement and listening to communities throughout.

The development of the strategy took into consideration findings from:

  • Joint Strategic Needs Assessments (JSNAs) from local authorities.
  • Large amounts of data from the Lancashire and Cumbria Health Equity Commission.
  • Insight gathered from engagement with local communities by partner organisations over the last five years.

Using this data and insight the partnership proposed six draft priorities for the integrated care strategy.

In October 2022, partners worked together to ask people living in Lancashire and South Cumbria to share their views on the six proposed priorities for our integrated care strategy. Following feedback, a draft integrated care strategy for Lancashire and South Cumbria was produced.

We launched a further engagement programme in March 2023, inviting feedback for a period of three weeks on the draft integrated care strategy to find out whether the final strategy document and the priorities it identifies can be easily understood, that they make sense and are meaningful to partners and residents of Lancashire and South Cumbria.

The online survey was open for three weeks and Healthwatch Together undertook face-to-face engagement (through focus groups and pop-up events) during this period. A face-to-face and virtual readers’ panel was also arranged, to have a more in-depth discussion about the strategy document. 

The development of the strategy and oversight of the engagement programme was coordinated through an Integrated Care Strategy development group which included representatives from organisations across the partnership.

Summary of feedback

  • Make it less cluttered
  • Remove jargon and technical language and simplify sentences/language.
  • Be clear about document’s audience
  • Include contacts 
  • Include glossary at the beginning of the document
  • Add a clear diagram of different systems
  • Unsure about use of ‘wealthier’.
  • Simplified infographics
  • A short video would be helpful (possibly animation)

  • 73% of respondents said it was either ‘easy’ or ‘very easy’ to understand
  • When asked how we can make the strategy easier to understand:
    • Remove technical language/jargon
    • Larger font and accessible colours
    • Create accessible versions, including
    • Easy Read, large print, braille, alternate languages, audio version, printable version
    • Reduce word count and increased graphics and/or produce a shorter version
    • Layout – information could be more evenly distributed and graph titles easier to read (not vertical)
    • Video produced alongside the strategy or animated version
    • Diagram showing interconnection of ICS/ICP/ICB etc.
    • Include glossary at the beginning or produce as separate document to refer to alongside strategy and add further terms to glossary
    • Separate explainer documents per priority
    • Reduce repetition
  • When asked how we could make the priorities easier to understand:
    • Provide examples of how they would work in real life
    • Include the priorities earlier in the document – as this is the most important part of the document
    • Move dying well to bottom of graphic
    • Working well – consideration for those unable to work
    • Simplify the language or explain what it means
    • Consider using different titles for the priorities instead of ‘[priority] well’
    • Underpinning themes should be included before the priorities
    • Consider reducing amount of information – lots of text on one page
    • Avoid using term ‘substance misuse’
    • Some women cannot breastfeed even though they want to

Response to Healthwatch engagement

Healthwatch Together engaged with a total of 387 people, of which 297 completed an in-person questionnaire. 90 people chose to leave their feedback through 5 focus groups.

Engagement targeted people's understanding of the five ICP priority areas.

Starting well

Do you understand the priority?

  • “Appears to be predominately aiming at the care sector. Do not think this is initially clear….”
  • “What does targeted health mean?”
  • “Sentence structure and punctuation poor”
  • “No pictures”
  • “Some local stats would be nice”
  • “There is far too many words on this page- it makes me not want to read it, so I don't know how it is accessible to people”

Additional comments:

  • “Will this make it easier to access support for children e.g. CAMHS? This could be easier.”
  • “The breastfeeding priority takes away choice. I don’t like that.”
  • “If people were to access services how would this link with things like social care? This needs to be clearer.”
  • “There’s a gap for support of 16-18 year olds.”
  • “More involvement from independent services. The council always passes you from A to B.”

Living well

Do you understand the priority?

  • “Useless words but overall easy to understand”
  • “Mental health is a key priority…….I think it should have a category of its own”
  • “I am a vulnerable service user with long term health conditions, living well is a priority for me”
  • “Living well is a key priority- we need to support people with health conditions such as diabetes to live healthier lives”

Additional comments:

  • “There needs to be free school meals for all families. Some don’t get them in half term if you have two parents who work, they don’t qualify. Even though there is in work poverty.”
  • “More involvement from independent services. The council always passes you from A to B.”

Working well

Do you understand the priority?

  • “…….The idea is good it is just academic”
  • “……use punctuation to break up the sentences and make the information easier to understand”

Additional comments:

  • “I can’t see anything for children with learning difficulties. They need support too into employment/ training.”
  • “In care they promote looking after your wellbeing but don’t act on it. They will ask me to do overtime and phone me when I am off with no concern for my wellbeing.”
  • “More volunteer opportunities”

Ageing well

Do you understand the priority?

  • “Make it less wordy”

Additional comments:

  • “They don’t listen to families especially dementia. A lot get put into wards that aren’t right or appropriate.”
  • “What is classed as ageing? This needs to be more specific”
  • “A lot of people haven’t got transportation. There’s so many things to go to but they can’t get there.”
  • “Most old people want to remain in their own home. It is very difficult to get care. This is a very big issue.”

Dying well

Do you understand the priority?

  • “Priorities are clear but dying is a difficult issue to talk about and pre-plan for”
  • “….must be approached sensitively”
  • “May want to rethink dying well as a talking point”
  • “The wording needs changing”
  • “This one has fewer words and may be accessible for some people”

Additional comments:

  • “I’m not keen on the wording – maybe something like ‘dying with dignity.”
  • “Being put in end-of-life care doesn’t always mean it is imminent. There is a spectrum, and it needs to be defined better and more person centred.”
  • “They just give you a book on what to do next. It is a bit impersonal. I was handed it on the way out of intensive care when my dad died and just left with it. It was a bit inappropriate”

What happened next...

Following the engagement exercise the draft strategy was redesigned, adjustments to the terminology were made and an accompanying summary document was produced.  These were approved by the Integrated Care Partnership at its April meeting and are available to view on this website.

View the integrated Care Strategy

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