5,707 people contributed their views to the Long Term Plan, including 884 people who completed the online survey.

Devon is developing a local version of the national NHS Long Term Plan, called Better for you, Better for Devon. The plan will make sure we are fit for the future, providing high-quality care and better health outcomes for people and their families, through every stage of life.

In Devon, we ran an eight-week period of engagement (from 11 July to 5 September 2019) to develop our own Long Term Plan, Better for You, Better for Devon. The plan will focus on improving people’s health and mental health, and supporting people to stay well.

The challenges we face

Part of the conversation centred on the big challenges we face, as these will influence the future of health and care:10

• Medical advances mean people are living longer – something we celebrate. But people now often live with multiple illnesses, such as cancer, heart problems and type 2 diabetes. We need to ensure services can provide what they need
• Preventable illnesses like type 2 diabetes are increasing, and the amount of time people live in good health has been decreasing since 2012
• Vital health and care jobs remain unfilled – 1 in 10 nurse jobs and 1 in 12 social worker posts in Devon remain vacant as demand for services increase. There is a shortage of people to undertake these roles
• There have been increases in NHS funding, but peoples’ needs for services are growing faster
• Devon’s population is growing and is expected to rise by about 33,000 people – equivalent to the population of Exmouth – over the next five years.

Building on previous work

Better for You, Better for Devon builds on work we have previously done and will focus on real changes to how we support people.

This will see us strengthening prevention to support people to live healthier lives, supporting GP and community services to intervene early to support local people, enhancing services to help children, young people and adults needing mental health support, and having high-quality, efficient hospital services in the right place when people need them.

We will work more closely with voluntary, community and social enterprise organisations, charities and the broader social care sector to improve people’s health and wellbeing.

How we involved local people

The majority of the engagement was delivered by local councils and NHS organisations, based on local priorities. This included focus groups, face-to-face discussions and surveys.

There was also county-wide engagement using 1,700 members of the public who are part of our new Citizen’s Panel, surveys of GP practice participation groups (PPGs) and phone questionnaires with patients.

The engagement was targeted to reach key groups, including; people who already use health services (patients or those with lived experience), general population, elected members, children and young people and protected groups.

• Online survey
• Printable survey

Engagement report

Following the engagement, Healthwatch Devon produced a report setting out the key findings, themes and recommendations.

Key themes

Where are services best provided?

People are attending A&E because they report it is easier to access than other services, for reasons such as availability of GP appointments and lack of understanding of alternative services. 45% of people highlighted the need to raise the awareness of alternative services, as currently attending A&E means a wait, but they will be seen and treated.

Almost 20% of people suggested the need to enhance and improve the pharmacy service, by offering better and more private consultation opportunities and building confidence in the medical knowledge as an alternative to A&E/GP.

Supporting parents around childbirth and new babies

As supported by the previous Better Births engagement, people want to see more local services available to them during and after pregnancy.

Supporting people to live healthier for longer

Responses highlighted a need for improved communication and coordination with the voluntary sector, with improved access to resources. Using community venues and holding clinics close to where people live, to enable more time for staff to engage with patients. Community members believe in local community-based services, community hospitals and community nurses.

What reduces your ability to live a healthy lifestyle?

The biggest factor affecting the ability to live a healthy life was identified as having limited time perhaps indicating a lack of a good work / life balance. Rural isolation was not seen as a barrier to a healthy lifestyle, but other factors such as lack of money / resources and limited time, which were particularly evident in Plymouth and Western.

Outpatients, follow-ups and the future of digital services

Although 50% prefer face to face hospital appointments, there is an appetite (47%) for the use of technology as an alternate to attending face to face appointments, depending on condition and level of confidence.

Promoting careers in health and social care

Poor pay was the main issue identified, along with providing easier access to training and bursaries was the third most popular response. There was a general consensus that children and young people should be engaged with, particularly through schools and colleges.

How far would you be willing to travel for non-emergency treatment

People expect non-urgent care to be available in Devon and Cornwall. If required to, 50% of people said they would be willing to travel for up an hour to access healthcare. 50% of people said that travelling for over an hour is unreasonable to access non-urgent.

Mental health and wellbeing

The positive effect of the Devon outdoor environment and the opportunities it offers has a big impact on mental health and well-being. Being part of a community, feeling the community spirit and participating in community activities is seen as hugely beneficial. Early education and awareness with children and young people is essential to help remove stigma and promote peer support.

How do you look after the health of your family?

Getting vaccinations and attending health screenings at the appropriate time were important to people. With significant numbers having given up smoking and stopped or reduced their alcohol intake.