Key findings

The Charter in the context of Community Healthcare: It was clear to most that the Charter applies to Community Healthcare. However some improvements were suggested, for example, in how Community Healthcare is defined in the Charter and what roles are included; explaining who the Charter is for; and how participants understand the different aspects of health and social care. Participants also wanted more specific information, such as around condition-specific challenges, charitable organisations, and the roles of carers and guardians.

Service user rights: The majority of the participants were happy with the section around users’ rights, saying it is clear, easy to read and inclusive, covering what they would expect to see. Many discussed areas for improvement, however, such as having an exhaustive list of rights in one place, making the language clearer and easier to understand, and expecting to see what happens when user rights are not respected. Further rights that participants would like to see added were also discussed, for example around person-centredness, accessible formats and resources, and being able to access further and specialised support and care.

Service user responsibilities: Participants identified a range of responsibilities on users of care services. Some said they would like this to be expanded on in the Charter to ensure these are clear and don’t assume prior or implicit knowledge.

Further information needs: Many said they would like further information included in the Charter, for example around the NCS, what it is, and how to access support through it, information about advocacy, and inclusive communication. Participants also highlighted that the implementation of the Charter must be accompanied by improved communication, including between staff and services to support the discussed rights and responsibilities, as well as a more person-centred and joined-up approach to care, with improved relationships.

Charter aims: The majority of the participants agreed that the Charter meets its aims. Some participants said it was good to know that the Charter defends users’ rights and the value of feedback and complaints. However, some would like the Charter aims to be referenced earlier in the document and with more detail and easier to access language.

Relevance and use of the Charter for participants: Most participants agreed that the Charter applies to their experience of Community Healthcare. Some participants thought the Charter was not relevant to them personally or their experiences, but recognised that it would be for others. Most participants said they would use the Charter if they had issues with the care they, or people they support, were receiving, or if they wished to make a complaint. Participants discussed the Charter as a good resource to rely on and a useful reference, but some thought that the Charter wouldn’t impact on their daily life. It was clear that most participants didn’t think they would use the Charter unless they had issues with their care.

The ‘Charter landscape’: Most participants were not aware of the Health and Social Care Standards nor the NHS Charter of Patient Rights and Responsibilities. For the few that were aware of these, this was due to activities related to work or volunteering. Most participants said that these are good resources to have and that they would use these if they had issues with their care, or needed to make a complaint or advocate for themselves or others. However, participants highlighted that, while these are good to have, low public awareness limits their benefit. Some participants were unsure how these resources will work alongside the NCS Charter. Participants also discussed the need for further clarity around the remit of these resources, to make it easier for people to know which one to use.

Priorities and key areas for improvement around the NCS Charter of Rights and Responsibilities: Key priorities and areas for improvement focused on supporting access, inclusion, and equality aspects, and highlighted the importance of the Charter leading to improvement of health and care in practice, and to improved understanding and engagement in health and care.

Recommendations

Based on what people told us, we made 6 recommendations including specific aspects that should be considered by the Scottish Government in the development of the NCS, and the NCS Charter specifically, working where appropriate with partner organisations, such as NHS Scotland, COSLA and others.

Recommendation 1

Consider implementing changes in the content, language, and structure of the NCS Charter based on these findings to increase clarity and understanding, and address information needs.

Recommendation 2

Ensure the NCS Charter helps users find the specialised information they need through appropriate signposting.

Recommendation 3

Work towards increased clarity within the ‘Charter landscape’.

Recommendation 4

Ensure the appropriate implementation of the NCS Charter and that it is supported by relevant processes as needed.

Recommendation 5

Ensure the impact and use of the NCS Charter is monitored, evaluated, and communicated to the public.

Recommendation 6

Work towards increasing awareness and understanding of the NCS Charter, among public and staff.