Dr Foster Intelligence
Dr Foster Holdings LLP
Better knowledge leads to better decisions
Tower Hamlets knew it had a problem as the costs of inappropriate Accident and Emergency admissions continued to rise. The local community was growing, so there was extra pressure on the PCT to solve the problem.
Each A&E attendance costs the trust between £55 to £100 per visit and with people being admitted with headaches, diarrhea, vomiting and fainting, the trust knew it could manage its resources better. Many of the symptoms were relatively minor and as such, are best treated by GPs or other health professionals.
In order to fully understand the problem, Dr Foster Intelligence's social marketing team used Experian's Mosaic Origins™ classification and Target Group Index data to map the behaviours, attitudes and backgrounds of the people with the highest levels of re-attendance.
Mosaic Origins groups people according to the part of the world their forebears most likely came from and includes name, religion and language in the analysis. The study found that the group most likely to repeatedly visit A&E for minor symptoms were bi-lingual men and women of Bangladeshi origin aged between 20 and 30 years old.
Dr Foster Intelligence's project team took the local population demographic data and asked what it meant. Focus groups gave the PCT insight into what residents thought about the local health services and why they used certain services over others.
The relatively casual appearance of GPs as compared to A&E workers, plus the tests that A&E professionals put all patients through, made some residents feel that their symptoms were taken more seriously in A&E, hence their attendance there. Also, in Bangladesh, a stomach ache could be dysentery, not just indigestion and so would need more serious medical attention than just the local GP.
Understanding the community better and knowing what was important to them and why gave the project team material for their creative work. The information campaign was tested on the focus groups, health professionals and community leaders to see if it met the local population's requirements for interesting, engaging information in an appealing format.
Solution:
The Local Heroes campaign aimed to raise awareness in the target audience of the roles GPs, pharmacists and health guides play in keeping communities healthy. Launched by local hero Baroness Uddin, the campaign focused on education and engagement with the local community.
More than 350 posters were displayed in central venues such as community centres and mosques, and leaflets were distributed by local people from the target group. Key messages were that GPs and pharmacists are experts and that many conditions don't need treatment. Communication also emphasised the importance of learning about family health in order to help them make the appropriate decision when problems arise. Two local surgeries supported the project by running direct mail campaigns to their patients.
The most high-profile aspect of the campaign was the stall in the Whitechapel market. Manned by local heroes and volunteers, the stand provided information and contacts for the local community. Many volunteers were local Bangladeshi community leaders. They distributed the materials and gave them extra gravitas. They also promoted alternatives to emergency care, including handing out leaflets with helpful hints for self-diagnosis and community treatment.
Outcome:
Between October and January of 2005/06 and October and January of 2006/07, accident and emergency attendances at the Royal London Hospital decreased by more than six per cent. At the same time, registrations and visits to GP surgeries rose.
Before the project, A&E attendances had been consistently rising in most of the local hospitals. A comparative study of the project found that attendances at two nearby hospitals continued the upward trend during the same period that Tower Hamlets reduced its attendances. The PCT continues its work to engage the local community and maintain the positive changes it saw in A&E attendance and local health knowledge.
Tool or service:
Dr Foster Limited, trading as Dr Foster Intelligence. Registered Company Number 3812015