1. Workshop C Reaching the hard to reach PiF Annual Conference Anne Joshua Associate Director Pharmacy, NHS Direct Anne.Joshua@nhsdirect.nhs.uk

2. Who are the hard to reach? Minority groups, e.g. BME, asylum seekers, European migrants, Slipping through the net, e.g. lone parent, older people, people in rural areas, carers, those who cannot read or write English Service resistant, e.g. 11-19 year olds, homeless, offenders Not all groups are hard to reach for all services and some pre-existing health or care conditions may lead to specific issues, e.g. mental health, disabilities, teenage parents

3. Factors that influence information Language Disability Culture Deprivation What is the key objective for the information ? Engagement with target audience to support development ? Cultural competence achieved through training and development of staff ? Timeliness and sustainability of the message ? Value for money/ budget constraints?

4. Multichannel, multi- service approach NHS Direct delivers a range services from its contact centres: NHS 111 services for a third of England’s population Complex health information and medicines enquiries service Dental nurse assessment service NHS 111 online service, with ‘speak to advisor’ service The Appointments Line The National Pandemic Flu Service Long-term conditions services, such as telehealth and telecare A national customer service telephone line to capture and publish patients’ feedback and reviews

5. Benefits of remote healthcare delivery Reduces pressure on high demand face-to-face health services Empowers patients to become more informed and take charge of decisions about their own health Last year: 0.7m A&E attendances/999 calls 1.5m GP consultations 0.6m other face-to-face appointments were avoided through patients using NHS Direct's phone and web core services

6. Health & Symptom Checkers

7. Demand by channel

8. Be destination agnostic Channel 4ManMOTCo-op pharmacy Can you place your tool where people already go, rather than where you want them to be?

10. Discussion 1.Who are your hard to reach group? And what is the objective for the information? 2.Effective engagement raises aspirations, quality and sustainability. What does it look like for your hard to reach group? 3.What are the barriers they face in accessing information/services? 4.What are the preferred channels of communication and primary languages spoken? 5.What level of involvement can the group have in developing the information and in dissemination? Information champions? 6. Examples of effective information ?