Engagement Report: Help Shape the Future of NHS Services in Essex

1. Introduction

This Essex NHS engagement report presents a comprehensive analysis of feedback gathered through the Help shape the future of NHS services in Essex survey, conducted between 3 June 2026 and 30 June 2026.

The survey forms part of NHS Essex’s ongoing commitment to working with people and communities to inform service improvement, reduce inequalities, and ensure that services reflect the needs and experiences of local populations.

A total of 2,200 survey responses were received with the majority responding via the digital engagement platform but some respondents preferring to respond via a print version. The results provide a solid evidence base drawn from individuals with recent and often frequent interactions with health and care services. The responses include both quantitative ratings and qualitative commentary, offering insight not only into how services are experienced, but also why those experiences occur and how they might be improved.

This report seeks to move beyond simple reporting by identifying patterns, drawing out key themes, and translating feedback into actionable insight for service design, planning, and communications.

2. Executive Summary

The findings show that public experience of NHS services in Essex is best described as functioning but under pressure. While many respondents report receiving good quality care once they access services, significant challenges remain around access, timeliness, and how joined up services are.

Overall ratings are concentrated in the middle range, with the largest proportion of respondents (36.4%) describing their experience as “fair”. A further 27.7% report a “good” experience, while nearly one-third (29.5%) describe their experience as poor or very poor. Only a small minority (6.4%) report a very good experience. This distribution indicates a system that is delivering care, but without consistency or excellence from a user perspective.

The strongest and most consistent theme across both quantitative and qualitative responses is difficulty accessing services, particularly within primary care.

Challenges in obtaining GP appointments are frequently described and appear to influence wider perceptions of the NHS.

Waiting times for hospital treatment, community services, and mental health support also feature prominently, reinforcing the perception of a system under significant pressure.

Respondents also highlighted practical barriers such as transport difficulties, travel distances and access to services closer to home, particularly in some rural and coastal communities.

Where respondents commented on their interactions with staff, feedback was often positive, reflecting appreciation for professionalism, compassion and dedication. This suggests that many concerns relate to system pressures, capacity constraints and access issues rather than the care provided by individual staff.

Despite these challenges, respondents consistently express confidence in NHS staff. Comments frequently reflect appreciation for professionalism, compassion, and dedication, suggesting that dissatisfaction is primarily driven by system and capacity issues rather than quality of clinical care.

The findings highlight a clear opportunity for NHS Essex to improve not only service access, but also public understanding of how the system works, what services are available, and how people can navigate care more effectively.

3. Demographics of respondents

A total of 2,200 respondents completed the survey. The dataset includes several demographic and equality-related questions, providing a clear picture of who engaged and helping to assess how representative the responses are across different communities.

Overall, the data shows strong engagement from a broad cross-section of residents across Essex, including people with a range of ages, backgrounds, and lived experiences of health and care services. The survey also includes responses from people who regularly use health and care services, carers, healthcare staff and residents living with long term conditions, providing valuable insight from those with direct experience of the system.

When considered alongside wider population data from the 2021 census, the survey sample demonstrates a reasonable level of alignment with the demographics of Essex, particularly in relation to ethnicity and sexual orientation.

Across Essex, 88.3% of the population identifies as White British, and the survey responses show a similarly high proportion of respondents (86%) identifying within White ethnic groups, with the majority identifying specifically as White British. While there is some underrepresentation of other ethnic groups, the overall pattern broadly reflects the demographic profile of the local population.

In terms of sexual orientation, 2.5% of residents aged 16 and over in Essex identify as lesbian, gay, bisexual or other minority sexualities (LGBTQ+).  The survey includes responses from individuals identifying as gay, lesbian, bisexual and other orientations, indicating that LGBTQ+ voices are present within the dataset. While proportions may vary, this inclusion supports the view that the survey has captured a range of perspectives in line with population-level trends.

Overall, the survey includes responses from a wide range of people across Essex and reflects some of the main characteristics of the local population. However, as with most voluntary surveys, some groups may be overrepresented or underrepresented. This should be considered when looking at the findings.

It remains important to continue strengthening engagement with underrepresented communities and to keep track of who takes part in future surveys to help ensure all voices are reflected in future insight and service design work.

See appendix one for a breakdown of the demographic data of respondents.

4. Overall experience of services

Respondents were asked to rate their overall experience of health and care services in Essex on a five-point scale from “very poor” to “very good.” The results show a clear clustering around “fair” and “good”, with fewer responses at extreme.

The high proportion of “fair” responses suggests that many people view their experience as acceptable but not meeting expectations. This middle-ground response is particularly significant, as it indicates a system that is not failing outright but is also not delivering consistently high-quality experiences. Comments from respondents support this finding. Many people said they received good care once they accessed services, but experienced problems with appointments, waiting times, communication and finding the right service.

Importantly, one in three respondents report a poor or very poor experience. This represents a substantial proportion of the population whose needs are not being met effectively and whose perceptions may influence wider public confidence in the NHS.

Taken together, these findings point to variation across the system. Some services and pathways are working well, while others are creating friction and dissatisfaction. The challenge for NHS Essex is therefore not only to address underperformance but also to reduce variation and create more consistent experiences.

5. Experience by service area

A more detailed exploration of responses reveals significant differences in experience across service types.

GP services

GP services emerged as the most significant pressure point within the system. Respondents frequently describe difficulties in accessing GP appointments, including long waits, limited availability, and challenges navigating booking systems. These experiences are reflected in both rating data and free-text comments, with references to “GP” and “appointments” appearing consistently in areas of dissatisfaction.

Given that primary care is often the first point of contact with the NHS, access challenges have a disproportionate impact on overall perception. Difficulties at this stage can delay care, increase demand elsewhere in the system and reduce confidence in services more broadly.

Hospital services

Experiences of hospital services are more varied. While many respondents report positive interactions once receiving care, concerns are frequently raised about the time taken to access treatment. Waiting lists, delays in diagnostic processes, and limited communication during waiting periods are key issues.

Some respondents also highlighted difficulties moving through referral pathways and understanding what would happen next while waiting for treatment.

This suggests that the quality of clinical care remains strong, but the patient journey leading up to treatment is a source of frustration and uncertainty.

Community services

Community-based services are less frequently referenced but tend to receive lower or less confident ratings than other services. Feedback indicates that awareness of these services is limited and that access routes are not always clear.

Respondents also highlighted the importance of having services available closer to home, particularly where travel, transport or distance make access more difficult.

This lack of visibility may contribute to under-utilisation, particularly for services designed to support prevention, recovery, and independent living. From a system perspective, this represents a missed opportunity to relieve pressure on acute services.

Mental health services

Mental health services stand out as a particularly challenging area. Respondents describe difficulty accessing support, long waiting times and limited availability of early intervention. These issues are compounded by concerns about knowing where to go for help.

The findings suggest that demand for mental health support is not being met consistently and that there is a need for both service capacity improvements and clearer communication about available support.

Urgent care

Feedback on urgent care is mixed. While some respondents report positive experiences, particularly in urgent treatment situations, others highlight long waiting times and confusion about where to seek help.

This variation suggests a need for clearer urgent care pathways better public understanding of services such as NHS 111, urgent treatment centres, and emergency departments.

6. Thematic analysis of qualitative feedback

Analysis of free-text responses provides additional depth and context to the quantitative findings. Several recurring themes emerge consistently across responses.

The most dominant theme is access, particularly in relation to appointments and waiting times. Respondents frequently describe frustration with delays, difficulty securing appointments and lack of timely care.

A second key theme is communication. Many respondents highlight uncertainty about what to expect, how long they will wait and where to go for help. This suggests a gap between service provision and public understanding.

System navigation also emerges as a challenge, with respondents describing difficulty moving between services, repeating information and experiencing disjointed care pathways.

Digital access was another important theme. Many respondents welcomed digital tools that make it easier to access care. However, others said digital only approaches can make it harder for some people to get support. Respondents highlighted the need for simple digital services, support for people who are less confident using technology and non-digital options for those who cannot easily access online services.

Many respondents also described practical barriers to accessing care, including transport difficulties, travel distances and accessing services closer to home. These issues were particularly important in some rural and coastal communities.

Some respondents highlighted the importance of prevention and early intervention, including better support to stay well and access help before health problems become more serious.

Importantly, positive feedback about staff is widespread. Respondents often express appreciation for the care, professionalism, and compassion shown by frontline staff, even when overall experiences are negative. This reinforces the conclusion that dissatisfaction is primarily system-driven rather than staff-related.

7. Variation by local authority area

Analysis of the free-text responses suggests that, while there are several themes common across Essex, some issues are more pronounced in local authority areas.

Across all areas, respondents raised concerns about GP access, hospital referrals, and waiting times. However, some local differences were also identified. In Maldon and Tendring, respondents were more likely to describe issues relating to community service availability and transport, suggesting that distance, travel and local provision are particularly key factors in these areas.

In Harlow, Brentwood and Epping Forest, comments more often highlighted communication and information, indicating a need for clearer service navigation and better public information. Colchester and Chelmsford showed a stronger focus on joined-up care and coordination, while Basildon, Colchester and Harlow showed relatively stronger concern around mental health support.

Taken together, these findings suggest that while some priorities require a county-wide response, others would benefit from more targeted, place-based consideration.

8. Key Insights

Analysis of the survey responses identified a number of key themes that help explain public experiences, priorities and opportunities for improvement across health and care services in Essex.

Access, waiting times and timely treatment are the biggest drivers of public experience. Respondents consistently identified easier access to GP and community services, faster diagnosis and treatment, and reduced waiting times as the most important priorities for improving health and care in Essex. These themes were reflected throughout both the quantitative findings and qualitative feedback.

People want services to feel more joined up and easier to navigate. Respondents frequently described challenges moving between services, repeating information and navigating complex pathways. There is a clear expectation that health and care services should work together more effectively, supported by better coordination, communication and information sharing.

Communication has a significant impact on confidence in services. Many respondents highlighted the need for clearer information, better updates and improved signposting. Feedback suggests that improving communication between services and patients could positively influence experience, understanding and trust.

Local, accessible and inclusive services matter. Transport barriers, travel distances, parking and access to services closer to home were recurring themes throughout the survey. While digital services were welcomed when they improved convenience and access, respondents also emphasised the importance of maintaining face to face and non-digital alternatives.

Prevention, early intervention and support for long term conditions remain important priorities. Respondents highlighted the value of helping people stay well, managing long term conditions effectively and providing earlier support before health needs become more serious. Additional priorities identified through free text comments included dementia care, carer support, dental care, end of life care and ADHD assessment waits.

Health is shaped by wider social and personal factors, not healthcare alone. Feedback highlighted the impact of mental health, caring responsibilities, disability, social isolation, transport challenges and financial pressures on people’s health and wellbeing. This reinforces the importance of a population health approach that considers both healthcare services and the wider factors that influence health outcomes.

Taken together, these insights provide a clear picture of the improvements that matter most to people and highlight opportunities to improve access, experience and health outcomes across Essex.

9. Recommendations

The findings from this engagement provide a robust evidence base to inform the refresh of the Population Health Improvement Plan (PHIP). They highlight both system-wide priorities and place-based variation, reinforcing the need for a coordinated, population health approach that addresses access, prevention, and inequalities.

Table: Implications for the Population Health Improvement Plan

Appendix 1 – breakdown of respondents by demographic questions

Geographical distribution

(Population figures based on 2021 Census data published by the Office for National Statistics (ONS))

Age profile

Gender identity

Sexuality

Ethnic background

People with a disability or long-term condition

Use of health services – multiple options