Exploring experiences around accessing health and social care
People come into contact with health and social care services in many different ways and at different points in life. Access to support, involvement in decisions about care, the ability to remain independent, and the experience of providing unpaid care can all shape everyday life, relationships, home life, work, and connection to the community.
The Access to Health and Social Care strand of the Changing Intergenerational Relationships (CIR) project is beginning to explore how people in Stirling and Clackmannanshire experience health, care, support, and changing needs at different points in life. We are interested in how people access services, how support is organised, and the role families, communities, and services can play when people’s circumstances change.
This work will bring together life-history interviews, community workshops, and secondary analysis of existing survey data. Together, these approaches will allow us to consider people’s accounts of health and care alongside wider patterns in health, wellbeing, caring, independence, and access to services across Scotland.
What is secondary analysis?
Social-science research often uses either primary data, collected directly by researchers during a project, or secondary data: information that already exists. Secondary analysis means using existing data to answer new questions as part of a different study.
Secondary-data research often uses quantitative methods to look for patterns in large datasets containing responses from hundreds or thousands of people. It can help researchers examine what is happening at a group or population level: for example, whether experiences of health, care, or wellbeing differ over time, between places, or between groups of people. If you have completed a survey or census form, your anonymised responses may have contributed to this kind of research.
For this strand of CIR, we are preparing to analyse existing Scottish survey data on health and care. This will allow us to examine patterns before and after the introduction of Health and Social Care Partnerships across Scotland, while placing Stirling and Clackmannanshire within that wider national context.
The analysis is expected to draw on information about general health, people’s ability to look after their health, support at home, independence, coordination of services, quality of life, GP care, and the experience of unpaid carers. It will not tell us everything about individual circumstances, but it can identify wider patterns and questions for the interview and workshop elements of the research to explore.
What is a life-history interview?
Many research interviews focus on one issue at a time. A life-history interview takes a wider view.
Rather than asking people only about a particular appointment, diagnosis, service, or caring arrangement, this approach invites them to reflect on experiences over time. Participants may discuss their health, family relationships, work, housing, caring responsibilities, community connections, experiences of support, and hopes or concerns for the future.
This matters because health and care needs can change over time. Someone may need support following a change in health while also managing work, housing, family responsibilities, or finances. People who provide unpaid care may need support with their own health and wellbeing, and people may draw on family, friends, neighbours, services, and community groups in different ways at different times.
The Access to Health and Social Care interviews have not yet begun. However, health and support featured regularly in earlier CIR interviews, particularly in the Changing Working Practices work package. These earlier accounts provide useful starting points for the work ahead, including reflections on:
- Physical and mental health, impairment, long-term conditions, and changes in health over time.
- How people’s own health, or the health of someone close to them, could shape work, relationships, and daily routines.
- Seeking formal and informal support, including practical adjustments, flexible arrangements, equipment, advice, and help from other people.
- Questions around whether support needs were seen as valid, how much help a person felt able to ask for, and how others responded.
- Questions around independence, choice, and maintaining a sense of control when circumstances changed.
The forthcoming interviews will allow us to explore these starting points in greater depth, including how people access health and social care services, manage changing care needs, and experience support at different points in life.
What is a community workshop?
A community workshop brings people together to explore ideas, compare experiences, and imagine what could change. Unlike an interview, which focuses on an individual’s story, workshops create space for people with different experiences and backgrounds to discuss an issue together.
For CIR, future workshops will take themes emerging from the life-history interviews back to local communities. Participants will be invited to discuss whether these themes reflect their own experiences, where they need more nuance, and what might make it easier for people to access health and social care.
The workshops are likely to explore:
- How people experience health, illness, disability, caring, independence, and changing support needs at different points in life.
- How health and social care services are accessed and experienced by people with different circumstances and in different parts of the region.
- The support people receive from families, friends, neighbours, community groups, and services, and where gaps or pressures can appear.
- How people make decisions about care, risk, independence, and support.
- What helps people feel heard, respected, safe, and involved in decisions about their health and care.
- What information, services, community connections, or other forms of support people feel would be useful.
We will add further information and emerging insights as the research moves forward.
Early Starting Points
The Access to Health and Social Care research is at an early stage, so it does not yet have findings of its own. However, health and support appeared frequently in earlier CIR interviews, particularly in Changing Working Practices. Drawing on this data allows us to build the foundations of the work package while preparing for the data collection to come.
Health cannot be ring-fenced
Earlier participants spoke about health in connection with work, relationships, caring, housing, transport, money, and community life. Their accounts suggest that changes in health can affect far more than treatment or appointments, shaping routines, work, confidence, independence, and the support people need from others.
These accounts also showed that people may manage health alongside other pressures, rather than dealing with one issue at a time. This will be an important starting point for exploring how health and social care services fit around people’s everyday lives, and where they may not.
Getting support is complicated
Earlier interviews suggested that seeking support was not always straightforward. Participants reflected on the need to establish that their health needs were “real”, decide what help they could reasonably ask for, and manage how other people might see them.
They described formal support, such as occupational-health involvement, changes to schedules, or equipment, alongside informal help from colleagues, family, and others around them. They also outlined how the responses of those around them could have a profound impact on whether participants felt supported, questioned, able to continue with work or welcome in shared spaces or at everyday activities and events.
This work package will examine how similar questions may arise in relation to health and social care more broadly: how people make sense of their needs, find information, ask for help, and experience the response of services and those around them.
Independence, care, and connection
Earlier accounts also raised questions about independence and connection. People may want support while retaining control over their own lives, decisions, and routines. Family members, friends, neighbours, and communities can play an important role, but these relationships can also involve practical pressures, changing responsibilities, and difficult decisions.
As this work develops, we will explore how these relationships change at different points in life, including the perspectives of people who use health and care services, unpaid carers, family members, and others involved in providing or arranging support.
Looking Ahead
This work package is only just beginning. Over the coming months, CIR will bring together interview accounts, community discussion, and secondary analysis to build a fuller picture of health and social care at different points in life.
This work package will explore not only whether services are available, but how people experience them: whether support feels coordinated, whether they are involved in decisions, and whether it helps them to feel safe, independent, and supported.
