NHS North Yorkshire
HUMAN GEOGRAPHY Human geography is a branch of the social sciences that studies the world, its people, communities and cultures with an emphasis on relations of and across space and place. Cancer and chemotherapy is a very difficult sensetive time in a persons life and needs too be treat with the utmost respect. Area and demographics can hugely influence they way patients perceive the whole treatment experience and even effect the treatment outcome.The area demographics such as, avearge incomes, ages and travelling distances can all have an effect on patients physical and emotional wellbeing. The following pages document a series of insights about the Human geography we encountered whilst carrying out research. These insights have been translated into opportunities for design.
INSIGHT TRAVELLING Patients could potentially have to travel from all over North Yorkshire.Travelling to a hospital from somewere in an area 3400 sq miles is difficult, bus services are infrequent and journeys increase stress levels before chemo. Most routes require changes of buses and times are infrequent,journeys are long and roads are narrow. Being alone on a bus can increase anxiety levels in patients and put them in the wrong frame of mind. Aswell as this the journeys can be very costly. After conducting research into commuting to the hospital i found that the commute can be very costly and take long periods of time to travel small distances. In one instance a 24mile journey can take up to 2 1/2 hours on a bus with one change.
“The travelling is the main worry,it gives me so much time to myself were i get worked up about the treatment and it is far too expensive.�
OPPORTUNITY Could the services be brought direct to the patients or at least more localised ? Travelling less would mean a more normal life for the patient , this potentially reducing stress levels and making the treatment more succesful. Main roads are of a poor quality which again makes travel expensive and time consuming. Bringing the services closer to the patients or carrying out chemotherapy at homes would be much more succesful for e.g mobile units , self administering ?
INSIGHT WEALTH 80% of North Yorkshire is defined as ‘super sparse’ with an average of 0.7 people per hectare. This percentage is represented mainly by workers in the agricultural sector who earn significantly less than workers in the other sectors. North yorkshire has an average GDHI of £13,800 per houseld compared to the national average of £16,000, this meaning households have less money to spend which can be a huge problem since transport across the district can be extremely expensive and time consuming.The main problem being that of cost. Scarborugh - York Hosipital Train - 48 minutes £15 return Bus - 1 hour 46 minutes £14 return
OPPORTUNITY With North Yorkshire familys being dependent on farming in rural areas travel costs can be extremely expensive to one of the chemotherapy units in the region. Is there the possibility of free travel or sites being more localised or chemo being brought to patients. Free transport or complimentary travel could be used , potentially via phone application. Not only does this save money on travel costs it also alows normality in the lives of patients. Wether this be allowing patients to live a normal lifestyle or wether it be saving money that could otherwise be needed.
INSIGHT CAPACITY Chemotherpay units in north yorkshire are few and far between.Normally fully booked out every day of the week were the 2 nurses per patient provide chemotherapy to 6 patients per day.The unit is extremely busy , 30% increase on average each year.
OPPORTUNITY Could some of the treatments be carried out in partially mobile unit or at home to free up spaces ? and only those who need to use the chemo unit. ? This would feee up beds, resources for the hospital and also help keep the cancer patients travel costs lower and give there a life a sense of normality.
INSIGHT Population The population in the York Trust is aging. About 50% of the current population in Yorkshire is over the age of 45. One of the biggest risk factors of cancer is age which explains the increased rate of cancer in the region. More patient care will be needed when at the same time money is tight. People in this age range might have children or other close family members thus consideration must be made for them in the treatment process. “We have seen an increase each year for patients receiving chemo. We project a 30% year on year increase in the amount of chemotherapy patients admitted to our hospital while also being asked to cut costs.”
OPPORTUNITY Create a space that anticipates an increased patient capacity and can evolve with changing patient needs. In addition concessions should be made so the growing demographic it serves feels comfortable as well as any family members who want to be involved in the chemotherapy process.Â
INSIGHT CURRENT TREATMENTS Insight: Cancer and chemotherapy treatments are invasive in a person’s life. Not only the time in chemo but also the fatigue that follows treatment can cause someone with cancer to feel separated from everyday life. Patients want an experience that is not unlike what they go through on their routine. Also inconspicuous graphics, advertising or attitudes about the treatment and cancer in general can create a negative stigma. “Patients want to feel normal. With a mobile chemo unit there is the possibility for patients to pop in, get treatment and go on with their lives.”
OPPORTUNITY The solution should consider utilizing where people can be found everyday such as shopping centres, the high street or supermarkets. The placement might be in high visibility areas but priority must still be placed on discretion. Design should focus on normalcy and not cry out for attention in order to make the patient feel normal and part of a routine.
INSIGHT: VERY LARGE CATCHMENT AREA North Yorkshire is the largest ceremonial county within the UK with a population of around 1,072,600 people. It covers an area of 8,608 km meaning that overall there is an average population density of only 125 people per square kilometer. Overall this isn’t a very high population density at all which is down to the vast landscape and farmlands that cover the county. This means that the population is stretched out over such a large place in rural areas which don’t have the best access to the nearest hospitals.
OPPORTUNITY This can be a good incentive for patients to use the service People living out in these rural areas may have trouble reaching the nearest hospital to receive treatment and when they can they may have to spend a lot of time and money reaching these areas, time and money that may be spent on things for themselves. Spending this extra time and money on themselves may provide some kind of distractions away from what they are currently going through.
OPPORTUNITY As the county is so big and the workforce will be spread about the whole region, could there be a possibility of NHS nurses qualified to treat cancer patients from each area being able to do a shift on the chemo bus if it goes into there area. A nurse local to that specific area could be able to interact better with the patient as they have something in common with the patient straight away. They may be able to help the patient feel more relaxed because they understand the local area and the people around there. This may also help moral of some staff who have long commutes to work each day.
INSIGHT CANCER RATES RISING Cancer rates in North Yorkshire are rising 30 % year on year. This increasing demand is puting stress on the local hospitals and stretching funding and resources.This increasing the spend of the NHS and potentially reducing the quality of treatment and care each person receives.
OPPORTUNITY With the rising cancer rates in the area, this puts pressure onto the hospitals and stretches resources in the region.To combat this problkem the treatments coud be caried out in local gp practices or in mobile units possibly located in car parks or local community centres.This could reduce issues with capacity and also provide a more local convenient service.