Outcome of Foundation Trust Public Consultation

Background

1. Name of applicant and Sussex Healthcare NHS Trust

2. Area served by the Trust East Surrey North West Sussex South Croydon

3. Contact details of person responsible for Gillian Francis-Musanu the public consultation Director of Corporate Affairs Surrey & Sussex Healthcare NHS Trust Canada Avenue Redhill RH1 5RH

Tel: 01737 768511 Ext 2862 e-mail: [email protected]

About the public consultation

4. Dates of public consultation Started Finished 21 November 2013 28 February 2014

5. Which media were used for the public consultation document? Engagement planning

Public events To advertise events we placed newspaper adverts, arranged for posters to be displayed locally and within the hospital on our notice boards and 24 digital information screens, advertised on our website and alerted our 5000 twitter followers, sent out press releases and offered regular interviews to print and broadcast. We walked around and gave out flyers to people visiting the hospital, sent posters to GP surgeries, placed articles in CCG and council newsletters, e-bulletins, intranet sites and websites. Many local groups, particularly the local business groups also placed articles and adverts in their newsletters and on their websites. We emailed and wrote to as many local organisations, voluntary sector, other health groups, and business partners that we could find and on the day we encouraged passers-by to join the FT discussion.

The events were arranged to offer maximum flexibility for people, with some held in the morning, some in the afternoon and many in the evening.

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 2 of 35

Stakeholders The consultation booklet was sent to all GP surgeries and other stakeholders identified in the consultation plan, plus we have taken a very proactive approach to engaging with others – WI, nursing homes, sports/football clubs, libraries, local shops, schools – requesting they cover FT in citizenship lessons etc.

In our mail-outs, we asked partner organisations ‘when’ we could attend their meeting and present. Uptake of this request was slow although Surrey County Council and and Council were very supportive. , Mole Valley and Tandridge councils were also very supportive by publishing our consultation materials on their websites and staff intranets, helping us with venues for our events and offering us free editorial in their magazines.

In our mail-outs we asked local groups if they would like us to come and present, and to GPs, we asked for all GPs and practice managers to send us their feedback and to display our materials in their waiting rooms.

Staff Staff engagement activities took place throughout the consultation period with the aim of a member of the Executive Team to visit every staff team meeting, as well as holding specific FT events and having information stalls around the hospital, so that every member of staff has had the opportunity to raise questions or concerns. We have utilised our All Staff, Senior Leaders, All Consultants and Trade Union Stewards, JNCC Committee meetings to take the opportunity to give the latest FT updates. At the February All Staff meeting we invited a member of staff from Kingston Hospital who was previously at the Royal Surrey County Hospital, to talk to our staff about how it feels as a member of staff going through the FT process, and beyond.

Managerial materials including a toolkit for managers and FAQs for staff were available on request and via the staff intranet. Regular ‘All staff’ (html) emails keep staff updated and notify them of FT engagement opportunities. We created a staff guide to becoming an FT leaflet and a schedule of activities was listed in the Consultation Plan. In their February payslips, every member of staff received a copy of the leaflet and a membership form so they can sign up a friend or patient. Our monthly internal staff newsletter carried FT stories throughout the consultation period, and it was one of the main campaigns running on our intranet.

Full consultation document in hard copy Yes Summary consultation document in hard copy Yes for staff Web-based consultation document Yes Talking Book / audio tape / CD Rom Available on request Large print versions Available on request Versions in ethnic languages (specify which) Available on request Other

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 3 of 35

5.1 Presentation at public meetings (specify where meetings were held and the number attending) Date Meeting type Venue Attendance 6 November 2013 Hot topic – care of the ESH 12 elderly and FT 25 November 2013 Public meeting Halls 11 Dorking 29 November 2013 Public meeting Oxted community 18 Centre 3 December 2013 Public meeting Meridian Hall 0 East Grinstead 9 December 2013 Public meeting ESH 15 13 December 2013 Public meeting Crawley Hospital 3 17 December 2013 Public meeting Reigate Community 5 Centre 2 January 2014 Public meeting Harlequin Theatre 22 Redhill 7 January 2014 Public meeting Drill Hall Horsham 23 10 January 2014 Public meeting Crawley Civic Centre 16 26 February 2014 Public meeting United Reformed 17 Church Purley 27 February 2014 Hot topic – care of the ESH 45 elderly / dementia and FT

5.2 Presentation at other meetings (specify where meetings were held and the number attending) Date Meeting Venue Attendance 11 September East Surrey League of ESH 75+ Friends AGM 21 November West Sussex Health and County Hall 22 Wellbeing Board Chichester 28 November Board to Board with East ESH 30 Surrey CCG 2 December Reigate and Banstead Local Reigate Town Hall 20 Committee 2 December Patient Experience Forum ESH 14 12 December Surrey Health and County Hall Wellbeing Board Kingston upon Thames 16 December Surrey Traveller Community Burpham, Guildford 9 Forum Health and Wellbeing Group 9 January Surrey CC Health Overview County Hall 16 & Scrutiny Committee Kingston upon Thames

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 4 of 35 13 January Horsham League of Friends Horsham Hospital 13 14 January Redhill 33 15 January Surrey Information Summit

20 January West Sussex Health and County Hall 22 Wellbeing Board Chichester 20 January East Surrey Empowerment Tandridge 16 Board 22 January West Sussex CC – Health County Hall 17 and Adult Social Care Chichester Committee 24 January East Surrey Hospital ESH 25 Volunteers 30 January West Sussex Health and County Hall 20 Wellbeing Board Horsham February East Surrey CCG Patient Nutfield 30 Reference Group 13 February Reigate and Banstead Reigate Town Hall 25 Council – member briefing 13 February West Sussex HASC liaison County Hall 2 members (Peter Griffiths, Dr Chichester David Skipp) 6 March Reigate and Banstead Reigate Town Hall 33 Voluntary Services

5.3 Presentation at staff meetings (specify where meetings were held and the number attending) Date Meeting Venue Attendance 15 November All staff meeting ESH 75 - 100 21 November Senior leaders ESH 50 - 75 13 December All staff meeting Crawley Hospital 25 - 50 13 January 2014 Junior doctors ESH 25 - 35 15 January Medicine senior managers / PGEC ESH <25 Clinical Leads 16 January Medicine and Surgery ESH <25 Matrons, Surgery Senior Sisters 16 January All staff meeting ESH 75 - 100 17 January Staff road show at main ESH 75 - 100 entrances 19 January Surgical Division senior ESH <25

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 5 of 35 managers and clinical leads 23 January Anaesthetists ESH 25 - 50 23 January Theatre staff ESH 25 - 50 23 January Staff Road show ESH 50 - 75 23 January Senior leaders ESH 50 - 75 23 January Microbiology staff Crawley 25 - 50 23 January All Staff Crawley – Comet Ward <25 24 January Volunteers ESH 25 - 50 29 January All Staff Health & Wellbeing ESH 600 - 700 event 31 January All Staff Horsham <25 3 February Medical Division ESH <25 20 March WACH Division ESH <25 7 February All consultants ESH 25 - 50 10 February All consultants ESH 25 - 50 12 February Unions - TUSC ESH <25 13 February Surgical Division ESH <25 14 February All Staff inc presentation ESH 50 - 75 from staff member of another FT 4 March Clinical Support Services ESH <25 Division 24 February Lead Clinicians ESH <25 25 – 28th February Senior Sisters ESH 6 Finance and procurement ESH 10 Porters ESH 25 Housekeeping ESH 25 12 March Transport and post room ESH <25 staff 21 March PALS and complaints ESH 5 12 February Night shift staff ESH 15

5.4 Consultation information sent / e-mailed to Local Authorities West Sussex County Council (Chair, CEO, HASC, Director Adult Services, Director Children’s Services, Health & Well Being Board) Surrey County Council (Chair, CEO, HSC, Director Adult Services, Director Children’s Services, Health & Well Being Board, Local Committee) Mid Sussex District Council (Leader and CEO) Horsham District Council (Leader and CEO) Crawley Borough Council (Leader and CEO)

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 6 of 35 Reigate and Banstead Borough Council (Leader and CEO) Tandridge Borough Council (Leader and CEO) Mole Valley Borough Council (Leader and CEO) East Grinstead Borough Council (Leader and CEO) Ash Parish Council Capel Parish Council Charlwood Parish Council Godstone Parish Council Tandridge Parish Council Wotton Parish Council Abinger Parish Council Buckland Parish Council Chaldon Village Council East Horsley Parish Council Limpsfield Parish Council Salford and Parish Council Tatsfield Parish Council Brockham Parish Council Betchworth Parish Council Leigh Parish Council Ockley Parish Council Headley Parish Council Holmwood Parish Council Mickelham Parish Council

Health Overview & Scrutiny Committees West Sussex County Council HASC Surrey County Council Surrey HSC

HealthWatch Health Watch Surrey Health Watch Sussex

MPs Crispin Blunt Sam Gyimah Henry Smith Chris Grayling Fancis Maude Nicholas Soames

CCGs Surrey Downs CCG East Surrey CCG

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 7 of 35 Crawley CCG Horsham and Mid Sussex CCG Croydon CCG

CCG Patient Reference Groups (via host CCGs) Surrey Downs CCG Patient Reference Group East Surrey CCG Patient Reference Group Crawley CCG Patient Reference Group Mid Sussex CCG Patient Reference Group

NHS organisations Ashford St Peters NHS Foundation Trust Brighton and Sussex University Hospitals NHS Trust East Sussex NHS Trust Frimley Park NHS Foundation Trust Queen Victoria NHS Foundation Trust Royal Surrey County NHS Foundation Trust Surrey & Borders NHS Trust South East Coast Ambulance NHS Foundation Trust Sussex Partnership Trust

Local Training and Education Board Kent Surrey Sussex Deanery Brighton and Sussex University Medical School

Other healthcare providers Sussex Community Trust First Community Health and Care Central Surrey Healthcare

GPs All GP surgeries in the proposed public constituencies (full lists in Appendix 1)

Libraries Materials for display throughout libraries in Surrey and Sussex

Hospital League of Friends East Surrey Hospital League of Friends Crawley League of Friends Horsham League of Friends Surrey and Sussex Healthcare NHS Trust Patients Council

Voluntary organisations

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 8 of 35 Carers Support Crawley Community Relations Forum Crawley Council for Voluntary Services Oxted Council for Voluntary Services Horsham Area Council for Voluntary Services Reigate and Banstead Council for Voluntary Services Surrey Compact Surrey Empowerment Board Tandridge Council for Voluntary Services Tandridge Health and Social Care Forum Action for Life – the East Surrey Walking for Health Scheme Horsham Voluntary Action Mid Sussex Council for Voluntary Services Family Line St Peter’s House Project, Redhill Voluntary action in Elmbridge Crawley community and Voluntary Services Carers support (East Surrey)

Community Groups Men’s Health Forum Surrey Youth Support Service Gender Identify Research and Education Society National Childcare Trust

Schools and Colleges Royal Alexandra and Albert School, Reigate East Surrey College, Redhill , Reigate Reigate 6th Form College, Reigate Dunnotar School, Reigate Oakwood School, Oriel High School, Crawley St Bedes Secondary School, Redhill Reigate Grammer School Woodfield School, Surrey Thomas Bennet Community College, Crawley St Wilfred’s Catholic School, Crawley Hazelwick School, Crawley Ifield Community College, Crawley Holy Trinity C of E Secondary School

Residential Care Homes Coppice Lea Care Home,

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 9 of 35 Chaldon Rise Nursing Home, Merstham The Reigate Beaumont The Elms Nursing Home, Redhill Wray Common Nursing Home, Reigate Kings Lodge Centre for Complex Needs, Nutfield, Redhill Acorn Court Care Home, Redhill, Nuffield Care Centre, Redhill The Barn House, Merstham Rutland Care Home, Reigate Wykeham House, Horley Chaldon Rise Nursing Care Home, Merstham Oakhurst Court Nursing Home, South Godstone The Brambles Care Centre, Horley Old Wall Cottage in Reigate, Betchworth Rosewood, Horley The Woodhatch Centre, Reigate

Other Regent House Community Centre, Horley Oxfam, Redhill Oxfam, Reigate Shopmobility, Redhill British Heart Foundation, Redhill British Heart Foundation, Crawley Redhill Evening Townswomen Guild, Redhill Marie Curie Cancer Care, Redhill St Catherine’s Hospice Charity Shop, Redhill Cancer Research UK, Reigate Age Concern, Merstham, Redhill and Reigate Age Concern, Banstead Age UK, Horley Age UK, Surrey The Children’s Trust, Crawley Donyngs Recreation Centre, Redhill The Children’s Trust, Young Epilepsy

5.5 Other consultation activity Hospital wards and departments Our Membership Officer regularly visited wards and departments around East Surrey, Crawley and Horsham hospitals. This face to face activity proved to be extremely effective at explaining the FT proposals and recruiting members.

Posters and leaflets were displayed prominently throughout all facilities from which the Trust

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 10 of 35 provides services.

Media / Social media We regularly engaged with our 5000 plus followers on Twitter about FT and had radio coverage from Heart and Radio Redhill.

Letters to community groups We met with other local groups as opportunities arise and in particular we have been keen to attend meetings with groups of people that are often more difficult to reach, such as the Gypsy and Traveller group. With our Chief Nurse a consultation and engagement Afternoon Tea event was held at East Surrey hospital with some of our patients with learning disabilities.

Website / intranet Both the website and intranet have dedicated FT pages targeted at patients and members of the public as well as staff.

Posters and leaflets Posters and leaflets are located in all main entrances and available on all digital display screens at East Surrey Hospital and Crawley Hospital.

Communication with staff In addition to the meetings with staff, [Corporate Governance Officer, and members of the Communications and Corporate Affairs Team) were available to hand out information and receive feedback:  in the main entrance on 17 January between 7am and 9am to catch staff on their way in to work  in the main entrance on 22 January between 12 and 1pm  In the restaurant between 12 and 1pm on 22 January

Display stands These were set up in key locations in the hospitals:  East Surrey hospital – main and east entrances; outside the restaurant, X-ray, OPD & ED restaurant  Crawley – main entrance  Horsham – outpatients department

Pop up stall We have been out and about with a pop-up stalls. The Trust Executive Team accompanied our Membership Officer talking to shoppers in local shopping centres, and this engagement activity will continue beyond the consultation period.  Belfry, Redhill  Whitgift Shopping Centre, Croydon,  Mid Sussex shopping centre,

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 11 of 35

We also took the stall to engage with the students at East Surrey College and will continue to engage with students at other nearby colleges as and when we are granted permission. We have written to all local schools asking how best to engage their students in our membership.

6 Number and type of formal responses received Type of response Number received Hard copy using proforma provided 23 Hard copy – others eg letter 5 On website 5 By e-mail 1 By telephone 0 By fax 0 By text 0 Verbally at public meetings 71 Verbally at community forums etc 38 Other – specify Comments were received at staff meetings, meetings with stakeholders including Trade Union Stewards Committee; Traveller Forum, local college, MPs, HWBBs etc Reigate Borough Council Members meeting 9 comments / questions

An e-mail reminder was sent to all partner organisations in the middle of January requesting feedback on the consultation proposals.

7 Was the pattern of responses to the public consultation in line with the demography and geography of the area? Were there any areas or groups that were not adequately represented in the responses received? Provide explanations where necessary. And details of Trust action plan to target under-represented areas

Different approaches were used to engage with different sectors of society and ensure the consultation engaged with a representative population.

Public engagement Public meetings were held in each of the proposed public constituencies and all except the meeting in East Grinstead (Mid Sussex constituency) attracted some attendance from local residents and other interested people. Although the numbers attending were often relatively low, the level of engagement and interest was high with the majority of people being very supportive of the Trust and the aspiration to become a foundation trust. The majority of people attending these meetings were in older age groups

The pop up stand in shopping centres provided excellent opportunities to meet with younger people including mothers with children and people of working age.

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 12 of 35

The meetings at East Surrey College [any other colleges] were well attended by students who were interested not only in the plans for FT status but also in the work of the Trust and potential future employment opportunities. More than 30 students also signed up to being members of the Trust.

Meetings were held with several user and other interest groups including Travellers in Surrey and Reigate voluntary services forum, Surrey Empowerment Forum & Disability group.

Patient and Carer engagement Throughout the consultation period our Membership Officer regularly visited wards and departments around East Surrey, Crawley and Horsham hospitals. This face to face activity proved to be extremely effective at explaining the FT proposals and recruiting members.

Presentations were also given to the Trust’s Patient Experience Forum and each of the League of Friends for East Surrey, Crawley and Horsham hospitals.

Membership information is included in all new appointment letters and is resulting in a number of new members being recruited each week.

The Trust has entered into a contract for membership support services with Membership Engagement Services who will provide regular analysis of the demographics of the membership and will also undertake targeted membership recruitment in any underrepresented public or patient constituencies. Staff living in underrepresented areas are being asked to identify opportunities for engagement with local groups.

Staff engagement A comprehensive programme of presentations and discussions at staff meetings included ward and departmental meetings, staff group specific discussions (junior doctors, Clinical Leads, Matrons etc) as well as the monthly All Staff meeting. It is estimated that approximately one third of all staff attended one or more meetings and some also attended the public meetings with relatives.

A toolkit and communications pack was also provided for managers to support discussion within teams and all members of staff received a summary leaflet with payslips in February.

Regular updates were also provided to the Trades Union Staff Consultative Committee.

Partner organisations The Trust FT Project Board includes members from both County Councils and the four Surrey and Sussex CCGs. Key elements of the FT application, including strategic intent; consultation plan and consultation document, were discussed by the FT Project Board prior to the start of consultation. Following the consultation the outcome of the consultation and the draft consultation response report were considered by the FT Project Board which made consequent recommendations to the Trust Board for changes to the proposed composition of the Council of Governors.

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 13 of 35 Engagement with the County Councils was positive throughout the consultation with presentations given to members of the HOSC / HASC committees and the Health & Wellbeing Boards. The Reigate and Banstead Council also accepted the offer of a presentation which was provided to members.

Perhaps reflective of the newness of their organisations and the breadth of issues they are managing, access to and comment back from CCGs was minimal. [No CCGs were willing to receive a presentation on the proposals, although a joint Board to Board was held with East Surrey CCG during the consultation period, and only two submitted a formal response to the consultation].

A meeting with the Reigate and Banstead Voluntary services was well attended.

About the consultation responses / comments received

8 Responses received from major stakeholders (individuals and organisations) and their general view – including local MPs, local authorities, local NHS organisations, professional and staff representative bodies, local commercial organisations, national and local voluntary organisations Name Broadly in Main issue raised favour / neutral opposed Surrey County Council Not stated Keen to work in partnership with the Trust and to have representation on the Council of Governors

Surrey Health Scrutiny In favour Notes improvements in performance by the Trust in Committee recent years Recommend emphasising quality of Trust leadership and encouraging participation of younger people (14+) for mutual benefit of public services

Family Line (charity) Not stated Keen to work in partnership with the Trust and would like to be a member

West Sussex County In favour We have no objections to your proposals as set out in Council Health and Adult the consultation document and support your Social Care Select application to become an FT. Committee We welcome the fact that your proposed governance arrangements will give West Sussex County Council a seat on your Council of Governors through an appointed governor. This is particularly important, given the interface and increasing integration

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 14 of 35 between health and social care. We also welcome your vision and values.

Crawley CCG In favour (with Recognise demonstrable improvements in service financial delivery and overall performance. caveats) Horsham and Mid Sussex Concerns relate to: CCG  impact of wider economic environment and Better Care Fund  little growth in CCG allocations  SaSH proposals for increasing range of services provided at ESH Payment by Results not seen as sustainable and placing financial risk with CCGs

Brighton and Sussex In favour No comments provided other than support for all of Medical School the consultation questions

Reigate Borough Council In favour Based on population size should Reigate have 3 (Members meeting) Governors

Is the Trust as passionate about having good managers as it is about good clinicians?

Will having a membership help the community to be involved and aware?

Has been a step change , good improvements demonstrated by number of good consultants

How can the Estates Strategy be improved?

Need to look at how to do more fundraising

Asked about relationships with CCGs and how commissioning decisions are made.

HealthWatch Surrey In favour Healthwatch Surrey responded in support of the application to become an NHS Foundation Trust and the appointment of a Health Watch representative to the Council of Governors to represent Surrey and Sussex

Trade Union Staff In favour Requested assurance that if it became authorised as

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 15 of 35 Consultative Committee an FT that the Trust would not go ahead without (TUSC) meaningful consultation with staff and the TUSC of any plans they may have to change any terms and conditions (i.e. to Agenda for change).

Asked whether the Trust had received any indication from any members of staff who were objecting to the “Auto-enrol” for staff.

Sussex Health & Wellbeing In favour Responded that responses to the consultation should Board really come from the constituent members of the Board (i.e. the CCGs, NHS England, Healthwatch etc.) – and that it isn’t really the HWB’s role, as a commissioning body, to respond to such consultations. The response noted that this shouldn’t be interpreted as lack of interest in SaSH - but rather that it’s not within the Board’s remit.

9 Apart from those listed in Q8 above, how many other responses were received in total?

28 formal 109 informal – i.e at meetings – excluding feedback from meetings with staff

9a. Was there a HOSC review process? Surrey Health Scrutiny Committee

Alan McCarthy, Chairman, and Michael Wilson, CEO, attended the January meeting of the Health Scrutiny Committee at Surrey County Council and presented the plans for the Trust’s FT application.

Writing to the Trust after the meeting the Chairman of the Health Scrutiny Committee made the following comments:

The Committee would like to offer its support for the (FT) application based on these plans and the discussion had with the Chairman and Chief Executive at the meeting.

The Committee would also like to note the improvements made by SASH in recent years which have allowed it to make quick progress to the application for FT status. As a result of the discussion on 9 January, the Committee recommended that:

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 16 of 35

a) The Trust should emphasise the quality of its leadership when publicising their FT application; and b) Encourage the participation of the younger cohort (14yrs+) for the mutual benefit of public services.

Additionally, the Committee offers its support while continuing to note the financial situation at SASH, which though much improved was in technical breach of the statutory breakeven duty of the NHS Act 2006 in 2013.

The Committee hopes to continue its positive working relationship with SASH in the future and will continue to monitor its progress.

West Sussex Health and Adult Social Care Select Committee (HASC)

The consultation documentation was sent to HASC along with a request to meet with members to present the proposals. Although it wasn’t possible for the whole committee to meet with the Trust two of its members did meet with the Trust CEO to discuss the proposals.

The Chairman of the Committee subsequently wrote to the Trust with the following response to the consultation:

Thank you for sending me a copy of the consultation document on Surrey and Sussex Healthcare NHS Trust’s proposal to become an NHS foundation trust. I am sorry that it was not possible to arrange for you to attend a meeting of the West Sussex Health and Adult Social Care Select Committee (HASC) to present your proposal, but we did forward the consultation document to all members of the HASC for comment. I was pleased to hear that HASC liaison members Peter Griffiths and Dr David Skipp had the opportunity to discuss this with you on 13 February. Their comments are included in this response.

HASC is aware that Foundation Trusts (FT) have more financial and operational freedom, but remain within the NHS, and that all NHS acute, mental health, ambulance and community service trusts are expected to become Foundation Trusts. As such, HASC understands that Surrey and Sussex Healthcare NHS Trust has no option but to apply for FT status. We have no objections to your proposals as set out in the consultation document and support your application to become an FT.

We welcome the fact that your proposed governance arrangements will give West Sussex County Council a seat on your Council of Governors through an appointed governor. This is particularly important, given the interface and increasing integration between health and social care. We also welcome your vision and values and hope to be updated on your plans for the future, either through our liaison members or through briefings for the Committee (as appropriate).

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 17 of 35 10 Excluding those recorded at Q8 above how many responses were: Broadly in favour Broadly neutral Broadly opposed

25 2 1

In addition to these formal responses, feedback was received from people attending the public meetings, meetings with special interest groups, conversations with the public in shopping centres and staff meetings with the vast majority being in favour.

Responses received to the specific questions raised

Only one formal response was received from a member of staff. However the tenor of all staff meetings, which were attended by approx. one third of all staff, and meetings with the Trade Union Staff Consultative Committee, was that staff were in favour of the proposals.

Q1 Do you agree with the Trust’s objectives and plans for the future?

Staff Public Yes 1 24 No 2 Not stated 1 Total 1 27

Q2 Do you agree with the proposed geographical areas for our membership?

Staff Public Yes 1 (but not for Croydon) 20 No 6 Not stated 1 Total 1 27

Q3 Do you think they are representative of the communities we serve?

Staff Public Yes 1 20 No 6 Not stated 1

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 18 of 35 Total 1 27

Q4 Do you agree that people aged 14 should be able to become a member?

Staff Public Yes 1 16 No 10 Not stated 1 Total 1 27

Q5 Do you agree with our proposals for the Council of Governors?

Staff Public Yes 24 No 1 (think there should be an 1 additional nurse / midwife) Not stated 1 Total 1 27

Q6 Do you agree with the proposed new name: Surrey & Sussex NHS Foundation Trust?

Staff Public Yes 1 21 No 5 Not stated 1 Total 1 27

Trust response

11 Does the Trust have any comments about the general tone of the responses received? For example were those opposing the proposals expressing fundamental objections or picking up minor (possibly technical) issues? Many of the responses received, and questions posed at meetings, related to issues broader than the Trust’s FT application, including  Concerns about the removal of services from Crawley hospital  How SaSH services relate to services provided at Crawley and Horsham hospitals and why

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 19 of 35 more services aren’t provided at these locations  Wanting to see additional primary care / community base services e.g. new GP surgeries in Crawley and Oxted, audiology (hearing aids) in Surrey, services to support frail older people  How services are funded e.g. if activity increases through Choice how will the Trust be funded to ensure quality doesn’t deteriorate  Concerns about transport system and difficulty for non-drivers to access services

Many respondents, and especially at the public meetings, raised understandable concerns about maintaining quality as an FT citing the failures at Mid Staffordshire and Morecambe Bay.

Responses relating to the FT proposals included  Wanting to more / understand better the differences between NHS trusts and NHSFTs; role of members and governors  Seeking assurance that the patient voice will be heard and that the emphasis on public governors doesn’t dilute this  Seeking assurance that the quality of services will be maintained  Questions about the minimum age for membership, membership constituencies, Council of Governors and name of the Trust

For the two CCGs that responded, the challenges facing the health economy were prominent in their joint response:  Financial – managing demand with limited income; transfer of funding from the NHS to the Better Care Fund  Integrated Care – delivering integrated care pathways in the community and patient’s homes rather than in an acute hospital Within this context the CCGs recognised the demonstrable improvements in service delivery and supported the aim of providing excellent DGH services for the catchment population. The response acknowledged that it is in the interests of all parties for SaSH to achieve FT status with the CCG wanting to play an active part in ensuring this success.

Responses from local councils noted the step change in quality and performance at the Trust in recent years. Surrey Health Scrutiny Committee positively encouraged the participation of younger people for the mutual benefit of public services.

Staff meetings were overwhelmingly in support of the FT proposals which were also supported by the Trust Trade Union Staff Consultative Committee. There were no objections from staff to the proposal to auto-enrol eligible staff as members.

Only one response was firmly against the proposal to become an FT. A member of the public felt that the Trust was not yet ready to become an FT and gave two reasons for this – firstly their experience of being a member of other FTs and secondly their experience as a patient at ESH.

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 20 of 35 12 What were the main topics that attracted critical response and what was the trust’s response? Issue (include in brackets the name of the main Trust’s response person(s) / bodies raising it) Trust objectives and plans for the future Several people asked to see the IBP or to have The consultation document, by its nature, more information about services currently provided summarised information. The provided and those planned for the future presentation given at meetings [and in information on the trust website] provided more (patient, public) detail of range of services currently provided and the areas for future development.

A short version of the IBP will be published later in the FT application process - once the Trust makes its final submission to the Trust Development Authority for their approval to apply to Monitor for consideration for FT status

In both formal responses and at meetings people All NHS trusts, including Surrey & Sussex questioned whether to the aspirations of the Healthcare NHS Trust are very mindful of the Trust can be sustained. In particular they were appalling levels of care exposed in some NHS concerned that the quality of services has hospitals. The provision of high quality of services deteriorated at other trusts after they have is a key objective of SaSH along with become foundation trusts. implementing our plans to continue to improve the experience of patients. One respondent expressed concerns about the quality of care they had experienced both as an The Care Quality Commission has recently inpatient at ESH and also when accompanying a introduced a rating for all trusts in which the mental health patient to A&E. These concerns Trust was placed in Group 6 which is the group were given as reasons for not supporting the considered least at risk of poor quality of care. Trust’s plans for FT as they didn’t think the Trust Also, nationally the Care Quality Commission has is yet ready. introduced a risk rating and inspection by the Chief Inspector of Hospitals. Without a good or / (patient, public) excellent] rating from this the Trust will not be able to apply to Monitor for FT status.

The two GGCs that responded were concerned The Trust is working with all its CCGs to ensure all about the Trust’s plans for the future which they our plans and priorities align with each other and considered to be ambitious plans for growth that deliver the maximum benefit for the local are at odds with wider NHS policy / planning community. guidance and especially the Better Care Fund The plans to develop the ESH site to provide a (CCGs) broader range of specialist and tertiary services in partnership with others have two main aims:  Firstly to provide services more locally for

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 21 of 35 patients so that they do not have to travel out of the area for treatment  To support CCG plans to repatriate activity from London teaching hospitals

At a meeting with local councillors the Trust was The Trust has an estates strategy and works in asked about the Estates Strategy for ESH conjunction with the LA both for planning applications and in developing, for example, its (LA Councillor) travel plans.

Membership Several responses questioned the rationale for The number of people who live in South Croydon including part of South Croydon in the public and choose to receive panned treatment at ESH is membership constituencies: increasing year on year.  Catchment too large and Croydon should be excluded The public constituencies comprise those  The catchment population is too large electoral wards from which around 10% or more given the poor quality of public transport of the resident population has received  Croydon is part of Greater London and treatment at the Trust. there is no benefit in including it

Don’t want Mayday Hospital to be included The consultation isn’t about Mayday (Croydon University) Hospital which is a separate NHS trust. (patient, public, staff)

Around a third of responses disagreed with the Two thirds of respondents supported the proposal for children 14 years and older to be proposed lower age limit of 14 years. eligible to be members. The reasons included:  14 seen as possibly too young In deciding to retain this age limit the Trust is  Members need to have a broad and keen to engage with younger people many of balanced view of the issues involved - who either have been, or may be patients or who sceptical of the input from people of this are carers for a relative who is a patient. Their age group other than specifically for experiences and insights in to the way services children’s’ services are provided will therefore be especially valuable  Minimum age should be the same as the in developing patient and carer awareness and legal voting age focus for service developments.  Minimum age should be the same as for consent to treatment  18 considered more appropriate

(patient, public) Several responses suggested 9000 members is The target public membership at authorisation as low given 3500-7000 are potentially staff and a FT is planned to be c5500 based on 1% of the their partners and so will have a better informed, population in each catchment area becoming a

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 22 of 35 or perhaps biased, view of services member. As noted above, the catchment area is all those electoral wards from which around 10% (patient, public) or more of the resident population has received treatment at the Trust.

A further 546 patient members are also planned to be recruited. This target was determined on the basis of it being 10% of the total public members which is a little above the current 7% of patients who live outside the Trust’s catchment area.

These membership targets are the minimum membership numbers that the Trust hopes to achieve. Membership recruitment will be on- going and so over time these numbers will be expected to increase until such time as the number of new members balances the number of members who leave.

The public and patient Governors elected to the Council of Governors will have an important role to play in representing the views of their constituencies not just their own personal views. Suggestion that patients and carers living in a This was considered by the Trust but was public constituency should be able to choose considered administratively complicated in whether to be a patient or public member and comparison to the proposed approach. hence to be able to stand for election as a Governor in either category This will be kept under review by the Council of Governors with review informed by appropriate (patient, public) analysis of the membership.

Request for information regarding whether any No concerns or objections have been raised by members of staff had indicated their objection to staff during the consultation process. auto-enrolment of staff.

(TUSC)

Council of Governors The composition of the Council of Governors To be effective the Council of Governors has to attracted a broad range of comments regarding be of a manageable size and the proposed appointed Governors: representation for partner organisations provides a broad spectrum of interest and relevance to the  There should be additional representation work of the Trust.

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 23 of 35 from ‘special interest’ / user groups e.g. third sector, long term mentally ill, The number of governors for each of the public disabled, elderly, carers constituencies is proportional to the resident  It will be difficult to have just one population for the constituency. This mirrors the umbrella organisation for voluntary sector statutory requirement for the membership to be covering two counties and similarly for representative of the population served. Healthwatch  Reigate and Banstead should have an In considering the overall size of the Council of additional governor Governors the Trust has decided to retain the  Not having an appointed Governor for overall number on the Council of Governors but Croydon could make the Croydon public to reduce the number of Patient Governors (out governor feel quite isolated of area) but increase the number of Public Governors. The Trust will provide development (public, patient, staff, voluntary sector, LA support for elected governors and a key role for Councillor) the Chair of the Council of Governors is to ensure that all Governors have equal opportunity to There were also several comments and participate in discussion and to influence the suggestions regarding elected Governors: decisions of the Council.

 A 5th staff Governor to represent patient interests was suggested, as was  An additional nurse / midwife governor  Elected Governors need to be representative of the socio-economic, ethnic, religious and age profile of the patient population (which itself will be different from the population as a whole)  Concern that if patient membership is restricted to only those patients / carers living outside the public constituencies then having 4 Patient Governors for a potentially small membership constituency would seem to be too many

(patient, public, staff)

Several responses related to the overall size of the Council of Governors: The Trust believes that the overall size of the Council of Governors is sufficient to enable the appropriate transaction of decisions and the  Will it be too large to be an effective constitution of the FT has clear guidelines and decision making body? procedures for managing conflicts of interest for  The number of appointed governors may all governors. be too high and also some may have conflicts of interest

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 24 of 35

(patient, public, voluntary sector forum ) One respondent suggested that Governors should The constitution of the FT has clear guidelines not be employed by / or be beneficiaries of and procedures for managing conflicts of interest. private healthcare providers However, a blanket exclusion of anyone employed by or a beneficial of private healthcare (patient, public) providers would not be beneficial as a key benefit of the Council of Governors is to consider new and different ways of providing services to better meet the needs of the local population.

Elections should be every 5 years The requirement of the DH Model Election Rules is for elections to be held every three years (patient, public) Name of Trust 20% of respondents disagreed with the proposed The majority of respondents supported the name of the Trust: proposed name.  The name doesn’t describe what the Trust does just where it is  The name isn’t geographically correct as doesn’t cover all of Surrey and Sussex  The name should include the word hospital  The name implies the intention to take over other NHS Trusts in Surrey & Sussex  The name should better describe the services provided

Several alternative suggestions were offered:

 ESNEWS – East Surrey and North East West Sussex  REACH – Royal and Community Health  East Surrey  East Surrey and Mid Sussex

(patient, public) Other Several respondents asked about the cost of the There some additional costs associated with the FT application process and being an FT: FT application and of being a FT.

 of the reorganisation (FT application) and Wherever possible additional activity, and hence the time it will take; cost, is being managed through existing teams

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 25 of 35  of recruiting and maintaining a and budgets. Where additional resource is membership required this is / will be procured in accordance  CRB checks for governors with Standing Financial Instructions to ensure value for money. (patient, public, voluntary sector forum) Several respondents said they would have liked Achieving FT status the NHS policy preferred to have had more information on the non-FT approach. The Trust Development Authority only options – merger, acquisition, franchising considers other options where FT status is not – and why they were discounted considered achievable.

(member of the public who works for a CCG) Request for assurance that if the Trust becomes The Trust does not have any plans to make authorised as an FT that it would not go ahead changes to staff terms and conditions. If this without meaningful consultation with staff and changes in the future then the normal the TUSC of any plans they may have to change consultation processes would be followed. any terms and conditions (i.e. to Agenda for change).

(TUSC)

13 What were the main topics that attracted support locally? (indicate in brackets the main sources of support e.g. patients, staff, general public) Topic Comments received Trust objectives and plans for the future Stakeholder responses noted the improvement in quality of the Trust’s leadership and the services provided.

(County Council) Membership Almost two thirds of those who responded agreed with children aged 14 yrs and above being eligible to be members:

 Definitely need insights from teenagers’ who are often uncluttered with adult style expectations  They are the adults of the future  They should have a say in children’s’ services

(patient, public)

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 26 of 35 Participation of younger people (14yrs +) will be for the mutual benefit of public services

(County Council) Council of Governors The majority of those responding agreed with the proposals for the Council of Governors and did not provide any further comment Name of Trust The majority of those responding agreed with the proposed name of the Trust and did not provide any further comment

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 27 of 35

14. Specifically, what was the general tenor of the responses with regard to:

Membership At public meetings there was general interest in becoming a member with the majority of those attending also completing a membership application form.

One respondent specifically raised a concern about the balance between the number of members who are either staff or related to staff and everyone else and felt this might introduce bias

No objections were received from staff regarding the auto- enrolment / opt out approach being proposed.

Council of Governors The proposals were generally supported.

Comments related to the size of the Council, and the number and type of Governors

Several comments asked about the level of help and support that will be provided to people wishing to stand for election as a governor.

Board of Directors No comments were received

Elections Although not a specific consultation question one respondent suggested that Governor elections should be held every 5 years

Constituencies Seven respondents thought the overall catchment area was too large. Of these four respondents specifically questioned the rationale for including a public constituency for the five Croydon electoral wards.

Respondents were against the proposal for two reasons:

 The larger the geographic area covered the more people to be treated which would impact negatively on those living in areas closer to the Trust  Transport links are not good enough to enable people to travel from south Croydon to the Trust

Boundaries The only comments received related to the proposal for a public constituency for Croydon (described above)

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 28 of 35 Constitution No comments were received Age limits Approx 2/3 of respondents were in favour of children aged 14yrs+ being able to be members with 1/3 against

There were no comments on the proposed minimum age for Governors

Youth representation Those in favour of membership from 14years described benefits in terms of the general perspective that younger people would bring as well as the ability to comment on children’s services

Staff representation Staff were in favour of the proposals to become a Foundation Trust and were also in favour of the representation of staff on the Council of Governors.

The Trade Union Staff Consultative Committee was in favour of the FT proposals

Vision The public and key stakeholders, other than the two CCGs that responded, liked the proposals to develop the ESH site to provide a wider range of specialist and tertiary services.

The two CCGs that responded were concerned that the proposals were expansionist and would put the CCGs at risk financially.

Transitional arrangements Not part of the consultation

HR Strategy Not part of the consultation

Communications Comments emphasised the need for effective communication

Any novel suggestions received One respondent suggested that Governors should not be as a result of the consultation? employed by / or be beneficiaries of private healthcare providers

Name of Trust The majority of respondents were in favour of the proposed name for the Trust.

A few respondents felt that the name could be improved and made suggestions for how this could be achieved e.g.:  Including the word hospital in the name  Having a name that describes what the Trust does rather than where it is  Being more accurate geographically

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 29 of 35 Other issues - specify No other material issues were raised

15. Is there anything else about the public consultation exercise and outcome that the Trust would like the Secretary of State or regulator know? The overwhelming majority of the formal responses and comments received at public staff and other meetings were supportive of the Trust’s aspiration to become a FT, its strategic plans and most of the proposed governance arrangements.

However, the consultation process did raise a pertinent concern about the proposed governance arrangements:

 That the proposed number of patient governors was too high given the number of patient members from outside of the catchment area

Following consideration by both the FT Project Board (which has Council, CCG and patient representation) and the Trust Board the following changes will be made to the composition of the Council of Governors:

 To retain the overall number of governors at 28 and to revise the composition by: o Reducing the number of patient governors to 1 (from 4) o Increasing the public governors from the following constituencies: . Reigate and Banstead to 3 (from 2) . Crawley to 3 (from 2) . Horsham to 3 (from 2) o Retain the number of CCG governors at 4: with each CCG governor representing 1 CCG . Crawley CCG - 1 . Horsham & Mid Sussex CCG – 1 . East Surrey CCG – 1 . Surrey Downs CCG -1

These changes address the issues identified in the consultation whilst also ensuring the Council remains legally constituted with a majority of patient / public governors.

16. Contact details for the person who will Gillian Francis- Musanu be available to answer detailed question Director of Corporate Affairs on the public consultation and provide Surrey & Sussex Healthcare NHS Trust copies of any responses required for Canada Drive scrutiny? Redhill RH1 5RH

Tel: 01737 768511 Ext 2862 e-mail: [email protected]

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 30 of 35

Staff engagement, involvement and wider cultural change

17. How have staff been given ample opportunity to play an active part in the dialogue and deliberations around the NHS Foundation Trust application? Where have staff dialogue and views influenced the broad HR strategy, which in turn supports the service development plans and organisational goals of the Trust?

As an organisation we have used a number of ways of engaging staff in our vision and values, and on ways to improve performance for the benefit of our patients.

At the heart of our Workforce Strategy is staff engagement which we see as more than just good communication. We have therefore concentrated on developing leadership at all levels of the organisation which has enabled the views of staff to be taken into account in our development and performance improvement plans. Our new partnership agreement negotiated with union representatives has further strengthened our work with staff representatives.

18. How did (and for the future, ‘how will’) the organisation ensure effective staff involvement and participation in shaping cultural change and service development and delivery, and embracing social partnership in its broadest sense?

Our strategy has been to ensure our workforce is representative of the communities we serve; we have and will continue to recruit locally recognising the positive impact that employment has on individuals. As a major employer in the area we are well placed to further engage with our communities. We have and will continue to develop our links with local schools and colleges and offer a wide range of work experience opportunities.

19. How has the organisation engaged with (and how will it continue to engage with) clinicians in determining the future direction of service provision, and how have the outcomes of such discussions been analysed from a cost / benefit perspective and integrated in to the service development plans outlines in the business plan (IBP)?

SaSH prides itself on being clinically led and managerially enabled and is pro active in the engagement

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 31 of 35 and participation of clinicians in agreeing the vision and future direction of future service provision. This has been done at trust wide, divisional and specialty levels in the development of the Clinical Strategy.

At a trust wide level the clinical strategic objectives were proposed and developed by the medical director and chief nurse. These were then shared with the divisional chiefs and lead clinicians who developed clinical priorities for their service developments which have been included in the clinical strategy. Each of the individual developments at specialty level were then linked backed to the clinical strategic objectives and the trust strategic objectives so that there was line of sight with how local developments enabled the Trust to meet its overarching strategy.

As the strategy was being developed the updated versions were shared with all of the lead clinicians, chief of services and chief nurses so that everyone could see the priorities of others and how everything fitted together across a five year timescale. The priorities were then aligned to other core strategies i.e. estates, workforce which in turn link to the long term financial model.

The clinical strategy will be reviewed on an annual basis as part of the annual business planning process. This will ensure that there is on-going engagement with clinicians and that clinically led service developments are reflected in the forward plans for the organisation.

20. How is the Trust developing / managing new (and existing) relationships with local health organisations and other local networks, social care, good citizenship and social responsibility, and playing a role in the wider community?

SaSH plays an active part in the local health economy working with CCGs, County and local authorities. This is evidenced in the part played in the Local Transformation Board, Urgent Care Board, Kent, Surrey & Sussex AHSN, along with a wide range of partnership and clinical and network events and meetings in both Surrey and Sussex along with other Provider and Commissioning organisations. The Trust will continue to engage and with our key stakeholders and with the wider community through the voluntary and community networks.

21. What is the degree of ‘integration’ of first rate HR practice in all the main functions of the organisation (operational, strategic and clinical) – with a view to demonstrating that good HR practice and thinking is present in the wider organisation and not only in the specialist HR function itself

The Trust recognises the importance of good people management skills in the delivery of excellent healthcare care to our patients and the key role that line managers play in supporting, developing and

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 32 of 35 motivating their teams.

A small team of professionally qualified corporate HR staff led by the Director of HR support the Board develop a culture of staff engagement through our Workforce Strategy and ensure that the HR policy framework to support managers and staff is effective. Our Partnership Agreement recognises the importance we place on engaging with our trade union colleagues as we develop our organisation.

At the heart of our strategy is the organisational development aspects of staff engagement which we describe in our ‘staff engagement star’. This provides a vehicle for delivering actions within the five themes of:-  Every role counts  Management and leadership  Promoting a health and safe working environment  Supporting personal development  Involvement in decision making

Operationally managers are supported by professionally qualified Divisional HR Business Partners who, as part of the management team provide leadership and professional expertise to support their Divisions deliver excellent services to patients through good people management. The Business Partners have developed ‘management guides’ and training which ensures that managers are equipped with the technical skills to interpret and apply the Trusts people management policies and procedures. More importantly they ensure that managers understand fully their key role in motivating, developing and managing their staff. Development of people management skills is also provided as part of our Essentials of Management training for new and aspiring managers in the Trust. Transactional HR advice and support is provided to Managers by our HR Advisory Service through Capsticks HR via telephone and attendance at formal employee relations ‘cases’.

22. How has the organisation demonstrated its commitment to unlocking the potential of all staff and enabling all staff to progress their skills and careers through lifelong learning and development?

The process of learning and development begins before an employee commences with us with development into the role through induction and provision of job related training. Throughout their employment learning and development needs are identified through our performance management and appraisal process. We have developed new roles for assistant practitioners and physicians assistants and will continue to work with staff and managers to develop our workforce to deliver our service development plans.

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 33 of 35

Appendix 1: GP practices to which the Consultation document was sent

NW Sussex

Bewbush Medical Centre, Crawley Bridge Medical Centre, Crawley Coachmans Medical Practice, Crawley Crawley Health Centre Furnace Green Surgery Crawley Gossops Green Medical Centre, Crawley Ifield Medical Practice, Crawley Langley Corner Surgery, Crawley Leacroft Medical Practice, Crawley Pound Hill Medical Group, Crawley Saxonbrook Medical Centre, Crawley Southgate Medical Group, Crawley Woodlands and Clerklands, Crawley

Courtyard Surgery, Horsham Holbrook Surgery, Horsham Orchard Surgery, Horsham Park Surgery, Horsham Riverside Surgery, Horsham Rudgwick Medical Centre, Rudgwick The Village Surgery, Southwater

The Brow Medical Centre, Burgess Hill The Surgery, Cowfold, Partridge Green

Crawley Down Health Centre Cuckfield Medical Practice, Dolphins Practice, Haywards Heath Judges Close Surgery, East Grinstead Lindfield Medical Centre The Meadows Surgery, Burgess Hill Mid Sussex Health Centre, Hurstpierpoint Moatfield Surgery, East Grinstead Newtons Practice, Haywards Heath Northlands Wood Practice, Haywards Heath Ouse Valley Practice, Handcross Parkview Health Partnership, Burgess Hill Ship Street Surgery, East Grinstead Silverdale Practice, Burgess Hill

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 34 of 35 Surrey Whyteleaf Surgery, Whyteleaf Warlingham Green Surgery, Warlingham Caterham Valley Medical Practice, Caterham Pond Tail Surgery, Godstone Oxted Health Centre Wayside Surgery, Horley Greystone House Medical Practice, Redhill Elizabeth House Medical Practice, Warlingham Chaldon Road Surgery, Caterham Townhill Medical Practice, Caterham Lingfield Surgery Smallfield Surgery Birchwood Medical Practice Health Centre, Horley Moat House Surgery, Merstham South Park Surgery, Reigate Woodlands Road Surgery, Redhill Wall House Surgery, Reigate Rusper Road Surgery, Newdigate Leith Hill Practice, Dorking Hawthorns Surgery, Redhill Holmhurst Medical Centre, Redhill Brockham Surgery North Holmwood Surgery Dorking South Holmwood Surgery Dorking Westcott Street Surgery, Dorking

Croydon (public constituency electoral wards) The Moorings Medical Practice, Kenley Mitchley Avenue Surgery, Sanderstead Purley Medical Centre, Purley Keston House Medical Centre, Purley Woodcote Medical Centre, Purley Bramley Avenue Surgery, Coulsdon Downlands Surgery, Old Coulsdon Chipstead Valley Road Surgery, Coulsdon Old Coulsdon Medical Practice The Coulsdon Medical Practice Dr Irfan, Old Coulsdon

Foundation Trust Consultation Response Author: Interim Programme Manager, FT Application Version: Final - 12.06.14 Page 35 of 35