Epidemiology & Health Science Team Analysis of responses to the public consultation survey on proposed health and social care change in Caithness December 2018 Publication produced and published by NHS Highland Public Health About the Epidemiology & Health Science Team As part of the NHS Highland Directorate of Public Health, the Epidemiology & Health Science team provide specialist skills in the areas of: Epidemiology, Evaluation, and Evidence base for Public Health functions 01463 704813 [email protected] Epidemiology and Health Science Team Directorate of Public Health NHS Highland Larch House Stoneyfield Business Park Inverness IV2 7PA Author(s): Carolyn Hunter-Rowe Acknowledgements: Sara Huc, Noelle O’Neill, Cameron Stark, Maimie Thompson If you require this document in an alternative format, such as large print or on a coloured background, please contact us to discuss your needs. CONTENTS Executive Summary 2 1. Introduction 3 2. Methods 3 3. Who responded to the consultation survey? 3 4. Preferred option 7 5. Awareness of consultation methods 15 6. Summary and Conclusions 17 References 18 Appendix 1 19 Appendix 2 20 Epidemiology & Health Science Team, Public Health 1 Executive Summary Epidemiology & Health Science Team, Public Health 2 1. Introduction The purpose of this report is to present the results of a public feedback survey on proposed major service change in Caithness. The survey is part of the NHS Highland formal public consultation on proposed changes to adult health and social care services in Caithness held between August and November 2018. The proposals under consultation include developing a Care Hub and Care Village in Thurso (located on Dunbar Hospital site, the only site considered in Thurso) and one in Wick (located at either Pulteney House or Town and County). The proposals were co-produced with local people, and form part of a number of proposed improvements to local health and social care services. The consultation documents presented a number of options for feedback and comment as follows: 1. No change – current arrangements continue 2. Care Hub/Care Village at Dunbar Hospital site (Thurso) and Town & County site (Wick) 3. Care Hub/Care Village at Dunbar Hospital site (Thurso) and Pulteney House (Wick) 4. No preference 5. Other The feedback survey aimed to ascertain the views of the public on the proposed changes and future solutions. Respondents were invited to select their preferred option as well as to comment on any aspect of the proposed options. Further information on the options under consideration is available in the full1 and summary2 public consultation documents available on the NHS Highland website. The Epidemiology and Health Science team, part of the Directorate of Public Health and Health Policy, were asked to analyse the responses to the consultation feedback survey and report the key findings. This report provides an impartial analysis of the responses received to the survey. 2. Methods 2.1. Survey design The public consultation survey was developed by the Head of Public Relations and Engagement for NHS Highland. Advice was also sought from the NHS Highland Clinical Governance team and the Scottish Health Council. The Scottish Health Council have an independent quality assurance role in supporting work carried out by NHS Boards to involve people in decisions about local health services. The survey was designed to capture feedback on the options for proposed changes to adult health and social care services in Caithness. The survey also included some standard questions to capture information about who responded to support equality and diversity monitoring and sensitivity analysis, for instance, where people lived. Two questions were also included to gather feedback on consultation awareness and information sources. Epidemiology & Health Science Team, Public Health 3 2.2. Data collection and management Formal public consultation took place over a three month period from 20 August 2018 to 23 November 2018. The public consultation survey and consultation documents were made available on the NHS Highland website from 20 August 2018. Responses to the survey could be completed electronically or by returning a paper copy (freepost address provided). The feedback survey was distributed to all 14,529 postal addresses in Caithness using an address list provided by Royal Mail. Survey forms were also available at public meetings during the formal consultation period and promoted on the NHS Highland website, social media and local media releases. Completed paper survey forms received by NHS Highland were reviewed and manually entered into the survey database by the Head of Public Relations and Engagement (Maimie Thompson). Forms with large amounts of text were transcribed verbatim by the Project Administrator and input to the database. Eight forms had free text comments that contained personal identifiable information (responder, individual patients or staff); these comments were excluded from the survey database. Survey forms were accepted and entered until 30 November 2018. Five forms were excluded that arrived after this date. A final data extract of the survey was downloaded on 3 December 2018 and sent to the Directorate of Public Health for analysis. The survey analysis does not include feedback on the public consultation received by email or letter. 2.3. Data analysis and reporting Simple descriptive analyses were undertaken using excel and a statistical software package (SPSS v25). Percentages were calculated using the total number of responses as the denominator rather than responses to each individual question. This method is most appropriate to this particular survey design.3 Sensitivity analyses were undertaken by calculating 95% confidence intervals for the proportion reporting a preferred option. The 95% confidence intervals are used to indicate whether there was any statistical overlap in the selected options. Responses were analysed geographically based upon answers to the question ‘Where do you live?’. Each record was assigned a consultation area using a geographical information system software package (ArcGIS). The consultation areas were defined using 2017 electoral ward boundaries for Thurso and Northwest Caithness Ward and Wick and East Caithness Ward (Appendix 1). Place names outwith the two Caithness ward boundaries were assigned the value ’Outwith’ and blank responses assigned the value ’Unknown’. All comments and viewpoints expressed in the survey were uploaded into a qualitative analysis software package (Dedoose). Themes were summarised using a standard framework.4 This involved the identification of themes and sub-themes using sentiment analysis, where comments are coded as positive, negative or neutral.5 A second coder reviewed a sample (n=70) of comments. Once all responses were coded, the coding framework was reviewed and reorganised to enable accurate analysis of the feedback for this report (Appendix 2). Epidemiology & Health Science Team, Public Health 2 3. Who responded to the consultation survey? 3.1. Number of responses There were 2,017 responses to the public consultation feedback survey. Of these 1,878 responses (93%) were written responses to the survey delivered to homes, 32 (2%) were written responses from surveys available at meetings and on the website, and 107 (5%) were responses to the online questionnaire. Respondents to the consultation survey were asked to indicate the basis upon which they were responding to the survey (Table 1). The majority of respondents indicated that they were responding to the survey as an individual (44%) or as a family or household (51%). Where respondents indicated that they were responding on behalf of a family, household or group, 382 responses provided details of the number of people the response was on behalf of. Of these, almost three quarters (73%) reported responding on behalf of one other person. The other household and group sizes reported varied between three and eight people. Table 1: How are you responding to this survey? Number of % of Status of responder respondents respondents Individual 892 44.2% Family/household 1,023 50.7% Group 8 0.4% Other 0 0.0% Prefer not to say 18 0.9% Not answered 76 3.8% Total responses 2,017 100.0% 3.2. Response rate Consultation respondents were asked to state the nearest town or village where they live, with responses assigned to one of the Highland wards in Caithness (Table 2). There were 1,046 responses (52%) received for Thurso and Northwest Caithness Ward, and 744 responses (37%) received for Wick and East Caithness Ward. There were 57 responses (3%) from outwith Caithness and 170 responses (8%) where the respondent did not provide a town or village. The consultation survey achieved an overall response rate of 9%. The response rate for Thurso and Northwest Caithness (10%) was greater than the response rate for Wick and East Caithness (7%). The overall response rate of 9% is higher than the 1% response rate considered ‘good’ by the Consultation Institute, and considerably higher than the average response rate (0.7%) for UK public consultations.6 Epidemiology & Health Science Team, Public Health 3 Table 2: Response rate by consultation area Number of Responses Population Response Consultation area responses (%) aged 16 rate (%) and over1 Thurso and Northwest Caithness Ward 1,046 51.9% 10,337 10.1% Wick and East Caithness Ward 744 36.9% 11,016 6.8% Total Caithness 1,790 88.7% 21,353 8.4% Outwith 57 2.8% - - Unknown 170 8.4% - - Total responses 2,017 100.0% 21,353 9.4% Source: Caithness Public Consultation Survey 1. NRS Small Area Population Estimates (2017), best fit to Caithness Electoral Ward boundaries The distribution of survey respondents by self-reported place of residence across the Caithness public consultation area is shown in Figure 1. The map indicates where responses from outwith the Caithness consultation area originate, but excludes those where a town or village names was not provided. Figure 1: Distribution of survey respondents in the Caithness public consultation area 3.3. Self-declared category of responder Consultation respondents were asked to state the category(s) that best describes who they were responding on behalf of.