Neighbourhood Survey Wyre Rural Extended Neighbourhood results February 2019

Executive summary

NHS and NHS Fylde and Wyre Clinical Commissioning Groups are committed to listening to patients and members of the public to ensure their views and experiences inform quality improvements and commissioning intentions. In December 2018, under the Healthier Fylde Coast partnership, which includes the NHS, local authority, the voluntary, community and faith sector and residents, the CCGs developed a ‘neighbourhood plan survey’ to provide public perceptions data in relation to the 10 neighbourhoods across coast.

The survey asked residents about their community (the place where they live, the surrounding area and the places they use in their daily life, for example, shops, schools and health services). It also asked how neighbourhoods (groups of GP practices, social care, local councils, the voluntary sector and residents, which usually cover populations of between 30,000 – 50,000) can work together to improve health and wellbeing in their community.

The survey ran from 16 November to 21 December 2018 and was promoted on social media, the CCGs’ website, via GP practices and through paper surveys in GP surgeries. Patient participation groups helped to distribute and promote the surveys. The survey was broken down into three distinct sections, ‘your community, ‘working together’ and ‘your voice’.

For the purposes of this report, the data analysis will focus on the first two sections, with the findings of the third section being used to inform a refresh of the CCGs’ communications and engagement strategy in Spring 2019 and to supplement the findings of the NHS 360 stakeholder survey.

A total of 1,562 responses (both online and paper responses) were received, with 153 responses coming from the Wyre Rural Extended Neighbourhood, which covers Over Wyre, and .

The table below shows a breakdown of the responses by practice.

Registered patients population Number of surveys January 2019 returned Garstang Medical Practice 18417 52 Great Eccleston Health Centre 7453 35 Over Wyre Medical Centre 11233 66

Key findings

Generally speaking, the respondents to the survey in WREN (Wyre Rural Extended Neighbourhood) rated ‘opportunities for walking’, ‘being able to get around’ and ‘natural spaces’ as at least good if not excellent. Overall, ‘places for children’ was rated as good, while more than a third of people rated ‘places for older children’ as poor. Generally speaking, people rated ‘sports and recreation facilities’ as could do better, while the majority of people rated ‘sense of community’ and ‘opportunities to take part’ as at least good.

In responding to what would help them feel their community is a better place to live well, the majority of people wanted to see better transport links and more public transport, followed by more for young people/teenagers. Interestingly (as this was unique to this particular

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neighbourhood), a number of respondents specifically mentioned the need for more, safe and well maintained pavements/footpaths.

More than half of people said they know what is in their local area to help them live a healthier life, while a quarter said they didn’t. The vast majority of people who answered the question ‘what local resources help you live a healthier life?’ cited green spaces and places to walk and cycle.

When asked about how well organisations work with others, people seemed to know the least about the CCGs, Blackpool Teaching Hospitals NHS Foundation Trust, schools and their employer. Generally speaking, most people felt most organisations could do better.

Ninety five per cent of people felt it was important for local services to work together to improve health and wellbeing and that if services worked together it would result in a better, more well-rounded service.

Data analysis

Your community

Thinking about where you live, how would you rate the following? (1 being very poor and 6 being excellent)

120

100

80 1 60 2 40 3 20 4

0 5 6 Don't know

As a mandatory question, 153 people answered the above question. More than 80% of people rated ‘opportunities for walking’ and ‘natural spaces’ as at least good, if not excellent, while more than half rated ‘being able to get around’ the same. More than half of people rated ‘places for children’ as good, while 37% rated ‘places for older children’ as poor. Forty per cent of respondents rated ‘sports and recreation facilities’ as could do better, while the majority of people rated ‘sense of community’ and ‘opportunities to take part’ as at least good.

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What would help you feel your community is a better place to live well?

Not everybody chose to answer the above question which received 100 responses, although some individuals did choose to make more than one comment. Analysis of this data showed some clear themes and trends, demonstrated in the above word cloud. The majority of people wanted to see better transport links, more public transport (particularly buses), safer roads and more/better cycles paths and less traffic, followed by more safe places/activities/facilities for young people/teenagers. Interestingly (as this was unique to this particular neighbourhood), a number of respondents specifically mentioned the need for more, safe and well maintained pavements/footpaths.

There were similar numbers of comments regarding a need for better sports facilities and other amenities, more activities to bring the community together and better GP access. People also want to see a more visible police presence.

You can view the full list of the categorised responses to this question in Appendix A and the verbatim responses in Appendix B.

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Generally, do you know what there is in your local area to help you live a healthier lifestyle?

No Don't know 25% 16%

Yes 59%

As a mandatory question, 153 people answered the above question. More than half of respondents said they know what there is in their local area to help them live a healthier lifestyle, a quarter said they didn’t.

What local resources help you live a healthier life?

Caveat – it appears a small minority of people answered the question on the basis of what local resources would help them live a healthier life.

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Not everybody chose to answer the above question which received 92 responses, although some individuals did choose to make more than one comment. The vast majority of people cited green spaces and places to walk and cycle as the local resources which help them to live a healthier life. Respondents also cited gym and sports facilities, community groups, such as walking clubs and slimming clubs, and the ‘green book’, the local community magazine.

You can view the full list of the categorised responses to this question in Appendix C and the verbatim responses in Appendix D.

Working together

How well do you feel the following organisations work with others (including the local community and voluntary sector) to improve health and wellbeing and provide healthy choices? (1 being very poor and 6 being excellent)

90

80

70

60 CCGs BTH 50 GP practices 40 Councils Schools 30 Your employer 20

10

0 1 2 3 4 5 6 Don't know

As a mandatory question, 153 people answered the above question. The majority of the respondents seemed to know the least about the CCGs, Blackpool Teaching Hospitals NHS Foundation Trust, schools and their employer, citing they didn’t know how well those organisations worked with others. Generally speaking, people thought most organisations could do better at working with others, although similar numbers also thought Blackpool Teaching Hospitals NHS Foundation Trust and GP practices were good at working with others.

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How important is it for local services to work together to improve health and wellbeing in your area?

No opinion Not important 4% 1%

Fairly important 15%

Very important 80%

As a mandatory question, 153 people answered the above question. The majority of people (95%) felt it was important for local services to work together to improve health and wellbeing in their area, only one person felt it wasn’t important.

Following on from the above question, respondents were asked to give a reason for their answer with 91 people choosing to give a response.

The majority of people believed that services should work together because it would result in a better, more well-rounded service, as well as making the best use of limited resources/funds. Respondents also stressed the importance of the people being informed about what services are available to them. People also felt it was important for services to

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work together as this would result in improved health of the local population. People in the Wyre Integrated Neighbourhood also highlighted its rurality and ageing population and felt it was important for services to work together to avoid duplication.

You can view the full list of the categorised responses to this question in Appendix E and the verbatim responses in Appendix F.

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Appendix A – categorised comments

What would help you feel your community is a better place to live well?

Transport/roads

1. Better public transport. 2. Improve public transport 3. better public transport 4. Better bus routes, better roads. 5. Need to improve the Bus service so that it is active during the day and later in the evenings 6. Better public transport 7. Sunday bus service 8. Less buses polluting the air with barely any passengers on or none at all 9. Train service. Improvement to it transport. 10. Bike lanes, a bus service every day of the week. 11. Buses to go around where people live and not just straight through town 12. Less traffic in town centres. 13. Better public transport, i.e. bus services. 14. Regular bus service 15. I live in Scorton and there is no bus service 16. Train service. Less traffic. 17. Reduction in traffic and road speeds 18. We need a better public transport system. The current bus service terminates at 9pm Monday to Saturday and no Sunday service. 19. Without a car, it's not possible to visit friends or family who are in hospital or nursing homes outside of the district. 20. Better public transport including a railway station. 21. A better bus route it's terrible here at not one to Garstang and if Lancaster bus is late miss the one to Poulton .Taxis very expensive 22. Better public transport 23. Segregated Cycle routes from schools and shops to main housing areas also electric car charging points it’s like the dark ages 24. Public transport. We cannot leave the village in the evenings because there is no public transport to get home 25. Improve road and pavement surfaces. 26. Better roads. Better public transport. 27. Road conditions also cause a major problem crossing from one side to the other to avoid bad pavement conditions. The village is more frequented by very heavy vehicles passing through the village to the redevelopment of social housing causing damage to rural roadways. 28. Public transport 29. A railway station would be a big plus to save long journeys to Preston or Lancaster 30. Reinstatement of evening bus service to Blackpool. 31. Few bus routes come but I would hate to rely on them. the bus to Lancaster breaks down regularly and after the 7:24 bus there isn't one until 10:07. 32. Better transport links 33. Better transport 34. Safer roads. Better public transport. 35. Better public transport links in the rural areas this is poor. 36. Slower traffic through the village 37. Better public transport to Blackpool, Lancaster and Garstang. 38. Better transport system

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39. Less traffic on inadequate roads and fewer speeding motorists. 40. Better bus services - we have none on a Sunday and limited in the evenings and only one the rest of the time 41. Fix roads 42. Better public transport.

Young people

1. Something for teenagers to do 2. More for young people 3. Places for teenagers to go 4. Teenagers need more social gatherings and maybe guidance and advice on alcohol and drugs and their effect long term, giving support too where needed. 5. Invest in our youngsters today, right now and avoid the consequences of drug abuse where in my experience more and more teenagers go on to stronger drugs or depend on anti-depressants. 6. More facilities for young people to meet and spend time together safely. 7. More social meeting places for teenagers 8. More facilities and support for young children 9. Very little for teenagers 10. Better facilities for teenagers 11. Better facilities for young people. 12. A place for teenagers to meet with friends 13. Something for teenagers. 14. Activities for teenagers 15. Improved facilities for young people. 16. Organised child and youth activities without having to travel miles. 17. There is very little for teenagers to do. Ideally an indoor space for poor weather or evenings. 18. Better facilities for teenagers /children so they do not have to hang about the streets/public areas. 19. Facilities for teenagers 20. Better play facilities for children 21. Less groups of teenagers on street corners, more activities, 22. More opportunities for activities young people. Youth clubs, language classes, wellbeing classes etc. I feel the over Wyre community is being abandoned by the WBC. 23. council listening to what younger people want and need instead of making decisions just to suit themselves, for example when 200 people sign a petition to use a space where young people can skate , don’t just ignore it and instead use the space for what the councillors themselves want which is a wildlife garden where people are not even allowed to walk around with their dogs hence it getting enjoyed by very few people and the young people are still left with nowhere to meet and have exercise. 24. Better recreation for kids

Environment

1. Less housing development as the roads have not and cannot cope with the additional traffic generated 2. Less Litter/fly-tipping. 3. Better lighting 4. There is a playground and field that could be done more with, perhaps a small basketball area or a BMX or skateboard area tailored to older kids, and a shelter. 5. Lovely countryside but no actual park to have a walk in. you'd have to drive

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Pavements  Pavements  Pram accessible walks that you can take the dog  Pavements on my road as there are no street lamps either.  More footpaths  More opportunities to cross busy roads.  Safer pavements/walkways for children to walk to school.  Pavements around the village require attention. A majority of elderly infirm residents find it difficult to manoeuvre either by foot of mobility scooters.  Beautiful countryside but very narrow or absent paths especially on blind corners make it dangerous for walking kids and dogs and letting kids cycle. No speeding deterrents at all. No safe path to school and 200 new houses are being built on the narrow road with narrow and absent footpaths with plan for another 400, so double the size of the village with no road infrastructure or parking.  Safer footpaths  A public footpath linking Nateby with Garstang  More lit pavements  Keep it clean, fix footpaths

Amenities/facilities

1. We need a leisure centre at Knott End for all the community to use and all age groups. 2. More shops and cafes open on Sunday. I have seen so many families wandering about looking for a cafe. 3. Bring back a swimming pool 4. Better sports facilities 5. A sports facility Over Wyre, e.g. swimming pool, accessible fitness classes. It’s a 30mins commute to the nearest place (that's if there is a bus) which prevents people from attending and keeping fit. 6. A swimming pool and gym that is affordable 7. More schools and medical staff as lots of new houses being built but no resources are being brought into the area to cope with the population increase. 8. Better family opportunities. - no joined up activities 9. Health & fitness family opportunities. E.g. nearest swimming pool is at least 30 mins away without traffic and not accessible family times and too far for additional needs children to travel alone when older. 10. Outdoor gym is a nonsense no organised activities to encourage usage 11. Reasonably priced YMCA facilities- 16 year olds have to pay adult prices for swimming. More incentives to keep fit 12. Better leisure facilities provided by LCC in the area without having to travel miles. e.g. a Gym, swimming pool, etc 13. Better indoor sport/leisure facilities (e.g. we have really small swimming pool only) 14. Build more communal spaces, sports facilities, shops, schools and young people’s spaces etc. when they build new houses in the area 15. More amenities. 16. Improved play area in central area of village away from main road and improved quality and access to multi-purpose sports area.

Health services

1. Being able to get an appointment to see our GP, without a five week wait. 2. I chose to move here due to local access and amenities. 3. If we had a better service from our GP

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4. Better access at getting a doctor appointment 5. More referrals should be taking place from GP's and their surgeries into activities happening in our community. We need social prescribing. 6. Full time doctors surgery. 7. More community clinics and mobile screening/mobile minor surgery e.g. for bread screening, cataracts. I have agoraphobia so am unable to leave Garstang. I am bond with a cataract in me eye but unable to get to a hospital. Also I can't get for breast screening for the same reason. Years ago mobile units used to go round areas dealing with both these problems. 8. Wider services at the generally excellent GP practice. Is it really necessary for a 20 mile plus round trip to remove a splinter at A&E. 9. GP practice to remain open Thursday PM 10. Better support for our PPG we need to publicise and advertise and try to get the input of patients but we need the support of the practice. 11. Better GP facilities 12. Bigger health centre

Community

1. Opportunities for local people to meet and socialise. 2. Events that bring people together. Opportunities to make new friends 3. More community gatherings for the elderly, there is a large elderly population in Knott End. 4. More social groups. 5. It would be great to feel more of the community - but as a couple with no children, who don't go to Church or go to the local pub, there's really limited ways of being involved in the community. This is possibly made more difficult by not having grown up in the area so we don't have long term friends in the village from school days etc. 6. There seems to be quite a lot of social clubs for older / retired people that take place in the week, but nothing really for younger, working people. 7. Community centre that is inclusive and not church centred 8. Better social activities 9. People to pull together more ...but let's face it people thrive on antagonism 10. More friendly people 11. Good neighbours

Police

1. Police presence 2. Stop the brazen passing on of drugs from youths in cars it has even been seen on Sainsbury’s car park. More police on the beat. 3. More police visibility 4. More police 5. More police in the community as two cash points recently rammed 6. Manned police station or a police presence 7. More police patrols 8. Improved and more regular police, fire and ambulance presence. 9. Community policing 10. More police presence/scrutiny.

Communication

1. More notice boards with information on about local things happening 2. Like an easy to access database with all this on. 3. More information about healthy lifestyle on a budget

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4. Better advertised groups and services particularly those for families with young children 5. Advertising what is available

Older people

1. More opportunities for older people to get out and socialise. 2. More entertainment for older age groups only the working men's Club once a week but entertainment not good 3. More opportunities for activities for older people. I feel the over Wyre community is being abandoned by the WBC.

Other

1. No provision for additional needs young people. 2. There is nothing wrong with the community as it is in my opinion. 3. I am quite happy living in the community and find the whole area and its people lovely. 4. More understanding of all peoples needs by parish councillors and local authority councillors. We are not all middleclass! 5. suddenly improving, with shops appearing! 6. If you’re fit, and your family lives more centrally, lots of opportunities are available for getting outdoors or using facilities, move just outside the centres of Garstang, Camus, Catterall this becomes a more challenging task. 7. Remote villages, i.e. Nateby, , etc, is a totally different story, particularly if you do not have a car, public transport is just a total no, taxis are very expensive and nit practical for families with children, proms etc. Much more needs to be achieved for everyone. 8. More evening events, ?? night school classes at St Aidens 9. Get rid of mindless thugs by giving them something to do.

Appendix B – verbatim comments

What would help you feel your community is a better place to live well? Being able to get an appointment to see our GP, without a five week wait. I chose to move here due to local access and amenities. Less housing development as the roads have not and cannot cope with the additional traffic generated Opportunities for local people to meet and socialise. something for teenagers to do If we had a better service from our GP There is nothing wrong with the community as it is in my opinion. I am quite happy living in the community and find the whole area and it’s poeple lovely. We need a leisure centre at Knott End for all the community to use and all age groups. Police presence. More notice boards with information on about local things happening Stop the brazen passing on of drugs from youths in cars it has even been seen on Sainsbury’s car park . More police on the beat. More shops and cafes open on Sunday. I have seen so many families wandering about looking for a cafe . - Better public transport. More for young people More police visibility More Police, better access at getting a doctor appointment

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Improve public transport Events that bring people together . Opportunities to make new friends Places for teenagers to go. Pavements, better public transport. Better bus routes, better roads. Bring back a swimming pool. More police in the community as two cash points recently rammed. More community gatherings for the elderly, there is a large elderly population in Knott End. Teenagers need more social gatherings and maybe guidance and advice on alcohol and drugs and their effect long term, giving support too where needed. When I was a teenager there were discos held regularly with no or little trouble whereas now I have learned from Facebook of social gatherings ending with intimidation of young individuals, actually being bullied and attacked, therefore needs more manning on events like this. NO ONE SHOULD BE BULLIED, END OF and should have someone to turn to if they are. Crack down on Weed and other substance abuse, police don't care unless it's class A drugs. Invest in our youngsters today, right now and avoid the consequences of drug abuse where in my experience more and more teenagers go on to stronger drugs or depend on anti-depressants. More understanding of all peoples needs by parish councillors and local authority councillors. We are not all middleclass! Only just moved here, so can’t really say yet. More facilities for young people to meet and spend time together safely. Need to improve the Bus service so that it is active during the day and later in the evenings More social meeting places for teenagers More referrals should be taking place from GP's and their surgeries into activities happening in our community. We need social prescribing. Better public transport More facilities and support for young children and a Sunday bus service More opportunities for older people to get out and socialise. better ports facilities Like an easy to access database with all this on. Less buses polluting the air with barely any passengers on or none at all A sports facility Over Wyre, eg swimming pool, accessable fitness classes. Its a 30mins commute to the nearest place (that's if there is a bus) which prevents people from attending and keeping fit. More social groups. More information about healthy lifestyle on a budget Better advertised groups and services particularly those for families with young children Pram accessible walks that you can take the dog Pavements on my road as there are no street lamps either. very little for teeanagers Train service. Improvement to it transport. It would be great to feel more of the community - but as a couple with no children, who don't go to Church or go to the local pub, there's really limited ways of being involved in the community. This is possibly made more difficult by not having grown up in the area so we don't have long term friends in the village from school days etc.

There seems to be quite a lot of social clubs for older / retired people that take place in the week, but nothing really for younger, working people. better facilities for teenagers bike lanes,more footpaths. a bus service every day of the week. a swimming pool and gym that is affordable Buses to go around where people live and not just straight through town Manned police station or a police presence More police patrols Less traffic in town centres. More opportunities to cross busy roads. Safer pavements/walkways for children to walk to school.

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Better public transport, i.e. bus services. Better facilities for young people. Regular bus service (I live in Scorton and there is no bus service A place for teenagers to meet with friends Less Litter/fly-tipping. train service. less traffic. Reduction in traffic and road speeds We need a better public transport system. The current bus service terminates at 9pm Monday to Saturday and no Sunday service. Without a car, it's not possible to visit friends or family who are in hospital or nursing homes outside of the district. Better public transport including a railway station. More schools and medical staff as lots of new houses being built but no resources are being brought into the area to cope with the population increase. A better bus route it's terrible here at pilling not oneto garstang and if lancaster bus is late miss the one to poulton .Taxis very expensive Better family opportunities. - no joined up activities Health & fitness family opportunities. Eg nearest swimming pool is at least 30 mins away without traffic and not accessible family times and too far for additional needs children to travel alone when older. No provision for additional needs young people. Something for teenagers. community centre that is inclusive and not church centrerd Better public transport Segregated Cycle routes from schools and shops to main housing areas also electric car charging points it’s like the dark ages

Outdoor gym is a nonsense no organised activities to encourage usage activities for teenagers reasonably priced YMCA facilities- 16 year olds have to pay adult prices for swimming . More incdentives to keep fit Full time doctors surgery. Improved facilities for young people. advertising what is available Organised child and youth activities without having to travel miles. Improved and more regular police, fire and ambulance presence. Better leisure facilities provided by LCC in the area without having to travel miles. e.g a Gym, swimming pool, etc More community clinics and mobile screening/mobile minor surgery eg for bread screening, cataracts. I have agoraphobia so am unable to Leave garstang. I am bond with a cataract in me eye but unable to get to a hospital. Also I can't get for breast screening for the same reason. Years ago mobile units used to go round areas dealing with both these problems. More friendly people better indoor sport/leisure facilities (e.g. we have really small swimming pool only) More entertainment for older age groups only the working men's Club once a week but entertainment not good Public transport. We cannot leave the village in the evenings because there is no public transport to get home Good neighbours Improve road and pavement surfaces. Build more communal spaces, sports facilities, shops, schools and young peeoples spaces etc when they build new houses in the area Better lighting. Better roads. Better public transport. More amenities. Pavements around the village require attention. A majority of elderly infirm residents find it difficult to maneuver either by foot of mobility scooters. Road conditions also cause a major problem crossing from one side to the other to avoid bad pavement conditions. The village is

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more frequented by very heavy vehicles passing through the village to the redevelopment of social housing causing damage to rural roadways. public transport community policing A railway station would be a big plus to save long journeys to Preston or Lancaster.

Reinstatement of evening bus service to Blackpool.

Wider services at the generally excellent GP practice. Is it really necessary for a 20 mile plus round trip to remove a splinter at A&E.

GP practice to remain open Thursday PM Catterall suddenly improving, with shops appearing! Beautiful countryside but very narrow or absent paths especially on blind corners make it dangerous for walking kids and dogs and letting kids cycle. No speeding deterrents at all. No safe path to school and 200 new houses are being built on the narrow road with narrow and absent footpaths with plan for another 400, so double the size of the village with no road infrastructure or parking. There is a playground and field that could be done more with, perhaps a small basketball area or a BMX or skateboard area tailored to older kids, and a shelter.There is very little for teenagers to do. Ideally an indoor space for poor weather or evenings. Few bus routes come but I would hate to rely on them. the bus to Lancaster breaks down regularly and after the 7:24 bus there isn't one until 10:07. lovely countryside but no actual park to have a walk in. you'd have to drive Better transport links Better transport and social activities Safer footpaths and roads.Better public transport. Better public transport links in the rural areas this is poor. Better facilities for teenagers /children so they do not have to hang about the streets/public areas. Better support for our PPG we need to publicise and advertise and try to get the inout of patients but we need the support of the practice. Facilities for teenagers A public footpath linking Nateby with garstang Slower traffic through the village Better play facilities for children More lit pavements Less groups of teenagers on street corners, more activities, better public transport to Blackpool, Lancaster and Garstang. Better transport system More opportunities for activities for older / young people. Youth clubs, language classes, well being classes etc. I feel the the over Wyre community is being abandoned by the WBC. Improved play area in central area of village away from main road and improved quality and access to multi purpose sports area. If your fit, and your family lives more centrally, lots of opportunities are available for getting outdoors or using facilities, move just outside the centres of Garstang, Camus, Catterall this becomes a more challenging task.

Remote villages, ie Nateby, Oakenclough, etc, is a totally different story, particularly if you do no have a car, public transport is just a total no, taxis are very expensive and nit practical for families with children, proms etc. Much more needs to be achieved for everyone. More police presence/scrutiny. Less traffic on inadequate roads and fewer speeding motorists. Better bus services - we have none on a Sunday and limited in the evenings and only one the rest of the time

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more evening events, ?? night school classes at St Aidens People to pull together more ...but let's face it people thrive on antagonism Better GP facilities Parish council listening to what younger people want and need instead of making decisions just to suit themselves, for example when 200 people sign a petition to use a space where young people can skate , don’t just ignore it and instead use the space for what the councillors themselves want which is a wildlife garden where people are not even allowed to walk around with their dogs hence it getting enjoyed by very few people and the young people are still left with nowhere to meet and have excercise. N/A Keep it clean, fix footpaths and roads, get rid of mindless thugs by giving them something to do. Bigger health centre, better recreation for kids Better public transport.

Appendix C – categorised comments

What local resources help you live a healthier life?

Outdoor space

1. Lovely places to walk. 2. Local open spaces 3. Lovely walks. 4. Outdoor gym and park 5. Just walking 6. Sufficient walking areas 7. We now walk for half an hour everyday - brisk and slower 8. For me, just good countryside walking 9. The many & varied public footpaths. 10. Walking Routes 11. Access to open countryside, 12. Open spaces 13. Access to parks and country walks 14. walks 15. Parks, footpaths 16. I am fortunate, I live in the countryside, have horses and land. There are many places where I can walk my dog. 17. Fresh air as I live in a rural community but there are heavy goods vehicles using the roads as a short cut making fresh air less available. 18. Local parks, cycling on the country roads 19. Good access to promenade 20. Millennium Green - Garstang (pram accessible walk) 21. Bridal ways 22. Cycle paths 23. The beach 24. For me it’s great living in the countryside as I really enjoy running and cycling. There aren't actually any community type resources that I access - just the country lanes for my runs and bike rides. 25. Lovely walks by the sea. 26. We’re walks beach lots of public footpaths 27. Outdoor space, lanes to run down. Only disadvantage is there are no good street lights for running at night 28. Non traffic walking along canal, millennium green, local walks

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29. I have dogs so walk every day either on my own or with a friend or my partner; I don't join local outdoor groups because these exclude dogs 30. The outdoors 31. Green spaces 32. Green spaces to explore, Trough of Bowland on the doorstep. 33. Areas for walking 34. Green spaces for walking and enjoying the outdoors. 35. Local park in walking distance to take children with good facilities 36. Can walk long way into town along canal which is lovely when time isn't an issue" 37. Being near the coast able to walk along seafront. Area is flat for walking and cycling 38. Parks, beaches, promenades 39. Walking 40. Kepple Lane Park 41. Opportunities to walk and cycle. Field for boys to play football. 42. Parks and beaches 43. Tourist information posts regular walks. 44. Country lanes for cycling and walking 45. Space 46. Millennium Green 47. Walking 48. Well signed paths through countryside and coastal paths. 49. Countryside living but within easy driving distance to Lancaster and Garstang

Gym/sports facilities

1. Very good fitness centres/gym/pool 2. Gym 3. Fitness classes for over 60s 4. Exercise Groups 5. Exercise classes at Elswick Village Hall and Great Eccleston Village Centre 6. Bowling greens, indoor bowls 7. There are local organisations such as pilates, yoga 8. The YMCA Leisure Centres, 9. Access to YMCA swimming pools 10. YMCA pool and gym are brilliant. 11. Currently member of acresfield gym although the opening hours need to be longer to fit round childcare 12. Several leisure/ swimming pools 13. Sporting activities, 14. Local swimming pool. 15. YMCA, 16. A keep fit class or two 17. Outdoor space 18. Swimming pool. 19. Golf club 20. There are a few classes in the local halls that help. Pilates and Piloxing 21. Lots of private physios and PTs

Negatives/suggestions

 We need a leisure centre at Knott End on Sea. Where everyone in our local area could use  A swimming pool would be a huge improvement  YMCA IS too pricey

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 We have a village football field and a fantastic all weather pitch - unfortunately the village council made a decision not to upkeep the all-weather pitch ( even though they have always charged individuals for its use ) instead they have spent village money on flowers., which are beautiful but again at the expense of providing facilities fir younger people to enjoy.

Community/groups

1. Walking clubs. We have a local football club which has facilities to accommodate classes, meetings etc and also a local village hall. 2. Women's institute who have monthly meetings and lots of activities. 3. GT Eccleston Village centre which organises courses events and activities 4. Walking, cycling groups, parenting groups, local library is a god send. 5. and good social groups within my village and also in Garstang 6. Plenty of activity groups and 7. slimming world groups, 8. Walking groups and encouragement to get people outdoors 9. I have an injury so am currently unable to join the running club and the cycling club. There are several local WI groups which are good for social health. The 3 Scorton churches are active and inclusive and are good for social emotional wellbeing. 10. Village centre classes. 11. Weight watchers club 12. Belonging to clubs and groups 13. Elswick Singers held in the village hall. 14. Family and Friends. 15. Walking groups, village centre hold various courses for good health and outside optical services are available on a fairly advertised basis. 16. I provide by running a singing group! 17. Weight watchers, sewing group, dancing 18. WWI – Health club and my own motivation 19. Join all the clubs 20. Library offers different group meetings 21. Many support groups, activities, social groups

Health services

1. My GP surgery 2. pharmacy services 3. Excellent Medical Centre and support offered there. 4. Good healthcare - dentist/doctors, lots of community clubs and interesting groups to get involved with. 5. Kepple Lane pharmacy offers smoking cessation

 Bigger health centre

Communication

1. Garstang Focus magazine is great at updating what is going on in the local community. 2. Local monthly magazine provides details of 'what going on' and appropriate community support programmes 3. Info provided through the free green book on a monthly basis is informative about opportunities. 4. Read the green book articles or do myself

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5. The green book that has information of what is going on locally. The local paper. Community notice board. 6. We have 'the green book' that has a great source of information. 7. Green book has local events in it

Local shops

1. Local healthy food shops and. 2. Fresh local produce from local shops. 3. local produce shops 4. local market / /choice of supermarkets

Other 1. Lots of social and physical activities taking place in our community. You just need to know you need or want to do something to help yourself and have the motivation and confidence to choose something and give it a go. The trouble is, people who are already lacking in confidence might find that first step overwhelming." 2. Stop smoking service was exceptional: my husband and I quit six years ago and are feeling the benefits. 3. The whole area. 4. Web 5. Check-ups. 6. Better public transport 7. Absolutely no idea, my family also say they aren’t aware of what resources are available 8. I wouldn't access immediately local resources but travel to ones in neighbouring areas (within either the larger Wyre or Blackpool area). 9. Don’t use any at present. I have done in the past.

Appendix D – verbatim comments

What local resources help you live a healthier life? Lovely places to walk. Local open spaces and very good fitness centres/gym/pool Garstang Focus magazine is great at updating what is going on in the local community. Local monthly magazine provides details of 'what going on' and appropriate community support programmes Lovely walks. gym and out door gym and park Just walking Local healthy food shops and sufficient walking areas. Stop smoking service was exceptional: my husband and I quit six years ago and are feeling the benefits. We now walk for half an hour everyday - brisk and slower. For me..just good countryside walking The whole area. The many & varied public footpaths. Fitness classes for over 60’s. We need a leisure centre at Knott End on Sea. Where everyone in our local area could use. Info provided through the free green book on a monthly basis is informative about opportunities.

Lots of social and physical activities taking place in our community. You just need to know you need or want to do something to help yourself and have the motivation and confidence to choose something and give it a go. The trouble is, people who are already lacking in

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confidence might find that first step overwhelming. N/a Elswick Singers held in the village hall. Exercise Groups. Walking Routes Family and Friends. - Access to open countryside, exercise classes at Elswick Village Hall and Great Eccleston Village Centre Open spaces Read the green book articles or do myself Parks, footpaths My gp surgery Access to parks and country walks Bowling greens , walks, indoor bowls. There are local organisations such as pilates, yoga, walking clubs. I am fortunate, I live in the countryside, have horses and land. There are many places where I can walk my dog. We have a local football club which has facilities to accommodate classes, meetings etc and also a local village hall. Fresh air as I live in a rural community but there are heavy goods vehicles using the roads as a short cut making fresh air less available. Fresh local produce from local shops. Well signed paths through countryside and coastal paths. Women's institute who have monthly meetings and lots of activities. GT Eccleston Village centre which organises courses events and activites. Web The YMCA Leisure Centres, local parks, cycling on the country roads. Access to YMCA swimming pools Walking, cycling groups, parenting groups, local library is a god send. YMCA pool and gym are brilliant. Good access to promenade Unsure Millennium Green - Garstang (pram accessible walk) Currently member of acresfield gym although the opening hours need to be longer to fit round childcare local produce shops bridal ways cycle paths the beach The green book that has information of what is going on locally. The local paper.community notice board. For me its great living in the countryside as I really enjoy running and cycling. There aren't actually any community type resources that I access - just the country lanes for my runs and bike rides. don't use any at present. I have done in the past. countryside living but within easy driving distance to Lancaster and Garstang and several leisure/ swimming pools good social groups within my village and also in Garstang Plenty of activity groups and lovely walks by the sea. We’re walks beach lots of public footpaths slimming world groups, sporting activities, outdoor space, lanes to run down. Only disadvantage is there are no good street lights for running at night Local swimming pool. Non traffic walking along canal, millenium green, local walks Walking groups and encouragement to get people outdoors I have dogs so walk every day either on my own or with a friend or my partner, I don't join local outdoor groups because these exclude dogs. I have an injury so am currently unable to join the running club and the cycling club. There are several local WI groups which are good

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for social health. The 3 Scorton churches are active and inclusive and are good for social emotional wellbeing. The outdoors, pharmacy services. YMCA, village centre classes. Green spaces Weight watchers club and a keep fit class or two. A swimming pool would be a huge improvement. Green spaces to explore, Trough of Bowland on the doorstep. Areasfor walking None I have to travel We have 'the green book' that has a great source of information. local market /outdoor space/choice of supermarkets None None YMCA IS too pricey Green spaces for walking and enjoying the outdoors.Swimming pool. Belonging to clubs and groups Check ups. Local park in walking distance to take children with good facilities Can walk long way into town along canal which is lovely when time isn't an issue Being near the coast able to walk along seafront. Area is flat for walking and cycling Golf club Better public transport Excellent Medical Centre and support offered there. Walking groups, village centre hold various courses for good health and outside optical services are available on a firley advertised basis. None I provide by running a singing group! there are a few classes in the local halls that help. Pilates and Piloxing Parks, beaches, promenades, good healthcare - dentist/doctors, lots of community clubs and interesting groups to get involved with. Weight watchers, walking, sewing group, dancing Can’t think of any Don't know WWI - Healthclub and my own motivation Kepple Lane Park Millennium Green Walking None Join all the clubs Opportunities to walk and cycle. Field for boys to play football. Absolutely no idea, my family also say they aren’t aware of what resources are available I wouldn't access immediately local resources but travel to ones in neighboring areas (within either the larger Wyre or Blackpool area). Parks and beaches Tourist information posts regular walks. Kepple Lane pharmacy offers smoking cessation. Library offers different group meetings. Lots of private physios and PTs. Many support groups, activities, social groups Green book has local events in it Country lanes for cycling and walking We have a village football field and a fantastic all weather pitch - unfortunately the village council made a decision not to upkeep the all weather pitch ( even though they have always charged individuals for its use ) instead they have spent village money on flowers., which are beautiful but again at the expense of providing facilities fir younger people to enjoy.

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N/A None Bigger heath centre Space

Appendix E – categorised comments

How important is it for local services to work together to improve health and wellbeing in your area? – Please give a reason for your answer

Joined up service/coordinated/consistent approach

1. If they work together hopefully it would become seamless which gives a better service for all service users 2. All services integrating to make delivery of a comprehensive package for individuals. 3. Services working together is the key to improvement 4. Working together will increase knowledge of what is available. 5. A rural area like this needs services to liaise with each other 6. It makes for a more fluid service with no feeling of blockers 7. Then there is a joined up services resources can work together. 8. It's really important that we have a joined-up approach to ensure everyone plays their part. Sharing information and ideas can be good for development of the area and addressing the needs of the local population. Decisions are often taken that don't make sense. 9. Needs to be a joined up approach 10. To produce an integrated service 11. Groups need openness and be prepared to share ideas etc

Negative/positive

1. Lack of coordination at present 2. I feel there is no joined up working arrangements in place. So there are barriers in place at the beginning. 3. I am employed by health and see little evidence of commissioners listening to those working at ground level 4. Referrals following discharge from hospital is a real cause for concern, no follow up, dispute between GP and BTH services regarding who should do the referral as neither want to pay whilst in the centre is the patient who is suffering and not receiving help or guidance. 5. The answer is an obvious yes, but practically we all know it’s just not going to happen. Fat cats, huge salaries, pot holes, rubbish, dog poo, the list is endless.

Reduce demand/better use of resources/funds

1. In the current financial climate where some services are stretch, other local services could help and provide additional support 2. With limited funding and resources local services must combine budgets and be more integrated 3. As resources are so limited due to government cuts organisations have to work together to make use of very limited resources 4. With limited resources, now more than ever, we should have collaborative working to support integrated services, and reduce duplication of effort. But this requires engagement and leadership from all services involved

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5. NHS can't do everything and no one has any funding. New houses, larger communities and benefit reductions means we all need to pull together and ensure we are not providing two services doing the same things and ensure the money goes in the right places to keep everyone safe. 6. The more things that are accessible from different organisations the more accessible they are to everyone. 7. Can make a better use of limited resources if work together, pool budgets etc. Pooling ideas and listening to local people will improve services. 8. Historical barriers to integrated services and commissioning makes services fragmented leading to delay in individuals getting assessments and services they need. 9. Surly it’s easier to achieve something working together. And cheaper. More could be achieved 10. Disparate working wastes money and energy

Communication/information

1. The older element don’t know what services are available to them and most don’t have internet 2. Better communications will always improve services working together. 3. I know that there is much work going on to improve facilities and bring together the medical organisations and with, communication but most people are unaware of what is going on and what is available. More work is needed at a local level to offer tailored help to the local community and to ensure all know what is available. 4. No point in having a service if you don’t know about it 5. If they are already doing anything, it isn't advertised very well. The only groups I am aware of are private and not council run. 6. To keep residents informed and updated. 7. More communication between support services will help highlight issues early. 8. If there is no cooperation and no communication people know nothing about what is going on and what groups or help are available some elderly people become isolated and younger people are reluctant to buy or stay in the area 9. need more information on what is available locally so working together would help get the information out 10. When people work together, the message gets out to others and together we can make a difference

Improved health

1. Happy & healthy people mean less cost & less burden on our overstretched medical services. 2. To stop obesity and addictive problems to save your health 3. Health promotion and disease prevention is vital for all services 4. prevention of ill health is as important as treatment 5. Good health and well being is the foundation for everything - it offers good standards of living for all, reduces illness including mental and physical, community support is good for everyone, keep people active and healthy and they rely less on NHS facilities and benefits. People like to feel valued, safe and healthy 6. It’s cheaper and more effective to prevent illness and poor health than cure it. Also services working together provide a range of support for different needs and could take the pressure of the GP/NHS 7. If everyone listens and works together, things get done and life improves. 8. Everyone should have the opportunity to live healthily which will improve their wellbeing

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Rural community/isolation

1. In a rural area private providers don't find it profitable to offer services 2. We are on outskirts of Wyre and have no direct links to anywhere in Wyre. Buses go to Preston or Lancaster 3. We are a rural area and have had cuts to some services 4. Over Wyre is a very rural area with little in the way of resources that are within travelling distance. Many resources do not take into account the age and ability of rural communities. 5. Local services should consider leisure centre to be opened at Knott End, could be part of the golf club ie; swimming pool, gym etc. As well as golf facilities. 6. not having to travel will encourage people to attend health programmes 7. Living in the countryside can be isolating for some of the population with poorer links to transport 8. Reduction in bus services in local area, therefore not creating a green environment, isolation for the elderly and teenagers

Better service

1. If all services amalgamated and worked as one “organisation” it would improve accessibility to services and enable staff members from each organisation to know exactly what is available in the local community. The merging of health and social care is particularly important in my opinion to support early hospital discharges and improved collaborative working - particularly care in the community and voluntary sector. 2. To make things more accessible by a common use 3. Working together is essential bringing together views and expressions, therefore better outcomes can be achieved 4. For more continuity and help 5. Working together across organisational boundaries is key to providing services which actually make a difference to individuals 6. So that vulnerable people don't slip through the net and get neglected. 7. Not everyone will know where to get help and advice so working together ensures more people are reached.

Reduce duplication

1. Avoid duplication. Create synergies. 2. There is a lot of duplication in the system which could be removed - this would make the system more efficient and also stop residents having to give the same information to many people. 3. Saves duplication of some tasks, easier access to service users, more inclusive 4. By working together all user groups will be considered with less likelihood of duplication. 5. If they do not work together then it wastes time & money on duplication with a less joined up outcome. Can be an issue with Garstang patients routinely referred to hospitals in Preston, Lancaster & Blackpool with no system of accessing records between them 6. So resources are not duplicated unnecessarily.

Older people

1. I can’t seem to find many organisations for over 60’s And gyms are too expensive. 2. Being elderly this is important

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3. As an OAP who has moved into pilling 18 months ago not a single person from any organisation has approached us about anything community based. We are fit and healthy but is anyone interested anyway no. 4. Large predominance of older people. 5. My perceived understanding of the health situation in my area is more a consequence of the age of the residents and given the amount of emergency vehicles I see (ambulances) I would assume a fair job is being done. 6. Many people need encouragement and help, particularly if they are aging and live alone. It’s easier to just do nothing for a lot of folks and if they are infirm, even worse

Community/engagement

1. Of course it's very important and as far as children are concerned a village raises the children. We need to know who is who and what's what, that way a community can communicate and show they care about everyone. 2. We need to get as much out of our community as possible 3. Local facilities to be shared in the community to allow access for all ages and abilities. 4. As we live in an area with a lot of older people we need community involvement to make sure these residents feel safe and are looked after in their homes

Individual responsibility

1. Only the individual is responsible for their health and well-being 2. I think it is important to provide to help provide services where they are needed, but individuals also have a responsibility themselves to make healthy choices too - there's a whole raft of private sector facilities that people can use, and communities could also develop clubs and activities themselves without public services having to provide and offer everything. 3. Individuals need to take responsibility for their own self care health and well-being, health improvement not just about what’s available, is also about motivation to engage in what’s offered and understanding the benefits

Other

1. Elswick and Great Eccleston are well equipped to help the mixture of ages within the two communities. From the Mother and Toddler Group to the Dementia Café. 2. Recycling bins left for two weeks in the heat we had this summer is attracting unwanted guests like flies and rodents. 3. So that you can keep a degree of independence. In older age. 4. We also need to prioritise funding for front line provision and not back office 5. Our local councils and LCC need to understand that people who live in Over Wyre are not all retired people who sit at home in front of the TV as soon as it goes dark. 6. We need to be able to leave our homes and enjoy a social life in the outlying towns and villages to take in a show, visit the cinema and to relax. 7. Many people are sitting looking at four walls because taxis are too expensive to add on to a night out for a single person, a couple or family on a fixed income. 8. Because I am not sure what difference they could make. 9. Reason for which answer? What is a clinical commissioning group please do these questionnaires in Plain English have the PPG read first 10. It would be great to be able to get an appointment at the doctors or with a practice nurse without having to wait for weeks. 11. In dementia cases vital to respond to person and carer as a partnership. This is lacking in my experience. 12. Need to support wellbeing but locally not effective

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13. CCG do not assess the larger picture, it is not all about targets. 14. Councils can do a lot to prevent illnesses getting worse by undertaking things like adaptations in the home, offering volunteering, maintaining parks etc. 15. Waste of time if they don’t. 16. To have a coherent policy and knowledge 17. Pleased that a Blackpool Alzheimer’s organisation is coming 'on board' for my husband.

Appendix F – verbatim comments

How important is it for local services to work together to improve health and wellbeing in your area? – Please give a reason for your answer Waste of time if they don’t. Lack of co ordination at present In the current financial climate where some services are stretch, other local services could help and provide additional support Working together will increase knowledge of what is available. The more things that are accesible from different organisations the more accessible they are to everyone. A rural area like this needs services to liaise with each other Only the individual is responsible for heir health and well-being Many people need encouragement and help, particularly if they are aging and live alone. It’s easier to just do nothing for a lot of folks and if they are infirm, even worse If they work together hopefully it would become seamless which gives a better service for all service users Happy & healthy people mean less cost & less burden on our overstretched medical services. I can’t seem to find many organisations for over 60’s And gyms are to expensive. Local services should consider leisure centre to be opened at Knott End, could be part of the golf club ie; swimming pool, gym etc. As well as golf facilities. To keep residents informed and updated. Avoid duplication. Create synergies. The older element don’t know what services are available to them And most don’t have internet Elswick and Great Eccleston are well equipped to help the mixture of ages within the two communities. From the Mother and Toddler Group to the Dementia Café. - In a rural area private providers don't find it profitable to offer services We are on outskirts of Wyre and hsve no direct links to anywhere in Wyre. Buses go to Preston or Lancaster It makes for a more fluid service with no feeling of blockers To stop obesity and addictive problems to save your health To have a coherent policy and knowledge With limited funding and resources local services must combine budgets and be more integrated So that vulnerable people don't slip through the net and get neglected. Of course it's very important and as far as children are concerned a village raises the children. We need to know who is who and what's what, that way a community can communicate and show they care about everyone. Recycling bins left for two weeks in the heat we had this summer is attracting unwanted guests like flies and rodents. So that you can keep a degree of independence. In older age. Health promotion and disease prevention is vital for all services All services integrating to make delivery of a comprehensive package for individuals.

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Everyone should have the opportunity to live healthily which will improve their wellbeing Services working together is the key to improvement As resources are so limited due to govt cuts organisations have to work together to make st of very limited resources There is a lot of duplication in the system which could be removed - this would make the system more efficient and also stop residents having to give the same information to many people. We also need to prioritise funding for front line provision and not back office. With limited resources, now more than every we should have collaborative working to support integrated services, and reduce duplication of effort. But this requires engagement and leadership from all services involved NHS can't do everything and no one has any funding. New houses, larger communities and benefit reductions means we all need to pull together and ensure we are not providing two services doing the same things and ensure the money goes in the right places to keep everyone safe. Saves duplication of some tasks, easier access to service users, more inclusive If all services amalgamated and worked as one “organisation” it would improve accessibility to services and enable staff members from each organisation to know exactly what is available in the local community. The merging of health and social care is particularly important in my opinion to support early hospital discharges and improved collaborative working - particularly care in the community and voluntary sector. To make things more accessible by a common use Then there is a joined up services resources can work together. I think it is important to provide to help provide services where they are needed, but individuals also have a responsibility themselves to make healthy choices too - there's a whole raft of private sector facilities that people can use, and communities could also develop clubs and activities themselves without public services having to provide and offer everything. Being elderly this is important living in the countryside can be isolating for some of the population with poorer links to transport More communication between support services will help highlight issues early. We are a rural area and have had cuts to some services Better communications will always improve services working together. Can make a better use of limited resources if work together, pool budgets etc. Pooling ideas and listening to local people will improve services. Because I am not sure what difference they could make. Not everyone will know where to get help and and advice so working together ensures more people are reached. It's really important that we have a joined-up approach to ensure everyone plays their part. Councils can do a lot to prevent illnesses getting worse by undertaking things like adaptations in the home, offering volunteering, maintaining parks etc. If they are already doing anything, it isn't advertised very well. The only groups I am aware of are private and not council run. Our local councils and LCC need to understand that people who live in Over Wyre are not all retired people who sit at home in front of the TV as soon as it goes dark. We need to be able to leave our homes and enjoy a social life in the outlying towns and villages to take in a show, visit the cinema and to relax. Many people are sitting looking at four walls because taxis are too expensive to add on to a night out for a single person, a couple or family on a fixed income. Sharing information and ideas can be good for development of the area and addressing the needs of the local population. Decisions are often taken that don't make sense. No point in having a service if you don’t know about it I feel there is no joined up working arrangements in place. So there are barriers in place at the beginning.

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I am employed by health and see little evidence of commissioners listening to those working at ground level Reason for which answer? What is a clinical commissioning group please do these questionnaires in Plain English have the ppg read first As we live in an area with alot of older people weneedcommunityinvolvement to make sure these residents feel safe and are looked after in there homes By working together all user groups will be considered with less likelyhood of duplication. We need to get as much out of our community as possible Over Wyre is a very rural area with little in the way of resources that are within travelling distance. Many resources do not take into account the age and ability of rural communities. For more continuity and help. As an oap who has moved into pilling 18 months ago not a single person from any organisation has approached us about anything community based. We are fit And healthy but is anyone interested anyway no. If there is no cooperation and no communication people know nothing about what is going on and what groups or help are available some elderly people become isolated and younger people are reluctant to buy or stay in the area It would be great to be able to get an appointment at the doctors or with a practice nurse without having to wait for weeks . Individuals need to take responsibility for their own self care health and well-being, health improvement not just about what’s available, is also about motivation to engage in what’s offered and understanding the benefits Needs to be a joined up approach In dementia cases vital to respond to person and carer as a partnership. This is lacking in my experience. Historical barriers to integrated services and commissioning makes services fragmented leading to delay in individuals getting assessments and services they need. Working together is essential bringing together views and expressions, therefore better outcomes can be achieved prevention of ill health is as important as treatment If they do not work together then it wastes time & money on duplication with a less joined up outcome. Can be an issue with Garstang patients routinely referred to hospitals in Preston, Lancaster & Blackpool with no system of accessing records between them pleased that a Blackpool Alzheimers organisation is coming 'on board' for my husband. need more information on what is available locally so working together would help get the information out Good health and well being is the foundation for everything - it offers good standards of living for all, reduces illness including mental and physical, community support is good for everyone, keep people active and healthy and they rely less on NHS facilities and benefits. People like to feel valued, safe and healthy When people work together, the message gets out to others and together we can make a difference Need to support wellbeing but locally not effective Large predominance of older people. I know that there is much work going on to improve facilities and bring together the medical organisations and with,communication but most people are unaware of what is gooing on and what is available. More work is needed at a local level to offer tailored help to the local community and to ensure all know what is available. So resources are not duplicated unessessatily. Groups need openess and be prepared to share ideas etc Z CCG do not assess the larger picture, it is not all about targets. Referrals following discharge from hospital is a real cause for concern, no follow up, dispute between GP and BTH services regarding who should do the referral as neither want to pay whilst in the centre is the patient who is suffering and not receiving help or guidance.

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Reduction in bus services in local area, therefore not creating a green environment, isolation for the elderly and teenagers. not having to travel will encourage people to attend health programmes It’s cheaper and more effective to prevent illness and poor health than cure it. Also services working together provide a range of support for different needs and could take the pressure of the GP/NHS The answer is an obvious yes, but practically we all know it’s just not going to happen. Fat cats, huge salaries, pot holes, rubbish, dog poo, the list is endless. My perceived understanding of the health situation in my area is more a consequence of the age of the residents and given the amount of emergency vehicles I see (ambulances) I would assume a fair job is being done.. To produce an integrated service. Surly it’s easier to achieve something working together. And cheaper. More could be achieved Local facilities to be shared in the community to allow access for all ages and abilities. Working together across organisational boundaries is key to providing services which actually make a difference to individuals If everyone listens and works together, things get done and life improves. disparate working wastes money and energy How am I supposed to know?

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