CS/13/26
Health and Wellbeing Scrutiny Committee
14 June 2013
1 Purpose
This paper sets out the plans being drawn up by South Devon and Torbay Clinical Commissioning Group (CCG) for engagement on future community services. This paper has a particular focus on the communities of Ashburton, Buckfastleigh and Bovey Tracey and their surrounding areas, although engagement will be carried out across the whole CCG area.
2 Background
Torbay and Southern Devon Health and Care NHS Trust, the provider of community services, started a consultation on 29 November 2012 on proposals to relocate all 10 inpatient beds from both Ashburton & Buckfastleigh and Bovey Tracey Community Hospitals to Newton Abbot Community Hospital. Under the proposals, other community services would have been offered at the two hospitals, such as outpatient clinics, diagnostic services, community activities and voluntary sector services; these were at the time undefined and to have been determined as part of the consultation process. The consultation ended on 24 February 2013.
In total, 780 responses were made to the consultation, a response rate of 2.81percent from the total number of leaflets distributed to households in the community. Of these, 68 percent favoured retaining the beds at Ashburton, Buckfastleigh and Bovey Tracey Community Hospitals, and 32 per cent were in favour of moving them to Newton Abbot.
The GP practices in Ashburton, Buckfastleigh and Bovey Tracey made formal responses to the consultation: Ashburton against the proposals, Bovey Tracey in favour, and Buckfastleigh in favour in principle but unable to support for lack of detail.
As part of the consultation, public meetings were held in Ashburton, Buckfastleigh, Chudleigh, Newton Abbot, Bovey Tracey and Widecombe in the Moor. These meetings were hosted by the Trust, but all were also attended by a CCG GP representative who was able to listen to the debate and answer questions on wider commissioning intentions. At some of these meetings, including Ashburton, Buckfastleigh and Widecombe, opinion was unanimously or overwhelmingly against the proposals. At others, views were more mixed. Some ideas for changing services also emerged, and both the Trust and the CCG gained valuable insight into the communities’ views and priorities. Those taking part were thanked for their valuable contributions.
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On 6 March 2013 Torbay and Southern Devon Health and Care NHS Trust told Devon Health and Wellbeing Scrutiny Committee that it had decided to pause its consultation process. This position was formally endorsed at a Trust Board meeting on 27 March 2013. It was agreed that the engagement of communities would be taken forward by South Devon and Torbay Clinical Commissioning Group, after it had become fully authorised on 1 April 2013, and following the local elections on 2 May.
The CCG has not seen individual responses to the consultation, except where these responses were sent directly to it. However, it has studied and noted the key themes that emerged.
3 Engagement by localities
In order to keep clinical commissioning local, the CCG is divided into five localities, shown at Figure 1 below. This division enables local commissioning plans to reflect the differing characteristics, needs and priorities of the communities; the needs and priorities in Chudleigh or Dartmouth, for example, will not be the same as those in Torquay.
Each locality has a Locality Commissioning Group, with a locality clinical lead and a locality manager, and encourages local GP practices to play an active part in commissioning.
One of the priorities for GPs in the locality commissioning groups is to ensure they have a good strategy for the next five years, supported and endorsed by local people, for the future of community services, including community hospitals. There has been discussion about the scope of the engagement and the clear desirability of including social care, given the interdependency and the need to coordinate all care around the individual. These discussions are continuing.
Through the engagement, commissioners will take the opportunity to inform people’s understanding of the challenges the NHS faces, with an aging population, increased numbers of people with complex needs or multiple long-term conditions, and more or less ‘flat cash’ in terms of resources with which to meet this rising demand. Locality commissioners will wish to engage with their communities about how best to meet these
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Separate engagement processes will be held in each of the localities, and tailored to the local requirements. (The Torquay locality, for example, has no community hospital within it.) The Moor to Sea locality encompasses the towns of Ashburton, Bovey Tracey, Buckfastleigh and Chudleigh, and extends from Dartmouth in the south to Widecombe in the moor.
4 The engagement process
Context
The engagement will take place within the context of national policy and evidence, the priorities of the wider CCG as set out in its three year strategic plan, and the Devon Health & Wellbeing Scrutiny Committee Future of Community Hospitals Task Group report of September 2012.
The Task Group report set out 12 recommendations for the future of community hospitals, including that: “Before any changes are made there needs to be real, meaningful and early engagement over the future of services, so that local people are shaping the future direction of local healthcare.”
The CCG is committed to a partnership approach and as such the locality commissioning groups will work closely with colleagues from social care, district councils, patient representatives, Healthwatch, the voluntary sector and other partners.
There are no proposals on the table; these will emerge from the engagement process itself.
In the Moor to Sea locality, plans are being drawn up to engage under the following process:
1: Identify key stakeholders and ensure they are informed and engaged.
2: Form a steering group from an initial meeting of stakeholders and interested parties, and make arrangements to keep other key stakeholders informed. The steering group will develop a project plan for ensuring that good process is followed, how the engagement will take place, the information that should be made available, how feedback will be collated and how stakeholders will receive feedback.
3: Undertake the engagement process, ensuring that as wide a range of people as possible have a chance to submit their views, in a variety of ways
4: Steering group will analyse feedback, and oversee the writing of the report, with a vision for the future of community services. This will be distributed among key stakeholders for discussion.
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5: The vision and engagement report will be used by the CCG in conjunction with partner organisations to develop clear plans and proposals. These will be taken to public consultation where this is appropriate, or on the advice of the Health and Wellbeing Scrutiny Committee.
5 Timeline for engagement in Moor to Sea locality
The following timeline will become more detailed after the initial steering group meeting.
11 June 14 June October December
Steering Group Health & Wellbeing Engagement Evaluation, development of draft plans first meeting Scrutiny Committee and testing with stakeholders
6 Conclusion
South Devon and Torbay Clinical Commissioning Group would welcome views on this approach from the Health and Wellbeing Scrutiny Committee and advice about the timing of progress reports to the Committee.
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