Consultation on the Future of Health Services in Northern Staffordshire: Report of Findings June 2019

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Table of Contents 1 Executive summary ...... 10 1.1 Introduction and background to the consultation ...... 10 1.2 Communications and engagement methodology ...... 12 1.3 Participants and respondents ...... 13 1.4 Feedback on the consultation proposals ...... 13 1.5 Conclusion ...... 18 2 Introduction...... 20 2.1 Report authors ...... 20 2.2 Report structure ...... 20 2.3 Background to the consultation ...... 20 2.4 Consultation governance and assurance ...... 24 2.5 Next steps...... 24 3 Communications and engagement methodology ...... 26 3.1 Consultation collateral ...... 26 3.2 Communication channels ...... 30 3.3 Stakeholder engagement and profiling ...... 44 4 Profiling of consultation respondents ...... 49 4.1 Overview of consultation respondents and participants ...... 49 4.2 Consultation survey respondents ...... 51 4.3 Event participants ...... 52 5 Feedback on the consultation proposals ...... 53 5.1 Reporting and analysis notes ...... 53 5.2 Feedback on the model of care and the integrated care hubs ...... 56 5.3 Feedback on the options for four integrated care hubs ...... 72 5.4 Feedback on the proposals for community hospitals and rehabilitation care beds ...... 116 5.5 Feedback on consultant-led outpatient clinics ...... 162 5.6 Feedback on accessing services ...... 171 5.7 Other comments ...... 174 6 Conclusion ...... 178 6.1 The proposed new model of care ...... 178 6.2 The proposals for integrated care hubs ...... 178 6.3 The proposals for community hospitals and integrated care hubs ...... 180 6.4 The proposals for consultant-led outpatient clinics ...... 181

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7 Appendices ...... 182 Appendix 1: Stakeholder engagement ...... 182 Appendix 2: Population quotas ...... 186 Appendix 3: Press coverage ...... 187 Appendix 4: Press releases ...... 188 Appendix 5: Press enquiries ...... 189 Appendix 6: Press advert ...... 190 Appendix 7: Social media paid advert creative ...... 190 Appendix 8: Overview of consultation respondents and participants data notes ...... 191 Appendix 9: Other event comments ...... 192 Appendix 10: Example social media schedule ...... 194 Appendix 11: Gunning Principles ...... 196 Appendix 12: Example social media feedback ...... 197 Appendix 13: Organisations responding to the survey ...... 198 Appendix 14: Organisations with representatives attending events ...... 199 Appendix 15: Organisations and MPs / councillors sending correspondence ...... 199 Appendix 16: Geographic groupings in the survey ...... 200

References

Table 1. Consultation options ...... 11 Table 2. Summary of the proposed options ...... 23 Table 3. Channels used ...... 30 Table 4. Distribution of consultation materials ...... 31 Table 5. E-newsletters: distribution, subjects, audience and recipients ...... 32 Table 6. Social media analytics ...... 34 Table 7. Organic social media analytics overview ...... 35 Table 8. Overview of events held ...... 36 Table 9. Public events ...... 37 Table 10. Protected characteristics focus groups ...... 38 Table 11. Carers’ Hub focus groups ...... 38 Table 12. Community workshop events ...... 39 Table 13. Retail promotional stands in retail locations ...... 39 Table 14. Clinical Commissioning Group (CCG) staff events ...... 39

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Table 15. Hospital stand events ...... 40 Table 16. Other promotional stand events ...... 40 Table 17. Residents' Association meetings ...... 41 Table 18. GP Locality meetings...... 41 Table 19. Other meetings ...... 42 Table 20. Correspondence received ...... 43 Table 21. Number of stakeholder organisations engaged, and channel management used for onward cascade ...... 44 Table 22. Stakeholder communications and engagement ...... 45 Table 23. Number of organisations representing protected characteristics ...... 47 Table 24. Audience response comparison ...... 50 Table 25. Respondent types in the survey ...... 51 Table 26. Demographic profile of members of the public responding to the survey ...... 51 Table 27. Respondent type of event participants ...... 52 Table 28. Demographic overview of members of the public participating in events ...... 52 Table 29. We are proposing creating four specialist integrated care hubs in Staffordshire Moorlands, Newcastle-under-Lyme, North of Stoke-on-Trent and South of Stoke-on-Trent so patients can get the care they need closer to home. To what extent do you agree or disagree with this approach? (Question 2) ...... 56 Table 30. Please explain why you agree or disagree with our proposal on integrated care hubs? (Question 3) Positive themes...... 57 Table 31. Please explain why you agree or disagree with our proposal on integrated care hubs? (Question 3) Negative themes...... 57 Table 32. Please explain why you agree or disagree with our proposal on integrated care hubs? (Question 3) For consideration themes...... 58 Table 33. How can any issues or concerns you have raised be overcome? (Question 4)...... 60 Table 34. What do you agree and disagree with in the proposed new model and integrated care hubs? Positive themes. Public event feedback ...... 62 Table 35. What do you agree and disagree with in the proposed new model and integrated care hubs? Negative themes. Public event feedback ...... 62 Table 36. What do you agree and disagree with in the proposed new model and integrated care hubs? For consideration themes. Public event feedback ...... 63 Table 37. Are there any specific groups of people you think may be disproportionately or unfairly impacted by this option? Please tell us who they are and how they may be impacted. Public event feedback ...... 64 Table 38. What do you agree and disagree with in the proposed new model and integrated care hubs? Positive themes. Focus group feedback...... 65 Table 39. What do you agree and disagree with in the proposed new model and integrated care hubs? Negative themes. Focus group feedback ...... 65 Table 40. What do you agree and disagree with in the proposed new model and integrated care hubs? For consideration themes. Focus group feedback ...... 66

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Table 41. Are there any specific groups of people you think may be disproportionately or unfairly impacted by this option? Please tell us who they are and how they may be impacted. Focus group feedback...... 67 Table 42. Correspondence feedback on model of care ...... 68 Table 43. Correspondence feedback on model of care: health equality and inequalities ...... 69 Table 44. Summary of agreement with the integrated care hubs approach ...... 70 Table 45. Overall agreement for South of Stoke-on-Trent Integrated Care Hub options ...... 72 Table 46. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from a new purpose-built site in Longton (Question 5A)...... 72 Table 47. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from Meir Primary Care Centre (Question 5B) ...... 73 Table 48. Please explain why you agree or disagree with our proposals for South of Stoke-on-Trent? (Question 6) ...... 74 Table 49. South of Stoke-on-Trent: How can any issues or concerns you have raised be overcome? (Question 7) ...... 76 Table 50. Please outline any alternative ideas you have about the location of the hubs in each area: South of Stoke-on-Trent. (Question 17A) ...... 77 Table 51. South of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback...... 78 Table 52. South of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback...... 79 Table 53. Survey respondents: Summary of agreement and disagreement with South of Stoke-on-Trent options ...... 80 Table 54. Overall agreement for Staffordshire Moorlands Integrated Care Hub options ...... 82 Table 55. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from the existing but refurbished Leek Moorlands Community Hospital (Question 8A) ...... 82 Table 56. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from a rebuilt facility at the existing Leek Moorlands Community Hospital site (Question 8B) ...... 83 Table 57. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from a new site in Kniveden (Question 8C) ...... 84 Table 58. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from existing Cheadle Community Hospital site (Question 8D) ...... 85 Table 59. Please explain why you agree or disagree with our proposals for Staffordshire Moorlands? (Question 9) ...... 86 Table 60. Staffordshire Moorlands. How can any issues or concerns you have raised be overcome? (Question 10) ...... 87 Table 61. Please outline any alternative ideas you have about the location of the hubs in each area: Staffordshire Moorlands (Question 17B) ...... 89 Table 62. Staffordshire Moorlands: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback...... 90

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Table 63. Staffordshire Moorlands: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback...... 91 Table 64. Correspondence feedback on options for integrated care hubs in Staffordshire Moorlands ...... 92 Table 65. Survey respondents: Summary of agreement and disagreement with Staffordshire Moorlands options ...... 93 Table 66. Overall agreement for Newcastle-under-Lyme Integrated Care Hub options ...... 95 Table 67. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from existing Bradwell Community Hospital site (Question 11A) ...... 95 Table 68. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from Milehouse Primary Care Centre (Question 11B) ...... 96 Table 69. Please explain why you agree or disagree with our proposals for Newcastle-under-Lyme? (Question 12) ...... 97 Table 70. Newcastle-under-Lyme. How can any issues or concerns you have raised be overcome? (Question 13) ...... 99 Table 71. Please outline any alternative ideas you have about the location of the hubs in each area: Newcastle-under-Lyme (Question 17C) ...... 100 Table 72. Newcastle-under-Lyme: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback...... 101 Table 73. Newcastle-under-Lyme: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback...... 102 Table 74. Survey respondents: Summary of agreement and disagreement with Newcastle-under- Lyme options ...... 103 Table 75. Overall agreement for North of Stoke-on-Trent Integrated Care Hub option ...... 105 Table 76. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from Haywood Community Hospital (Question 14) ...... 105 Table 77. Please explain why you agree or disagree with our proposals North of Stoke-on-Trent? (Question 15) ...... 107 Table 78. North of Stoke-on-Trent: How can any issues or concerns you have raised be overcome? (Question 16) ...... 108 Table 79. Please outline any alternative ideas you have about the location of the hubs in each area: North of Stoke-on-Trent (Question 17D) ...... 109 Table 80. North of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback...... 110 Table 81. North of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback...... 111 Table 82. Survey respondents: Summary of agreement and disagreement with North of Stoke-on-Trent option ...... 112 Table 83. What other services do you think should be included in the integrated care hubs? Services suggested. Public event feedback...... 113 Table 84. What other services do you think should be included in the integrated care hubs? Other comments. Public event feedback...... 114

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Table 85. What other services do you think should be included in the integrated care hubs? Focus groups feedback...... 114 Table 86. Currently community services are available at five hospitals across Northern Staffordshire. We are proposing a new approach which offers these out of hospital services in the community. To what extent do you agree or disagree with this approach? (Question 18)...... 117 Table 87. Please explain why you agree or disagree with our proposals for community rehabilitation beds? (Question 19) ...... 118 Table 88. How can any issues or concerns you have raised be overcome? (Question 20) ...... 119 Table 89. Do you have any comments you would like to make about the proposed change in bed numbers and associated modelling? (Question 21) ...... 121 Table 90. To what extent do you agree or disagree with each of the options for community hospital rehabilitation beds (Question 22) ...... 122 Table 91. Please explain why you agree or disagree with our proposals for community rehabilitation hospital beds? (Question 23) ...... 123 Table 92. How can any issues or concerns you have raised be overcome? (Question 24) ...... 124 Table 93. Please outline any alternative ideas you have about the provision of community rehabilitation beds. (Question 25) ...... 125 Table 94. Feedback from correspondence on community hospitals and care home beds...... 127 Table 95. To what extent do you agree or disagree with the option: Provide all beds at Haywood Community Hospital (Question 22A) ...... 130 Table 96. (Option 1) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback ...... 131 Table 97. (Option 1) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus groups feedback ...... 132 Table 98. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Leek Moorlands Community Hospital (Question 22B) ...... 134 Table 99. (Option 2) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback ...... 135 Table 100. (Option 2) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus groups feedback ...... 136 Table 101. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Longton Cottage Hospital (Question 22C) ...... 137 Table 102. (Option 3) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback...... 138 Table 103. (Option 3) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus groups feedback ...... 139 Table 104. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Cheadle Community Hospital (Question 22D) ...... 141 Table 105. (Option 4) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback ...... 142

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Table 106. (Option 4) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus groups feedback ...... 143 Table 107. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Bradwell Community Hospital (Question 22E) ...... 145 Table 108. (Option 5) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback ...... 146 Table 109. (Option 5) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus groups feedback ...... 146 Table 110. Feedback from correspondence on option 5 for community rehabilitation beds ...... 147 Table 111. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and the remainder at NHS commissioned beds in local care homes (Question 22F) ...... 149 Table 112. During the pre-consultation process, some people were worried about the quality of care at these homes. To what extent are the steps we would take reduce any concerns you may have about this option? (Question 26) ...... 150 Table 113. Option 6 proposes that 55 beds would be provided in local care homes. Please outline your concerns below. (Question 27) ...... 151 Table 114. (Option 6) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback ...... 153 Table 115. (Option 6) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus groups feedback ...... 154 Table 116. Correspondence feedback on option 6 for community rehabilitation beds ...... 155 Table 117. Survey respondents: Summary of agreement and disagreement with community hospital beds proposals ...... 158 Table 118. To what extent do you agree or disagree with the proposed changes to move the following services: Colon and rectal check-ups (Question 28A) ...... 162 Table 119. To what extent do you agree or disagree with the proposed changes to move the following services?: Dermatology (Question 28B) ...... 163 Table 120. To what extent do you agree or disagree with the proposed changes to move the following services: Nephrology (kidney problems) (Question 28C) ...... 163 Table 121. To what extent do you agree or disagree with the proposed changes to move the following services: Neurology (Question 28D) ...... 164 Table 122. To what extent do you agree or disagree with the proposed changes to move the following services: Trauma and orthopaedics (Question 28E) ...... 165 Table 123. To what extent do you agree or disagree with the proposed changes to move the following services: General surgery (Question 28F) ...... 165 Table 124. Please explain why you agree or disagree with our proposal for some of our consultant-led outpatients clinics? (Question 29) ...... 166 Table 125. How can any issues or concerns you have raised be overcome? (Question 30) ...... 167 Table 126. Feedback from correspondence on consultant-led outpatients clinics ...... 168 Table 127. Summary of agreement and disagreement with consultant-led outpatients clinic proposals ..... 169

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Table 128. How would you normally travel to your local NHS hospital? (Question 31) ...... 171 Table 129. Do you have any concerns about being able to travel to or access any services and what would need to happen to make this less of a concern? (Question 32) ...... 171 Table 130. Summary of travel methods ...... 173 Table 131. Do you have any other views you wish to share with us on the ideas described in this consultation document? (Question 33) ...... 174 Table 132. Feedback from the ‘Save Leek Hospital’ postcards ...... 176

Figure 1. The healthcare model...... 21 Figure 2. A sample page of the consultation summary document ...... 27 Figure 3. A4 poster...... 28 Figure 4. A5 leaflet ...... 28 Figure 5. A sample page spread of the easy read consultation document ...... 29 Figure 6. Breakdown of reach by channel and advert ...... 34 Figure 7. Map showing the locations of the events held ...... 35 Figure 8. Map of consultation activity and IMD ...... 46

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1 Executive summary

1.1 Introduction and background to the consultation This report presents the feedback from the public consultation on the Future of Local Health Services in Northern Staffordshire which ran for 14 weeks from 10 December 2018 to 17 March 2019. The consultation was led by North Staffordshire Clinical Commissioning Group (CCG) and Stoke-on-Trent CCG. The consultation presented options to the public on the location of integrated care hubs and community rehabilitation beds. The feedback from the public, sta

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keholders and partners during the consultation will be used by the CCGs’ Governing Bodies to inform their decision-making process on which options to take forward.

1.1.1 Background to the consultation The background information in this section is taken from the consultation document The Future of Health Services in Northern Staffordshire The case for change The rationale for change is centred around the following key factors:  Health and wellbeing of the population of Northern Staffordshire  Poverty and deprivation across Northern Staffordshire  The care and quality provided by health services  Hiring and retaining NHS workers  The health service finances  Varying standards and appropriateness of buildings. The new care model The new model of care is designed for all adults (aged over 18) but is particularly focused on supporting people with high clinical needs who are most at risk of being admitted to hospital such as adults with several long-term conditions. It is a new approach to community-based care that improves patients’ outcomes and gives them access to the care they need closer to home, avoiding long and unnecessary hospital stays. The new care model would:  Reduce the need for community rehabilitation hospital beds as more services are moved into the community  Help to deliver better, more person-centred community-based services  Enable the reduction in the number of beds needed to approximately 132.

The proposals: integrated care hubs and community hospitals and rehabilitation beds The proposals include four options for integrated care hubs which are presented in Table 1. The integrated care hubs are a new way of delivering community-based services using a more joined-up approach. They give the community access to several services in ‘one place’. The hubs are designed to meet the needs of patients and ensure they receive the right care, without having to go into hospital.

Table 1. Consultation options Option 1A: One hub with services delivered from a new site built to meet the needs of

local people at Greendock Street, Longton. South of Stoke- Preferred option. on-Trent options Option 1B: One hub with services delivered from the building at Meir Primary Care Centre, Weston Road.

Option 2A: Refurbish the current hospital estate to turn it into an integrated care hub. Staffordshire Moorlands Integratedcare hubs options Option 2B: Rebuild the current Leek Moorlands Community Hospital. This would involve building a new hub on the existing site.

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Preferred option.

Option 2C: One hub with services delivered from a new site in Kniveden.

Option 2D: One hub with services delivered from Cheadle Community Hospital.

Option 3A: One hub with services delivered from Bradwell Community Hospital. Newcastle- Preferred option. under- Lyme options Option 3B: One hub with services delivered from Milehouse Primary Care Centre on Lymebrook Way, Millrise Village.

North of Stoke- Option 4A: One hub with services delivered from Haywood Community Hospital. on-Trent option Only option that met the criteria.

Option one All 132 community hospital beds at Haywood Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Leek Option two

Moorlands Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Longton Option three Cottage Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Cheadle Option four Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Bradwell

Option five rehabilitationbeds

Communityhospital Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 NHS Option six commissioned assessment beds where patients would stay for up to six weeks funded by the NHS in local care homes rated ‘good’ or ‘outstanding’. Preferred option.

The following Tier 4 services that have low clinic numbers move from Leek Moorlands Community Hospital

to Royal Stoke University Hospital: led led -  Colon and rectal check ups  Dermatology (skin problems such as eczema and psoriasis)  Nephrology (kidney problems)  Neurology (issues such as headache and migraines)

Consultant  Trauma and orthopaedic surgery (follow up appointments and for x-ray only) outpatientclinics  General surgery (minor surgery such as lumps and hernias).

1.2 Communications and engagement methodology Information was distributed to target audiences using the agreed communications and engagement strategy and associated content plan covering print media, social media, radio, briefing documents, email newsletters, the consultation microsite, face-to-face engagement events and proactive media relations and partner stakeholder engagement. Mapping of key local stakeholders and organisations who could assist in the promotion of the consultation as widely and effectively as possible across the identified areas was undertaken. A stakeholder database was created to log stakeholders’ details and manage all communication with them.

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Equalities and health inequalities Engagement was planned to target a representative sample that reflected the demographic composition of the area. A population profile of the area, including demographics such as age, gender, ethnicity and religion was produced from the 2011 census data (see Appendix 2) with a quota calculated to provide a target sample to be gathered. The consultation plan explained the need for the consultation process to enable all those stakeholders and groups who have an interest in the proposals to be empowered to get involved and give feedback. The consultation process has been subject to an equalities impact analysis to confirm that the process for consultation and decision-making is fully compliant with the CCGs’ legal duties under the Equality Act 2010 and the NHS Act 2006 (as amended) and taking people’s protected characteristics into account. Reporting and analysis The consultation survey used a combination of ‘open text’ questions, for respondents to make written comments and ‘closed’ questions where respondents ‘ticked’ their response to a set of pre-set responses. All open questions were read and coded against a series of themes. The themes created from the survey were also used to read, code and analyse the correspondence received alongside the feedback from the public events and focus groups.

1.3 Participants and respondents Feedback was gathered via an online and paper survey; events, including large-scale public events. The survey received 553 responses. Six public events and 20 focus groups saw a total of 451 participants, and a further 162 people were present at the 11 Residents’ Associations meetings which were visited by members of the consultation team. Across all these meetings, 285 demographic profiling questionnaires were completed. Feedback was also received via 2,395 ‘Save Leek Hospital’ postcards, social media and at promotional stand events.

1.4 Feedback on the consultation proposals This section provides feedback on the model of care, options for integrated care hubs, proposals for community hospital rehabilitation beds, proposals for consultant-led outpatients clinics plus people’s experiences of accessing services. Feedback is presented from all engagement methods: the consultation survey, public events and focus groups and also correspondence received.

1.4.1 Feedback on the proposed model of care and integrated care hubs This section provides feedback on the model of care and integrated care hubs approach. Overall, 373 (71%) respondents to the survey indicated they strongly agreed or agreed with this approach, compared to 85 (16%) respondents who disagreed or strongly disagreed. Support was at similar levels across the Northern Staffordshire and Stoke-on-Trent area. Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree / Agree 71% 79% 69% 71% 70% 88% 56% Neither agree nor 11% 10% 16% 7% 10% 6% 18% disagree Strongly disagree / 16% 11% 13% 21% 19% 6% 22% Disagree Don’t know 1% 0% 2% 1% 0% 0% 4%

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Base 523 107 114 72 168 17 45 Across all engagement methods, there was agreement with the idea of integrated care hubs and to co-locate services in one place. Access was a key theme throughout – for example, needing to consider poor transport access to services. The need for further information on the proposals and what services integrated care hubs provide was another key theme throughout.

1.4.2 Feedback on the options for four integrated care hubs This section provides feedback on the options for integrated care hubs in the four areas: South of Stoke-on- Trent, Staffordshire Moorlands, Newcastle-under-Lyme and North of Stoke-on-Trent. Survey respondents and event participants were asked to provide feedback on the proposals for integrated care hubs in South of Stoke-on-Trent, Staffordshire Moorlands, Newcastle-under-Lyme and North of Stoke- on-Trent. In the South of Stoke-on-Trent, the largest proportion of respondents to the consultation survey supported option 1A (the preferred option). Option 1A: Hub services Option 1B: Hub services delivered delivered from a new purpose- from Meir Primary Care Centre built site in Longton Strongly agree / Agree 38% 35% Neither agree nor disagree 25% 28% Strongly disagree / Disagree 24% 24% Don’t know 13% 15% Base 429 357  Option 1A (preferred option): Agreement was much higher amongst people living in Stoke-on- Trent, with 60 (62%) respondents strongly agreeing or agreeing, compared to 27 (22%) in Leek and Moorlands, 39 (39%) in Newcastle-under-Lyme and 16 (28%) in Cheadle.  Option 1B: Agreement was highest amongst people living in Stoke-on-Trent and Cheadle, with 34 (46%) and 26 (48%) respectively strongly agreeing or agreeing, compared to 29 (27%) in Leek and Moorlands and 23 (29%) in Newcastle-under-Lyme. There were similar amounts of positivity for option 1A and 1B across all engagement methods, although there was more negativity around option 1B compared to option 1A in the survey comments. This was partly due to respondents feeling Meir Primary Care Centre is too small and lacks capacity for greater patient numbers. An individual responding on behalf of Meir Primary Care Centre PPG (Patient Participation Group) disagreed with option 1A and agreed with option 1B, whereas North Staffordshire GP Foundation and University Hospitals of North Midlands NHS Trust expressed preference for option 1A. The themes raised were similar across all feedback channels, especially around access and ease of travel and the need to ensure that poor transport access will be addressed when locating the integrated care hub in the South of Stoke-on-Trent. Making use of existing buildings and not wasting money / using funding effectively was also a key theme throughout, suggesting why option 1A did not receive higher levels of support. In Staffordshire Moorlands, the largest proportion of respondents to the consultation survey supported option 2A. The preferred option was option 2B. Option 2A: Hub Option 2B: Hub Option 2C: Hub Option 2D: Hub services delivered services delivered services services delivered

from the existing from a rebuilt delivered from from existing but refurbished facility at the a new site in Cheadle

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Leek Moorlands existing Leek Kniveden Community Community Moorlands Hospital site Hospital Community Hospital site Strongly agree / Agree 65% 44% 6% 37% Neither agree nor 16% 19% 16% 20% disagree Strongly disagree / 13% 30% 67% 36% Disagree Don’t know 6% 7% 11% 7% Base 402 403 331 353  Option 2A: Agreement was much higher amongst respondents living in Leek and Moorlands, with 133 (89%) strongly agreeing or agreeing, compared to 41 (55%) in Stoke-on-Trent, 36 (48%) in Newcastle-under-Lyme and 27 (44%) in Cheadle.  Option 2B (preferred option): Agreement was highest in Leek and Moorlands, with 74 (57%) strongly agreeing or agreeing, compared to 38 (44%) in Stoke-on-Trent, 36 (44%) in Newcastle- under-Lyme and 12 (20%) in Cheadle.  Option 2C: Similar proportions of respondents strongly agreed or agreed in Stoke-on-Trent (4 / 6%), Newcastle-under-Lyme (4 / 6%), Cheadle (2 / 4%) and Leek and Moorlands (6 / 5%). Disagreement was higher in Leek and Moorlands (97 / 87%) and Cheadle (47 / 84%), compared to Stoke-on-Trent (28 / 45%) and Newcastle-under-Lyme (32 / 49%).  Option 2D: A greater proportion of respondents living in Cheadle (60 / 86%) strongly agreed or agreed with this option, compared to 22 (33%) in Stoke-on-Trent, 17 (26%) in Newcastle-under-Lyme and 16 (14%) in Leek and Moorlands. A key theme raised across the survey and events was the need for care in Leek, suggesting why options 2A and 2B received higher levels of agreement in the survey than the other options. Respondents from North Staffordshire GP Federation and Leek and Biddulph Patient Locality Group supported option 2A, with the Leek and Biddulph Patient Locality Group respondent commenting that more than one hub is required in the Moorlands area. Leek Town Council and University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option (2B). Needing to retain care in Cheadle (option 2D) was also frequently mentioned across all channels, with the need for more than one hub in the Staffordshire Moorlands being highlighted. Feedback in the survey and at focus groups and public events considered that Kniveden (option 2C) was a poor location for a hub. Estates, finance and access were also key themes across all channels – for example, ensuring poor transport access is considered. The need to stop wasting money by using existing buildings was highlighted, suggesting why rebuilding Leek Moorlands Community Hospital (option 2B) received lower levels of support than refurbishing the existing hospital (option 1A). In Newcastle-under-Lyme, the largest proportion of respondents to the consultation survey supported option 3A (the preferred option). Option 3A: Hub services delivered Option 3B: Hub services delivered from existing Bradwell Community from Milehouse Primary Care Hospital site Centre Strongly agree / Agree 63% 16% Neither agree nor disagree 21% 34% Strongly disagree / Disagree 4% 32% Don’t know 11% 18% Base 457 312

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 Option 3A (preferred option): A greater proportion of respondents living in Newcastle-under-Lyme (116 / 97%) strongly agreed or agreed with this proposal, compared to Stoke-on-Trent (69 / 71%), Cheadle (23 / 38%) and Leek and Moorlands (45 / 35%).  Option 3B: A greater proportion of respondents living in Newcastle-under-Lyme (19 / 25%) strongly agreed or agreed, compared to in Stoke-on-Trent (10 / 18%), Cheadle (7 / 15%) and in Leek and Moorlands (6 / 6%). Newcastle Borough Council, University Hospitals of North Midlands NHS Trust and a respondent from North Staffordshire GP Federation expressed agreement with the preferred option (option 3A). A key theme across all feedback channels was agreement with option 3A, due to the need to provide care in Bradwell. Across the survey and events, there was also disagreement with option 3B due to the location of Milehouse Primary Care Centre, with the need for easy access being a key theme throughout all the feedback methods. In the North of Stoke-on-Trent, 70% of respondents supported option 4A (the only option). Option 4A: Hub services delivered

from Haywood Community Hospital Strongly agree / Agree 70% Neither agree nor disagree 16% Strongly disagree / Disagree 6% Don’t know 7% Base 443  Option 4A (only option): A lower proportion of respondents living in Leek and Moorlands (78 / 60%) agreed with this option, compared to Stoke-on-Trent (79 / 80%), Newcastle-under-Lyme (78 / 77%) and Cheadle (43 / 66%). University Hospitals of North Midlands NHS Trust and a respondent from North Staffordshire GP Federation supported this option. There was agreement with option 4A across all feedback channels due to its convenient location. However, access, especially parking, was highlighted as an issue across all channels.

1.4.3 Feedback on the proposals for community hospitals and rehabilitation beds This section presents feedback on the approach and the six options for community hospitals and rehabilitation beds. Survey respondents were asked to give feedback on the approach to providing out of hospital services in the community:  275 (55%) of respondents strongly agreed or agreed with this proposal  157 (31%) of respondents disagreed or strongly disagreed. The proposal not providing enough beds to meet demand was a key theme across all feedback channels. The need for beds to be provided at community hospitals, especially Leek Moorlands Community Hospital, and for community hospitals to remain open were also key themes. Survey respondents were also asked whether they agreed or disagreed with each option:  Option 2 received the most agreement from survey respondents.  Options 1 and 6 received the least agreement from survey respondents. Options 2 – 6 include 77 community hospital beds at Haywood Community

Hospital and:

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Option 2: Option 6: Option 1: All Option 3: Option 4: Option 5: 55 beds at 55 NHS 132 beds at 55 beds at 55 beds at 55 beds at Leek commissioned Haywood Longton Cheadle Bradwell Moorlands assessment Community Cottage Community Community Community beds in local Hospital Hospital Hospital Hospital Hospital care homes Strongly agree / 15% 65% 28% 38% 43% 15% Agree Neither agree nor 14% 10% 20% 20% 13% 8% disagree Strongly disagree / 68% 33% 50% 40% 41% 72% Disagree Don’t know 2% 2% 2% 3% 3% 4% Base 355 426 352 367 387 396 Respondents were more likely to strongly agree or agree with options that were nearer to their location.  Option 1 (all beds at Haywood Community Hospital in the North of Stoke-on-Trent): Agreement was highest in Stoke-on-Trent (18 / 26%) and lowest in Cheadle (4 / 8%).  Option 2 (beds at Haywood Community Hospital in Stoke-on-Trent and Leek Moorlands Community Hospital): Agreement was highest in Leek and Moorlands (151 / 93%) and lowest in Newcastle-under-Lyme (30 / 37%).  Option 3 (beds at Haywood Community Hospital in Stoke-on-Trent and Longton Cottage Hospital in Stoke-on-Trent): Agreement was highest in Stoke-on-Trent (41 / 52%) and lowest in Leek and Moorlands (11 / 10%).  Option 4 (beds at Haywood Community Hospital in Stoke-on-Trent and Cheadle Community Hospital): Agreement was highest in Cheadle (54 / 84%), compared to Newcastle-under-Lyme (16 / 21%).  Option 5 (beds at Haywood Community Hospital in Stoke-on-Trent and Cheadle Community Hospital): Agreement was highest in Newcastle-under-Lyme (90 / 84%) and lowest in both Cheadle (7 / 15%) and Leek and Moorlands (16 / 15%).  Option 6 – preferred option (beds at Haywood Community Hospital in Stoke-on-Trent and local care homes): Agreement was highest in Stoke-on-Trent (20 / 24%) and lowest in Cheadle (4 / 7%). Despite this being the preferred option, there were low levels of support for option 6. Disagreement was higher in Cheadle (47 / 87%) and Leek and Moorlands (110 / 85%), compared to Stoke-on-Trent (52 / 61%) and Newcastle-under-Lyme (53 / 62%). Disagreement towards option 6 was a key theme across all engagement methods, with a key reason being concerns raised over the quality of care in care homes. Concern was raised over option 6 in correspondence from two local MPs, a local councillor, North Staffs Pensioners’ Convention and the Community Hospitals Association, with concern also raised in the survey from respondents from North Staffordshire GP Federation and Leek and Biddulph Patient Locality Group. Key themes were concerns over the quality of care in care homes and community hospitals being more suitable for rehabilitation as they have access to the required health services. A consideration raised across all feedback channels was the need for enough well-trained staff to cover care needs. A difference across the feedback channels was that option 1 received positive feedback at focus groups, as it was commented that Haywood Community Hospital is a good hospital with good services and facilities. In the survey, option 1 received low levels of agreement, as it was commented that beds need to be locally- based and split geographically, with access being a key theme.

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1.4.4 Feedback on consultant-led outpatient clinics This section presents feedback on proposals to move consultant-led outpatient clinics from Leek Moorlands Community Hospital to Royal Stoke University Hospital. Consultation survey respondents were asked their views on the proposals to move certain consultant-led outpatient clinics:  between 29% and 32% strongly agree / agree  between 43% and 46% strongly disagree / disagree Colon and Trauma and General rectal Dermatology Nephrology Neurology orthopaedics surgery check-ups Strongly agree / 31% 29% 32% 32% 30% 32% Agree Neither agree nor 18% 18% 17% 17% 16% 17% disagree Strongly disagree / 43% 46% 43% 43% 46% 44% Disagree Don’t know 8% 7% 8% 8% 7% 8% Base 474 472 471 470 470 462 For all of the outpatients clinics, agreement with the proposal was lower among respondents living in Leek and Moorlands, compared to Cheadle, Newcastle-under-Lyme and Stoke-on-Trent. Across different feedback methods, the need to keep care in Leek and ensure easy access to services were key themes, suggesting why all the clinics received similarly low levels of agreement in the survey.

1.4.5 Feedback on accessing services This section presents feedback on accessing services. Travelling by car was the most common travel method used by survey respondents to travel to their local NHS hospital. Total Own car 64% On foot 6% Public transport 11% Taken by a friend 2% Taken by a relative 8% Other 10% Base 532 As highlighted in feedback on the integrated care hubs options and community hospital and care home beds, parking was an issue. The need for more public transport services and to consider the needs of non-drivers was also highlighted.

1.5 Conclusion There was support with the approach to creating four integrated care hubs, with 71% of survey respondents agreeing with the approach. For the integrated care hubs in each of the areas, in the South of Stoke-on-Trent, there was a slightly higher proportion of survey respondents who agreed with the preferred option (1A), but agreement was at 38%. Key themes were around access and making use of existing buildings.

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In Staffordshire Moorlands, the highest proportion of survey respondents supported option 2A; the preferred option (2B) was second highest. The need for care in Leek was a key theme. In Newcastle-under-Lyme, the highest proportion of survey respondents supported the preferred option (3A), with the need for care in Bradwell being a key theme. In the North of Stoke-on-Trent, 70% of survey respondents agreed with the singular option. Access was highlighted as an issue, especially parking. For the options for community hospital rehabilitation beds, option 2 received the most agreement from survey respondents. Option 1 and option 6 (the preferred option) received the least agreement from survey respondents. A key concern over option 6 was the quality of care in care homes. Proposals to move consultant-led clinics received similar levels of agreement and disagreement for each service; between 29% and 32%, strongly agreed and agreed whilst between 43% and 46% strongly disagreed and disagreed. Across different feedback methods, the need to keep care in Leek and ensure easy access to services were key themes, suggesting why all the clinics received similarly low levels of agreement in the survey. Key themes across feedback methods were access, estates and finance; the need to ensure easy access to services, retain and use existing buildings and not waste money.

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2 Introduction This report presents the feedback from the public consultation on the Future of Local Health Services in Northern Staffordshire which ran over 14 weeks from 10 December 2018 to 17 March 2019. The consultation was led by North Staffordshire Clinical Commissioning Group (CCG) and Stoke-on-Trent CCG. The consultation presented options to the public on the location of integrated care hubs and community rehabilitation beds. The feedback from the public, stakeholders and partners during the consultation will be used by the CCGs’ Governing Bodies to inform their decision-making process on which options to take forward.

2.1 Report authors North Staffordshire and Stoke-on-Trent CCGs commissioned NHS Midlands and Lancashire Commissioning Support Unit (MLCSU) Communications and Engagement Service to formulate the communications and engagement approach. They also coordinated the independent analysis of the feedback from the consultation to produce this report.

2.2 Report structure This report is split across the following sections:  Section 1: Executive summary  Section 2: Introduction, purpose of the report and background to the consultation  Section 3: Communications and engagement, including the collateral and channels used and an overview of stakeholder engagement  Section 4: A profile of consultation respondents  Section 5: Feedback from the survey, events, correspondence and other channels  Section 6: Conclusion  Section 7: Appendices

2.3 Background to the consultation The background information in sections 2.3 to 2.8 is taken from the consultation document The Future of Health Services in Northern Staffordshire Since October 2017, North Staffordshire and Stoke-on-Trent CCGs have been speaking to local people to gather their opinions on how the delivery of community-based health services could be improved. Over 500 people were engaged with, including members of the public, patients, carers, voluntary sector and representatives of diverse communities, clinicians and local and national politicians. Information was gathered about the services available and how much they were being used. The CCGs also looked at information about local health problems, population data, equality data, travel times and quality of services.

2.3.1 The case for change The rationale for change is centred around the following key factors:  Health and wellbeing: The health of people in Northern Staffordshire is generally worse than the UK, with higher prevalence of depression, diabetes, high blood pressure and obesity.

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 Poverty and deprivation: Stoke-on-Trent is the 16th most deprived local authority area in England. There are also pockets of high deprivation in Newcastle-under-Lyme and Staffordshire Moorlands.  Care and quality: Health services in Northern Staffordshire are generally safe and well-led, but there has been a focus on treating people in hospital when they might be able to be treated in the community or at home.  Workforce: It has been difficult to hire and retain enough NHS workers to staff community hospitals in Northern Staffordshire.  Finance: The health and care system in Northern Staffordshire is currently spending far more money than it receives.  Buildings: The condition of community hospitals in the area varies, with many needing significant investment. To read more, see pages 6-8 of the consultation document.

2.3.2 The proposed health care model Following conversations with the public, patients, clinicians, staff and other experts, the CCGs developed a new care model and way of delivering community-based health and care services to provide local people with the right care, in the right place, at the right time – whilst seeking to secure the local health system’s financial future. The new model of care is designed for all adults (aged over 18) but is particularly focused on supporting people with high clinical needs who are most at risk of being admitted to hospital such as adults with several long-term conditions. It is a new approach to community-based care that improves patients’ outcomes and gives them access to the care they Figure 1. The healthcare model need closer to home, avoiding long and unnecessary hospital stays. The new care model would:  Reduce the need for community rehabilitation hospital beds as more services are moved into the community  Help to deliver better, more person-centred community- based services  Enable the reduction in the number of beds needed to approximately 132. The CCGs also want to make sure that they are making best use of services. The approach addresses some of the challenges faced in some consultant-led outpatient clinics. The aims of the new model:  Helps people recover quickly when they are ill, so they can be independent again as soon and as safely as possible  Reduces how long people spend in a major hospital  Allows people to live with and manage their health conditions more effectively  Gives people the choice of dying at home if that is what they want. This approach is based on 10 principles that came from meetings with local people, knowledge of the best clinical practice (nationally and internationally) and the NHS General Practice Forward View. They are:

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 Home is the preferred setting for care whenever possible  Care should be person-centred  Patients should feel confident and supported to manage their own illnesses  The providers of health and care should work together to improve people’s outcomes  Care should be planned and proactive  Care should be delivered by medical professionals who have different expertise working together  The care model should use ‘trusted assessors’ to make initial decisions about the care that people need  Strong professional leadership is a must  Staff should feel empowered  People should only go into hospital when they really need to.

2.3.3 The options The CCGs are proposing changes that involve transforming the way services are provided and where they are based. This is to help improve the health and wellbeing of local people and better meet their needs. The proposals would join-up these key services in the community using a more patient-centred integrated approach using the following models.

2.3.3.1 Integrated care hubs Integrated care hubs are a new way of delivering community-based services using a more joined-up approach. They give the community access to several services in ‘one place’. The hubs are designed to meet the needs of patients and ensure they receive the right care, without having to go into hospital. Using a patient-centred approach, these hubs give those who have several health conditions access to a team of local experts who work together to plan the best care pathways, that manage long-term conditions and keep them out of hospital beds. The proposals include four options for integrated care hubs which are presented in Table 1.

2.3.3.2 Community hospital rehabilitation beds At present, people use five community hospitals across Northern Staffordshire:  Haywood Community Hospital  Leek Moorlands Community Hospital  Longton Cottage Hospital  Cheadle Community Hospital  Bradwell Community Hospital. Currently, too many people are given a community hospital bed when they do not need to be there. The new approach is centred on developing wide-ranging, out-of-hospital services by providing the care and support they need in their local community, closer to home. Evidence shows that patients are likely to get better sooner if they are sent home quickly. Most people would prefer to be treated at home if possible; therefore, the CCGs want to help people avoid unnecessary stays in hospital. The proposals include six options for community hospital rehabilitation beds which are presented in Table 1.

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2.3.3.3 Consultant-led outpatient clinics (Tier 4 services) There are a number of consultant-led clinics for outpatients at both Leek Moorlands Community Hospital and Royal Stoke University Hospital. These are called ‘Tier 4 services’ because they need a specialist consultant to deliver the change. The proposals include one option for consultant-led outpatient clinics. These are presented in Table 2. Table 2. Summary of the proposed options Option 1A: One hub with services delivered from a new site built to meet the needs of local people at Greendock Street, Longton. South of Stoke- Preferred option. on-Trent options Option 1B: One hub with services delivered from the building at Meir Primary Care Centre, Weston Road.

Option 2A: Refurbish the current hospital estate to turn it into an integrated care hub.

Option 2B: Rebuild the current Leek Moorlands Community Hospital. This would involve building a new hub on the existing site. Staffordshire Preferred option. Moorlands options Option 2C: One hub with services delivered from a new site in Kniveden.

Option 2D: One hub with services delivered from Cheadle Community Hospital. Integratedcare hubs

Option 3A: One hub with services delivered from Bradwell Community Hospital. Newcastle- Preferred option. under- Lyme options Option 3B: One hub with services delivered from Milehouse Primary Care Centre on Lymebrook Way, Millrise Village.

North of Stoke- Option 4A: One hub with services delivered from Haywood Community Hospital. on-Trent option Only option that met the criteria.

Option one All 132 community hospital beds at Haywood Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Leek Option two

Moorlands Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Longton Option three Cottage Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Cheadle Option four Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 beds at Bradwell

Option five rehabilitationbeds

Communityhospital Community Hospital.

77 community hospital beds at Haywood Community Hospital and 55 NHS Option six commissioned assessment beds where patients would stay for up to six weeks funded by the NHS in local care homes rated ‘good’ or ‘outstanding’. Preferred option.

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The following Tier 4 services that have low clinic numbers move from Leek Moorlands Community Hospital

to Royal Stoke University Hospital: led led -  Colon and rectal check ups  Dermatology (skin problems such as eczema and psoriasis)  Nephrology (kidney problems)  Neurology (issues such as headache and migraines)

Consultant  Trauma and orthopaedic surgery (follow up appointments and for x-ray only) outpatientclinics  General surgery (minor surgery such as lumps and hernias).

2.4 Consultation governance and assurance The consultation operated within a robust governance structure which included a structured assurance process. The CCGs followed the NHS England assurance process for major service changes and reconfigurations. Details of this process can be found here: https://www.england.nhs.uk/wp-content/uploads/2018/03/planning- assuring-delivering-service-change-v6-1.pdf

This consultation has been monitored by the Consultation Institute, under its Consultation Quality Assurance Scheme. The Institute is happy to confirm that the exercise has fully met its requirements for good practice. The CCGs regularly met with and discussed the consultation process with Stoke-on-Trent City Council and Staffordshire Moorlands District Council. A Joint Health Overview and Scrutiny Committee was formed between Stoke-on-Trent City Council and Staffordshire County Council which met before and during the consultation process. A workshop was held for members and a formal response was received. The CCGs’ Governing Bodies have also scheduled meetings ‘in common’ in public at the start and after the publication of this document.

2.5 Next steps The CCGs’ Governing Bodies will be meeting ‘in common’ in public to undertake due consideration of the outcomes of the consultation on 25 June 2019. It is important to note that at this point, no decision on the final options to take forward will be made. Governing Body members will receive and consider the feedback received and will determine which options will be put forward to inform the Decision Making Business Case (DMBC). The Equalities Impact Assessment will be updated before being considered by the Governing Bodies in order to inform their decision about the options. The Governing Bodies will be asked to give their approval to take forward a full work-up of the options, having taken public feedback into account. Should the Governing Bodies agree to move forwards, the CCGs will begin a process to develop the DMBC with NHS and local authority commissioning partners. This will involve a full review of the impact assessments which will reflect all feedback received through the consultation and will also include full capital and revenue costs for each option. The DMBC will also need to reflect any new options, depending upon whether they are materially different. At this point, further consultation on new emerging options may need to be undertaken.

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The DMBC will be subject to NHS England assurance through both the Clinical Senate and NHS England and NHS Improvement formal assurance processes. These will mirror those that were undertaken through the development of the Pre-Consultation Business Case. The CCGs are aiming to complete this process by the end of November 2019, with the caveat that additional steps could be undertaken at any point in time. Should these timescales be met and the assurance process completed, the CCGs aim to take the DMBC to an Extra Ordinary Governing Body in public in December 2019. At this point, the Governing Bodies will consider the options in full and decide on the configuration of adult intermediate rehabilitation beds, the location and configuration of the integrated care hubs and some Tier 4 services which are currently located at Leek Moorlands Community Hospital.

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3 Communications and engagement methodology This section details the communication and engagement activities undertaken during the consultation across the two CCG areas. First presenting the collateral used and then detailing the communications channels used. Information was distributed to target audiences using the agreed communications and engagement strategy and associated content plan covering print media, social media, radio, briefing documents, email newsletters, the consultation microsite, face-to-face engagement events and proactive media relations and partner stakeholder engagement.

3.1 Consultation collateral The following collateral was used to engage target audiences during the consultation:

3.1.1 Engagement events A deliberative event approach was used and events were structured as follows:  Why we’re here  Session 1: The reasons for change  Session 2: The new model of care  Session 3: The options for integrated care hubs  Session 4: The options for the location of community hospital beds  Q&A session. For each of the sessions, participants were given a presentation and then asked to provide feedback around the questions ‘What do you like?’, ‘What are you concerned about and how do you think may be negatively impacted?’ and ‘What other suggestions do you have?’. Each participant was also asked to complete a demographic profiling questionnaire.

3.1.2 Demographic profiling questionnaire A questionnaire asking respondents for their postcode and details on their protected characteristics1 was developed for use at all events. This enabled the consultation team to report on the profile of people who had been engaged with during the consultation period.

3.1.3 Consultation survey (both online and paper) The survey comprised of five sections allowing respondents to give structured feedback around:  The proposal around integrated care hubs and their locations  The proposal around community hospital rehabilitation beds and consultant-led outpatient clinics  Access to services

1 The nine protected characteristics include: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion / belief, sex and sexual orientation.

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 Any other comments  Demographic profiling and postcode.

3.1.4 Video content Three short videos were produced to support maximising online engagement.

3.1.5 Pull-up banners These were designed for use at all events to encourage footfall to promotional stands in hospitals, GP surgeries, libraries and other public areas.

3.1.6 Consultation document (50 pages) This was designed as the main access point for the public to explore and understand the consultation and the proposals. The document included an overview of the challenges faced, the proposals, the case for change, how the options were developed, what we are consulting about, a glossary and a copy of the survey as an insert. View the consultation document.

3.1.7 Consultation summary document Alongside the consultation document, a shorter, leaflet-style summary document was produced. This included a brief overview of the background to the consultation and focussed on explaining the proposals and the location of options discussed. Figure 2. A sample page of the consultation summary document

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3.1.8 A5 leaflets and A4 posters These were developed to promote the consultation including details on who was leading the consultation, what it was about, the dates of the consultation, and how to get involved / give feedback. Figure 3. A4 poster

Figure 4. A5 leaflet

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3.1.9 Media toolkit and media relations A proactive media relations strategy was implemented to engage local press and radio to maximise media coverage. Local journalists were also briefed throughout the consultation to proactively foster relationships and generate positive PR opportunities.

3.1.10 Social media collateral During the consultation, social media was used extensively to raise awareness, explain the consultation and the proposals and encourage feedback. A Twitter schedule was developed for use during the consultation (see Appendix 10) and posts for use on Facebook were produced (see Appendix 7).

3.1.11 Spotlight documents Before and during the consultation, a series of ‘Spotlight documents’ were produced which focus on specific aspects of the consultation and the proposals. The following Spotlight documents were published on the consultation microsite:  Spotlight on Modelling the Number of Rehabilitation Beds  Spotlight on Quality Inspection  Spotlight on Home First and Hospital Readmissions  Spotlight on Consultation Finances  Spotlight on Workforce

3.1.12 Easy read documents Easy read versions of the main documents about the consultation and the proposals were produced. Figure 5. A sample page spread of the easy read consultation document

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3.2 Communication channels A mix of communications channels were used to raise awareness about the consultation, explaining what the consultation was about and encouraging the local communities to provide feedback on the new model of care and proposals and options. Table 3 lists the channels used. Table 3. Channels used Communication channels Sub channels Distribution channels - Print media - E-newsletters - Radio - Consultation microsite - Paid social media advertisement Social media engagement Organic social media engagement Large public events, focus groups, promotional stand events and existing Face-to-face engagement events meeting attendance Correspondence -

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3.2.1 Distribution channels Alongside electronic communication channels, there was a significant distribution of hard copy materials. Documents and volumes distributed are listed in Table 4. Stakeholders, including hospital staff, GP surgery employees and patients, pharmacies, public sector partners and organisations who engage with and represent protected characteristics groups were identified and proactively encouraged to help distribute consultation collateral and surveys. Alongside this, collateral was also distributed through the various events that took place. Stakeholders could also independently request collateral via email, phone or using the contact form on the consultation microsite. Table 4. Distribution of consultation materials Document type Distribution Quantities Councils 510 Councillors 775 GP surgeries 115 Hospitals (staff, patients and the public) 550 Paper surveys Members of the public 81 Voluntary / support organisations 760 Events and other channels 3,759 Total number of paper surveys distributed 6,550 Members of the public 49 Media outlets 40 Councils 20 Consultation Libraries 10 documents Hospitals (staff, patients and the public) 2 Councillors 2 Events and other channels 878 Total number of consultation documents distributed 971 Large local employers 225 Council buildings 470 Councillors 550 GPs and pharmacies 166 Hospitals (staff, patients and the public) 1,900 Media 30 Consultation Members of the public 106 summaries Religious buildings 100 Supermarkets 4,050 Universities 225 Voluntary / support organisations 132 Events and other channels 1,596 Total number of consultation summary documents distributed 9,550 GP practices and pharmacies 394 Hospitals (staff, patients and the public) 22 A4 posters Events and other channels 84 Total number of posters distributed 500 GP practices and pharmacies 4,845 A5 leaflets Events and other channels 9,625 Total number of A5 leaflets distributed 14,470

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3.2.2 Print media Press activity consisted of 15 proactive press releases issued to the local media covering Stoke-on-Trent, Newcastle-under-Lyme and Staffordshire Moorlands. See Appendix 4 for a full list of press releases. In total, 38 pieces of editorial were featured in the Leek and Post Times and The Sentinel (Stoke-on-Trent) between 16 November 2018 and 26 March 2019. A total of 42 media enquiries were generated as a result of media handling between 4 December 2018 and 13 March 2019. See Appendix 5 for a full list of proactive and reactive press enquiries. Adverts were placed in The Sentinel which reaches audiences across The Potteries (Hanley, Burslem, Tunstall, Fenton, Longton and Stoke), Newcastle-under-Lyme, Leek, Cheadle, Cheddleton, Crewe, Nantwich, Alsager, Sandbach, Stafford, Stone, Biddulph, Congleton and Eccleshall. Adverts ran on 31 January, 18 February and 4 March 2019. See Appendix 6 to view the advertisement.

3.2.3 E-newsletters E-newsletters were sent to stakeholder mailing lists with the latest consultation news and events. Table 5 shows the subject lines of each e-newsletter sent. Two distribution lists were used: a stakeholder list and a list of members of the Pre-Consultation Business Case stakeholder group. See Appendix 1 for a list of stakeholder types. The public and any other interested organisations (e.g. media) could request to receive a copy of the e- newsletter using the contact form on the consultation microsite or by emailing their request to the consultation mailbox. Table 5. E-newsletters: distribution, subjects, audience and recipients

Open Click Date Subject line Audience Recipients rate rate Statement on consultation timelines for N/A (no 19 September 2018 Future of Local Health Services in Northern PCBC List 48 66.7% links) Staffordshire CCGs meeting on Future of Local Health 19 November 2018 PCBC List 48 85.4% 18.8% Services in Northern Staffordshire Future of Local Health Services in Northern PCBC List 119 61.9% 18.6% 12 December 2018 Staffordshire – Newsletter Stakeholder List 254 36.9% 4.8% Future of Local Health Services in Northern PCBC List 128 39.1% 13.3% 15 January 2019 Staffordshire – Newsletter Stakeholder List 253 20.9% 3.6% PCBC List 128 33.6% 1.6% 16 January 2019 Join us at our public event on 16 January Stakeholder List 253 14.1% 0.4% New Event in Leek: Future of Local Health PCBC List 130 39.2% 10% 21 January 2019 Services in Northern Staffordshire Stakeholder List 253 17.4% 2% Future of Local Health Services in Northern PCBC List 134 40.3% 11.9% 11 February 2019 Staffordshire – Important News Stakeholder List 255 24.8% 6.4% Future of Local Health Services in Northern PCBC List 139 32.6% 9.4% 14 March 2019 Staffordshire – Important News Stakeholder List 255 17.6% 2.8%

3.2.4 Radio Adverts were run on Signal 1 and Signal 2 local radio stations from 12 February to 17 March 2019. A total of 12 adverts were run each week in peak time slots that received an estimated weekly listenership of 241,000 people.

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Radio interviews featured on Moorlands Radio and BBC Radio Stoke-on-Trent featured campaign spokespeople who used key messages to encourage the public to share their feedback using the survey. See Appendix 3 for more detail on the interview topics.

3.2.5 Consultation microsite The consultation microsite (https://www.healthservicesnorthstaffs.nhs.uk/) provided the public with online and mobile access to the digital version of the consultation survey, a suite of information documents and the locations and times of consultation events. Copy for the site (including SEO [search engine optimisation] keywords) was regularly reviewed to optimise and index pages. The site was designed as the online gateway for the public to access key information about the consultation. It was structured around the following pages:  Consultation: An overview of the consultation and proposals, the rationale behind the consultation, scrutiny and assurance and the case studies  Our Journey: Details of the processes and decisions taken before the consultation (Pre-Consultation Business Case)  Events: Promotion of the public events and promotional stand events  News and Documents: Links to press releases and the suite of consultation collateral (e.g. the consultation document, Spotlight reports and Pre-Consultation Business Case)  FAQs: Answers to frequently asked questions, including questions raised at the public events  Get in touch: Contact details and an online contact form that the public, stakeholders and partners could use to request copies of the consultation collateral.

3.2.6 Social media engagement (paid and organic) Social media marketing was used to promote the online survey and encourage attendance at events. Both paid advertisements and organic social media marketing engagement tactics were used. Social media visuals used call-to-action copy to encourage the public, patients and stakeholders to complete the survey and book a place at public events. See Appendix 7 and 10 for examples of social media posts. To ensure the social media campaign was effective, a content plan was produced which included a minimum of six posts and/or tweets per week across partner social media Twitter and Facebook pages and MLCSU social channels.

3.2.6.1 Paid social media advertisements Paid social media advertisements featured on Facebook messenger and Instagram used the platforms segmentation tools to reach specific audiences. Criteria included:  living around or within the consultation area  aged 16-75 years old  having a personal interest in ‘family’, ‘NHS’, ‘community’ or ‘health’. Two advertisement sets were run – a general advertisement set (using two different adverts) and a smaller advertisement set which was used to quickly raise public awareness of the ‘Have Your Say’ campaign. In total, the campaign had a reach of 748,759 and was displayed 2,025,295 times (‘impressions’). Table 6 shows a detailed breakdown of the analytics for the general advertisement set.

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Table 6. Social media analytics Advertisement set: General Number of different advertisements 2 adverts Social media channels Facebook, Instagram and Facebook Messenger Reach (how many people have seen the content) 741,820 Impressions (how many times content has been displayed) 1,882,825 Women reached 394,511 Men reached 342,063 Age group with the most reach 25-34 The smaller advertisement set (specific event version 1) had a reach of 141,791 and generated 142,473 impressions. Figure 6 shows a breakdown of reach of each advert on each placement. Figure 6. Breakdown of reach by channel and advert

450,000 401,426 Facebook 400,000 350,440 Instagram 350,000 Messenger 300,000

250,000

200,000 162,617 150,000 113,343 100,000 70,975 34,912 42,861 50,000 22,897 4,282 0 General 1 General 2 Specific Event Version 1 Advert

3.2.6.2 Organic social media engagement Organic social media posts were promoted on both North Staffordshire and Stoke-on-Trent CCGs’ Facebook pages and the shared Twitter account (@StaffsCCGs) using a strategic social media content strategy to support a consistent approach to publishing. The reach of organic style posts was maximised by using hashtags to promote posts in specific areas and engage local ‘influencers’ (e.g. influential stakeholders and local councillors). They were encouraged to ‘like’, ‘share’, ‘comment’ and re-purpose posts. Residents’ Associations were also proactively engaged to help promote the digital element of the communications and engagement strategy. Table 7 shows an overview of the Facebook and Twitter analytics.

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Table 7. Organic social media analytics overview Facebook Posts throughout the consultation period 126 Total reach 4,649 Total click-throughs 219 Total likes 83 Twitter Total impressions 42,255 Average impressions 274.4 Total click-throughs 171 Total replies 3 Total likes 72

3.2.7 Face-to-face engagement events The following engagement events and stakeholder meetings were held throughout the consultation period:  Public events  Focus groups with protected characteristics groups, carers and community groups  Promotional stands in retail outlets, NHS and other public buildings  Attendance at external meetings, including Residents’ Associations and GP locality meetings. Events were spread across the localities to raise awareness and maximise opportunities to gather feedback from across the consultation area. Figure 7 maps the locations of events across the CCGs’ areas. Figure 7. Map showing the locations of the events held

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Table 8 presents an overview of the consultation events and the attendance figures. Table 8. Overview of events held Number Purpose of Total Type of event Event Audience of events event attendance held Inform and Public event Public event gather Members of the public 6 241 feedback Members of the public with Protected Inform and protected characteristics / characteristics gather seldom heard groups and 13 116 focus groups feedback staff at organisations representing these groups Focus groups Inform and Carers’ focus gather Carers 5 64 groups feedback Community Inform Community organisations 2 30 workshops Retail promotional Inform Members of the public 5 263 stands Promotional CCG staff Inform CCG staff 3 48 stand events Hospital Hospital staff and members promotional Inform 14 199 of the public stands Residents’ Inform and Association gather Members of the public 11 162 meetings feedback External meeting GP locality Not Inform GPs 3 attendance meetings collected Range of stakeholders e.g. Other external Inform NHS staff, community 14 217 meetings organisations Total 76 1,340

3.2.7.1 Public events There were six large-scale public events attended by a total of 241 people. Five events were initially planned for Longton (Meir), Leek, Haywood (Port Vale), Bradwell and Cheadle. A second event was organised in Leek in response to high public demand in this area. This event was run as a ‘question and answer’ session. At these public events, the deliberative event structure was used and feedback was gathered from all participants.

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Table 9 shows dates, locations and numbers attending each of the public events. Table 9. Public events Date of Local Authority Event name Location Participants event Area 16 January Longton Ormiston Meridian Academy (Meir) Stoke-on-Trent 5 2019 (Meir) Sandon Road, Stoke-on-Trent ST3 7DF Leek 24 January St Edward's Academy Leek (Staffordshire 77 2019 Westwood Road, Leek ST13 8DN Moorlands) 28 January Haywood Port Vale FC Stoke-on-Trent 12 2019 (Port Vale) Vale Park, Hamil Road, Burslem ST6 1AW 13 February Holy Trinity Community Centre Newcastle-under- Bradwell 37 2019 London Road, Newcastle-under-Lyme ST5 1LQ Lyme Cheadle 25 February Manor Hotel, Watt Place Cheadle (Staffordshire 71 2019 Cheadle, Stoke-on-Trent ST10 1NZ Moorlands) Leek 11 March St Edward's Academy Leek (2) (Staffordshire 39 2019 Westwood Road, Leek ST13 8DN Moorlands) Total 241

3.2.7.2 Focus groups Focus groups were held to engage protected characteristics organisations, carers groups and other community organisations. These enabled stakeholders to gain information regarding the consultation, ask questions and provide feedback. A shorter version of the deliberative event presentation was used for the focus groups. Feedback was gathered from focus group participants using the same questions as at the large public deliberative events.

3.2.7.2.1 Protected characteristics focus groups Protected characteristics focus groups were organised collaboratively with organisations representing those groups identified in the Equality Impact Assessment and Quality Impact Assessment reports.

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Table 10 shows the dates, locations and attendance figures from the protected characteristics focus groups. Table 10. Protected characteristics focus groups Date of event Organisation Location Attendance One Recovery John O Gaunt 22 January 2019 10 Staffordshire Pool Dam, Newcastle-under-Lyme ST5 2RR Dudson Centre 29 January 2019 Healthwatch Stoke 5 Hope Street, Hanley, Stoke-on-Trent ST1 5DD Haywood Hospital User Haywood Hospital 1 February 2019 8 Group High Lane, Stoke-on-Trent ST6 7AG Disability Solutions North Staffordshire Conference Centre 6 February 2019 9 West Midlands Hartshill Road, Hartshill, Stoke-on-Trent ST4 7NY Community Room, Marks and Spencers 11 February 2019 Green Door Wolstanton Grange Lane Wolstanton Retail Park 9 Newcastle-under-Lyme ST5 0AP John O Gaunt 14 February 2019 Trans Staffordshire 19 Pool Dam, Newcastle-under-Lyme ST5 2RR Arnold Bennett Room, City Central Library 15 February 2019 Breathe Easy 8 Bethesda Street, Hanley, ST1 3RS The Bill Goodwin Room, Dudson Centre 20 February 2019 North Staffs Mind 7 Hope Street, Hanley, Stoke-on-Trent ST1 5DD Methodist Church 21 February 2019 Moorlands Home Link 7 43 Chapel Street, Cheadle ST10 1DU 22 February 2019 Saltbox Carelink Adelaide Street, Burslem, ST6 2BD 6 Community Health Room 9, Cobridge Community Health Centre 28 February 2019 7 Voice Church Terrace, Stoke-on-Trent ST6 2JN Haywood Hospital The Seminar Room, Haywood Hospital 6 March 2019 13 Volunteers High Lane, Stoke-on-Trent ST6 7AG Edinburgh House 15 March 2019 YMCA University Quarter, Harding Road, Hanley, 8 Stoke-on-Trent ST1 3AE Total 116

3.2.7.2.2 Carers’ focus groups Carers’ focus groups were held at Carers’ Hubs. These focus groups were not promoted publicly. During the events, respondents could complete demographic profiling questionnaires – although this was not compulsory. Table 11 shows dates, locations and attendance figures from the Carers’ Hub focus groups. Table 11. Carers’ Hub focus groups Date of event Location Attendance Carers’ Hub – Cheadle Community Fire Station 23 January 2019 9 Ashborne Road, Cheadle ST10 1HF North Staffs Carers – Carers Support Group 4 February 2019 26 Carers Centre, 1 Duke Street, Fenton ST4 3NR Carers’ Hub – The Green Treehouse Community Café 18 February 2019 6 High Street, Biddulph ST8 6AS Carers’ Hub – Headway Carers Group 22 February 2019 Cobridge, Headway House, Elder Road, Cobridge, Stoke-on-Trent 9 ST6 2JE Carers’ Hub – Bradwell Carers Group 1 March 2019 14 The Jill Clewes Academy, Riceyman Road, Bradwell ST5 8LF Total 64

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3.2.7.2.3 Community workshops Community workshops were held with Healthwatch and VAST (a charity supporting voluntary groups) to keep voluntary and community organisations informed and ensure that feedback was gathered from these groups. Table 12 shows locations, dates and attendance figures from the community workshop events. Table 12. Community workshop events Date of event Organisation Location Attendance The Dudson Centre 21 February 2019 Healthwatch Stoke-on-Trent 14 Hope Street, Hanley, Stoke-on-Trent ST1 5DD The Dudson Centre 26 February 2019 VAST 16 Hope Street, Hanley, Stoke-on-Trent ST1 5DD Total 30

3.2.7.3 Promotional stand events Promotional stand events were set up at locations across the consultation area to maximise awareness of the consultation and encourage the public to share their thoughts and feedback using the consultation survey as well as attend other events.

3.2.7.3.1 Retail promotional stands Promotional stands were set up in retail outlets including shopping centres, indoor markets and large supermarkets across the consultation area to encourage the public to share their thoughts and feedback using the consultation survey. Table 13 shows dates, locations and attendance figures from the retail promotional stand events. Table 13. Retail promotional stands in retail locations Date of event Location No. of people spoken to Affinity Staffordshire 15 January 2019 64 Talke Retail Park, Talke Pits, Stoke-on-Trent, ST7 1XD Longton Indoor Market 18 January 2019 29 Transport Lane, Stoke-on-Trent ST3 2HW Sainsbury's Stoke-on-Trent 1 February 2019 62 Minton House, London Road, Stoke-on-Trent ST4 7QD Leek Trestle Market 6 February 2019 60 11 Market Place, Leek ST13 5HH Tesco Meir 11 February 2019 48 Lysander Road, Meir, Stoke-on-Trent ST3 7WB Total 263

3.2.7.3.2 CCG staff events Promotional stands were set up at the headquarters of the Clinical Commissioning Groups (CCGs) to encourage their staff to share their thoughts and feedback using the consultation survey. Table 14 shows dates, locations and attendance figures from the CCG staff events. Table 14. Clinical Commissioning Group (CCG) staff events Date of event Location No. of people spoken to 1st Floor, Edwin House, Centrum 100 21 January 2019 15 2nd Avenue, Burton upon Trent DE14 2WF 3rd Floor, Smithfield One Building 22 January 2019 19 Leonard Coates Way, Hanley ST1 4FA 1st Floor, Staffordshire Place Two 23 January 2019 14 Tipping Street, Stafford ST16 2LP Total 48

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3.2.7.3.3 Hospital stand events Promotional stands were set up in hospitals to engage staff, patients and members of the public. Table 15 shows dates, locations and attendance figures. Table 15. Hospital stand events Date of event Location No. of people spoken to Atrium, Royal Stoke University Hospital 25 January 2019 59 Newcastle Road, Stoke-on-Trent ST4 6QG Seminar Room, Haywood Hospital 31 January 2019 28 High Lane, Stoke-on-Trent ST6 7AG Seminar Room, Haywood Hospital 7 February 2019 3 High Lane, Stoke-on-Trent ST6 7AG Aynsley Ward Day Room, Longton Cottage Hospital 12 February 2019 3 Upper Belgrave Road, Stoke-on-Trent ST3 4QX Atrium, Royal Stoke University Hospital 13 February 2019 41 Newcastle Road, Stoke-on-Trent ST4 6QG Aynsley Ward Day Room, Longton Cottage Hospital 18 February 2019 24 Upper Belgrave Road, Stoke-on-Trent ST3 4QX Ward 3 Day Room, Cheadle Hospital 19 February 2019 17 Royal Walk, Cheadle, Stoke-on-Trent ST10 1NS MPFT HQ, Chesterton Room, Morston House 21 February 2019 Leaflet distribution only The Midway, Newcastle-under-Lyme ST5 1QG MPFT HQ, Chesterton Room, Morston House 25 February 2019 Leaflet distribution only The Midway, Newcastle-under-Lyme ST5 1QG Staff Dining Room, Leek Moorlands Community Hospital 27 February 2019 Leaflet distribution only Ashbourne Road, Leek ST13 5BQ Lecture Room, Haywood Hospital 1 March 2019 7 High Lane, Stoke-on-Trent ST6 7AG Ward 3 Day Room, Cheadle Hospital 5 March 2019 13 Royal Walk, Cheadle, Stoke-on-Trent ST10 1NS Seminar Room, Bradwell Hospital 7 March 2019 3 Talke Road, Chesterton, Newcastle-under-Lyme ST5 7NJ Seminar Room, Bradwell Hospital 13 March 2019 1 Talke Road, Chesterton, Newcastle-under-Lyme ST5 7NJ Total 199

3.2.7.3.4 Other promotional stand events Other promotional stand events were held at a range of locations. Table 16 shows dates, locations and attendance figures. Table 16. Other promotional stand events Date of event Type of location Location No. of people spoken to Staffordshire Buddies 7 March 2019 Charity 13 9 Birch Terrace, Hanley ST1 3JN Stoke-on-Trent City Council – The Civic Centre 8 March 2019 Large employer 42 Glebe Street, Stoke-on-Trent ST4 1 HH Silverdale Athletic Community Building 12 March 2019 Carers’ Café 55 Sutton Avenue, Silverdale ST5 6TA Shelton Primary Care Centre 12 March 2019 Primary care centre 11 Norfolk Street, Stoke-on-Trent ST1 4PB Fegg Hayes Futures, The Hub 13 March 2019 Carers’ Café 25 Fegg Hayes Road, Stoke-on-Trent ST6 6QR Biddulph Primary Care Centre 13 March 2019 Primary care centre 29 Wharf Road, Biddulph, Stoke-on-Trent ST8 6AG Total 175

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3.2.7.4 Existing meeting attendance Existing stakeholder meetings were attended to promote the consultation. Representatives at events used a short stakeholder presentation. Where possible, those in attendance were asked to complete a demographic profiling questionnaire.

3.2.7.4.1 Residents’ Association meetings In total, the consultation team attended and presented at 11 Residents’ Association meetings. Table 17 shows dates, locations and attendance figures from Residents’ Association meetings. Table 17. Residents' Association meetings Date of event Association Location Attendance Range of associations and Longton Community Fire Station, 266 Uttoxeter 30 January 2019 16 community groups Rd, Stoke-on-Trent ST3 4QE Bradwell Lodge Community Centre 31 January 2019 Porthill Residents’ Meeting 21 Bradwell Lane, Newcastle-under-Lyme ST5 8PS Grosvenor House 5 February 2019 Red House Community Trust 11 7 Grosvenor Street, Longton ST3 2LR Penkhull Residents' North Staffordshire Conference Centre 11 February 2019 18 Association Hartshill Road, Stoke-on-Trent ST4 7NY Pittshill and Great Chell St Michaels Church 27 February 2019 4 Residents' Association Chell ST6 6JT Longton Hall Community St Paul’s Church 27 February 2019 10 Association 131 Longton Hall Road, Stoke-on-Trent ST3 2EL Northwood Residents’ Hope Community Church 28 February 2019 26 Association Hanley, Stoke-on-Trent ST1 2DA Eaton Park Residents’ Bellringer Public House 4 March 2019 22 Association Kettering Drive, Eaton Park ST2 9ND Joiners Square Community 6 March 2019 Cornes Street, Stoke-on-Trent ST1 3JA 15 Centre Normacot Residents' Westfield Children’s Centre 13 March 2019 11 Association Beuccleuch Road, Normacot ST3 4RF Upper Tean Residents' Great Wood Hall 14 March 2019 8 Association Hollington Road, Tean, Stoke-on-Trent ST10 4JY Total 162

3.2.7.4.2 GP locality meetings Representatives from the CCGs’ consultation team attended GP locality meetings to engage GPs around the proposals. Table 18 details the dates and locations. Table 18. GP Locality meetings Date of event Location St Paul's Church 13 February 2019 Longton Hall Road, Longton ST3 2EL The Madeley Centre 14 February 2019 New Road, Madeley CW3 9DN Leek Rugby Club 19 February 2019 Chestnut Walk, Cheddleton ST13 7BJ

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3.2.7.4.3 Other meetings A range of additional stakeholder meetings were attended to inform stakeholders of the proposals. Table 19 shows dates, locations and attendance figures from other partner / local stakeholder meetings. Table 19. Other meetings Date of event Organisation Location Attendance Learning Resource Centre at The Cheadle Academy 21 January 2019 Cheadle Council 34 Station Road, Cheadle ST10 1LH Local Equality Advisory Staffordshire Place Two 23 January 2019 2 Forum Tipping Street, Stafford ST16 2LP North Staffordshire Lawton House 24 January 2019 Combined Healthcare 20 Bellringer Road, Trentham, Stoke-on-Trent ST4 8HH Trust Board Stoke-on-Trent Alliance Civic Centre 30 January 2019 17 Board Glebe Street, Stoke-on-Trent ST4 1HH West Midlands The Academy 30 January 2019 Ambulance Service Trust 15 Dudley Road, Brierley Hill, West Midlands DY5 1LQ Board Midlands Partnership St. George's Hospital 31 January 2019 NHS Foundation Trust 26 Corporation Street, Stafford ST16 3SR Board Haywood Hospital 1 February 2019 Haywood User Group 9 High Lane, Stoke-on-Trent ST6 7AG Staffordshire Moorlands The Council Chamber 13 February 2019 Overview and Scrutiny 12 Moorlands House, Stockwell Street, Leek ST13 6HQ Committee Stoke-on-Trent Joint Civic Centre 13 February 2019 Health Overview and 18 Glebe Street, Stoke-on-Trent ST4 1HH Scrutiny Committee Cobridge Community Centre Not 14 February 2019 Community Health Voice Bursley Road, Cobridge, Stoke-on-Trent ST6 3DQ collected Patient Congress Hanley Community Fire Station Not 19 February 2019 (North Staffs and Stoke- Lower Bethesda Street, Stoke-on-Trent ST1 3RP collected on-Trent) Norton Cricket Club 25 February 2019 MHA (care charity) 12 Community Drive ST6 1QF Newcastle-under-Lyme Astley Room, Castle House 4 March 2019 Overview and Scrutiny 17 Barracks Road, Newcastle-under-Lyme ST5 1BL Committee Chatterley Centre 14 March 2019 MHA (care charity) 35 Wilding Road, Ball Green ST6 8BQ Total 217

3.2.8 Correspondence In addition to the formal feedback channels, public and patients independently shared their thoughts and views using a range of correspondence methods including emails sent to the consultation mailbox, written correspondence sent to the freepost consultation address and comments submitted through the contact form on the consultation microsite. All correspondence has been analysed as part of the reporting process. Additionally, the ‘Save Leek Hospital’ group independently produced postcards for residents to raise their opposition to the closure of Leek Moorlands Community Hospital. A total of 2,395 postcards were received.

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Table 20 shows the types of correspondence, formats and the total number of each correspondence type. Table 20. Correspondence received Online Total Telephone Type Letters Emails form FOI number calls comments received MP / councillors 3 2 - - 1 6 Members of the public 6 6 2 2 2 18 Local authorities / councils 5 - - - - 5 Voluntary / representative organisations 2 - - - - 2 NHS Trust 2 - - - - 2 Clinician 0 1 - - - 1 ‘Save Leek Hospital’ group postcards 2,395 - - - - 2,395 Total number of items of correspondence 18 9 2 2 3 34 (excluding postcards)

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3.3 Stakeholder engagement and profiling Mapping of key local stakeholders and organisations who could assist in the promotion of the consultation as widely and effectively as possible across the identified areas was undertaken. A stakeholder database was created to log stakeholders’ details and manage communication with them. Stakeholders were contacted to assist in:  promoting the consultation survey  hosting and promoting the engagement activities  distributing the consultation collateral.

3.3.1 Stakeholder types A range of stakeholders and partners were identified to support communications and engagement activities, distributing collateral and planning and event coordination. Table 21 shows a breakdown of the stakeholder types and the communications methods used to engage them. See Appendix 1 for a detailed breakdown of the engagement with each organisation. Table 21. Number of stakeholder organisations engaged, and channel management used for onward cascade Type of organisation Number of stakeholders Contact reason NHS / health / GP  Promotion and onward cascade of information 12 organisations  Arranging events MPs / councillors 32  Promoting and onward cascade of information  Promotion and onward cascade of information Voluntary sector / 105  Arranging focus groups community organisations  Attendance at existing meetings Community / Residents’  Promotion and onward cascade of information 51 Associations  Attendance at existing meetings Local authorities / parish 23  Promotion and onward cascade of information councils  Promotion and onward cascade of information Large local employers 26  Arranging promotional stands at events  Arranging the distribution of consultation collateral Supermarkets / retail 50  Arranging promotional stands locations

GP practices /  Arranging the display of consultation collateral and 196 pharmacies A5 leaflet distribution

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3.3.2 Method and frequency of engagement Stakeholders were communicated using both emails and telephone calls. Communications were tailored depending on the stakeholder type and contact details available. Table 22 shows the frequency of engagement with each stakeholder groups. Table 22. Stakeholder communications and engagement Total number of emails Total number of phone Total number of Type of organisation sent across all calls made across all organisations engaged organisations organisations NHS / health / GP organisation 12 369 0 MPs / councillors 32 197 N/A Voluntary / community 105 747 139 organisations Community / Residents’ 51 207 26 Associations Local authorities / parish councils 23 162 1 Large local employers 26 20 14 Supermarkets / retail locations 50 14 45 GP practices / pharmacies 196 N/A 147

See Appendix 1 for a detailed breakdown of the engagement with each organisation.

3.3.3 Equalities and health equalities Engagement was planned to target a representative sample of the area that reflected the demographic composition of the area. A population profile of the area, including demographics such as age, gender, ethnicity and religion was produced from census data (see Appendix 3) with a quota calculated to provide a target sample to be gathered. Demographic information gathered within the survey and at events was used to profile those engaged during the consultation against the profile of the CCGs’ populations. The demographic profile of consultation respondents was monitored throughout the consultation period, with any under-represented groups targeted for further engagement. This approach was taken to assist in meeting the CCGs’ Public Sector Equality Duty requirement, as outlined in Section 149 of the Equality Act 2010. Locations within the consultation area with the highest levels of deprivation were specifically targeted in line with the duty to engage those with health inequalities. The Indices of Multiple Deprivation (IMD) shows that Leek and Stoke-on-Trent were the most deprived areas within the consultation area. These areas were targeted for engagement to ensure the views of these communities were captured. Figure 8 shows the consultation activity for the area overlaid on a map showing the Indices of Multiple Deprivation.

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Figure 8. Map of consultation activity and IMD

The consultation plan identified the need for the consultation process to reach all those who have an interest in the proposals and ensure they are empowered and enabled to get involved. The consultation process has been subject to an equalities impact analysis to confirm that the process for consultation and decision- making is fully compliant with the CCGs’ legal duties under the Equality Act 2010 and the NHS Act 2006 (as amended) and taking people’s protected characteristics into account. The Equality Impact Assessment revealed that the two protected groups most likely to be affected by the proposals were older people and those with a disability. Organisations representing these groups were contacted to cascade information and organise events. Focus groups were held with carers’ forums, Moorlands Home Link, Saltbox Carelink and Carers’ Cafés were attended to promote the consultation. Focus groups were also held with Disability Solutions, Breathe Easy (a support group for those with lung conditions), North Staffs Mind and Green Door (a charity that provides workshops and outdoor activities to overcome isolation, especially among older and disabled people).

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In response to the Stoke-on-Trent Adults and Neighbourhoods Overview and Scrutiny Committee, Residents’ Associations were proactively contacted and attendance at meetings to promote the consultation was arranged. An easy read version of the consultation document was produced. Reach, a group advocacy project based in Stoke-on-Trent (part of Asist, Advocacy Services in Staffordshire) held eight meetings with adults with learning difficulties to gather their feedback on the thoughts, ideas, experiences and comments. An easy read report of their findings was produced. Consultation information was made available on request in different formats and languages and reasonable adjustment and support was made available to give everyone an opportunity to participate; larger scale public events were held in accessible locations and all participants were asked to specify any particular needs to allow them to meaningfully participate. Steps were taken to ensure that ethnic minority groups are represented in the cross-section of consultees by making contact with places of worship and social groups. The consultation plan identified the ‘working well’ as the hardest to reach group. In order to reach people aged 30-50 who work during the day, the 10 largest employers in the area were contacted to reach the views of staff. Social media was also targeted to reach this age group. A total of 93 organisations from the stakeholder database were used to increase engagement with the specific groups within the nine protected characteristics and seldom heard groups. Table 23 shows the number of organisations engaged to maximise involvement and proactively capture feedback from these groups. Table 23. Number of organisations representing protected characteristics Protected characteristics Number of organisations Age 37 Disability 60 Gender reassignment 17 Marriage and civil partnership 14 Pregnancy 16 Race 28 Religion / belief 29 Sex 21 Sexual orientation 21  Age: The age of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted.  Disability: Information about whether respondents and attendees had a disability was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted. Accessibility was ensured at public events, such as hearing groups and ensuring collateral was suitable.  Gender reassignment: The gender identity of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted.  Marriage and civil partnership: The relationship status of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted.  Pregnancy and maternity: Information about whether respondents and attendees were pregnant or had recently given birth was optionally gathered in the survey, focus groups and public events to ensure a

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representative sample was gathered. Stakeholders representing this group were identified and contacted.  Race: The ethnicity of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing ethnic minorities were identified and contacted.  Religion or belief: The religion or belief of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted.  Sex: The sex of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered.  Sexual orientation: The sexual orientation of respondents and attendees was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted and materials were distributed.  Travellers: Stakeholders representing this group were identified and contacted using. A total of 50 surveys were distributed to the traveller community via Stoke-on-Trent Council.  Homeless: Stakeholders representing this group were identified and contacted.  Military veterans: Whether respondents and attendees were military veterans was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Stakeholders representing this group were identified and contacted.  Carers: Whether respondents and attendees were carers was optionally gathered in the survey, focus groups and public events to ensure a representative sample was gathered. Five focus groups were held at Carers’ Hubs and two promotional stand events were held at Carers’ Cafés.

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4 Profiling of consultation respondents In this section, the respondents and participants to the consultation are profiled. This section includes a breakdown of the respondent types responding to the events, as well as demographic information for those who indicated they were responding as a member of the public. During the consultation, respondents to the consultation survey and participants at public events, focus groups and Residents’ Association meetings were asked to complete a demographic profiling questionnaire. The results from those surveys are presented here for respondents who indicated they were responding as a member of the public. The profile of respondents and participants to the consultation are compared to the profile of the CCGs’ populations.

4.1 Overview of consultation respondents and participants Table 24 shows the profile of respondents and participants to the consultation compared to the population of consultation area. This includes survey respondents and participants at public events, focus groups and meetings where attendees were asked to complete the demographic profiling questionnaires. Only survey respondents and event participants who indicated they were responding as a member of the public have been included in the table. If they indicated, they were responding on behalf of an organisation they have been excluded. For an explanation of the data sources, see Appendix 8.

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Table 24. Audience response comparison Overall profile of consultation Total CCG population Demographic profiling participants Count % Count % Base 482,837 622 Under 16 88,714 18% 0 0% 16-19 22,506 5% 3 0% 20-29 66,118 14% 14 2% 30-39 58,108 12% 43 7% Age 40-49 61,194 13% 75 12% 50-59 65,027 13% 128 21% 60-69 55,383 11% 175 28% 70-79 42,148 9% 154 25% 80 and over 23,639 5% 30 5% Base 469,985 606 Gender Males 232,991 50% 218 36% Females 236,994 50% 388 64% Base 469,985 613 White: Total 434,199 92% 602 98% White: English/Welsh/Scottish/Northern Irish/British 425,389 91% 600 98% White: Irish 1,256 0% 1 0% White: Gypsy or Irish Traveller 267 0% 0 0% White: Other White 7,287 2% 1 0% Mixed/multiple ethnic group: Total 6,583 1% 2 0% Mixed/multiple ethnic group: White and Black Caribbean 2,695 1% 1 0% Mixed/multiple ethnic group: White and Black African 767 0% 0 0% Mixed/multiple ethnic group: White and Asian 1,994 0% 1 0% Mixed/multiple ethnic group: Other Mixed 1,127 0% 0 0% Asian/Asian British: Total 22,456 5% 4 1% Ethnicity Asian/Asian British: Indian 3,402 1% 2 0% Asian/Asian British: Pakistani 11,001 2% 2 0% Asian/Asian British: Bangladeshi 1,253 0% 0 0% Asian/Asian British: Chinese 2,310 0% 0 0% Asian/Asian British: Other Asian 4,490 1% 0 0% Black/African/Caribbean/Black British: Total 4,689 1% 5 1% Black/African/Caribbean/Black British: African 3,103 1% 0 0% Black/African/Caribbean/Black British: Caribbean 1,130 0% 3 0% Black/African/Caribbean/Black British: Other Black 456 0% 2 0% Other ethnic group: Total 2,058 0% 1 0% Other ethnic group: Arab 563 0% 0 0% Other ethnic group: Any other ethnic group 1,495 0% 1 0% Base 384,561 595 Single 128,300 33% 62 10% Married 180,076 47% 397 67% Relationship Living with partner N/A N/A 52 9% status In a registered same-sex civil partnership 549 0% 0 0% Separated 9,594 2% 10 2% Divorced 36,057 9% 34 6% Widowed 29,985 8% 40 7% Base 469,985 616 Christian 303,686 65% 389 63% Buddhist 1,364 0% 2 0% Hindu 1,975 0% 0 0% Jewish 157 0% 0 0% Religion Muslim 16,578 4% 2 0% Sikh 841 0% 0 0% Other religion 1,657 0% 18 3% No religion 112,879 24% 159 26% Religion not stated 30,848 7% 46 7% Base 469,985 647 Disability With a disability / long-term condition 102,780 22% 192 30% Base 584 95% Heterosexual n/a 97% 500 86% Sexual Gay or lesbian n/a 0.4% 7 1% orientation Bisexual n/a 0.4% 6 1% Other n/a 0.2% 0 0% Don’t know/refuse n/a 1.8% 71 12%

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4.2 Consultation survey respondents Table 25 presents the respondent types in the survey. Table 25. Respondent types in the survey Survey respondent types As a member of the public 494 93% On behalf of an NHS organisation 21 4% On behalf of another public sector organisation 5 1% On behalf of another organisation 0 0% On behalf of a patient representative organisation 9 2% On behalf of a voluntary organisation 2 0.4% Base 531 Table 26 is a demographic overview of survey respondents. Please note this table includes those responding as a member of the public (494) and excludes those responding on behalf of an organisation (37). Table 26. Demographic profile of members of the public responding to the survey Gender identity* Gender Yes 6 1% Female 304 63% No 390 88% Male 158 33% Prefer not to say 47 11% Other 1 0.2% Base 443 Prefer not to say 23 5% Relationship status Base 486 Married 304 64% Sexual orientation Single 52 11% Heterosexual or straight 384 84% Live with partner 40 8% Bisexual 5 1% Widowed 32 7% Gay 3 1% Divorced 26 5% Lesbian 3 1% Separated 5 1% Prefer not to say 59 13% Prefer not to say 14 3% Base 455 Base 474 Age Ethnicity 16-19 1 0.2% White: Welsh/English/Scottish/Northern Irish/British 458 95% 20-29 12 2% Asian or Asian British: Indian 2 0.4% 30-39 40 8% Black/Black British: Black British 2 0.4% 40-49 61 13% Black/Black British: Black African 2 0.4% 50-59 98 20% Black/Black British: Black Caribbean 1 0.2% 60-69 131 27% White: Irish 1 0.2% 70-79 114 24% Asian/Asian British: Pakistani 1 0.2% 80 and over 18 4% Mixed: White and Black Caribbean 1 0.2% Prefer not to say 10 2% White: Any other white background 1 0.2% Base 485 Other 1 0.2% Religion/beliefs Prefer not to say 13 3% Christian 281 60% Base 483 No religion 111 24% Currently pregnant Atheist 17 4% Yes 6 1% Pagan 5 1% No 408 95% Buddhism 2 0.4% Prefer not to say 14 4% Islam 1 0.2% Base 431 Other 8 2% Recently given birth (last 26 weeks) Prefer not to say 41 9% Yes 3 1% Base 466 No 413 95% Carer for someone Prefer not to say 18 4% No 326 70% Base 434 Yes – Care for young person(s) aged under 24 35 7% Disability Yes – Care for adult(s) aged 25-49 9 2% Yes 150 30% Yes – Care for older person(s) aged over 50 81 17% No 288 58% Prefer not to say 26 6% Prefer not to say 56 11% Base 468 Base 494 Military veteran *Have you gone through any part of a process or do you intend to (including Yes 16 3% thoughts and actions) to bring your physical sex appearance and/or your gender role more in line with your gender identity? (This could include changing your No 430 93% name, your appearance and the way you dress, taking hormones or having gender Prefer not to say 17 4% confirming surgery) Base 463

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4.3 Event participants In total there were 613 participants who attended the six public events, the 30 focus groups and the 11 Residents’ Association meetings. At these events participants were asked to complete demographic profiling questionnaires. In total 285 were completed. Of these 132 were responding on behalf of organisations and have been excluded from tables 27 and 28. Table 27 presents the respondent types at events. Table 27. Respondent type of event participants Event participants: respondent type As a member of the public 153 54% On behalf of an NHS organisation 9 3% On behalf of another public sector organisation 18 6%

On behalf of another organisation 29 10% On behalf of a patient representative organisation 14 5% On behalf of a voluntary organisation 62 22% Base 285 Table 28 presents a demographic overview of event participants. Please note that this table includes those responding as a member of the public and excludes those who are responding on behalf of an organisation. Table 28. Demographic overview of members of the public participating in events Gender identity* Gender Yes 1 1% Female 84 58% No 113 88% Male 60 41% Prefer not to say 14 11% Prefer not to say 2 1% Base 128 Base 146 Relationship status Sexual orientation Married 93 66% Heterosexual or straight 116 89% Live with partner 12 9% I do not know/I am not sure 2 2% Single 10 7% Lesbian 1 1% Divorced 8 6% Bisexual 1 1% Widowed 8 6% Prefer not to say 10 8% Separated 5 4% Base 130 Other 1 1% Age Prefer not to say 4 3% 16-19 2 1% Base 141 20-29 2 1% Ethnicity 30-39 3 2% White: Welsh/English/Scottish/Northern Irish/British 142 97% 40-49 14 10% Black/Black British: Black Caribbean 1 0.7% 50-59 30 20% Black/Black British: Black British 1 0.7% 60-69 44 30% Asian/Asian British: Pakistani 1 0.7% 70-79 40 27% Mixed: White and Asian 1 0.7% 80 and over 12 8% Prefer not to say 1 0.7% Base 147 Base 147 Religion/beliefs Currently pregnant Christian 108 72% No 117 96% No religion 23 15% Prefer not to say 5 4% Atheist 8 5% Base 122 Islam 1 1% Recently given birth (last 26 weeks) Other 5 3% No 11 97% Prefer not to say 5 3% Prefer not to say 4 3% Base 150 Base 115 Carer for someone Disability No 82 63% Yes 42 27% Yes – Care for young person(s) aged under 24 11 8% No 103 67% Yes – Care for adult(s) aged 25-49 3 2% Prefer not to say 8 5% Yes – Care for older person(s) aged over 50 32 27% Base 153 Prefer not to say 5 4% Military veteran Base 130 Yes 4 4% *Have you gone through any part of a process or do you intend to (including No 108 95% thoughts and actions) to bring your physical sex appearance and/or your gender role more in line with your gender identity? (This could include changing your Prefer not to say 2 2% name, your appearance and the way you dress, taking hormones or having gender Base 114 confirming surgery)

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5 Feedback on the consultation proposals This section presents the feedback on the proposals from consultation survey, events correspondence and other channels. The section is structured into the following sub-sections:  Reporting and analysis notes  Feedback on the model of care  Feedback on proposals for integrated care hubs  Feedback on the proposals for community hospitals and rehabilitation care beds  Feedback on accessing services  Other comments, including comments from postcards.

5.1 Reporting and analysis notes Feedback from the consultation was gathered using an online survey and a paper survey (which was then inputted into the online survey). Feedback was also gathered at events with facilitators completing resource booklets. Responses were also received via correspondence (e.g. emails, letters and postcards from the ‘Save Leek Hospital’ campaign group).

5.1.1 Geography of respondents and participants Geography of survey respondents Survey respondents were asked to provide their postcode. This was then used to understand where respondents lived. Using the postcode district coverage and Local Authority area, postcode districts were assigned to one the following areas:  Stoke-on-Trent  Newcastle-under-Lyme  Cheadle  Leek and Moorlands  Other / out of area  Postcode not provided. For details of the postcodes that were assigned to each area, see Appendix 16. When creating these geographies, the following was considered:  the number of responses within a geography  the Local Authority Area  the need to understand the viewpoints of respondents from across the consultation area. Consequently, respondents from the Cheadle area have been shown separately from the rest of Staffordshire Moorlands which is shown as Leek and Moorlands. It was also important to understand survey respondents in the context of the Index of Multiple Deprivation (IMD). When looking at the IMD rank of average score, Stoke-on-Trent is the 14th most deprived local authority area in the country. Newcastle-under-Lyme is ranked 156 and Staffordshire Moorlands is ranked 207, where 1 is most deprived and 326 is least deprived. The assigned geographies produced for this report of findings, as far as possible, using the postcode districts, have been created to allow comparison with the IMD for the local authority areas. Consequently, when comparing the responses by the assigned geography, this is also, as far as possible, comparing areas by deprivation.

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Geography of the six public events The six public events were evenly distributed across the consultation area in the centres of population. Two events were in Stoke-on-Trent, one event was in Newcastle-under-Lyme, two events were in Leek and one event was in Cheadle. These locations were chosen to ensure they enabled local people from the areas to participate. The events took place in areas which are the most deprived in the country (Stoke-on-Trent events) compared to the those in the least deprived areas of the country (Newcastle-under-Lyme and Staffordshire Moorlands). Focus groups had a target audience of protected characteristics and those representatives from organisations representing protected characteristics.

5.1.2 Analysing and presenting feedback For each section, feedback will be presented on the consultation proposals from all of the engagement methods used.

5.1.2.1 Presentation of feedback by section Within the findings section of this report, feedback is presented in a standard way. For each section, feedback from the consultation survey is presented first This is followed by feedback from the public events and focus groups, then feedback from the correspondence received and finally feedback from the other channels not listed. This includes where they mention feedback appropriate to the section, from the Easy Read report, hospital stand events and other events. Key organisational comments and differences between organisational and public feedback have been highlighted throughout.

5.1.2.2 Analysing and presenting feedback from the survey The consultation survey used a combination of ‘open text’ questions, for respondents to make written comments and ‘closed’ questions where respondents ‘ticked’ their response to a set of pre-set responses. For example, ‘to what extent to do you agree with [proposal]’ with the options: agree, disagree, neither or unsure. Closed questions have been reported in tables, with answers cross-tabulated by the six geographies created. The open questions were handled differently. A random sample of responses from each open question were read and the key themes (codes) mentioned by respondents were identified. This was undertaken for every open question. Some codes were replicable across more than one question, while others were specific to one or two questions. This means that every comment was coded, because the list of themes was not predetermined, but instead emerged from the responses received. The most frequently mentioned themes are presented in this report; therefore, some questions with high levels of responses do not have all their themes listed – just the most frequently mentioned. The themes mentioned in this report cover the majority of the comments raised. The ‘base figure’ refers to the number of respondents providing an answer to each question. This number varies as involvement in this consultation was voluntary, therefore respondents were able to skip past questions in the survey they did not wish to answer. All questions were cross-tabulated by the demographic profiling questions (the nine protected characteristics) and by the geographies listed above. Significance testing was undertaken to identify where specific characteristic groups held a particular view or raised a theme. This has been reported throughout the report. The survey tables contain both individual and organisational responses.

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5.1.2.3 Organisational responses Some survey respondents indicated they were responding on behalf of an organisation. In the report we have reported this by stating that ‘an individual’ or ‘respondent from’ [organisation] said [comment]’. The differences between responses from organisations and members of the public have been included for the quantitative survey questions. See Appendix 13 for a full list of organisations responding to the survey. Section 3.2.7.2.1 also presents a list of the organisations which hosted focus groups. Comments raised by organisations in the survey and in correspondence have also been included in the report.

5.1.2.4 Analysing and presenting feedback from events, correspondence and other channels The coding frames created from the survey were also used to read, code and analyse the correspondence received and feedback from the public events and focus groups. The key themes raised in these are presented in this report. Comments raised by organisations in correspondence have also been highlighted. A voluntary organisation based in Stoke-on-Trent supporting adults with learning difficulties invited their members to meetings to talk about the consultation and produced a report of their findings. The key themes from their report are also presented in this report.

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5.2 Feedback on the model of care and the integrated care hubs This section reports the feedback on the new model of care and the integrated care hubs. Respondents to the survey were asked to provide feedback on the proposal to create four integrated care hubs. Participants at the public events and focus groups were asked what they agreed with or disagreed with about the integrated care hubs and the new model of care.

5.2.1 Feedback from the survey Table 29 shows the proportion of respondents who agreed or disagreed with the proposal to create four specialist integrated care hubs. Overall, 373 (71%) respondents indicated they strongly agreed or agreed with this approach, compared to 85 (16%) respondents who disagreed or strongly disagreed. A higher proportion of respondents living in Stoke-on-Trent (84 / 79%) strongly agreed or agreed to this proposal, compared to Cheadle (51 / 71%), Leek and Moorlands (119 / 71%) and Newcastle-under-Lyme (79 / 69%). Table 29. We are proposing creating four specialist integrated care hubs in Staffordshire Moorlands, Newcastle-under- Lyme, North of Stoke-on-Trent and South of Stoke-on-Trent so patients can get the care they need closer to home. To what extent do you agree or disagree with this approach? (Question 2) Stoke- Newcastle- Leek and Other/ out Postcode not Total Cheadle on-Trent under-Lyme Moorlands of area provided Strongly agree 25% 33% 28% 21% 21% 29% 16% Agree 46% 46% 41% 50% 49% 59% 40% Neither agree nor 11% 10% 16% 7% 10% 6% 18% disagree Disagree 6% 5% 4% 7% 5% 0% 16% Strongly disagree 11% 7% 10% 14% 14% 6% 7% Don’t know 1% 0% 2% 1% 0% 0% 4% Base 523 107 114 72 168 17 45

When analysing by the nine protected characteristics, there were no significant differences identified within the cohorts. Organisational responses  When analysing by respondent type, a higher proportion of NHS organisations (20 / 95%) strongly agreed or agreed, compared to members of the public (336 / 71%) and patient representative groups (4 / 44%).  A respondent who indicated they were responding on behalf of Borderland Voices commented that it is important that patients can access a range of services under one roof and close to home.  A respondent from GP Services commented that care close to home provides support and continuity for patients and their families.  Five respondents from Midlands Partnership Foundation Trust indicated that integrated care hubs were a good idea, would reduce pressure on the NHS, improve partnership working and lead to better patient outcomes.  A respondent from North Staffordshire GP Federation commented in support of integrated care hubs in the four areas. When considering locating the hubs, the following should be considered: STP plans, NHS long-term plans and the need to strengthen primary and community services to sustain the health and social care systems across Northern Staffordshire. They question the financial modelling and ask if Estates and Technology Transformation Fund (ETTF) funds are included and whether the monies from the disposal of Longton Cottage Hospital will be invested in integrated care hubs.  A respondent from Stoke Health Centre expressed agreement with the model of care but highlighted the need for nutrition services.

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 A respondent from Wolstanton Medical Centre expressed agreement with the model, but queried how this would be managed. Integrated care hub themes Respondents were asked why they agreed or disagreed with the proposal on integrated care hubs. Tables 30, 31 and 32 present the positive, negative and for consideration themes raised by respondents in this open text question. There were 312 positives comments, 188 negative comments and 261 comments for consideration. Table 30 shows the positive comments from the coded open question responses. Positive comments were around the themes of access, the proposals and service provision. The top three positive themes were: ‘Convenient/central location/provides in community care options/close to home’ (114), ‘Integrated care hubs/“one stop shops” are a good idea’ (70) and ‘Will reduce travel needs/good transport access’ (41). Table 30. Please explain why you agree or disagree with our proposal on integrated care hubs? (Question 3) Positive

themes.

-

Trent under

- - and

Positive themes on

-

Total

Lyme

Cheadle

provided

Leek Leek

Moorlands

Nopostcode

Stoke

Newcastle Other/out of area Convenient/central location/provides in community care 114 22 27 14 36 8 7 options/close to home Access Will reduce travel needs/good transport access 41 8 8 9 12 2 2 Good parking options 7 1 2 3 1 0 0 Integrated care hubs/“one stop shops” are a good idea 70 8 15 14 23 4 6 Generally positive about proposal (No specific reason for Proposal 30 10 3 2 13 1 1 agreement) If it's done right (as in the proposal), it will be good 15 4 4 2 4 0 1 Service Reduce pressure on other NHS services/good use of 35 9 7 6 10 2 1 provision resources Base 432 85 85 68 143 15 36 Table 31 shows the negative themes from the coded open question responses. Negative comments were around the themes of access, proposals, finance and service provision. The top three negative themes were: ‘Poor transport access’ (63); ‘Does not consider rural/isolated patients’ (43) and ‘Hubs don’t work / are a bad idea’ (22). Table 31. Please explain why you agree or disagree with our proposal on integrated care hubs? (Question 3) Negative

themes.

-

Trent under

- - and

Negative themes on

-

Total

Lyme

postcode

Cheadle

provided

Leek Leek

Moorlands

No

Stoke

Newcastle Other/out of area Poor transport access 63 12 3 22 22 0 4 Does not consider rural/isolated patients 43 3 1 12 21 0 6 Access Parking is an issue/lack of parking 17 3 3 4 4 1 2 Too far/need to be closer to home/inconvenient 17 4 1 3 7 0 2 Issues with parking costs/charges 3 0 1 0 1 0 1 Finance It's a waste of money/stop wasting money 18 3 4 1 7 1 2 Proposal Hubs don’t work/are a bad idea 22 4 4 6 4 1 3 Service Lack of GP/doctor availability (hard to get appointments) 5 1 2 1 1 0 0 provision

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Base 432 85 85 68 143 15 36 Table 32 shows the themes for consideration raised by respondents from the coded open question responses. The comments for consideration were around the themes of access, retaining specific community hospitals, service provision, estates and buildings and finance. The top three for consideration themes were: ‘Need to consider accessibility/mobility’ (37); ‘Need more information/lack of reasoning/evidence/explanation for proposal’ (30) and ‘Need to consider the care of patients with complex needs’ (28) and ‘Keep Leek open/need care in Leek’ (28) (joint third). Table 32. Please explain why you agree or disagree with our proposal on integrated care hubs? (Question 3) For

consideration themes.

-

Trent under

- - and

For consideration themes on

-

Total

Lyme

Cheadle

provided

Leek Leek

Moorlands

Nopostcode

Stoke

Newcastle Other/out of area

Need to consider accessibility/mobility 37 5 6 8 15 1 2 Access Use both hospitals/need more than one hub to cover 20 5 4 4 5 0 2 patient needs Keep Leek open/need care in Leek 28 1 0 5 21 0 1 Community Keep Cheadle open/need care in Cheadle 16 2 0 10 2 0 2 hospitals Keep Haywood open/need care in Haywood 1 0 0 0 1 0 0 Keep Bradwell open/need care in Bradwell 3 0 3 0 0 0 0 Consultation Need more information/lack of 30 7 5 3 11 0 4 process reasoning/evidence/explanation for proposal Environmental Consider environmental/ecological impact of 6 0 0 3 3 0 0 impact proposals Estates and Use/renovate existing site/buildings/facilities 18 2 3 5 6 0 2 buildings Finance Funding/investment needs to be sufficient/increased 17 5 3 2 4 1 2 Particular Need to consider the care of patients with complex 28 8 10 0 8 0 2 groups needs Need provision of community/recovery beds 19 4 3 2 9 0 1 Service Need enough beds to cope with demand 5 2 1 1 1 0 0 provision Need to provide additional services/facilities 16 5 1 1 9 0 0 Proposal requires adequate/good staff/staffing Staffing 17 4 7 2 3 0 1 numbers Other 30 5 9 2 9 0 5 Other Not answered 2 0 0 0 1 0 1 Base 432 85 85 68 143 15 36

The most frequently mentioned themes raised in each location are listed below by positive, negative or for consideration. If two or more themes were mentioned the same number of times all are listed: Stoke-on-Trent  Positive: ‘Convenient/central location/provides in community care options/close to home’ (22)  Negative: ‘Poor transport access’ (12)  For consideration: ‘Need to consider the care of patients with complex needs’ (8).

Newcastle-under-Lyme  Positive: ‘Convenient/central location/provides in community care options/close to home’ (27)  Negative: ‘It’s a waste of money/stop wasting money’ (4); ‘Hubs don’t work/are a bad idea’ (4)

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 For consideration: ‘Need to consider the care of patients with complex needs’ (10).

Cheadle  Positive: ‘Convenient/central location/provides in community care options/close to home’ (14); ‘Integrated care hubs/“one stop shops” are a good idea’ (14)  Negative: ‘Poor transport access’ (22)  For consideration: ‘Keep Cheadle open/need care in Cheadle’ (10).

Leek and Moorlands  Positive: ‘Convenient/central location/provides in community care options/close to home’ (36)  Negative: ‘Poor transport access’ (22)  For consideration: ‘Keep Leek open/need care in Leek’ (21). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 40-49 were more likely to comment that ‘Integrated care hubs/“one stop shops” are a good idea’, compared to those aged 60-79. o Respondents aged 40-69 were more likely to comment that ‘The proposals reduce pressure on other NHS services/good use of resources’ than those aged 70-79. Respondents were asked how issues or concerns relating to the model of care could be overcome. Table 33 shows the themes raised and suggestions made. The main issues and concerns were around the themes of access, retaining community hospitals, service provision, estates and buildings and finance. The top three suggestions were: ‘Retain services at Leek Moorlands Community Hospital’ (46); ‘Address transportation issues’ (44) and ‘More public consultation is required; for example, talking to residents to find out their needs’ (35).

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Table 33. How can any issues or concerns you have raised be overcome? (Question 4)

-

Trent under

- -

Model of care on

-

Total

Lyme

Cheadle

provided

Leek and and Leek

Moorlands

Nopostcode

Stoke

Newcastle Other/out of area Address transportation issues (Lack of transport 44 4 8 11 13 4 4 options) Does not consider rural/isolated patients 30 2 3 6 15 1 3 Need adequate local resources 13 3 2 1 5 0 2 Access One site is not enough to cover area/need more than 15 2 1 2 8 1 1 one hub/centre Issues with parking costs/charges 3 2 0 0 0 0 1 Parking is an issue/lack of parking 13 5 3 3 2 0 0 Retain services at Leek (Moorlands)/use these 46 2 0 4 38 1 1 services Retain services at Cheadle/use these services 26 1 0 11 13 0 1 Community Retain services at Bradwell/use these services 10 1 7 0 0 1 1 hospitals Retain community/local hospitals (No location 20 2 6 2 10 0 0 specified) Retain services at Biddulph/use these services 10 1 0 0 9 0 0 Public consultation/research (Talk/listen to us/find out Consultation 35 11 5 6 8 2 3 needs) process Need more information/reassurance about plans 15 4 0 3 5 1 2 Current buildings are modern/new enough/not old 2 0 1 0 0 0 1 Estates and Use/renovate existing site/buildings/facilities 23 2 1 5 14 0 1 building Future proof site/consider long-term needs 2 2 0 0 0 0 0 It's a waste of money/stop wasting money 16 3 2 4 4 2 1 Finance Funding/investment needs to be sufficient/increased 9 0 5 2 1 1 0 Quality of care Improve communication within NHS services 11 4 1 2 2 0 2 Provide rehabilitation/care beds 26 5 3 3 12 1 2 Service Integrate GP services in proposal 9 3 0 3 2 1 0 provision Provide additional NHS services at current locations 7 0 1 3 3 0 0 Stop closing/reducing services 5 1 0 0 4 0 0 Staffing Retain good/adequate staff/staffing levels 20 3 6 2 8 0 1 Other 47 16 8 4 14 1 4 No, none, nothing (Inc. not my local area/no concerns) 12 1 6 1 2 0 2 Other Don't know 3 3 0 0 0 0 0 Not answered 9 4 4 0 1 0 0 Base 310 58 59 45 111 12 25 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘More public consultation or research is required; for example, talking to residents to find out their needs’ (11)  Newcastle-under-Lyme: ‘Transportation issues should be addressed’ (8)  Cheadle: ‘Transportation issues should be addressed’ (11), and ‘Services should remain at Cheadle Community Hospital’ (11)  Leek and Moorlands: ‘Services should remain at Leek Moorlands Community Hospital’ (38). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age

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o Respondents aged 70-79 were more likely to comment: ‘Address transportation issues (lack of transport options)’, compared to those aged 50-59. o Respondents aged 40-49 were more likely to comment: ‘Public consultation/research (talk/listen to us/find out needs)’, compared to those aged 50-59 and 70-79. o Respondents aged 50-59 were more likely to comment: ‘Funding/investment needs to be sufficient/increased’, compared to those aged 70-79. o Respondents aged 40-49 were more likely to comment: ‘Retain good/adequate staff/staffing levels’, compared to those aged 70-79. o Respondents aged 60-69 were more likely to comment: ‘Provide rehabilitation/care beds (beds for people who have personal care needs to recover in)’, compared to those aged 50- 59 and 70-79.  Gender o Female respondents were more likely to comment: ‘Funding/investment needs to be sufficient/increased’, compared to male respondents.  Caring responsibilities: o Respondents who cared for an older person were more likely to comment: ‘Funding/investment needs to be sufficient/increased’, compared to respondents who were not carers.

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5.2.2 Feedback from the public events and focus groups This section presents feedback on the model of care from the public events and focus groups.

5.2.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about the proposed new model and integrated care hubs. Tables 34, 35 and 36 present the positive, negative and for consideration themes raised respectively. Table 34 shows the positive themes raised at public events which were around the proposals and service provision. Table 34. What do you agree and disagree with in the proposed new model and integrated care hubs? Positive themes. Public event feedback Number of tables Total

mentioning this theme number of

public

Positive themes events mentioning

Leek this theme

Cheadle

Longton

Bradwell Haywood If it’s done right (as in the proposal), it will be good 0 4 2 3 4 4 Proposals Integrated care hubs/“one stop shops” are a good idea 1 1 1 0 1 4 Generally positive about proposal 0 2 0 1 0 2 Service Reduce pressure on other NHS services/good use of 0 0 0 1 0 1 provision resources Base (number of tables) 2 13 3 9 11 Table 35 shows the negative themes raised at public events which were around access, finance and care homes and concerns over privatisation. Table 35. What do you agree and disagree with in the proposed new model and integrated care hubs? Negative themes. Public event feedback Number of tables Total

mentioning this theme number of

public Negative themes events

mentioning

Leek

Cheadle Longton

Bradwell this theme Haywood Poor transport access 1 2 0 1 5 4 Does not consider rural/isolated patients 1 1 0 2 2 4 Access Too far/need to be closer to home/inconvenient 0 2 0 0 1 2 Lack of GP/doctor availability 0 2 0 0 0 1 Proposals are driven by costs / cuts to services 1 1 0 0 1 3 Finance It’s a waste of money/stop wasting money 0 0 0 0 1 1 Implementation of Model of care is work in progress 1 0 0 0 0 1 proposals Privatisation Concerns over privatisation 1 0 0 2 0 2 Care homes are not fit-for-purpose 0 1 0 0 1 2 Care homes Concerns over the use of care homes 0 0 0 1 0 1 Service provision Stop closing/ reducing services 0 3 0 0 1 2 Base (number of tables) 2 13 3 9 11

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Table 36 shows the themes raised for consideration at public events which were around access, service provision, the consultation process, finance and quality of care. Table 36. What do you agree and disagree with in the proposed new model and integrated care hubs? For consideration themes. Public event feedback Number of tables mentioning this Total

theme number of

public For consideration themes events mentioning

Leek this theme

Cheadle

Longton

Bradwell Haywood Consider role of social care and access to social care services 0 1 1 5 2 4 Consider patient choice (e.g. patients may prefer to be in hospital) 0 1 0 1 2 3 Convenient/provides in community care options/close to home 0 3 2 2 0 3 Access Address transportation issues (Lack of transport options) 0 0 0 1 1 2 Consider locating services according to local need 0 1 0 0 1 2 Use both hospitals/need more than one hub to cover patient 0 0 0 0 2 1 needs Need more information/lack of reasoning/evidence/explanation for 0 3 1 1 4 4 Consultation proposal process Model of care is already being implemented 1 1 0 1 0 3 Public consultation (Talk/listen to us/find out needs) 0 1 0 0 0 1 Finance Funding needs to be sufficient to cover proposal 0 1 1 3 2 4 Partnership working / improved communication between services 1 2 0 3 1 4 is required Quality of Consider the need for governance (e.g. going into vulnerable care 0 0 1 1 0 2 people's homes) Consider continuity of care 0 0 0 0 1 1 Need enough beds to cope with demand (no location specified for 0 3 0 1 2 3 beds) Consider the use of social prescribing/voluntary sector 0 0 1 0 1 2 Consider the need for children's services/services for all ages 0 2 0 0 1 2 Consider the need for mental health services 0 1 0 0 1 2 Service Provide additional NHS services at current locations 0 1 0 0 1 2 provision Consider out-of-hours care 0 0 0 2 0 1 Keep Cheadle open/need care in Cheadle (Cheadle hospital) 0 0 0 0 4 1 Integrate GP services in proposal 0 2 0 0 0 1 Keep Leek open/need care in Leek (Moorlands) 0 2 0 0 0 1 Retain community/local hospitals 0 1 0 0 0 1 Consider the role of pharmacies for minor illnesses 1 0 0 0 0 1 Staffing Proposal requires adequate/good staff/staffing numbers 1 5 1 4 4 5 Vulnerable Consider the need for family support/impact on families 0 1 1 1 1 4 groups Need to consider the care of patients with complex needs 1 0 0 1 3 3 Base (number of tables) 2 13 3 9 11

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Health equalities and inequalities Public event participants were asked if there were any specific groups who may be disproportionately or unfairly impacted. Table 37 shows which groups participants thought would be disproportionately or unfairly impacted. Table 37. Are there any specific groups of people you think may be disproportionately or unfairly impacted by this option? Please tell us who they are and how they may be impacted. Public event feedback Number of tables Total

mentioning this theme number of

public

events

mentioning

Leek

Cheadle

Longton Bradwell

Haywood this theme Consider those with mental health issues 1 1 0 1 2 4 Consider the elderly population 0 4 1 1 4 4 Consider vulnerable children and younger people (e.g. young 0 2 1 1 1 4 carers) Does not consider rural/isolated patients 0 5 1 2 7 4

Consider disabled patients 0 1 0 1 0 2 Consider poverty in the area 0 1 0 0 1 2 Consider end-of-life / terminally ill patients 1 1 0 0 0 2 Consider families and support networks (e.g. patients without 0 0 1 2 0 2 family support/living alone) Consider those with language difficulties (e.g. English not first 0 0 1 1 0 2 language)

Particulargroups Consider dementia patients 0 0 0 1 1 2 Consider those with learning difficulties 0 0 1 0 0 1 Consider vulnerable adults 0 0 1 0 0 1 Punjabi community may be disproportionately affected 1 0 0 0 0 1 Consider those with alcohol dependence or substance misuse 1 0 0 0 0 1 Existing care home residents will be affected 0 0 0 1 0 1 Poor transport access (buses/trains/difficult for non-drivers) 0 2 2 1 6 4 Proposal requires adequate/good staff/staffing numbers 0 3 0 2 1 3 Consider patient choice 1 1 0 0 1 3 Need more information on plans 0 3 0 0 1 2 Consider continuity of care 0 0 1 1 0 2 Funding needs to be sufficient to cover proposal 0 1 0 0 0 1 Improve communication within NHS services (and social 0 1 0 0 0 1 care/voluntary sector Care in hospital may be better than care at home 0 2 0 0 0 1 Stop closing/reducing services 0 1 0 0 0 1

Generalcomments Model of care is already being implemented 0 1 0 0 0 1 Need provision of community/recovery beds 0 0 0 1 0 1 Vulnerable people should benefit from the proposal 0 0 0 0 1 1 Parking is an issue/lack of parking 0 0 0 0 1 1 Base (number of tables) 2 13 3 9 11

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5.2.2.2 Feedback from the focus groups The focus groups enabled targeted groups of individuals with specific characteristics and from organisations representing specific groups within the community. Their conversations usually focussed on the model of care and service provision and how it would work. Consequently, in contrast to the survey and public events there is less discussion about access, finance and estates and buildings. Focus group participants were asked what they agreed and disagreed with about the proposed new model and integrated care hubs. Tables 38, 39 and 40 present the positive, negative and for consideration themes raised respectively. Table 38 shows the positive themes raised which are around the proposal and access. Table 38. What do you agree and disagree with in the proposed new model and integrated care hubs? Positive themes.

Focus group feedback.

Positive themes

theme

protected

workshops

community

Mentions at Mentions at

focusgroups focusgroups focusgroups

characteristics

mentioningthis

Totalnumberof Mentions at carers

If it’s done right (as in the proposal), it will be good 2 3 1 6 Integrated care hubs/“one stop shops” are a good idea 0 1 1 2 Proposal (range of services in one place) Generally positive about proposal (No specific reason for 0 0 1 1 agreement) Convenient/provides in community care options/close to Access 0 0 1 1 home Base (number of tables) 13 5 2 19 Table 39 shows the negative themes raised which were around access, implementing the proposals and service provision. Table 39. What do you agree and disagree with in the proposed new model and integrated care hubs? Negative themes.

Focus group feedback

Negative themes

theme

protected

workshops

community

Mentions at Mentions at

focusgroups focusgroups focusgroups

characteristics

mentioningthis

Totalnumberof Mentions at carers Poor transport access (buses/trains/difficult for non- 1 1 1 3 drivers) Lack of GP/doctor availability (hard to get 0 2 1 3 Access appointments) Too far/need to be closer to home/inconvenient 1 0 1 2 Parking is an issue/lack of parking 0 1 0 1 Implementation Model of care is work in progress 1 0 0 1 of proposals Service Stop closing/ reducing services 0 1 0 1 provision Base (number of tables) 13 5 2 19

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Table 40 shows the themes raised for consideration which were service provision, access, funding, staffing and the consultation process. Table 40. What do you agree and disagree with in the proposed new model and integrated care hubs? For consideration

themes. Focus group feedback

nity

Consideration themes

groups

thistheme

workshops

commu

Mentions at

focusgroups

Mentions at carers

groupsmentioning

characteristicsfocus

Mentionsprotected at Totalnumberof focus Consider role of social care and access to social care 2 1 2 5 services Use both hospitals/need more than one hub to cover Access 1 1 0 2 patient needs Address transportation issues (Lack of transport 0 0 1 1 options) Community Keep Cheadle open/need care in Cheadle (Cheadle 0 1 0 1 hospitals hospital) Consultation Need more information/lack of 3 0 2 5 process reasoning/evidence/explanation for proposal Estates and Consider listed buildings at Leek Moorlands Community 1 0 0 1 buildings Hospital Funding needs to be sufficient to cover proposal 2 1 1 4 Funding Consider the need for family support/impact on families 1 0 1 2 Particular Need to consider the care of patients with complex 1 0 0 1 groups needs (severely disabled/care homes/multiple illnesses) Partnership working/improved communication between 2 1 2 5 services is required Consider the use of social prescribing/voluntary sector 4 0 1 5 Consider the need for mental health services 3 0 0 3 Consider the need for governance (e.g. going into 0 0 2 2 vulnerable people's homes) Consider the need for children's services/services for all 1 0 1 2 ages Service Consider the need for governance (e.g. going into 0 0 2 2 provision vulnerable people's homes) Consider the need for drug/alcohol services 0 1 1 2 Need to provide additional services/facilities 2 0 0 2 Consider locating services according to local need 0 0 1 1 Integrate GP services in proposal 1 0 0 1 Consider patient choice (e.g. patients may prefer to be 0 0 1 1 in hospital) Consider continuity of care 1 0 0 1 Consider out-of-hours care 0 0 1 1 Staffing Proposal requires adequate/good staff/staffing numbers 3 1 2 6 Base (number of events) 13 5 2 19

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Health equalities and inequalities Focus group participants were asked if there were any specific groups who may be disproportionately or unfairly impacted. Table 41 shows the groups they think may be disproportionately or unfairly impacted and other general considerations. Table 41. Are there any specific groups of people you think may be disproportionately or unfairly impacted by this option?

Please tell us who they are and how they may be impacted. Focus group feedback.

theme

groups

workshops

focusgroups

Mentions at carers

characteristicsfocus

Mentionsprotected at

Totalnumberof focus

groupsmentioning this Mentions at community

Consider those with mental health issues 1 1 2 4 Consider the elderly population 1 1 1 3 Consider disabled patients 1 0 0 1 Consider vulnerable children and younger people (e.g. young 0 0 1 1 carers) Consider those with alcohol dependence or substance misuse 0 0 1 1 Particular Does not consider rural/isolated patients (Inc. large area to groups 0 0 1 1 cover, consider geographical needs) Consider families and support networks (e.g. patients without 0 1 0 1 family support/living alone) Consider vulnerable adults 0 1 0 1 Consider those with multiple conditions 0 0 1 1 Consider homeless patients 0 0 1 1 Improve communication within NHS services (and social care / 1 2 1 4 voluntary sector Need more information on plans 1 1 1 3 General Poor transport access (buses/trains/difficult for non-drivers) 1 2 0 3 considerations Funding needs to be sufficient to cover proposal 0 1 1 2 Consider patient choice 1 0 0 1 Use both hospitals/need more than one hub to cover patient 1 0 0 1 needs Base (number of events) 13 5 2 19

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5.2.3 Feedback from the correspondence Table 42 shows the feedback on the model of care received from correspondence. Similar to the consultation survey and the public events the main themes were around access, retaining community hospitals, and the consultation process.

Table 42. Correspondence feedback on model of care

Model of care themes

Total

Trust

Clinician

Local authority Local

MPscouncillors /

Membersof the public Voluntaryorganisation Need to consider accessibility/mobility 6 1 0 0 1 0 8 Address transportation issues 1 0 0 0 1 0 2 Access Does not consider rural/isolated patients 1 0 0 0 0 0 1 Need to be local and community-based 1 0 0 0 0 0 1 Keep Leek open/need care in Leek 5 0 0 0 0 1 6 Retain community/local hospitals 2 1 0 0 1 1 5 Community Keep Cheadle open/need care in Cheadle 3 0 0 0 1 0 4 hospitals Keep Haywood open/need care in Haywood 1 0 0 0 0 0 1 Keep Longton open/need care in Longton 1 0 0 0 0 0 1 Public consultation (Talk/listen to us/out needs) 2 3 0 0 3 1 9 Consultation General concerns about the consultation process 4 2 0 1 1 1 9 process Need more information/reassurance about plans 5 2 0 0 0 1 8 Estates and Use/renovate existing site/buildings/facilities 0 0 0 0 0 1 1 buildings Proposals are driven by costs/cuts to services 3 1 0 0 0 1 5 Finance Funding needs to be sufficient to cover proposal 0 1 0 0 0 0 1 General positive Integrated care hubs/“one stop shops” are a good idea 1 1 0 1 1 2 6 Consider the effects on readmission rates 1 1 0 0 0 0 2 Impact on NHS Proposals are damaging to the NHS 1 0 0 0 0 1 2 Local population Consider the growing population in the area 0 0 0 0 1 0 1 Proposals will have an adverse impact on patient care 2 1 0 0 0 1 4 Quality of care Consider quality of care while building work takes place 0 0 0 0 0 1 1 Service provision Need to provide additional services/facilities 0 0 0 0 0 1 1 Staffing Proposal requires adequate/good staff/staffing numbers 0 2 0 1 0 1 4 Base (correspondence numbers) 18 6 1 2 5 2 34 Organisational responses  The Staffordshire and Stoke-on-Trent Joint Health Scrutiny Committee commented in support of integrated care hubs sited in the four areas.  The Community Hospitals Association commented in support of the service model, but highlighted that clarity is required on whether the hubs will accommodate new or existing patients and staff and that existing community hospital accommodation should be utilised where possible.  North Staffordshire Combined Healthcare NHS Trust commented in support of the proposals to develop integrated care hubs, but expressed disappointment that community-based services were not co-produced in partnership with the Trust.  North Staffs Pensioners’ Convention expressed support for the integrated care hubs concept but queried how they would be implemented without having adverse impacts on services and staffing.

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 University Hospitals of North Midlands NHS Trust commented that improvements to system workforce planning are required. Table 43 shows feedback from correspondence received about health equality and inequalities.

Table 43. Correspondence feedback on model of care: health equality and inequalities

Health equality and inequalities

Total

Trust

MPs /

public

Clinician

Voluntary

councillors

organisation

Local authority Local Membersof the Consider the elderly population 4 2 0 0 1 0 7 Consider disabled patients 1 1 0 0 0 0 2 Consider poverty in the area 0 2 0 0 0 0 2 Consider that health in the area is worse than average 0 1 0 0 0 0 1 Consider the health challenges in the area caused by historic industries 0 1 0 0 0 0 1 Base (correspondence numbers) 18 6 1 2 5 2 34

5.2.4 Feedback from other channels not listed above

5.2.4.1 Easy read report It was commented that care is needed at Longton Cottage Hospital and that transportation issues should be addressed.

5.2.4.2 Retail promotional stands It was commented that more information is required, with concerns raised about the consultation process.

5.2.4.3 External meetings It was commented that more information is required; there is a need to ensure there are enough well-trained staff voluntary services should be considered and transport issues addressed. There was some agreement with the proposals and concerns about the consultation process.

5.2.4.4 Hospital stand events It was commented that more information is required; enough qualified staff to cover care needs are required; accessibility the needs of elderly patients should be considered; communication between NHS services should be improved and innovative service provision and long-term needs should be considered. There were also general concerns about the consultation process and a lack of access to appointments.

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5.2.5 Summary of feedback on the model of care Overall, 373 (71%) survey respondents indicated they strongly agreed or agreed with the approach to create four integrated care hubs, compared to 85 (16%) respondents who disagreed or strongly disagreed. Support was at similar levels across the Northern Staffordshire and Stoke-on-Trent area. For further detail, please refer to table 29. Table 44. Summary of agreement with the integrated care hubs approach Total Strongly agree / Agree 71% Neither agree nor disagree 11% Strongly disagree / Disagree 17% Don’t know 1% Base 523 Comparing feedback from the survey, public events, focus groups and correspondence Across all feedback channels, there was agreement with the idea of integrated care hubs and to co-locate services in one place. A key theme throughout was access; for example, needing to consider poor transport access to services. The need for further information on the proposals and what services integrated care hubs provide was also a key theme throughout. A difference between the feedback channels was that the need to consider to social care was highlighted at the events. Organisational responses In the survey, a higher proportion of NHS organisations (20 / 95%) strongly agreed or agreed with the approach to create, compared to members of the public (336 / 71%) and patient representative groups (4 / 44%). A respondent from North Staffordshire GP Federation commented in support of integrated care hubs in the four areas and highlighted that the following should be considered: STP plans, NHS long-term plans and the need to strengthen primary and community services to sustain the health and social care systems across Northern Staffordshire. Themes from the survey  Key themes in both agreements and disagreements with the proposals were around access, that integrated care hubs will be convenient and provide care close to home but also that poor transport access needs to be considered  There was support for the idea of integrated care hubs and co-locating a range of services in one place. Themes from public events  Similar to the survey, there was agreement with the idea of integrated care hubs and co-locating a range of services in one place and that it would be positive if the proposals are implemented.  There was negativity around access; for example, poor transport access to services and the proposal does not consider rural/isolated patients  Key considerations raised at public events were around adequate staffing, impact on families, partnership between services, access to social care and the need for more information on the proposals.

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Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Similar to the survey and public events, there was agreement that if the proposals are implemented, it would be positive  Similar to the public events, there was negativity around access  Key considerations raised at focus groups were similar to the public events: around adequate staffing, partnership between services, access to social care and the need for more information on the proposals. The role of social prescribing and the voluntary sector was also highlighted as a key consideration. Themes from correspondence  Key themes raised in correspondence were around the consultation process and access; for example, the need to consider accessibility and for more public consultation and information around the proposals.

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5.3 Feedback on the options for four integrated care hubs This section presents the feedback on the proposals for integrated care hubs in:  South of Stoke-on-Trent  Staffordshire Moorlands  Newcastle-under-Lyme  North of Stoke-on-Trent.

5.3.1 Feedback on the options for the integrated care hubs in the South of Stoke-on-Trent This section presents the feedback on the options for the South of Stoke-on-Trent. The options were:  Option 1A: Hub services delivered from a new purpose-built site in Longton (preferred option)  Option 1B: Hub services delivered from Meir Primary Care Centre.

5.3.1.1 Feedback from the survey Comparing feedback on option 1A and option 1B In the South of Stoke-on-Trent, the largest proportion of respondents to the consultation survey supported option 1A – the preferred option. Table 45. Overall agreement for South of Stoke-on-Trent Integrated Care Hub options Option 1A: Hub services delivered from a Option 1B: Hub services delivered

new purpose-built site in Longton from Meir Primary Care Centre Strongly agree / Agree 38% 35% Neither agree nor disagree 25% 28% Strongly disagree / Disagree 24% 24% Don’t know 13% 15% Base 429 357 Option 1A: Hub services delivered from a new purpose-built site in Longton (preferred option) Table 46 shows the proportion of respondents who agreed or disagreed with integrated care hub services being delivered from a new purpose-built site in Longton. Overall, 122 (38%) respondents strongly agreed or agreed with this proposal, compared to 101 (24%) respondents who disagreed or strongly disagreed. Agreement was much higher amongst people living in Stoke-on-Trent, with 60 (62%) respondents strongly agreeing or agreeing, compared to 27 (22%) in Leek and Moorlands, 39 (39%) in Newcastle-under-Lyme and 16 (28%) in Cheadle. Table 46. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from a new purpose-built site in Longton (Question 5A) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 19% 35% 20% 14% 10% 13% 11% Agree 19% 27% 19% 14% 12% 25% 31% Neither agree nor 25% 15% 22% 25% 37% 25% 23% disagree Disagree 10% 6% 9% 14% 9% 13% 14% Strongly disagree 14% 11% 16% 26% 9% 19% 11% Don’t know 13% 5% 15% 7% 23% 6% 9% Base 429 97 101 57 123 16 35 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:

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 Age o Respondents aged 30-39 and 50-59 were more likely to strongly agree or agree, compared to those aged 70-79. Organisational responses When analysing by respondent type, a higher proportion of NHS organisations (12 / 71%) strongly agreed or agreed, compared to members of the public (141 / 36%) and patient representative groups (3 / 33%). Option 1B: Hub services delivered from Meir Primary Care Centre Table 47 shows the proportion of respondents who agreed or disagreed with hub services being delivered from Meir Primary Care Centre. Overall, 122 (34%) respondents strongly agreed or agreed with this proposal compared to 86 (24%) respondents who disagreed or strongly disagreed. Agreement was highest amongst people living in Stoke-on-Trent and Cheadle, with 34 (46%) and 26 (48%) respectively strongly agreeing or agreeing, compared to 29 (27%) in Leek and Moorlands and 23 (29%) in Newcastle-under-Lyme. Table 47. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from Meir Primary Care Centre (Question 5B) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 15% 22% 14% 19% 9% 21% 7% Agree 20% 24% 15% 30% 18% 14% 10% Neither agree nor 28% 23% 22% 28% 38% 36% 21% disagree Disagree 11% 9% 21% 4% 6% 7% 28% Strongly disagree 13% 16% 15% 13% 6% 7% 24% Don’t know 15% 22% 14% 19% 9% 21% 7% Base 357 74 78 54 108 14 29 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Gender o Male respondents were more likely to strongly disagree or disagree, compared to female respondents.  Marriage and civil partnership o Respondents who were single were more likely to strongly agree or agree, compared to those who were married or living with a partner. Organisational responses When analysing by respondent type, a higher proportion of members of the public (112 / 35%) strongly agreed or agreed, compared to NHS organisations (4 / 31%) and patient representative groups (2 / 25%). Themes in agreement and disagreement in the South of Stoke-on-Trent Table 48 shows the themes raised by respondents when asked why they agreed or disagreed with the proposals for integrated care hubs in the South of Stoke-on-Trent. Option 1A received a total of 74 positive comments and 8 negative comments, whilst option 1B received a total of 46 positive comments and 55 negative comments. Respondents also made some general considerations and comments which cannot be attributed to a specific option but provide insight into the reasons they are either supportive or unsupportive of the options. By the three main themes, the main positive, negative and other comments were: Access

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 Positive comments: ‘Convenient/central location/provides in community care options/close to home’, ‘Will reduce travel needs/good transport access’ and ‘Good parking options’  Negative comments: ‘Parking is an issue/lack of parking’, ‘Too far/need to be closer to home/inconvenient’, and ‘Poor transport access (buses/trains/difficult for non-drivers)’. Estates and buildings  Other comment: ‘Use/renovate existing site/buildings/facilities’. Finance  Negative comments: ‘It's a waste of money/stop wasting money’  Other comment: ‘Funding/investment needs to be sufficient/increased’.

Table 48. Please explain why you agree or disagree with our proposals for South of Stoke-on-Trent? (Question 6)

Lyme

-

Trent

-

Moorlands

under on

South of Stoke-on-Trent

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle

Option 1A Positive Longton mentions 43 13 7 7 8 1 7 Positive A purpose-built facility is a good idea 31 7 11 4 4 1 4 Negative Negative Longton mentions 8 1 2 3 1 1 0 Option 1B Positive Positive comments on Meir Primary Care Centre option 46 12 6 13 11 3 1 Negative Meir mentions 36 13 8 7 4 2 2 Negative Current centres too small/lack of capacity for patient 19 7 6 2 2 2 0 numbers General / considerations Convenient/central location/provides in community care 42 18 8 4 8 0 4 options/close to home Parking is an issue/lack of parking 33 12 5 10 2 2 2 Too far/need to be closer to home/inconvenient 26 7 5 4 6 1 3 Will reduce travel needs/good transport access 18 9 1 3 4 1 0 Access Poor transport access (buses/trains/difficult for non- 15 4 3 2 3 2 1 drivers) Use both hospitals/need more than one hub to cover 11 5 2 1 1 0 2 patient needs Good parking options 9 4 1 0 3 1 0 Need to consider accessibility/mobility 9 4 1 0 2 1 1 Community Keep Bradwell open/need care in Bradwell 2 0 2 0 0 0 0 hospitals Consultation Need more information/lack of 16 9 1 3 2 0 1 process reasoning/evidence/explanation for proposal Estates and Use/renovate existing site/buildings/facilities 82 21 18 18 18 3 4 buildings It's a waste of money/stop wasting money 60 16 13 15 10 4 2 Finance Funding/investment needs to be sufficient/increased 7 4 3 0 0 0 0 General Hubs don't work/ are a bad idea 8 1 3 2 0 1 1 negative General Integrated care hubs/“one stop shops” are a good idea 7 3 1 1 1 0 1 positive

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Other 34 14 6 8 2 0 4 No, none, nothing (Inc. not my local area) 43 1 4 4 31 2 1 Other Don't know 2 0 1 0 0 1 0 Not answered 2 1 1 0 0 0 0 Base 299 85 60 48 71 12 23 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Use/renovate existing site/buildings/facilities’ (21)  Newcastle-under-Lyme: ‘Use/renovate existing site/buildings/facilities’ (18)  Cheadle: ‘Use/renovate existing site/buildings/facilities’ (18)  Leek and Moorlands: ‘Use/renovate existing site/buildings/facilities’ (18). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 40-49 and 50-59 were more likely to comment: ‘Use/renovate existing site/buildings/facilities (good existing facility/hospital)’, compared to those aged 70-79. o Respondents aged 50-59 were more likely to comment: ‘Current centres too small/lack of capacity for patient numbers’, compared to those aged 70-79.  Gender o Female respondents were more likely to comment: ‘Use/renovate existing site/buildings/facilities (good existing facility/hospital)’, compared to male respondents. Organisational responses  An individual responding on behalf of Meir Primary Care Centre PPG disagreed with option 1A and agreed with option 1B. They said that Meir is poorly designed and does not meet the current needs effectively. However, they also commented that this would be a cheaper option and that building a new building would be a waste of money, especially if it was poorly designed.  North Staffordshire GP Foundation expressed a preference for Longton, as for Meir to be a hub, all services would have to be moved. How issues and concerns could be overcome in the South of Stoke-on-Trent Table 49 shows the themes raised by respondents when asked how any issues or concerns relating to the options for integrated care hubs in the South of Stoke-on-Trent could be overcome. The top three ways to overcome issues or concerns raised were: ‘Public consultation/research (talk/listen to us/find out needs)’ (32); ‘Use/renovate existing site/buildings/facilities’ (26) and ‘Does not consider rural/isolated patients’ (18).

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Table 49. South of Stoke-on-Trent: How can any issues or concerns you have raised be overcome? (Question 7)

Lyme

-

Trent

-

Moorlands

under

South of Stoke-on-Trent on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle Does not consider rural/isolated patients 18 7 4 2 3 0 2 Parking is an issue/lack of parking 17 7 5 3 1 1 0 Address transportation issues (Lack of transport 14 4 5 2 1 1 1 Access options) One site is not enough to cover area/need more than 3 2 0 0 0 1 0 one hub/centre Need adequate local resources 0 0 0 0 0 0 0 Retain services at Longton/use these services 12 4 0 3 2 2 1 Retain services at Meir/use these services 9 1 2 3 1 2 0 Community Retain community/local hospitals (No location specified) 8 2 3 0 2 0 1 hospitals Retain services at Cheadle/use these services 7 0 0 6 1 0 0 Retain services at Leek (Moorlands)/use these services 4 0 0 0 3 0 1 Retain services at Bradwell/use these services 3 1 2 0 0 0 0 Consultation Public consultation/research (talk/listen to us/find out 32 15 4 0 9 2 2 process needs) Use/renovate existing site/buildings/facilities 26 5 4 11 5 1 0 Estates and A purpose-built facility is a good idea 8 3 3 0 0 1 1 buildings Future proof site/consider long-term needs 2 1 1 0 0 0 0 It's a waste of money/stop wasting money 16 5 4 3 2 1 1 Finance Funding/investment needs to be sufficient/increased 3 2 0 0 0 0 1 Quality of Improve communication within NHS services 7 4 1 0 1 0 1 care Improve on care/service not buildings/renovations 3 2 0 1 0 0 0 Provide additional NHS services at current locations 3 2 0 0 1 0 0 Service By providing rehabilitation beds/ Hospital beds 3 2 0 0 0 0 1 provision Stop closing/reducing services 0 0 0 0 0 0 0 Other 24 10 9 1 2 0 2 No, none, nothing 3 0 1 0 2 0 0 Other Don't know 1 0 0 0 1 0 0 Not answered 15 2 5 2 5 1 0 Base 171 54 37 23 36 8 13 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Public consultation/research (talk/listen to us/find out needs)’ (15)  Newcastle-under-Lyme: ‘Transportation issues need to be addressed’ (5) and ‘Parking is an issue’ (5)  Cheadle: ‘Use/renovate existing site/buildings/facilities’ (11)  Leek and Moorlands: ‘Public consultation/research (talk/listen to us/find out needs)’ (2). When analysing by the nine protected characteristics, there were no significant differences identified within cohorts. Table 50 shows the themes raised by respondents when asked to outline any alternative ideas about the location of the hubs in the South of Stoke-on-Trent. Respondents did not make any alternative suggestions regarding the location of hubs, therefore this table presents considerations raised by respondents. The top three alternative ideas themes were: ‘Use/renovate existing site/buildings/facilities’ (11); ‘Chosen locations need to be convenient/central’ (10) and ‘Parking is/should be appropriate for needs’ (9).

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Table 50. Please outline any alternative ideas you have about the location of the hubs in each area: South of Stoke-on-

Trent. (Question 17A)

-

Trent under

- -

South of Stoke-on-Trent on

-

Total

Lyme

Cheadle

provided

Nopostcode

Stoke

Newcastle Other/out of area Leek and and Leek Moorlands Chosen locations need to be convenient/central 10 2 2 2 1 1 2 Access Parking is/should be appropriate for needs 9 4 1 1 0 0 3 Has/needs good transport links 4 2 1 0 0 0 1 Community Retain services at Longton/use these services 9 6 2 0 0 1 0 hospitals Consultation Public consultation/research (Talk/listen to us/find out 4 2 0 1 0 0 1 process needs) Use/renovate existing site/buildings/facilities 11 4 2 2 1 1 1 Estates and Future proof site/consider long-term needs 1 1 0 0 0 0 0 buildings Current building is already modern/up-to-date purpose- 0 0 0 0 0 0 0 built Finance It's a waste of money/stop wasting money 3 1 2 0 0 0 0 General Generally positive about/agree with proposal 2 0 1 0 1 0 0 positive No, none, nothing 25 6 5 3 9 2 0 Other 12 9 1 1 1 0 0 Other Not answered 11 0 2 1 7 1 0 Don't know 3 2 0 1 0 0 0 Base 93 34 16 12 20 6 5 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Services should be retained and used at Longton’ (6)  Newcastle-under-Lyme: ‘Chosen locations need to be convenient/central’ (2); ‘Services should be retained and used at Longton’ (2); ‘Existing facilities should be used’ (2) and ‘Money should not be wasted’ (2)  Cheadle: ‘Existing facilities should be used’ (2) and ‘Chosen locations need to be convenient/central’ (2)  Leek and Moorlands: ‘Chosen locations need to be convenient/central’ (1); ‘Existing facilities should be used’ (1) and ‘Generally positive about proposal’ (1). When analysing by the nine protected characteristics, there were no significant differences identified within cohorts. Organisational responses A respondent from Biddulph Valley Surgery commented that Biddulph Primary Care Centre should be used.

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5.3.1.2 Feedback from the public events and focus groups This section presents feedback on the options for integrated care hubs in the South of Stoke-on-Trent from the public events and focus groups.

5.3.1.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about the options for integrated care hubs in the South of Stoke-on-Trent. Table 51 shows the positive, negative and for consideration themes raised for options 1A and 1B. Respondents also made some general / considerations comments which cannot be attributed to specific options. Table 51. South of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback. Number of tables mentioning this theme

Total number

of events South of Stoke-on-Trent mentioning

this theme

Leek

Cheadle

Longton

Bradwell Haywood Option 1A Positive Longton mentions 2 1 1 2 1 5 Convenient/central location/provides in 0 0 0 2 0 1 Positive community care options/close to home A purpose-built facility is a good idea 0 0 0 2 0 1 Will reduce travel needs/good transport access 1 0 0 0 0 1 Negative Negative Longton mentions 0 0 0 1 1 2 Consider quality of care while building work takes Consideration 0 0 1 0 0 1 place Option 1B Positive comments on Meir Primary Care Centre Positive 0 0 0 3 1 2 option Negative Meir mentions 1 1 1 0 1 4 Current centres too small/lack of capacity for Negative 1 0 1 0 0 2 patient numbers Parking is an issue/lack of parking 0 0 0 0 3 1 Consideration Use/renovate existing site/buildings/facilities 0 0 0 2 1 2 General / Unattributed Need to consider accessibility/mobility 1 0 0 1 0 2 Poor transport access 0 0 0 0 1 1 Address transportation issues (Lack of transport 0 0 0 1 0 1 options) Access One site is not enough to cover area/need more 0 0 0 0 1 1 than one hub/centre Does not consider rural/isolated patients 0 0 1 0 0 1 Consider opening times of proposed hubs 0 0 0 1 0 1 Retain services at Cheadle/use these services 0 0 0 0 1 1 Community Retain services at Longton/use these services 0 1 0 0 0 1 hospitals Public consultation/research (Talk/listen to 0 0 0 1 0 1 us/find out needs) Estates and Future proof site/consider long-term needs 0 0 0 1 0 1 buildings Funding/investment needs to be 0 0 1 0 1 2 Finance sufficient/increased It’s a waste of money/stop wasting money 0 0 0 0 1 1

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General Integrated care hubs/“one stop shops” are a 2 0 1 0 0 2 positive good idea Service Consider voluntary services 0 0 0 0 1 1 provision Improve communication within NHS services 1 0 0 1 0 2 Base (number of tables) 2 13 3 9 11

5.3.1.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about the options for integrated care hubs in the South of Stoke-on-Trent. Table 52 shows the positive, negative and consideration themes raised for options 1A and 1B. Respondents also made some general / considerations comments which cannot be attributed to a specific option. Table 52. South of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback.

Mentions at events

South of Stoke-on-Trent

Total

rotected

groups

ommunity

arersfocus

P

workshops

C

C

focusgroups characteristics Option 1A Positive Longton mentions 4 1 1 6 Positive A purpose-built facility is a good idea 1 0 0 1 Consideration Consider quality of care while building work takes place 1 0 0 1 Option 1B Negative Meir mentions 1 0 1 2 Negative Current centres too small/lack of capacity for patient numbers 0 0 1 1 Consideration Use/renovate existing site/buildings/facilities 1 0 0 1 General / Unattributed Parking is an issue/lack of parking 2 1 2 5 Address transportation issues 2 1 1 4 Access Need to consider accessibility/mobility 2 0 1 3 Poor transport access 1 0 0 1 Future proof site/consider long-term needs 0 0 1 1 General positive Integrated care hubs/“one stop shops” are a good idea 1 0 1 2 Service provision Improve communication within NHS services 0 0 1 1 Base 13 5 2 19

5.3.1.3 Feedback from the correspondence The University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option (1A). A local MP commented in support of option 1A, commenting that this is the only option that would fully enhance primary care facilities in the area. They also comment that the new hub should not just provide GP practices, but also a range of walk-in services. They comment that the current offer of healthcare in the South of Stoke-on-Trent is poor compared to the north of the city, which increases pressure on A&E. The Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) highlighted that Stoke-on-Trent City Council members expressed preference for option 1A.

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5.3.1.4 Feedback from other channels not listed above

5.3.1.4.1 Easy read report Respondents were asked which option they preferred, with 20 (65%) choosing Longton (1A) and 11 (35%) choosing Meir (1B). There was positivity around the Longton option (1A) with comments that a purpose-built facility is a good idea and both positivity and negativity around the Meir option (1B). Considerations were raised: ‘Retain services at Longton’; ‘Use existing facilities’; ‘Stop wasting money’ and ‘Accessibility and mobility need to be considered’.

5.3.1.4.2 Hospital stand events It was commented that Longton Cottage Hospital should be retained and used.

5.3.1.5 Summary of feedback on the options for the integrated care hubs in the South of Stoke-on-Trent There is a similar level of agreement for both options for integrated care hubs in the South of Stoke-on-Trent in the survey. Table 53 shows there is slightly more agreement for the preferred option (option 1A) compared option 1B. Table 53. Survey respondents: Summary of agreement and disagreement with South of Stoke-on-Trent options

Option 1A: Hub services delivered Option 1B: Hub services delivered from a new purpose-built site in from Meir Primary Care Centre Longton Strongly agree / Agree 38% 35% Neither agree nor disagree 25% 28% Strongly disagree / Disagree 24% 24% Don’t know 13% 15% Base 429 357 Comparing feedback from the survey, public events, focus groups and correspondence There were similar amounts of positivity for option 1A and 1B across all feedback channels, although there was more negativity around option 1B compared to option 1A in the survey comments, partly due to respondents feeling Meir Primary Care Centre is too small and lacks capacity for greater patient numbers. The themes raised were similar across all feedback channels, especially around access and ease of travel and the need to ensure that considering poor transport access would be addressed when locating the integrated care hub in the South of Stoke-on-Trent. Making use of existing buildings and not wasting money / using funding effectively was also a key theme throughout, suggesting why option 1A did not receive higher levels of agreement. Organisational responses  A higher proportion of NHS organisations agreed with option 1A compared to members of the public, whereas a higher proportion of members of the public agreed with option 1B compared to NHS organisations.  The University Hospitals of North Midlands NHS Trust also expressed agreement with the preferred option (1A) in correspondence.  The Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) highlighted that Stoke-on-Trent City Council members expressed preference for option 1A.  A local MP commented in support of option 1A, commenting that this is the only option that would fully enhance primary care facilities in the area.

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 An individual responding in the survey on behalf of Meir Primary Care Centre PPG disagreed with option 1A and agreed with option 1B, whereas North Staffordshire GP Foundation expressed a preference for option 1A. Themes from the survey  Option 1A: The idea of a purpose-built facility in Longton was received positively. However, there was a small group that expressed negativity towards the idea of an integrated care hub in Longton  Option 1B: There was positivity towards delivering services from Meir Primary Care Centre. However, there was also negativity around the use of Meir, in particular that the centre is too small and lacks capacity  General comments / considerations: Other key themes to consider were around estates, finance and access; for example, using existing buildings; not wasting money and providing care close to home  When reviewing the feedback by protected characteristic, females were more likely to comment that existing facilities should be used, compared to males. Themes from public events  Option 1A: There was more positivity around this option than negativity.  Option 1B: There was negativity around this option, although there was also positivity, mostly at the Bradwell public event  General comments / considerations: The need to consider finance (e.g. not wasting money); accessibility and communication within NHS services was highlighted. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Option 1A: There was positivity around this option  Option 1B: There was negativity around this option  General comments / considerations: Key themes raised were around access; for example, the lack of parking and the need to address transportation issues. Alternative options Survey respondents did not provide specific alternative options when asked if they had alternative ideas about the location of integrated care hubs. Comments raised discussed choosing locations which were central, easy access, good parking, made use of existing buildings and ensures facilities remain in Longton.

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5.3.2 Feedback on the options for the integrated care hubs in Staffordshire Moorlands This section presents the feedback on the options for Staffordshire Moorlands. The options were:  Option 2A: Hub services delivered from the existing but refurbished Leek Moorlands Community Hospital  Option 2B: Hub services delivered from a rebuilt facility at the existing Leek Moorlands Community Hospital site (preferred option)  Option 2C: Hub services delivered from a new site in Kniveden  Option 2D: Hub services delivered from existing Cheadle Community Hospital site. 5.3.2.1 Feedback from the survey Comparing feedback on Option 2A, Option 2B, Option 2C and Option 2D In Staffordshire Moorlands, the largest proportion of respondents to the consultation survey supported option 2A compared to option 2B, the preferred option. Table 54. Overall agreement for Staffordshire Moorlands Integrated Care Hub options Option 2B: Hub Option 2A: Hub services delivered Option 2D: Hub services delivered Option 2C: Hub from a rebuilt services delivered from the existing services facility at the from existing but refurbished delivered from existing Leek Cheadle Leek Moorlands a new site in Moorlands Community Community Kniveden Community Hospital site Hospital Hospital site Strongly agree / Agree 65% 44% 6% 37% Neither agree nor 16% 19% 16% 20% disagree Strongly disagree / 13% 30% 67% 36% Disagree Don’t know 6% 7% 11% 7% Base 402 403 331 353 Option 2A: Hub services delivered from the existing but refurbished Leek Moorlands Community Hospital. Table 55 shows the proportion of respondents who agreed or disagreed with hub services being delivered from the existing but refurbished Leek Moorlands Community Hospital. Overall, 260 (65%) respondents strongly agreed or agreed with this proposal compared to 54 (13%) respondents who disagreed or strongly disagreed. Agreement was much higher amongst respondents living in Leek and Moorlands, with 133 (89%) strongly agreeing or agreeing, compared to 41 (55%) in Stoke-on-Trent, 36 (48%) in Newcastle-under-Lyme and 27 (44%) in Cheadle. Table 55. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from the existing but refurbished Leek Moorlands Community Hospital (Question 8A) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 41% 28% 19% 23% 68% 29% 29% Agree 24% 27% 29% 21% 21% 36% 21% Neither agree nor 16% 25% 20% 20% 5% 36% 21% disagree Disagree 6% 7% 7% 15% 3% 0% 4% Strongly disagree 7% 5% 8% 21% 3% 0% 7%

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Don’t know 6% 8% 17% 0% 0% 0% 18% Base 402 75 75 61 149 14 28 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Gender: Male respondents were more likely to disagree or strongly disagree, compared to female respondents.

Organisational responses  When analysing by respondent type, a higher proportion of patient representative groups (7 / 88%) strongly agreed or agreed, compared to members of the public (236 / 65%) and NHS organisations (9 / 56%).  A respondent who indicated that they were responding on behalf of Borderland Voices expressed support for this option, due to the money already spent on Leek Moorlands Community Hospitals.  A respondent who indicated they were responding on behalf of Support Staffordshire also expressed support for this option, due to the money already spent on Leek Moorlands Community Hospitals.  A respondent from North Staffordshire GP Federation supported option 2A. Option 2B: Hub services delivered from a rebuilt facility at the existing Leek Moorlands Community Hospital site (preferred option) Table 56 shows the proportion of respondents who agreed or disagreed with hub services being delivered from a rebuilt facility at the existing Leek Moorlands Community Hospital site. Overall, 176 (44%) respondents strongly agreed or agreed with this proposal compared to 123 (31%) respondents who disagreed or strongly disagreed. Agreement was highest in Leek and Moorlands, with 74 (57%) strongly agreeing or agreeing, compared to 38 (44%) in Stoke-on-Trent, 36 (44%) in Newcastle-under-Lyme and 12 (20%) in Cheadle. Table 56. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from a rebuilt facility at the existing Leek Moorlands Community Hospital site (Question 8B) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 25% 23% 21% 11% 38% 25% 10% Agree 19% 21% 23% 8% 19% 13% 24% Neither agree nor 19% 26% 20% 15% 11% 38% 34% disagree Disagree 13% 12% 7% 21% 17% 6% 3% Strongly disagree 17% 10% 11% 44% 15% 19% 10% Don’t know 7% 8% 18% 0% 0% 0% 17% Base 403 86 82 61 129 16 29 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 60-79.  Caring responsibilities o Respondents who cared for a young person were more likely to strongly agree or agree, compared to those who were not carers.  Marriage and civil partnership

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o Respondents who lived with a partner were more likely to strongly agree or agree, compared to those who were single. Organisational responses  When analysing by respondent type, a similar proportion of members of the public (164 / 44%), NHS organisations (7 / 44%) and patient representative groups (3 / 43%) strongly agreed or agreed.  A respondent who indicated that they were responding on behalf of Borderland Voices commented that rebuilding and remodelling would be expensive due to the hospital’s listed status. Option 2C: Hub services delivered from a new site in Kniveden Table 57 shows the proportion of respondents who agreed or disagreed with hub services being delivered from option 2C: a new site in Kniveden. Overall, 19 (6%) respondents strongly agreed or agreed with this option compared to 222 (67%) respondents who disagreed or strongly disagreed. Similar proportions of respondents strongly agreed or agreed in Stoke-on-Trent (4 / 6%), Newcastle-under- Lyme (4 / 6%), Cheadle (2 / 4%) and Leek and Moorlands (6 / 5%). Disagreement was higher in Leek and Moorlands (97 / 87%) and Cheadle (47 / 84%), compared to Stoke-on-Trent (28 / 45%) and Newcastle- under-Lyme (32 / 49%). Table 57. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from a new site in Kniveden (Question 8C) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 2% 5% 0% 0% 1% 0% 4% Agree 4% 2% 6% 4% 5% 7% 4% Neither agree nor 16% 32% 20% 9% 5% 43% 17% disagree Disagree 19% 11% 22% 13% 25% 14% 22% Strongly disagree 48% 34% 28% 71% 62% 36% 26% Don’t know 11% 16% 25% 4% 2% 0% 26% Base 331 62 65 56 111 14 23 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 and 70-79 were more likely to disagree or strongly disagree, compared to those aged 40-49. Organisational responses  When analysing by respondent type, a higher proportion of members of the public (19 / 6%) strongly agreed or agreed, compared to 0% agreement from NHS organisations and patient representative groups.  A respondent who indicated they were responding on behalf of Borderland Voices indicated that the current Leek Moorlands Community Hospital site is more accessible. Option 2D: Hub services delivered from existing Cheadle Community Hospital site Table 58 shows the proportion of respondents who agreed or disagreed with hub services being delivered from the existing Cheadle Community Hospital site. Overall, 130 (37%) respondents strongly agreed or agreed with this proposal, compared to 126 (36%) respondents who disagreed or strongly disagreed. A greater proportion of respondents living in Cheadle (60 / 86%) strongly agreed or agreed with this option, compared to 22 (33%) in Stoke-on-Trent, 17 (26%) in Newcastle-under-Lyme and 16 (14%) in Leek and Moorlands.

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Table 58. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from existing Cheadle Community Hospital site (Question 8D) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 24% 20% 5% 77% 5% 15% 23% Agree 13% 14% 21% 9% 9% 23% 15% Neither agree nor 20% 32% 27% 6% 18% 38% 12% disagree Disagree 14% 11% 15% 4% 21% 8% 12% Strongly disagree 22% 14% 15% 4% 46% 15% 12% Don’t know 7% 11% 17% 0% 1% 0% 27% Base 353 66 66 70 112 13 26 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 40-79 were more likely to strongly agree or agree, compared to those aged 30-39.  Gender o Male respondents were more like to disagree or strongly disagree, compared to female respondents.  Caring responsibilities o Respondents who were carers for a young person were more likely to disagree or strongly disagree, compared to those who were not carers. Organisational responses  When analysing by respondent type, a higher proportion of members of the public (121 / 38%) strongly agreed or agreed, compared to patient representative groups (2 / 29%) and NHS organisations (3 / 23%).  A respondent who indicated they were responding on behalf of Cheadle Council expressed agreement with this option, as care is required in Cheadle due to its population. Themes in agreement and disagreement in Staffordshire Moorlands Table 59 shows the positive, negative and for consideration themes raised by respondents when asked why they agreed or disagreed with the proposals for integrated care hubs in Staffordshire Moorlands. Respondents also made some general / considerations comments which cannot be attributed to a specific option but provide insight into the reasons they are either supportive or unsupportive of the options. By the three main themes the main positive, negative and other comments were: Access  Positive comments: ‘Convenient/central location/provides in community care options/close to home’, ‘Will reduce travel needs/good transport access’ and ‘Good parking options’  Negative comments: ‘Poor transport access (buses/trains/difficult for non-drivers)’, ‘Too far/need to be closer to home/inconvenient’, ‘Use both hospitals/need more than one hub to cover patient needs’ and ‘Does not consider rural/isolated patients’. Estates and buildings  Other comments: ‘Use/renovate existing site/buildings/facilities’ and ‘Current building is already modern/up to date purpose-built (no renovation needed)’.

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Finance  Negative comments: ‘It's a waste of money/stop wasting money (Inc. use financially practical options)’  Other comments: ‘Funding/investment needs to be sufficient/increased’.

Table 59. Please explain why you agree or disagree with our proposals for Staffordshire Moorlands? (Question 9)

Lyme

-

Trent

-

Moorlands

under on

Staffordshire Moorlands

-

-

Outof area

Total

Cheadle

and

Stoke

Other /

Leek Leek

Nopostcode provided Newcastle Option 2A Positive Respondent expresses agreement with 2A 8 0 0 1 7 0 0 Option 2A / 2B For Keep Leek open/need care in Leek 94 14 10 10 51 5 4 consideration Option 2B / 2C Positive A purpose-built facility is a good idea 9 1 1 2 5 0 0 Option 2B Positive Respondent expresses agreement with 2B 12 1 1 3 6 0 1 Option 2C Negative Kniveden is a bad location for a hub 31 3 1 4 21 1 1 Option 2D For Keep Cheadle open/need care in Cheadle 29 3 1 19 3 0 3 consideration General / consideration Poor transport access (buses/trains/difficult for non-drivers) 52 4 5 21 15 4 3 Too far/need to be closer to home/inconvenient 39 8 6 10 14 0 1 Convenient/central location/provides in community care 35 6 2 6 20 1 0 options/close to home Access Will reduce travel needs/good transport access 21 3 2 4 11 1 0 Use both hospitals/need more than one hub to cover 21 3 0 8 9 1 0 patient needs Does not consider rural/isolated patients 17 2 0 7 8 0 0 Good parking options 13 0 0 5 8 0 0 Community Keep Bradwell open/need care in Bradwell (Bradwell 3 0 3 0 0 0 0 hospitals hospital good location) Consultation Need more information/lack of 26 4 0 6 13 1 2 process reasoning/evidence/explanation for proposal Environmental Consider environmental/ecological impact of proposals 1 0 0 0 1 0 0 impact Use/renovate existing site/buildings/facilities 126 26 14 17 61 5 3 Estates and Current building is already modern/up to date purpose-built building 21 2 2 9 8 0 0 (no renovation needed) It's a waste of money/stop wasting money (Inc. use 99 13 13 18 47 2 6 Finance financially practical options) Funding/investment needs to be sufficient/increased 7 1 1 0 3 1 1 Either option is fine/ no preference 8 0 0 3 5 0 0 General Generally positive about proposal 6 2 1 1 1 0 1 positive Integrated care hubs/“one stop shops” are a good idea 3 0 0 2 1 0 0 Service Need to provide additional services/facilities (x- 15 1 1 4 8 0 1 provision ray/scanner/etc)

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Need provision of community/recovery beds 12 2 1 2 7 0 0 Other 38 5 6 11 11 1 4 Other No, none, nothing (Inc. not my local area) 16 8 6 0 0 1 1 Not answered 1 0 1 0 0 0 0 Base 372 66 53 68 151 15 19 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Use existing facilities’ (26)  Newcastle-under-Lyme: ‘Use existing facilities’ (14)  Cheadle: ‘Poor transport access’ (21)  Leek and Moorlands: ‘Use existing facilities’ (61). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Gender o Male respondents were more likely to comment that: ‘Either option is fine/no preference’, compared to female respondents. Organisational responses  There were four respondents from Leek Health Centre PPG. All respondents felt Leek should be retained. Two respondents felt that the geography of the Moorlands means that having just one hub is not sufficient. It was felt that existing resources should be used, and money should not be wasted. All respondents agreed with option 2A; there was no agreement for option 2C or 2D.  A respondent from Leek and Biddulph Patient Locality Group commented that more than one hub is required in the Moorlands area, due to the geography of the area and poor transport access. They strongly agreed with option 2A, as existing facilities should be used and rebuilding Leek Moorlands Community Hospital would be a waste of money. How issues and concerns could be overcome in Staffordshire Moorlands Table 60 shows the suggestions and themes raised by respondents when asked how any issues or concerns relating to the options for integrated care hubs in Staffordshire Moorlands could be overcome. The top three issues and concerns raised were: ‘Use/renovate existing site/buildings/facilities’ (57); ‘Retain services at Cheadle/use these services’ (41) and ‘Retain services at Leek (Moorlands)/use these services’ (41).

Table 60. Staffordshire Moorlands. How can any issues or concerns you have raised be overcome? (Question 10)

-

-

on

-

and Lyme

Staffordshire Moorlands -

area

Total

Trent

Cheadle

provided

Leek Leek

Stoke

Moorlands

Newcastle

under

Other/out of

Nopostcode

Address transportation issues (Lack of transport 40 5 6 13 13 3 0 options) Does not consider rural/Isolated patients 28 2 2 7 15 2 0 Access One site is not enough to cover area/need more than 13 2 0 2 7 1 1 one hub/centre Parking is an issue/lack of parking 10 2 3 2 2 1 0 Need adequate local resources 4 0 0 0 4 0 0 Retain services at Cheadle/use these services 41 2 0 25 12 0 2 Retain services at Leek (Moorlands)/use these Community 41 3 0 6 30 1 1 services hospitals Retain services at Biddulph/use these services 8 0 0 0 8 0 0 Retain services at Bradwell/use these services 3 0 3 0 0 0 0 Consultation Public consultation/research (Talk/listen to us/find out 33 6 4 8 14 0 1

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process needs) Need more information on plans 8 0 0 2 5 1 0 Use/renovate existing site/buildings/facilities 57 5 5 15 32 0 0 Estates and Current buildings are modern/new enough/not old 5 1 0 4 0 0 0 buildings Future proof site/consider long-term needs 4 1 0 0 3 0 0 It's a waste of money/stop wasting money 29 5 2 6 15 0 1 Finance Funding/investment needs to be sufficient/increased 4 1 1 0 2 0 0 Quality of Improve communication within NHS services 6 2 2 1 1 0 0 care Stop closing/reducing services 14 1 1 4 7 1 0 Service Provide rehabilitation/care beds 14 2 0 2 9 0 1 provision Provide additional NHS services at current locations 9 0 0 1 7 0 1 Provide additional NHS services at location 3 0 0 1 2 0 0 Staffing Retain good/adequate staff/staffing levels 6 0 3 0 2 0 1 Other 15 5 2 0 7 1 0 No, none, nothing 1 0 0 0 1 0 0 Other Don't know 2 1 1 0 0 0 0 Not answered 10 2 4 1 2 1 0 Base 209 26 30 45 94 8 6 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘More consultation with the public is required’ (6)  Newcastle-under-Lyme: ‘Transportation issues should be addressed’ (6)  Cheadle: ‘Services should be retained and used at Cheadle Community Hospital’ (25)  Leek and Moorlands: ‘Existing facilities should be used’ (32). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 were more likely to comment: ‘Parking is an issue/lack of parking’, compared to those aged 70-79. o Respondents aged 60-69 were more likely to comment: ‘Use/renovate existing site/buildings/facilities (good existing facility/hospital)’, compared to those aged 50-59. o Respondents aged 50-59 and 70-79 were more likely to comment: ‘One site is not enough to cover area/need more than one hub/centre’, compared to those aged 60-69. Table 61 shows the suggestions and themes raised when respondents were also asked to outline any alternative ideas about the location of the hubs in Staffordshire Moorlands. Respondents did not make any alternative suggestions regarding the location of hubs, therefore this table presents considerations raised by respondents. The top three alternative ideas were: ‘Retain services at Leek (Moorlands)/use these services’ (59), ‘Use/renovate existing site/buildings/facilities’ (44) and ‘Retain services at Cheadle/use these services’ (26).

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Table 61. Please outline any alternative ideas you have about the location of the hubs in each area: Staffordshire Moorlands

(Question 17B)

-

Trent under

- -

Moorlands on

Staffordshire Moorlands

-

Total

Lyme

Cheadle

provided

and

Nopostcode

Stoke

Newcastle Other/out of area Leek Leek Chosen locations need to be convenient/central 25 2 2 5 15 1 0 Has/needs good transport links 19 0 1 4 12 0 2 Access One site is not enough to cover area/need more than one 16 1 0 7 7 0 1 hub/centre Parking is/should be appropriate for needs 9 1 1 2 2 0 3 Does not consider rural/isolated patients 5 1 1 2 0 1 0 Retain services at Leek (Moorlands)/use these services 59 7 1 8 40 2 1 Community Retain services at Cheadle/use these services 26 4 0 13 8 0 1 hospitals Retain services at Biddulph/use these services 10 0 0 0 10 0 0 Retain community/local hospitals (No location specified) 3 0 1 0 1 1 0 Consultation Public consultation/research (Talk/listen to us/find out 7 1 0 3 2 0 1 process needs) Use/renovate existing site/buildings/facilities 44 5 1 5 30 2 1 Estates and Future proof site/consider long-term needs 1 0 0 0 1 0 0 buildings Current building is already modern/up-to-date purpose- 0 0 0 0 0 0 0 built Finance It's a waste of money/stop wasting money) 7 0 1 1 5 0 0 General Generally positive about/agree with proposal 0 0 0 0 0 0 0 positive Particular Consider needs of an ageing/elderly population 7 0 0 0 7 0 0 groups Privatisation Dislike privatisation of NHS services 1 1 0 0 0 0 0 Centralise/combine GP services 10 0 0 1 9 0 0 Service Provide rehabilitation/care beds 5 0 0 1 4 0 0 provision Reduce pressure on other NHS services/good use of 0 0 0 0 0 0 0 resources Other 12 2 0 1 9 0 0 No, none, nothing 18 5 6 2 4 1 0 Other Don't know 2 2 0 0 0 0 0 Not answered 10 0 3 1 4 2 0 Base 183 22 14 39 95 7 6 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Retain services at Leek (Moorlands)/use these services’ (7)  Newcastle-under-Lyme: ‘Chosen locations need to be convenient/central’ (2)  Cheadle: ‘Retain services at Cheadle/use these services’ (13)  Leek and Moorlands: ‘Retain services at Leek (Moorlands)/use these services’ (40). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 70-79 were more likely to comment: ‘Retain services at Cheadle/use these services’, compared to respondents aged 50-59.  Gender o Male respondents were more likely to comment: ‘Has/needs good transport links’, compared to female respondents.

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o Female respondents were more likely to comment: ‘Centralise/combine GP services’, compared to male respondents.

5.3.2.2 Feedback from the public events and focus groups This section presents feedback on the options for integrated care hubs in Staffordshire Moorlands from the public events and focus groups.

5.3.2.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about the options for integrated care hubs in the Staffordshire Moorlands. Table 62 shows the positive, negative and for consideration themes raised for options 2A, 2B, 2C and 2D. Respondents also made some general / considerations comments which cannot be attributed to a specific option. Comments were similar to those raised by survey respondents, focussing on access, estates and finance. Table 62. Staffordshire Moorlands: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback. Number of tables Total

mentioning this theme number of

public Staffordshire Moorlands events

mentioning

Leek

Cheadle

Longton Bradwell

Haywood this theme Option 2A Positive Agreement with 2A 0 4 0 1 0 2 Option 2B Positive Agreement with 2B 0 4 0 2 0 2 Option 2A / 2B Keep Leek open/need care in Leek 1 5 0 1 0 3 Retain services at Leek (Moorlands)/use these services 0 2 1 0 0 2 For Current building is already modern/up-to-date purpose-built 0 2 0 0 0 1 consideration Consider listed buildings at Leek Moorlands Community 0 1 0 0 0 1 Hospital Option 2C Positive Positive mention for Kniveden 0 2 0 0 0 1 Negative Kniveden is a bad location for a hub 0 1 0 2 2 3 Option 2D Agreement with 2D 0 0 0 0 6 1 Positive Good parking options 0 0 0 0 2 1 Negative Too far/need to be closer to home/inconvenient 0 1 0 0 0 1 Keep Cheadle open/need care in Cheadle 0 0 0 1 8 2 For Retain services at Cheadle/use these services 0 0 0 0 8 1 consideration Current buildings are modern/new enough/not old 0 0 0 0 2 1 General / considerations Consider patient choice (e.g. which hub to attend) 1 0 0 0 0 1 Use both hospitals/need more than one hub to cover patient 0 1 0 1 7 3 needs Does not consider rural/isolated patients 0 4 0 3 6 3 Access Poor transport access 0 0 0 1 6 2 Parking is an issue/lack of parking 0 1 0 0 1 2 Convenient/central location/provides in community care 0 0 1 0 0 1 options/close to home Need adequate local resources 0 1 0 0 0 1 Address transportation issues 0 0 0 0 2 1 Public consultation/research (Talk/listen to us/find out needs) 0 1 0 1 0 2 Consultation Need more information/lack of process 0 6 0 1 1 3 reasoning/evidence/explanation for proposal

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Use/renovate existing site/buildings/facilities 0 5 0 0 1 2 Estates and A purpose-built facility is a good idea 0 1 0 1 0 2 building Future proof site/consider long-term needs 0 1 0 0 1 2

Consider quality of care while building work takes place 0 0 0 2 0 1 It’s a waste of money/stop wasting money 0 2 0 1 1 3 Finance Funding/investment needs to be sufficient/increased 0 1 0 0 0 1 General Integrated care hubs/“one stop shops” are a good idea 0 1 0 0 0 1 positive Need to provide additional services/facilities 0 3 1 0 3 3 Service Improve communication within NHS services 0 1 0 0 1 2 provision Do not co-locate too many services 0 0 0 0 1 1 Staffing Retain good/adequate staff/staffing levels 0 1 0 0 1 2 Base (number of tables) 2 13 3 9 11

5.3.2.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about the options for integrated care hubs in the Staffordshire Moorlands. Table 63 shows the positive, negative and for consideration themes raised for options 2A, 2B, 2C and 2D. Respondents also made some general / considerations comments which cannot be attributed to a specific option. Table 63. Staffordshire Moorlands: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback.

Mentions at events

Staffordshire Moorlands

Total

Protected

workshops

Community

focusgroups

characteristics Carersfocus groups Option 2A / 2B Positive Respondent expresses agreement with 2B 1 0 0 1 Keep Leek open/need care in Leek 2 0 0 2 For consideration Retain services at Leek [Moorlands]/use these services 0 1 0 1 Option 2C Negative Kniveden is a bad location for a hub 0 0 1 1 General / considerations Poor transport access 4 0 1 5 Does not consider rural/isolated patients 2 0 0 2 Access Use both hospitals/need more than one hub to cover patient 1 0 0 1 needs Parking is an issue/lack of parking 1 0 0 1 Consultation Need more information/lack of reasoning/evidence/explanation 1 0 0 1 process for proposal Current building is already modern/up-to-date purpose-built (no Estates and 1 0 0 1 renovation needed) buildings Current buildings are modern/new enough/not old 0 0 1 1 Finance It’s a waste of money/stop wasting money 1 0 0 1 Base (number of events) 13 5 2 19

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5.3.2.3 Feedback from the correspondence Table 64 shows the themes raised in correspondence regarding the options for integrated care hubs in the Staffordshire Moorlands area.

Table 64. Correspondence feedback on options for integrated care hubs in Staffordshire Moorlands

Staffordshire Moorlands

Total

Trust

MPs /

public

Clinician

Voluntary

councillors

organisation

Local authority Local Membersof the It’s a waste of money/stop wasting money (to rebuild Leek) 4 0 0 0 0 0 4 Keep Cheadle open/need care in Cheadle 3 0 0 0 0 0 3 Respondent expresses disagreement with preferred option (2B) 2 0 0 0 0 0 2 Respondent expresses agreement with 2B 0 0 0 1 1 0 2 Base (correspondence numbers) 18 6 1 2 5 2 34 Organisational responses Leek Town Council and University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option.

5.3.2.4 Feedback from other channels not listed above

5.3.2.4.1 Easy read report Respondents were asked which option they preferred, with 10 (56%) choosing a refurbished Leek Moorlands Community Hospital (2A); 8 (44%) choosing a rebuilt facility at Leek (2B) and no respondents choosing Cheadle (2C) or Kniveden (2D) with it comments that Kniveden is a bad location for a hub. There were positive comments about both Leek option (2A and 2B), with comments that a purpose-built facility is a good idea and existing facilities should be used, but also that it is a waste of money to rebuild Leek Moorlands Community Hospital. Considerations were raised: transportation issues need to be addressed; enough well- trained staff are needed; consider quality of care while building work takes place and Leek Moorlands Community Hospital should remain open as care is needed in Leek.

5.3.2.4.2 Hospital stand events It was commented that rebuilding Leek Moorlands Community Hospital would be a waste of money.

5.3.2.5 Summary of feedback on the options for the integrated care hubs in Staffordshire Moorlands Option 2A received the highest level of agreement in the survey compared to the preferred option, option 2B, which received the second highest level of agreement. Table 65 shows that option 2C received the lowest level of agreement.

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Table 65. Survey respondents: Summary of agreement and disagreement with Staffordshire Moorlands options

Option 2B: Hub Option 2A: Hub services delivered Option 2D: Hub services delivered from a rebuilt Option 2C: Hub services delivered from the existing facility at the services delivered from existing but refurbished existing Leek from a new site in Cheadle Leek Moorlands Moorlands Kniveden Community Community Community Hospital site Hospital Hospital site Strongly agree / Agree 65% 44% 6% 37% Neither agree nor disagree 16% 19% 16% 20% Strongly disagree / Disagree 13% 30% 67% 36% Don’t know 6% 7% 11% 7% Base 402 403 331 353 Comparing feedback from the survey, public events, focus groups and correspondence A key theme raised across the survey and events was the need for care in Leek, suggesting why options 2A and 2B received higher levels of agreement in the survey than the other options. Needing to retain care in Cheadle (option 2D) was also frequently mentioned across all channels, with the need for more than one hub in the Staffordshire Moorlands being highlighted. Kniveden (option 2C) was considered, in the survey, focus groups and public events a bad location for a hub. Estates, finance and access were also key themes across all channels; for example, ensuring poor transport access is considered. The need to stop wasting money by using existing buildings was highlighted, suggesting why the preferred to rebuild Leek Moorlands Community Hospital (option 2B) received lower levels of agreement than the option to refurbish the existing hospital (option 2A). Organisational responses  Agreement with option 2A was higher among patient representative groups, compared to members of the public and NHS organisations.  Respondents from North Staffordshire GP Federation and Leek and Biddulph Patient Locality Group supported option 2A, with the Leek and Biddulph Patient Locality Group respondent commenting that more than one hub is required in the Moorlands area, due to the geography of the area and poor transport access.  In correspondence, Leek Town Council and University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option (2B). Themes from the survey  Option 2A / Option 2B: A key theme raised, supporting both options, was that care is required in Leek  Option 2C: A key theme was that Kniveden is a bad location for the hub  General comments / considerations: Other key themes to consider were around estates and finance; for example, using existing buildings and not wasting money. For further detail, please refer to table 59. Themes from public events  Option 2A: There was agreement with this option  Option 2B: There was agreement with this option. In support of options 2A and 2B, a key theme was raised that care is required in Leek

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 Option 2C: Although there was some positivity around this option, it was commented that Kniveden is a bad location for a hub  Option 2D: There was agreement with this option at the Cheadle event, with support for care being provided in Cheadle  General comments / considerations: Key considerations raised were around the need for more than one hub in Staffordshire Moorlands; to consider rural / isolated patients and for more information. For further detail, please refer to table 62. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Option 2A / 2B: A key theme raised, supporting both options, was that care is required in Leek  General comments / considerations: Poor transport access was highlighted as a key consideration. For further detail, please refer to table 63. Themes from correspondence Key themes from correspondence were that money should not be wasted rebuilding Leek Moorlands Community Hospital and services are required in Cheadle. Alternative options Survey respondents did not provide specific alternative options when asked if they had alternative ideas about the location of integrated care hubs. Comments raised discussed ensuring services remain at Leek and Cheadle, making use of existing buildings and ensuring services are in convenient locations.

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5.3.3 Feedback on the options for the integrated care hubs in Newcastle- under-Lyme This section presents the feedback on the options for Newcastle-under-Lyme. The options were:  Option 3A: Hub services delivered from existing Bradwell Community Hospital site (preferred option)  Option 3B: Hub services delivered from Milehouse Primary Care Centre. 5.3.3.1 Feedback from the survey Comparing feedback on Option 3A and Option 3B In Newcastle-under-Lyme, the largest proportion of respondents to the consultation survey supported option 3A, the preferred option. Table 66. Overall agreement for Newcastle-under-Lyme Integrated Care Hub options Option 3A: Hub services delivered Option 3B: Hub services delivered from existing Bradwell Community from Milehouse Primary Care Hospital site Centre Strongly agree / Agree 63% 16% Neither agree nor disagree 21% 34% Strongly disagree / Disagree 4% 32% Don’t know 11% 18% Base 457 312 Option 3A: Hub services delivered from existing Bradwell Community Hospital site (preferred option) Table 67 shows the proportion of respondents who agreed or disagreed with hubs services being delivered from the existing Bradwell Community Hospital site. Overall, 289 (63%) respondents strongly agreed or agreed with this option, compared to 22 (5%) respondents who disagreed or strongly disagreed. A greater proportion of respondents living in Newcastle-under-Lyme (116 / 97%) strongly agreed or agreed with this proposal, compared to Stoke-on-Trent (69 / 71%), Cheadle (23 / 38%) and Leek and Moorlands (45 / 35%). Table 67. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from existing Bradwell Community Hospital site (Question 11A) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 41% 44% 76% 17% 19% 50% 36% Agree 22% 27% 22% 22% 16% 25% 31% Neither agree nor 21% 20% 1% 30% 37% 19% 17% disagree Disagree 2% 1% 2% 5% 2% 0% 6% Strongly disagree 2% 1% 0% 10% 2% 0% 3% Don’t know 11% 7% 0% 17% 23% 6% 8% Base 457 97 119 60 129 16 36 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 40-49 were more likely to strongly agree or agree, compared to those aged 50-79.  Gender o Male respondents were more likely to disagree or strongly disagree, compared to female respondents.

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Organisational responses  When analysing by respondent type, a higher proportion of NHS organisations (14 / 74%) strongly agreed or agreed, compared to members of the public (263 / 64%) and patient representative groups (2 / 25%).  A respondent from North Staffordshire GP Federation supported option 3A. Option 3B: Hub services delivered from Milehouse Primary Care Centre Table 68 shows the proportion of respondents who agreed or disagreed with hub services being delivered from Milehouse Primary Care Centre. Overall, 49 (16%) respondents strongly agreed or agreed with this option, compared to 99 (32%) respondents who disagreed or strongly disagreed. A greater proportion of respondents living in Newcastle-under-Lyme (19 / 25%) strongly agreed or agreed, compared to in Stoke-on-Trent (10 / 18%), Cheadle (7 / 15%) and in Leek and Moorlands (6 / 6%). Table 68. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from Milehouse Primary Care Centre (Question 11B) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 8% 9% 12% 9% 4% 13% 5% Agree 8% 9% 13% 6% 2% 6% 14% Neither agree nor 34% 37% 12% 38% 49% 31% 36% disagree Disagree 14% 14% 25% 11% 5% 19% 14% Strongly disagree 18% 14% 35% 15% 9% 25% 9% Don’t know 18% 18% 4% 21% 30% 6% 23% Base 312 57 77 47 93 16 22 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Caring responsibilities o Respondents who were not carers were more likely to disagree or strongly disagree, compared to those who cared for an older person. Organisational responses When analysing by respondent type, a higher proportion of patient representative groups (2 / 25%) strongly agreed or agreed, compared to members of the public (43 / 15%) and NHS organisations (2 / 15%). Themes in agreement and disagreement in Newcastle-under-Lyme Table 69 shows the themes raised when respondents were asked why they agreed or disagreed with the proposals for integrated care hubs in Newcastle-under-Lyme. Option 3A received a total of 101 comments for consideration and option 3B received a total of 36 negative comments. Respondents also made some general / considerations comments which cannot be attributed to a specific option but provide insight into the reasons they are either supportive or unsupportive of the options. By the three main themes the main positive, negative and other comments were: Access  Positive comments: convenient/central location/provides in community care options/close to home, good parking options, will reduce travel needs/good transport access and use both hospitals/need more than one hub to cover patient needs

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 Negative comments: too far/need to be closer to home/inconvenient, poor transport access (buses/trains/difficult for non-drivers), parking is an issue/lack of parking  Other comments: need to consider accessibility/mobility. Estates and buildings  Other comments: use/renovate existing site/buildings/facilities and one option requires less renovation work. Finance  Negative comments: it's a waste of money/stop wasting money (Inc. use financially practical options)  Other comments: funding/investment needs to be sufficient/increased.

Table 69. Please explain why you agree or disagree with our proposals for Newcastle-under-Lyme? (Question 12)

Lyme

-

Trent

-

Moorlands

under

Newcastle-under-Lyme on

-

-

outof area

Total

Cheadle

and

Stoke

Other/

Leek Leek

Nopostcode provided Newcastle Option 3A Consideration Keep Bradwell open/need care in Bradwell 101 21 57 6 6 6 5 Option 3B Negative Milehouse is a bad location for a hub 36 5 19 4 4 2 2 General / consideration Does not consider rural/isolated patients 7 0 2 0 5 0 0 Convenient/central location/provides in community care 49 8 29 3 4 1 4 options/close to home Good parking options 31 6 16 2 4 3 0 Too far/need to be closer to home/inconvenient 28 2 8 7 7 0 4 Poor transport access (buses/trains/difficult for non- Access 25 4 15 1 3 1 1 drivers) Parking is an issue/lack of parking 22 1 15 1 2 1 2 Need to consider accessibility/mobility 13 4 4 1 2 0 2 Will reduce travel needs/good transport access 12 3 7 2 0 0 0 Use both hospitals/need more than one hub to cover 6 1 2 0 1 1 1 patient needs Community Keep Leek open/need care in Leek (Leek Moorlands 1 1 0 0 0 0 0 hospitals hospital good location) Consultation Need more information/lack of 6 2 2 0 0 2 0 process reasoning/evidence/explanation for proposal Estates and Use/renovate existing site/buildings/facilities 69 21 28 8 9 1 2 buildings One option requires less renovation work 11 5 4 0 0 1 1 It's a waste of money/stop wasting money (Inc. use 20 7 6 3 3 1 0 Finance financially practical options) Funding/investment needs to be sufficient/increased 6 4 2 0 0 0 0 General negative Hubs don't work/ are a bad idea 5 1 0 1 2 0 1 Integrated care hubs/"one stop shops" are a good idea 4 1 0 1 1 0 1 General positive (range of services in one place) Either option is fine/ no preference 7 1 2 2 0 2 0 Reduce pressure on other NHS services/good use of Service provision 14 1 8 2 3 0 0 resources Other Other 38 6 17 3 5 4 3

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No, none, nothing (Inc. not my local area) 33 7 0 5 19 1 1 Don't know 4 0 0 0 3 1 0 Not answered 4 0 0 0 4 0 0 Base 274 59 99 30 59 13 14 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Bradwell Community Hospital should be kept open’ (21); ‘Use existing facilities’ (21)  Newcastle-under-Lyme: ‘Bradwell Community Hospital should be kept open’ (57)  Cheadle: ‘Existing facilities should be used’ (8)  Leek and Moorlands: ‘Existing facilities should be used’ (9). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 60-79 were more likely to comment that, convenient/central location/provides in community care options/close to home, compared to those aged 40-59.  Gender o Male respondents were more likely to comment that, convenient/central location/provides in community care options/close to home, compared to female respondents. How issues and concerns could be overcome in Newcastle-under-Lyme Table 70 shows the themes raised when respondents were asked how issues or concerns relating to the options for integrated care hubs in Newcastle-under-Lyme could be overcome. The top three issues and concerns raised were: ‘Public consultation/research (talk/listen to us/find out needs)’ (27); ‘Address transportation issues (lack of transport options)’ (20) and ‘Retain services at Bradwell/use these services’ (15).

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Table 70. Newcastle-under-Lyme. How can any issues or concerns you have raised be overcome? (Question 13)

Lyme

-

Trent provided

-

Moorlands

under

Newcastle-under-Lyme on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode Newcastle

Address transportation issues (Lack of transport options) 20 5 7 3 1 3 1 Parking is an issue/lack of parking 13 2 8 1 0 1 1 Access Does not consider rural isolated patients/ Geographical location 6 2 2 0 2 0 0 Need adequate local resources 3 0 1 0 1 0 1 Retain services at Bradwell/use these services 15 0 14 0 0 1 0 Retain community/local hospitals (No location specified) 10 2 6 1 1 0 0 Community Retain services at Milehouse/use these services 4 0 3 1 0 0 0 hospitals Retain services at Cheadle/use these services 2 0 0 2 0 0 0 Retain services at Leek (Moorlands)/use these services 0 0 0 0 0 0 0 Consultation Public consultation/research (Talk/listen to us/find out needs) 27 7 7 1 9 2 1 process Need more information/reassurance about plans 0 0 0 0 0 0 0 Use/renovate existing site/buildings/facilities 11 3 4 0 4 0 0 Estates and Current buildings are modern/new enough/not old 4 0 1 3 0 0 0 buildings Future proof site/consider long-term needs 3 1 2 0 0 0 0 It's a waste of money/stop wasting money 8 4 1 0 3 0 0 Finance Funding/investment needs to be sufficient/increased 5 1 4 0 0 0 0 Quality of care Improve communication within NHS services 2 1 0 0 1 0 0 Service Provide rehabilitation/care beds (beds for people who have 8 2 4 0 2 0 0 provision personal care needs to recover in) Other 16 5 6 0 3 1 1 No, none, nothing 5 2 2 1 0 0 0 Other Don't know 1 0 0 1 0 0 0 Not answered 13 2 2 2 5 2 0 Base 120 25 47 11 24 8 5 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Public consultation/research (Talk/listen to us/find out needs)’ (5)  Newcastle-under-Lyme: ‘Retain services at Bradwell/use these services’ (14)  Cheadle: ‘Address transportation issues (Lack of transport options)’ (3)  Leek and Moorlands: ‘Public consultation/research (Talk/listen to us/find out needs)’ (9). When analysing by the nine protected characteristics, there were no significant differences identified within cohorts. Table 71 shows the themes raised when respondents were asked to outline any alternative ideas about the location of the hubs in Newcastle-under-Lyme. Respondents did not make any alternative suggestions regarding the location of hubs, therefore this table presents considerations raised by respondents. The top three alternative ideas were: ‘Retain services at Bradwell Community Hospital’ (23); ‘Use existing facilities’ (20) and ‘Chosen locations need to be convenient/central’ (12).

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Table 71. Please outline any alternative ideas you have about the location of the hubs in each area: Newcastle-under-Lyme

(Question 17C)

Lyme

-

Trent provided

-

Moorlands

under

Newcastle-under-Lyme on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode Newcastle

Chosen locations need to be convenient/central 12 1 8 2 1 0 0 Has/needs good transport links 4 0 3 0 0 0 1 Parking is/should be appropriate for needs (Inc. reasonable Access 3 0 2 0 0 1 0 parking costs) One site is not enough to cover area/need more than one 3 1 0 0 0 0 2 hub/centre Community Retain services at Bradwell/use these services 23 6 12 1 2 0 2 hospital Estates and Use/renovate existing site/buildings/facilities 20 8 10 0 1 1 0 buildings Future proof site/consider long-term needs 0 0 0 0 0 0 0 General positive Generally positive about/agree with proposal 2 0 2 0 0 0 0 Service Provide rehabilitation/care beds 2 0 2 0 0 0 0 provision Other 12 3 3 0 1 1 4 No, none, nothing 19 4 3 3 6 3 0 Other Don't know 4 2 0 2 0 0 0 Not answered 13 1 3 1 7 1 0 Base 98 23 34 9 17 7 8 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Use/renovate existing site/buildings/facilities’ (8)  Newcastle-under-Lyme: ‘Retain services at Bradwell/use these services’ (12)  Cheadle: ‘Chosen locations need to be convenient/central’ (2)  Leek and Moorlands: ‘Retain services at Bradwell/use these services’ (2). When analysing by the nine protected characteristics, there were no significant differences identified within cohorts.

5.3.3.2 Feedback from the public events and focus groups This section presents feedback on the options for integrated care hubs in Newcastle-under-Lyme from the public events and focus groups.

5.3.3.1.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about the options for integrated care hubs in Newcastle-under-Lyme. Table 72 shows the positive, negative and for consideration themes raised for options 3A and 3B. Respondents also made some general / considerations comments which cannot be attributed to specific options.

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Table 72. Newcastle-under-Lyme: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback. Number of tables mentioning

this theme Total number of

public events Newcastle-under-Lyme mentioning this

theme

Leek

Cheadle

Longton

Bradwell Haywood Option 3A Positive Agreement with option 3A 0 1 1 7 1 4 Keep Bradwell open/need care in Bradwell 0 0 0 5 2 2 For Retain services at Bradwell/use these 0 0 0 2 0 1 consideration services One option requires less renovation work 0 0 1 2 0 2 Option 3B Negative Milehouse is a bad location for a hub 0 0 0 4 0 1 General / considerations Parking is an issue/lack of parking 0 0 1 5 0 2 Poor transport access (buses/trains/difficult 0 0 0 4 0 1 for non-drivers) Address transportation issues (Lack of 0 0 0 4 0 1 transport options) Access Convenient/central location/provides in 0 0 0 1 0 1 community care options/close to home Does not consider rural/isolated patients (Inc. large area to cover, consider 0 0 0 0 1 1 geographical/local needs) Need to consider accessibility/mobility 0 0 0 1 0 1 Need more information/lack of Consultation 0 0 2 1 0 2 reasoning/evidence/explanation for proposal process Either option is fine/ no preference 1 0 0 0 0 1 Reduce pressure on other NHS 0 0 0 1 0 1 Service services/good use of resources provision Need to provide additional services/facilities 0 0 0 1 0 1 (x-ray/scanner/etc) Base (number of tables) 2 13 3 9 11

5.3.3.1.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about the options for integrated care hubs in Newcastle-under-Lyme. Table 73 shows the positive, negative and for consideration themes raised for options 3A and 3B. Respondents also made some general / considerations comments which cannot be attributed to a specific option.

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Table 73. Newcastle-under-Lyme: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Focus group feedback.

Mentions at events

Newcastle-under-Lyme

Total

groups

Protected

workshops

Community

Carersfocus

focusgroups characteristics Option 3A For Keep Bradwell open/need care in Bradwell 1 0 0 1 consideration Option 3B Negative Milehouse is a bad location for a hub 1 0 0 1 General / consideration Address transportation issues (Lack of transport options) 2 1 1 4 Access Parking is an issue/lack of parking 3 1 0 4 Poor transport access (buses/trains/difficult for non-drivers) 2 2 0 4 Consultation Either option is fine/ no preference 0 0 1 1 process Need more information/lack of reasoning/evidence/explanation for Service 1 0 0 1 proposal provision Reduce pressure on other NHS services/good use of resources 0 1 0 1 Base (number of events) 13 5 2 19

5.3.3.3 Feedback from the correspondence Newcastle Borough Council and University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option. A local MP also expressed agreement with the preferred option, as Bradwell Community Hospital has greater capacity for quality service provision; is easily accessible from the A34 and by bus and is well-known by local residents. The MP also comments that Bradwell’s accessibility is underplayed in the consultation document.

5.3.3.4 Feedback from other channels not listed above

5.3.3.4.1 Easy read report Respondents were asked which option they preferred, with 15 (79%) choosing Bradwell Community Hospital (3A) and 4 (21%) choosing Milehouse Primary Care Centre (3B). There was agreement with option 2A, with comments that parking is good, and facilities should be used and services retained at Bradwell Community Hospital. There was also agreement with option 2B, with comments that Milehouse Primary Care Centre is in a good location, but it was also commented that Milehouse is in an inconvenient location. Considerations were raised: enough well-trained staff are required to cover needs; transportation issues to Bradwell should be addressed and more information is required on the proposal.

5.3.3.4.2 Hospital stand events It was commented that Bradwell Community Hospital has poor transport access and parking.

5.3.3.5 Summary of feedback on the options for the integrated care hubs in Newcastle- under- Lyme There was a greater level of agreement for option 3A in the survey, which was the preferred option, compared to option 3B. Table 74 shows the level of agreement and disagreement.

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Table 74. Survey respondents: Summary of agreement and disagreement with Newcastle-under- Lyme options

Option 3A: Hub services delivered Option 3B: Hub services delivered from existing Bradwell Community from Milehouse Primary Care Centre Hospital site Strongly agree / Agree 63% 16% Neither agree nor disagree 21% 34% Strongly disagree / Disagree 4% 32% Don’t know 11% 18% Base 457 312 Comparing feedback from the survey, public events, focus groups and correspondence A key theme across all feedback channels was agreement with option 3A, due to the need to provide care in Bradwell. Across the survey and events, there was also disagreement with option 3B due to the location of Milehouse Primary Care Centre, with the need for easy access being a key theme throughout all the feedback methods. Organisational responses  Agreement with the preferred option was higher among NHS organisations, compared to members of the public and patient representative groups.  A respondent from North Staffordshire GP Federation supported the preferred option (option 3A).  Newcastle Borough Council and University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option in correspondence. Themes from the survey  Option 3A: There was agreement that care is required in Bradwell and Bradwell Community Hospital should remain open  Option 3B: There was disagreement around this option, as Milehouse Primary Care Centre was considered a bad location for a hub  General comments / considerations: Key considerations raised were around estates and access; for example, using existing buildings and ensuring hubs services are in convenient locations. For further detail, please refer to table 69. Themes from public events  Option 3A: There was agreement with this option and the need to provide care in Bradwell  Option 3B: There was disagreement around this option at the Bradwell event, as Milehouse Primary Care Centre was considered a bad location for a hub  General comments / considerations: Key considerations raised were around access, especially parking, and the need for more information around the proposals. For further detail, please refer to table 72. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Option 3A: There was some agreement with this option and the need to provide care in Bradwell  Option 3B: There was some disagreement around this option at the Bradwell event, as Milehouse Primary Care Centre was considered a bad location for a hub

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 General comments / considerations: Key considerations raised were around access; for example, poor transport access and the need to address the lack of public transport and that parking is an issue. For further detail, please refer to table 73. Alternative options Survey respondents did not provide specific alternative options when asked if they had alternative ideas about the location of integrated care hubs. Comments raised discussed ensuring services remain at Bradwell Community Hospital and making use of existing buildings.

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5.3.4 Feedback on the options for the integrated care hubs in North of Stoke- on-Trent This section presents the feedback on the one option for the North of Stoke-on-Trent. This was option 4A: hub services delivered from Haywood Community Hospital.

5.3.4.1 Feedback from the survey Feedback on Option 4A In the North of Stoke-on-Trent, the largest proportion of respondents to the consultation survey supported option 4A, the preferred option. Table 75. Overall agreement for North of Stoke-on-Trent Integrated Care Hub option Option 4A: Hub services delivered from Haywood Community Hospital Strongly agree / Agree 70% Neither agree nor disagree 16% Strongly disagree / Disagree 6% Don’t know 7% Base 443 Option 4A: Hub services delivered from Haywood Community Hospital Table 76 shows the proportion of respondents who agreed or disagreed with hubs services being delivered from Haywood Community Hospital. Overall, 308 (70%) of respondents strongly agreed with agreed with this option, compared to 30 (7%) respondents who disagreed or strongly disagreed. A lower proportion of respondents living in Leek and Moorlands (78 / 60%) agreed with this option, compared to Stoke-on-Trent (79 / 80%), Newcastle-under-Lyme (78 / 77%) and Cheadle (43 / 66%). Table 76. Please indicate the extent to which you agree or disagree with the proposed hub locations in each locality below: Hub services delivered from Haywood Community Hospital (Question 14) Newcastle Leek and Postcode Stoke-on- Other/ out Total -under- Cheadle Moorland not Trent of area Lyme s provided Strongly agree 41% 51% 47% 37% 32% 50% 28% Agree 29% 29% 31% 29% 28% 31% 25% Neither agree nor 16% 12% 12% 15% 22% 6% 28% disagree Disagree 2% 3% 2% 3% 2% 0% 3% Strongly disagree 4% 3% 5% 9% 2% 0% 6% Don’t know 7% 2% 4% 6% 14% 13% 9% Base 443 99 101 65 130 16 32 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 were more likely to strongly agree or agree, compared to those aged 60-79.  Disability o Respondents with a physical disability (8 / 13%) were more likely to strongly disagree or disagree, compared to those with a sensory disability (0% of 31).

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Organisational responses  When analysing by respondent type, a higher proportion of NHS organisations (17 / 94%) strongly agreed or agreed, compared to members of the public (278 / 69%) and patient representative groups (5 / 56%).  A respondent from North Staffordshire GP Federation supported the preferred option. Themes in agreement and disagreement in the North of Stoke-on-Trent Table 77 shows the themes raised when respondents were asked why they agreed or disagreed with the proposals for integrated care hubs in the North of Stoke-on-Trent. Option 4A received a total of 59 positive comments and 47 negative comments. Respondents also made some general / considerations comments which cannot be attributed to a specific option but provide insight into the reasons they are either supportive or unsupportive of the options. By the three main themes the main positive, negative and other comments were: Access  Positive comments: ‘Convenient/central location/provides in community care options/close to home’, ‘Keep Haywood open/need care in Haywood (Haywood hospital good location)’, ‘Will reduce travel needs/good transport access’, and ‘Good parking options’  Negative comments: ‘Parking is an issue/lack of parking’ and ‘Too far/need to be closer to home/inconvenient’. Estates and buildings  Positive comments: ‘Use/renovate existing site/buildings/facilities (good existing facility/hospital)’ and ‘Current building is already modern/up to date purpose-built (no renovation needed)’. Consultation process  Negative comments: ‘Need more information/lack of reasoning/evidence/explanation for proposal’.

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Table 77. Please explain why you agree or disagree with our proposals North of Stoke-on-Trent? (Question 15)

Lyme

-

Trent

-

Moorlands

under on

North of Stoke-on-Trent

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle Option 4A Convenient/central location/provides in community care 41 11 14 2 8 2 4 options/close to home Will reduce travel needs/good transport access 10 3 1 2 2 0 2 Positive Good parking options 8 5 1 1 0 1 0 Current service provision is good 7 1 2 2 1 0 1 Reduce pressure on other NHS services/good use of 3 1 0 0 2 0 0 resources Parking is an issue/lack of parking 23 4 5 3 8 2 1 Too far/need to be closer to home/inconvenient 10 2 0 4 4 0 0 Poor transport access (buses/trains/difficult for non- 8 3 0 3 1 1 0 Negative drivers) It's a waste of money/stop wasting money (Inc. use 5 1 2 0 1 0 1 financially practical options) Hubs don't work/ are a bad idea 1 0 0 0 0 0 1 Keep Haywood open/need care in Haywood (Haywood Consideration 39 8 8 11 9 1 2 hospital good location) General / consideration Access Need to consider accessibility/mobility 2 1 0 0 1 0 0 Community Keep Bradwell open/need care in Bradwell (Bradwell 5 1 3 1 0 0 0 hospitals hospital good location) Consultation Need more information/lack of 25 9 3 5 6 1 1 process reasoning/evidence/explanation for proposal Use/renovate existing site/buildings/facilities (Good 72 16 20 12 20 3 1 Estates and existing facility/hospital) buildings Current building is already modern/up to date purpose- 23 5 3 5 6 3 1 built (no renovation needed) Option is fine 13 6 4 1 1 0 1 General positive Integrated care hubs/"one stop shops" are a good idea 7 2 4 1 0 0 0 (range of services in one place) Need to consider the care of patients with complex needs Particular groups 2 1 0 0 1 0 0 (severely disabled/care homes/multiple illnesses) Need to provide additional services/facilities (x- Service provision 3 1 2 0 0 0 0 ray/scanner/etc) Other 10 2 3 1 4 0 0 Other No, none, nothing 17 4 1 0 11 1 0 Not answered 5 0 1 0 3 0 1 Base 259 68 56 39 72 13 11 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Use/renovate existing site/buildings/facilities (Good existing facility/hospital)’ (16)  Newcastle-under-Lyme: ‘Use/renovate existing site/buildings/facilities (Good existing facility/hospital)’ (20)  Cheadle: ‘Use/renovate existing site/buildings/facilities (Good existing facility/hospital)’ (12)  Leek and Moorlands: ‘Use/renovate existing site/buildings/facilities (Good existing facility/hospital)’ (20).

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Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 were more likely to comment: ‘Use/renovate existing site/buildings/facilities (good existing facility/hospital)’, compared to those aged 40-49 and 60- 79. o Respondents aged 40-49 were more likely to comment: ‘Either option is fine/ no preference’, compared to those aged 50-79.  Caring responsibilities o Respondents who were carers for an older person were more likely to comment: ‘Integrated care hubs/“one stop shops” are a good idea (range of services in one place)’, compared to those who were not carers. o Respondents who were carers for an older person were more likely to comment: ‘Either option is fine/ no preference’, compared to those who were not carers. How issues and concerns could be overcome in the North of Stoke-on-Trent Table 78 shows the themes raised when respondents were asked how any issues or concerns relating to the options for integrated care hubs in the North of Stoke-on-Trent could be overcome. The top three issues and concerns were: ‘Parking is an issue/lack of parking’ (27), ‘Public consultation/research (talk/listen to us/find out needs)’ (18) and ‘Address transportation issues (lack of transport options)’ (14).

Table 78. North of Stoke-on-Trent: How can any issues or concerns you have raised be overcome? (Question 16)

Lyme

-

Trent

- under

North of Stoke-on-Trent on

-

-

Total

Cheadle

Stoke

Other/out of area

Leek and and Leek Moorlands

Nopostcode provided Newcastle

Parking is an issue/lack of parking 27 9 6 3 6 2 1 Address transportation issues (Lack of transport options) 14 4 4 4 1 1 0 Access Does not consider rural/isolated patients 5 2 1 1 1 0 0 Need adequate local resources 3 0 1 0 1 1 0 Community Retain services at Haywood/use these services 8 3 1 1 3 0 0 hospitals Retain services at Cheadle/use these services 5 0 0 5 0 0 0 Consultation Public consultation/research (Talk/listen to us/find out needs) 18 6 4 0 6 1 1 process Need more information/reassurance about plans 0 0 0 0 0 0 0 Estates and Use/renovate existing site/buildings/facilities 8 2 1 0 5 0 0 buildings Finance It's a waste of money/stop wasting money 9 4 2 0 2 1 0 Service Provide additional NHS services at current locations 4 0 1 0 2 1 0 provision Staffing Retain good/adequate staff/staffing levels 5 3 2 0 0 0 0 Other 17 7 5 4 1 0 0 No, none, nothing 3 0 1 0 1 1 0 Other Don't know 2 0 1 1 0 0 0 Not answered 18 4 7 0 5 2 0 Base 108 31 28 13 27 7 2

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The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Parking is an issue’ (27)  Newcastle-under-Lyme: ‘Parking is an issue’ (6)  Cheadle: ‘Retain services at Cheadle/use these services’ (5)  Leek and Moorlands: ‘Parking is an issue’ (6) and ‘Public consultation/research (talk/listen to us/find out needs)’ (6). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Gender o Female respondents were more likely to comment: ‘Parking is an issue/lack of parking’, compared to male respondents. Table 79 shows the themes raised when respondents were also asked to outline any alternative ideas about the location of the hubs in the North of Stoke-on-Trent. Respondents did not make any alternative suggestions regarding the location of hubs; therefore this table presents considerations raised by respondents. The top three alternative ideas raised were: ‘Use existing facilities’ (13), ‘Retain and use services at Haywood Community Hospital’ (11), ‘Parking is/should be appropriate for needs’ (5) and ‘Chosen locations need to be convenient/central’ (5) (joint third). Table 79. Please outline any alternative ideas you have about the location of the hubs in each area: North of Stoke-on-Trent

(Question 17D)

Lyme

-

Trent

- under

North of Stoke-on-Trent on

-

-

Total

Cheadle

Stoke

Other/out of area

Leek and and Leek Moorlands

Nopostcode provided Newcastle

Parking is/should be appropriate for needs 5 3 0 1 0 0 1 Access Chosen locations need to be convenient/central 5 2 1 1 1 0 0 Has/needs good transport links 4 2 0 1 0 0 1 Community Retain services at Haywood/use these services 11 6 2 1 2 0 0 hospitals Consultation Public consultation/research (Talk/listen to us/find out needs) 2 0 0 0 1 0 1 process Estates and Use/renovate existing site/buildings/facilities 13 5 3 1 4 0 0 buildings General Generally positive about/agree with proposal 1 0 1 0 0 0 0 positive Other 10 4 1 1 0 2 2 No, none, nothing 20 4 5 2 5 3 1 Other Don't know 3 1 0 2 0 0 0 Not answered 13 1 3 1 6 2 0 Base 76 23 15 9 18 7 4 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Retain and use services at Haywood Community Hospital’ (6)  Newcastle-under-Lyme: ‘Use existing facilities and buildings’ (3)  Cheadle: Limited comments raised

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 Leek and Moorlands: ‘Use existing facilities and buildings’ (4). When analysing by the nine protected characteristics, there were no significant differences identified within cohorts.

5.3.4.2 Feedback from the public events and focus groups. This section presents feedback on the options for integrated care hubs in the North of Stoke-on-Trent from the public events and focus groups.

5.3.4.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about the options for integrated care hubs in the North of Stoke-on-Trent. Table 80 shows the positive, negative themes raised for options 4A. Respondents also made some general / considerations comments. Table 80. North of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback.

Total Number of tables number of mentioning this theme public North of Stoke-on-Trent events

mentioning

this theme

e

n

ell

od

Leek

Bradw

Haywo

Cheadl Longto Option 4A Agreement with preferred option 0 2 2 1 1 4 Convenient/central location/provides in community 1 0 0 1 0 2 Positive care options/close to home Will reduce travel needs/good transport access 0 0 0 1 0 1 Good parking options 0 0 0 2 0 1 Parking is an issue/lack of parking 0 1 2 1 1 4 Poor transport access (buses/trains/difficult for Negative 0 1 0 0 1 2 non-drivers) It’s a waste of money/stop wasting money 0 0 0 0 1 1 General / considerations Community Only one hub is required in Stoke-on-Trent 0 0 0 0 1 1 hospitals Retain services at Cheadle/use these services 0 0 0 0 1 1 Consultation Need more information/lack of 0 0 0 1 0 1 process reasoning/evidence/explanation for proposal Estates and Current building is already modern/up-to-date 0 0 0 0 1 1 buildings purpose-built (no renovation needed) Base (number of tables) 2 13 3 9 11

5.3.4.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about the options for integrated care hubs in the North of Stoke-on-Trent. Table 81 shows the positive, negative themes raised for options 4A. Respondents also made some general / considerations comments.

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Table 81. North of Stoke-on-Trent: What do you agree with? / What do you disagree with? How can the issues, concerns or

challenges you have raised be overcome? Focus group feedback.

North of Stoke-on-Trent

theme

groups

workshops

focusgroups

Mentions at carers

characteristicsfocus

Mentionsprotected at

Totalnumberof focus

groupsmentioning this Mentions at community Option 4A Agreement with preferred option 1 1 0 2 Positive Keep Haywood open/need care in Haywood 1 0 0 1 Parking is an issue/lack of parking 4 1 0 5 Negative Poor transport access 2 2 0 4 Too far/need to be closer to home/inconvenient 0 1 0 1 General / consideration Access Need to consider accessibility/mobility 1 0 0 1 Community Retain services at Biddulph/use these services 0 1 0 1 hospitals Consultation Need more information/lack of 1 0 1 2 process reasoning/evidence/explanation for proposal Service Provide additional NHS services at current locations 1 0 0 1 provision Need to provide additional services/facilities 0 1 0 1 Base (number of events) 13 5 2 19

5.3.4.3 Feedback from the correspondence There was agreement with this option from University Hospitals of North Midlands NHS Trust.

5.3.4.4 Feedback from other channels not listed above

5.3.4.4.1 Easy read report There was agreement with agreement with preferred option, with comments that Haywood Community Hospital is a good hospital with good parking. Considerations were also raised: more information is required, and enough well-trained staff are needed.

5.3.4.4.2 Hospital stand events It was commented that Haywood Community Hospital has poor transport access; parking is an issue and accessibility should be considered.

5.3.4.5 Summary of feedback on the options for the integrated care hubs in North of Stoke- on-Trent Table 82 shows that overall, 308 (70%) of survey respondents strongly agreed with agreed with this option, the only option shortlisted in the North of Stoke-on-Trent, compared to 30 (7%) respondents who disagreed or strongly disagreed.

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Table 82. Survey respondents: Summary of agreement and disagreement with North of Stoke-on-Trent option

Option 4A: Hub services delivered from Haywood

Community Hospital Strongly agree / Agree 70% Neither agree nor disagree 16% Strongly disagree / Disagree 6% Don’t know 7% Base 443 Comparing feedback from the survey, public events, focus groups and correspondence There was agreement with option 4A across all feedback channels due to its convenient location. Access was, however, highlighted as an issue across all channels, especially parking. Organisational responses  Agreement was higher among NHS organisations, compared to members of the public and patient representative groups  A respondent from North Staffordshire GP Federation supported the preferred option  In correspondence, there was agreement with the option from University Hospitals of North Midlands NHS Trust. Themes from the survey  Option 4A: There was agreement with this option due its convenient location, but parking was also highlighted as an issue  General comments / considerations: Using existing buildings was a key theme. For further detail, please refer to table 77. Themes from public events  Option 4A: Similar to the survey, there was agreement with this option due its convenient location, but parking was also highlighted as an issue, as was transport. For further detail, please refer to table 80. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Option 4A: Similar to the public events, there was agreement with this option due its convenient location, but parking and transport were highlighted as issues. For further detail, please refer to table 81. Alternative options Survey respondents did not provide specific alternative options when asked if they had alternative ideas about the location of integrated care hubs. Comments raised discussed ensuring services remain at Haywood Community Hospital and making use of existing buildings.

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5.3.5 Feedback on services required at integrated care hubs Attendees at public events and focus groups were asked to give feedback on which services they felt were required in the integrated care hubs.

5.3.5.1 Feedback from the public events Table 83 shows the services that public event attendees suggested should be included in the integrated care hubs. Table 83. What other services do you think should be included in the integrated care hubs? Services suggested. Public event feedback. Number of tables Total

mentioning this theme number

of public

Integrated care hub services events mentioni

Leek ng this

Cheadle

Longton Bradwell Haywood theme Consider children's / young people's services / services for all ages 1 3 1 2 6 5 Consider voluntary services 1 1 0 1 1 4 Phlebotomy 0 7 1 3 3 4 Mental health services 0 4 1 3 6 4 Consider preventative services (Inc. wellbeing) 0 0 1 1 1 3 X-ray 0 3 0 1 2 3 District nurses / health visitors 0 2 0 2 1 3 Audiology / hearing tests 0 4 0 2 2 3 Dementia care services / memory clinics 0 2 0 1 2 3 Physiotherapy 0 2 0 1 2 3 Consider social care 0 4 0 1 3 3 Podiatry 0 2 0 1 1 3 Antenatal / maternity care services 0 2 0 0 3 2 Dentistry 0 1 0 1 0 2 Diabetic services 0 1 0 0 2 2

Dietetics / nutrition services 0 1 0 1 0 2 Cardiac services 0 0 0 1 1 2 Ophthalmology / opticians / eye tests 0 1 0 0 1 2 Bowel screening 0 0 0 0 1 1 Rheumatology 0 0 0 0 1 1 Dermatology 0 0 0 0 1 1 Urology 0 0 0 0 1 1 Palliative care 0 0 0 0 1 1 Servicessuggested GP services 0 0 0 1 0 1 Pharmacy 0 0 0 1 0 1 Community beds 0 1 0 0 0 1 Dialysis / stoma care 0 1 0 0 0 1 Infusion therapy 0 0 0 0 1 1 Warfarin clinic 0 0 0 0 1 1 Fracture clinic 0 0 0 1 0 1 Respiratory services (e.g. COPD) 0 0 0 0 2 1 Substance / alcohol misuse services 0 0 0 0 1 1 Obesity clinics 0 0 0 0 1 1 Health promotion / advice 0 0 0 0 1 1 Smoking cessation 0 0 0 0 1 1 Minor surgery 0 0 0 0 1 1 ENT clinics 0 1 0 0 0 1 Non-health services (e.g. benefits / housing support) 0 0 0 1 0 1 Parkinson’s / stroke services 0 0 0 1 0 1

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Speech and language therapy 0 0 0 1 0 1 Consider fitness / exercise services 0 0 0 1 0 1 Base (number of tables) 2 13 3 9 11 Table 84 shows the other comments made when attendees were asked what other services should be included in the integrated care hubs. Table 84. What other services do you think should be included in the integrated care hubs? Other comments. Public event feedback. Number of tables Total

mentioning this theme number

of public

Integrated care hub services events mentioni

Leek ng this

Cheadle

Longton Bradwell Haywood theme Particular Consider services for the homeless 0 1 0 0 0 1 groups Consider those who don't normally engage 0 0 0 1 0 1 Include minor injuries unit / walk-in services 0 1 0 1 0 2 No other services are required 1 0 0 0 1 2 Service Stop closing / reducing services 0 1 0 0 1 2 delivery Consider telephone consultations 0 1 0 0 0 1 Consider out-of-hours care 0 0 1 0 0 1 Services should reflect local need 0 0 1 0 0 1 Poor transport access (buses/trains/difficult for non-drivers) 0 1 1 2 1 4 Need more information on plans 0 3 2 1 4 4 Funding needs to be sufficient to cover proposal 1 1 0 0 2 3 General Proposal requires adequate/good staff/staffing numbers 0 1 0 2 4 3 comments Improve communication within NHS services 0 1 1 2 0 3 Parking is an issue/lack of parking 0 1 0 0 1 2 If it’s done right (as in the proposal), it will be good 0 0 0 0 3 1 Lack of GP/doctor availability (hard to get appointments) 0 0 0 0 1 1 Base (number of tables) 2 13 3 9 11

5.3.5.2 Feedback from the focus groups Table 85 shows the services suggested and comments when attendees were asked what services should be included in the integrated care hubs.

Table 85. What other services do you think should be included in the integrated care hubs? Focus groups feedback.

Integrated care hub services

theme

groups

workshops

focusgroups

Mentions at carers

characteristicsfocus

Mentionsprotected at

Totalnumberof focus

groupsmentioning this Mentions at community Mental health services 4 0 2 6 Consider voluntary services 4 0 1 5 Substance / alcohol misuse services 1 0 2 3 Health promotion / advice 2 0 1 3 Services Consider social care 1 0 2 3 suggested Consider children's / young people's services / services for all ages 0 0 2 2 Diabetic services 1 1 0 2 Neurology 1 0 1 2 Phlebotomy 0 1 0 1

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X-ray 1 0 0 1 Physiotherapy 0 1 0 1 Ophthalmology / opticians / eye tests 0 1 0 1 Smoking cessation 1 0 0 1 Minor surgery 0 1 0 1 Consider services for the homeless 0 0 1 1 Consider out-of-hours care 1 0 0 1 Consider preventative services (Inc. wellbeing) 0 0 1 1 Consider fitness / exercise services 1 0 0 1 Need more information on plans 2 0 2 4 Funding needs to be sufficient to cover proposal 2 0 0 2 General Proposal requires adequate/good staff/staffing numbers 1 0 1 2 comments Poor transport access (buses/trains/difficult for non-drivers) 0 1 0 1 If it’s done right (as in the proposal), it will be good 1 0 0 1 Base (number of events) 13 5 2 19

5.3.5.3 Feedback from external meetings It was commented that GP services should be integrated into the proposal.

5.3.5.4 Feedback from hospital stand events It was commented that additional services are required at integrated care hubs.

5.3.5.5 Summary of feedback on services required at integrated care hubs Key themes across the public events and focus groups were the need include mental health services in integrated care hubs and the need to consider voluntary services. In the public events, the need to include phlebotomy services and services for all ages; for example, children and younger people, was highlighted. Key considerations were needing more information on plans and funding being sufficient to cover the proposals.

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5.4 Feedback on the proposals for community hospitals and rehabilitation care beds This section presents feedback on the approach and the options for community hospitals and rehabilitation care beds. The options were:  Option 1: All 132 beds at Haywood Community Hospital  Option 2: 77 beds at Haywood Community Hospital and 55 beds at Leek Moorlands Community Hospital  Option 3: 77 community hospital beds at Haywood Community Hospital and 55 beds at Longton Cottage Hospital  Option 4: 77 community hospital beds at Haywood Community Hospital and 55 beds at Cheadle Community Hospital  Option 5: 77 community hospital beds at Haywood Community Hospital and 55 beds at Bradwell Community Hospital  Option 6: 77 community hospital beds at Haywood Community Hospital and 55 NHS commissioned assessment beds in local care homes (preferred option).

5.4.1 Feedback on the approach to community hospital rehabilitation beds This section presents feedback on the approach to community hospital rehabilitation beds. Currently community services are available at five hospitals across Northern Staffordshire. In the consultation the CCGs proposed a new approach which offers these out of hospital services in the community. The proposal includes the provision of approximately 132 community hospital rehabilitation beds across a number of sites. Survey respondents were asked to indicate the extent to which they agreed or disagreed with this approach, why they agreed or disagreed with the approach, how any issues or concerns they have raised could be overcome and if they have any other comments about the proposed change in bed numbers and associated modelling. In this section the feedback from the survey respondents on this approach is presented.

5.4.1.1 Feedback on the level of agreement with the proposed approach Survey respondents were asked to give feedback on the approach to providing out of hospital services in the community. Table 86 shows the proportion of respondents who agreed or disagreed with the community hospital rehabilitation beds approach. Overall, 275 (55%) of respondents strongly agreed or agreed with this proposal, compared to 157 (31%) respondents who disagreed or strongly disagreed. A greater proportion of respondents in Cheadle (54 / 75%) agreed with the approach, compared to Stoke-on- Trent (61 / 59%), Newcastle-under-Lyme (56 / 50%) and Leek and Moorlands (76 / 47%).

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Table 86. Currently community services are available at five hospitals across Northern Staffordshire. We are proposing a new approach which offers these out of hospital services in the community. To what extent do you agree or disagree with this approach? (Question 18) Newcastle Postcode Stoke-on- Leek and Other / out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 21% 25% 25% 24% 13% 41% 19% Agree 33% 34% 25% 51% 33% 35% 22% Neither agree nor 12% 15% 17% 7% 8% 18% 11% disagree Disagree 11% 9% 16% 4% 13% 0% 14% Strongly disagree 20% 16% 15% 14% 28% 6% 25% Don’t know 2% 1% 1% 0% 4% 0% 8% Base 503 104 111 72 163 17 36 When analysing by the nine protected characteristics, there were no significant differences identified within cohorts. Organisational responses  When analysing by respondent type, a higher proportion of NHS organisations (15 / 71%) strongly agreed or agreed, compared to members of the public (250 / 54%) and patient representative groups (3 / 33%).  A respondent who indicated they were responding on behalf of Borderland Voices indicated that they were unconvinced that the reduction in beds was warranted, and that care homes beds are a good alternative.  There were four respondents from Leek Health Centre PPG; all strongly disagreed with the proposal, with concerns over the quality and cost of private sector care. They all strongly agreed with having beds at Leek Moorlands Community Hospital and disagreed with the other options, apart from one respondent who agreed with Cheadle having beds. Privatisation was a key concern and that proposals for moving beds away from Leek could have adverse impacts on patient care.  Five of the six respondents from Midlands Partnership Foundation Trust (MPFT) indicated that they agreed with the approach.  A response was received from a someone who works between MPFT and Staffordshire County Council, agreeing the approach to keep people close to home, based on their experience working on a dementia care scheme which empowered the elderly to stay independent and saved money. They commented that patients require effective care packages and have support to stay at home. They suggested that funding should be used for care packages.  A respondent from North Staffordshire GP Federation strongly disagreed with the proposals, commenting that beds should be commissioned in a community hospital setting and dispersing beds across the area makes quality difficult to manage. They also suggested that care homes do not offer the same standard of care and have a high turnover of staff, who are poorly paid.  A respondent from Leek and Biddulph Patient Locality Group expressed disagreement with the proposals due to the need for adequate numbers of appropriately trained staff and concerns over the quality of care homes. They commented that care home beds are a false economy and feel the modelling is flawed. They expressed agreement with option 2.  A respondent from Wolstanton Medical Centre in Newcastle-under-Lyme expressed disagreement with the model, as using care homes risks inefficiencies and may not be for the benefit of the patients. Themes around the proposals for community rehabilitation beds Table 87 shows the themes raised by respondents when asked why they agreed or disagreed with the proposals for community rehabilitation beds.

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The top three themes were: ‘Proposal does not provide enough capacity to cover needs’ (67); ‘Healthcare provision outside hospitals is not adequate/poor’ (66) and ‘Needs to be local/community-based’ (56).

Table 87. Please explain why you agree or disagree with our proposals for community rehabilitation beds? (Question 19)

Lyme

-

Trent

-

Moorlands

under

Community rehabilitation hospital beds on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle Needs to be local/community-based 56 5 8 15 24 0 4 Access Beds need to be split geographically/at more than one 10 4 2 3 1 0 0 location Proposal does not provide enough capacity to cover needs 67 11 22 11 14 3 6 Don't close beds/reopen previously closed beds 35 12 8 5 7 1 2 Capacity Issues surrounding bed blocking/people unable to leave 26 7 4 6 7 2 0 beds because of lacking home care packages Care homes Disagreement with proposal about use of care homes 18 3 1 1 12 0 1 Agree with proposal for Leek/ need beds at Leek 12 0 0 2 10 0 0 Community Keep local/community hospitals open 12 2 2 1 5 0 2 hospitals Agree with proposal for Cheadle/ need beds at Cheadle 8 0 0 4 4 0 0 Agree with proposal for Haywood/ need beds at Haywood 2 1 0 0 1 0 0 Finance It's a waste of money/stop wasting money 7 0 1 0 4 1 1 General Agree with the proposal generally 27 5 5 6 7 3 1 positive Particular Consider the needs of an elderly/ageing population 19 3 5 4 5 0 2 groups Privatisation No to privatisation/use of private firms for care 14 1 3 0 6 2 2 Healthcare provision outside hospitals is not adequate/poor 66 16 9 2 35 2 2 Quality of Caring for patients at home/in the home is best 29 6 6 6 9 2 0 care Will ensure good care provision/ provide good care 11 6 1 1 3 0 0 Service Rehabilitation care should be separate from acute care 31 14 2 3 10 1 1 provision Staffing Enough/well trained staff to cover needs 35 5 8 4 15 0 3 Other 46 8 9 8 14 1 6 Other Don't know 2 1 0 0 0 1 0 Not answered 3 1 0 0 2 0 0 Base 391 82 76 59 132 15 27 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Healthcare provision outside hospitals is not adequate/poor’ (16)  Newcastle-under-Lyme: ‘Proposal does not provide enough capacity to cover needs’ (22)  Cheadle: ‘Services need to be local and community-based’ (15)  Leek and Moorlands: ‘Healthcare provision outside hospitals is not adequate/poor’ (35). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age

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o Respondents aged 40-49 were more likely to comment: ‘Rehabilitation care should be separate from acute care’, compared to those aged 70-79.  Gender o Female respondents were more likely to comment: ‘Don't close beds/reopen previously closed beds’, compared to male respondents.  Caring responsibility o Respondents who were carers for an older person were more likely to comment: ‘Disagreement with proposal about use of care homes’, compared to those who were not carers.

5.4.1.2 Feedback on how any issues or concerns raised to the new approach could be overcome Table 88 shows the themes raised by respondents when asked how any issues could be overcome. The top three themes were: ‘Proposal does not provide enough capacity to cover needs (Inc. not enough beds)’ (38); ‘Needs to be local/community-based’ (31) and ‘Agree with proposal for Leek/ need beds at Leek’ (31).

Table 88. How can any issues or concerns you have raised be overcome? (Question 20)

-

Trent under

- - and

Community rehabilitation hospital beds on

-

Total

Lyme

Cheadle

provided

Leek Leek

Moorlands

Nopostcode

Stoke

Newcastle Other/out of area

Needs to be local/community-based 31 3 2 6 20 0 0 Beds need to be split geographically/at more than one 14 2 1 3 8 0 0 location Access Address transportation issues (Lack of transport 7 0 2 2 2 0 1 options) Parking is an issue/lack of parking 3 0 1 1 1 0 0 Proposal does not provide enough capacity to cover 38 4 9 5 18 2 0 needs (Inc. not enough beds) Capacity Don't close beds/reopen previously closed beds 19 5 2 4 7 1 0 Issues surrounding bed blocking/people unable to 1 1 0 0 0 0 0 leave beds because of lacking home care packages Care homes Disagreement with proposal about use of care homes 7 2 1 1 3 0 0 Agree with proposal for Leek/ need beds at Leek 31 0 1 2 28 0 0 Keep local/community hospitals open 22 1 7 2 10 0 2 Agree with proposal for Cheadle/ need beds at Community 13 0 0 5 8 0 0 Cheadle hospitals Agree with proposal for Haywood/ need beds at 5 0 3 0 2 0 0 Haywood Retain services at Bradwell/ Use these services 5 0 5 0 0 0 0 Consultation Public consultation/research (Talk/listen to us/find out 28 7 7 3 8 2 1 process needs) It's a waste of money/stop wasting money (Inc. use 15 3 2 2 7 1 0 Finance financially practical options) Funding/Investment needs to be sufficient/Increased 11 4 4 0 2 0 1 Particular Consider the needs of an elderly/aging population 4 1 2 0 1 0 0 groups Privatisation No to privatisation/use of private firms for care 7 3 0 1 3 0 0 Quality of Caring for patients at home/in the home is best 8 4 0 1 0 1 2

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care Healthcare provision outside hospitals is not 1 0 0 0 0 1 0 adequate/poor Improve communication within NHS services (Inc. listen 8 4 1 2 1 0 0 Service to staff) provision Rehabilitation care should be separate from acute care 3 3 0 0 0 0 0 Staffing Enough/well trained staff to cover needs 31 6 8 7 6 1 3 Other 44 10 6 4 22 0 2 No, none, nothing 5 0 1 1 1 2 0 Other Don't know 1 0 0 1 0 0 0 Not answered 7 1 4 0 2 0 0 Base 249 48 48 37 97 9 10 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘More public consultation is required; for example, talking to residents to find out their needs’ (7)  Newcastle-under-Lyme: ‘The proposal does not provide enough beds to meet demand’ (9)  Cheadle: ‘The proposal requires enough well-trained staff’ (7)  Leek and Moorlands: ‘Beds are required at Leek Moorlands Community Hospital’ (28). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 were more likely to comment: ‘Proposal does not provide enough capacity to cover needs’, compared to those aged 60-69. o Respondents aged 50-59 were more likely to comment: ‘Keep local/community hospitals open’, compared to those aged 70-79. o Respondents aged 70-79 were more likely to comment: ‘Funding/Investment needs to be sufficient/Increased’, compared to those aged 60-69.  Gender o Male respondents were more likely to comment: ‘Disagreement with proposal about use of care homes’, compared to female respondents.  Caring responsibility o Respondents who were carers for an older person were more likely to comment: ‘Needs to be local/community-based’, compared to respondents who were not carers. o Respondents who were carers for an older person were more likely to comment: ‘Caring for patients at home/in the home is best’, compared to respondents who were not carers.

5.4.1.3 Feedback on the proposed change in bed numbers and associated modelling The proposed new care model would mean less need for community rehabilitation hospital beds due to the due to more community services into the community. The proposed new care model would help to deliver better, more person-centred community-based services, this would enable the CCGs to reduce the number of beds needed to approximately 132 beds. (To read more see the consultation document and Spotlight on Beds). Table 89 shows the themes raised when respondents were also asked to give comments on proposed change in bed numbers and associated modelling. The top three themes were: ‘The proposal does not provide enough capacity to cover needs’ (69); ‘Future proof site/consider long-term needs’ (30) and ‘Agree with proposal for Leek/need beds at Leek’ (24).

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Table 89. Do you have any comments you would like to make about the proposed change in bed numbers and associated

modelling? (Question 21)

Lyme

-

Trent

-

Moorlands

under

Community rehabilitation hospital beds on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

No postcode No provided Newcastle

Beds need to be split geographically/at more than one location 14 2 2 0 8 0 2 Access Needs to be local/community-based 13 1 0 1 9 0 2 Address transportation issues (Lack of transport options) 12 2 2 3 4 0 1 Proposal does not provide enough capacity to cover needs 69 11 15 7 30 2 4 Don't close beds/reopen previously closed beds 23 4 9 2 7 0 1 Capacity Issues surrounding bed blocking/people unable to leave beds 16 2 1 2 9 2 0 because of lacking home care packages Care homes Disagreement with proposal about use of care homes 15 4 1 2 8 0 0 Need to have/use beds at Longton 2 2 0 0 0 0 0 Agree with proposal for Leek/ need beds at Leek 24 1 1 1 20 0 1 Community Agree with proposal for Haywood/ need beds at Haywood 9 2 2 1 4 0 0 hospitals Agree with proposal for Bradwell/ need beds at Bradwell 5 0 3 0 1 1 0 Need to have/use beds at Cheadle. 5 0 0 3 2 0 0 Consultation Need more information/lack of reasoning/evidence/explanation 14 5 0 1 6 1 1 process for proposal Future proof site/consider long-term needs 30 7 6 6 9 0 2 Estates and Use/renovate existing site/buildings/facilities (Good existing buildings 2 0 0 1 1 0 0 facility/hospital) Taking into account the long-term costs (use financially practical 8 1 2 1 2 1 1 options) Finance Funding/ investments need to be sufficiently increased (stop 5 1 2 1 0 0 1 cutting costs) Particular Consider the needs of an elderly/ageing population 20 5 5 3 6 1 0 groups Privatisation No to privatisation/use of private firms for care 15 2 2 2 6 1 2 Community-based care needs to improve for proposal to work 20 8 4 0 8 0 0 Quality of Delivering patient care is more important than cost 8 1 0 2 4 0 1 care efficiency/savings Healthcare provision outside hospitals is not adequate/poor 2 0 0 2 0 0 0 Other 12 1 7 1 2 0 1 Other No, none, nothing 14 2 6 0 3 3 0 Not answered 1 0 0 0 1 0 0 Base 193 33 45 20 76 8 11 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Proposal does not provide enough capacity to cover needs’ (11)  Newcastle-under-Lyme: ‘Proposal does not provide enough capacity to cover needs’ (15)  Cheadle: ‘Proposal does not provide enough capacity to cover needs’ (7)  Leek and Moorlands: ‘Proposal does not provide enough capacity to cover needs’ (30). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:

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 Gender o Male respondents were more likely to comment: ‘Taking into account the long-term costs’, compared to female respondents o Female respondents were more likely to comment: ‘Proposal does not provide enough capacity to cover needs’, compared to male respondents.  Caring responsibility o Respondents who were not carers were more likely to comment: ‘Beds need to be split geographically/at more than one location’, compared to those who cared for an older person.

5.4.1.4 Summary on the approach to community hospitals and rehabilitation beds For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, including the approach, see section 5.4.9. Survey respondents were asked to give feedback on the approach to providing out of hospital services in the community.  275 (55%) of respondents strongly agreed or agreed with this proposal  157 (31%) respondents who disagreed or strongly disagreed. Overall, key themes raised by survey respondents in relation to the community hospital beds approach were that the proposal does not provide enough capacity to cover needs; services need to be local or community based and beds are required at Leek Moorlands Community Hospital.

5.4.2 Feedback on the six community rehabilitation beds options proposals This section presents feedback on the six community options for community hospital rehabilitation beds.

5.4.2.1 Feedback from the survey Table 90 shows the overall proportion of respondents who agreed or disagreed with each of the options for community hospital beds. A greater proportion of respondents strongly agreed or agreed with option 2 (278 / 65%), compared to option 1 (54 / 15%), option 3 (98 / 28%), option 4 (139 / 38%) option 5 (168 / 43%) and option 6 (61 / 15%). A more detailed breakdown by respondent location for each of the options is presented in the following sections. Table 90. To what extent do you agree or disagree with each of the options for community hospital rehabilitation beds (Question 22) Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Strongly agree 8% 41% 13% 20% 29% 6% Agree 7% 24% 15% 18% 14% 9% Neither agree nor 14% 10% 20% 20% 13% 8% disagree Disagree 25% 12% 22% 20% 16% 12% Strongly disagree 43% 11% 28% 20% 25% 60% Don’t know 2% 2% 2% 3% 3% 4% Base 355 426 352 367 387 396 Table 91 shows the themes raised when respondents were asked for further feedback on why they agreed or disagreed with the community beds proposals. The top three themes were: ‘Healthcare provision outside hospitals is inadequate/poor’ (101); ‘Needs to be local/community-based’ (96); and ‘Beds need to be split geographically/at more than one location’ (69).

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Table 91. Please explain why you agree or disagree with our proposals for community rehabilitation hospital beds?

(Question 23)

Lyme

-

Trent

-

Moorlands

under

Community rehabilitation hospital beds on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle Needs to be local/community-based 96 14 22 17 37 2 4 Access Beds need to be split geographically/at more than one 69 17 9 12 23 4 4 location Proposal does not provide enough capacity to cover needs 37 8 9 7 10 0 3 Don't close beds/reopen previously closed beds 21 2 6 3 9 0 1 Capacity Issues surrounding bed blocking/people unable to leave beds 11 1 0 3 7 0 0 because of lacking home care packages Care homes Disagreement with proposal about use of care homes 63 17 14 9 18 2 3 Agree with proposal for Leek/ need beds at Leek 39 3 3 5 26 0 2 Community Agree with proposal for Haywood/ need beds at Haywood 17 3 2 4 6 0 2 hospitals Agree with proposal for Cheadle/ need beds at Cheadle 15 0 0 9 4 0 2 Keep local/community hospitals open 8 1 1 1 4 0 1 Finance It's a waste of money/stop wasting money 19 3 4 5 5 1 1 General Agree with the proposal generally 15 5 3 1 6 0 0 positive Particular Consider the needs of an elderly/ageing population 20 5 2 4 8 0 1 groups Privatisation No to privatisation/use of private firms for care 19 7 7 1 1 0 3 Healthcare provision outside hospitals is not adequate/poor 101 25 21 15 36 1 3 Quality of Will ensure good care provision/ provide good care 12 4 6 1 1 0 0 care Caring for patients at home/in the home is best 4 1 1 0 2 0 0 Service Rehabilitation care should be separate from acute care 9 0 3 2 2 1 1 provision Staffing Enough/well trained staff to cover needs 34 9 8 3 11 2 1 Other 46 12 15 3 9 2 5 No, none, nothing 1 0 0 0 0 1 0 Other Don't know 1 1 0 0 0 0 0 Not answered 3 1 0 0 2 0 0 Base 378 78 81 59 126 10 24 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Healthcare provision outside hospitals is not adequate/poor’ (25)  Newcastle-under-Lyme: ‘Needs to be local/community-based’ (22)  Cheadle: ‘Services need to be local or community-based’ (17)  Leek and Moorlands: ‘Needs to be local/community-based’ (37). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Gender o Female respondents were more likely to comment: ‘Enough/well trained staff to cover needs’, compared to male respondents o Female respondents were more likely to comment: ‘Healthcare provision outside hospitals is not adequate/poor’, compared to male respondents o Male respondents were more likely to comment: ‘Proposal does not provide enough capacity to cover needs’, compared to female respondents

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o Male respondents were more likely to comment: ‘Agree with proposal for Haywood/ need beds at Haywood’, compared to female respondents.  Caring responsibilities o Respondents who were carers for an older person were more likely to comment: ‘Agree with proposal for Haywood/ need beds at Haywood’, compared to those who were not carers o Respondents who were not carers were more likely to comment: ‘Disagreement with proposal about use of care homes’, compared to respondents who were carers for an older person o Respondents who were carers for an older person were more likely to comment: ‘Keep local/community hospitals open’, compared to those who were not carers. Table 92 shows the themes raised when respondents were asked how any issues could be overcome. The top three themes were: ‘Agree with proposal for Leek/ need beds at Leek’ (39); ‘Keep local/community hospitals open’ (27) and ‘Public consultation/research (talk/listen to us/find out needs)’ (26).

Table 92. How can any issues or concerns you have raised be overcome? (Question 24)

Lyme

-

Trent

-

Moorlands

under

Community rehabilitation hospital beds on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle

Beds need to be split geographically/at more than one 25 6 5 4 9 1 0 location Access Needs to be local/community-based 22 2 1 6 11 0 2 Address transportation issues (Lack of transport options) 8 1 1 2 2 1 1 Parking is an issue/lack of parking 2 1 1 0 0 0 0 Don't close beds/reopen previously closed beds 18 2 4 3 9 0 0 Capacity Proposal does not provide enough capacity to cover 10 4 1 0 4 0 1 needs Care homes Disagreement with proposal about use of care homes 18 7 3 2 6 0 0 Agree with proposal for Leek/ need beds at Leek 39 1 2 2 33 0 1 Keep local/community hospitals open 27 5 8 5 7 1 1 Community Agree with proposal for Haywood/ need beds at Haywood 17 2 2 3 10 0 0 hospitals Agree with proposal for Cheadle/ need beds at Cheadle 14 0 2 8 3 0 1 Retain services at Bradwell/ Use these services 6 1 4 0 1 0 0 Consultation Public consultation/research (Talk/listen to us/find out 26 7 5 3 7 2 2 process needs) It's a waste of money/stop wasting money 23 7 3 2 9 1 1 Finance Funding/Investment needs to be sufficient/Increased 7 0 4 1 0 1 1 Particular groups Consider the needs of an elderly/aging population 3 1 0 1 1 0 0 Privatisation No to privatisation/use of private firms for care 14 4 3 0 6 0 1 Quality of care Caring for patients at home/in the home is best 2 1 0 1 0 0 0 Improve communication within NHS services 6 3 1 0 0 1 1 Service provision Rehabilitation care should be separate from acute care 2 1 0 0 1 0 0 Staffing Enough/well trained staff to cover needs 15 4 3 1 6 0 1 Other 47 12 6 7 16 2 4 Other No, none, nothing 1 0 0 0 0 1 0 Not answered 5 1 2 0 2 0 0 Base 232 47 47 35 83 9 11

The most frequently mentioned theme by respondent location was:

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 Stoke-on-Trent: ‘Disagreement with the use of care homes’ (7); ‘Money should not be wasted’ (7) and ‘More public consultation is required; for example, listening to residents to find out their needs’ (7)  Newcastle-under-Lyme: ‘Community hospitals should be kept open’ (8)  Cheadle: ‘Beds are required at Cheadle Community Hospital’ (8)  Leek and Moorlands: ‘Bed are required at Leek Moorlands Community Hospital’ (33).

Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Gender o Male respondents were more likely to comment: ‘Caring for patients at home/in the home is best’, compared to female respondents o Male respondents were more likely to comment: ‘Funding/Investment needs to be sufficient/increased’, compared to female respondents. Table 93 shows the themes and suggestions raised when respondents were asked whether they had any alternative ideas about the provision of community rehabilitation beds. The top three themes raised were: ‘The need for beds at Leek Moorlands Community Hospital’ (32); ‘Don't close beds/reopen previously closed beds’ (29) and ‘Considering the long-term costs’ (22).

Table 93. Please outline any alternative ideas you have about the provision of community rehabilitation beds. (Question 25)

-

Trent under

- -

Moorlands on

-

Total

Lyme

Cheadle

and

Stoke

Newcastle Other/out of area

Leek Leek Nopostcode provided Beds need to be split geographically/at more than one location 21 5 3 3 9 1 0 Access Needs to be local/community-based (convenient locations) 21 5 0 3 12 1 0 Address transportation issues (Lack of transport options) 12 1 2 1 6 2 0 Don't close beds/reopen previously closed beds 29 8 7 3 10 0 1 Proposal does not provide enough capacity to cover needs 21 5 4 0 11 0 1 Capacity Issues surrounding bed blocking/people unable to leave beds 6 1 1 0 4 0 0 because of lacking home care packages Care homes Disagreement with proposal about use of care homes 11 3 1 1 6 0 0 Agree with proposal for Leek/ need beds at Leek 32 2 2 2 26 0 0 Agree with proposal for Haywood/ need beds at Haywood 18 6 1 0 11 0 0 Community Agree with proposal for Bradwell/ need beds at Bradwell 10 3 5 0 2 0 0 hospitals Need to have/use beds at Longton 10 6 0 0 2 0 2 Need to have/use beds at Cheadle 9 3 0 3 3 0 0 Consultation Need more information/lack of reasoning/evidence/explanation 8 1 1 1 2 3 0 process for proposal Estates and Use/renovate existing site/buildings/facilities 11 2 1 0 7 0 1 buildings Future proof site/consider long-term needs 6 3 2 0 0 0 1 Taking into account the long-term costs (use financially 22 5 2 2 12 0 1 practical options) Finance Funding/ investments need to be sufficiently increased (stop 7 2 1 1 2 0 1 cutting costs) Particular Consider the needs of an elderly/ageing population 6 1 3 0 2 0 0 groups

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Privatisation No to privatisation/use of private firms for care 4 3 0 1 0 0 0 Community-based care needs to improve for proposal to work 17 8 4 1 4 0 0 Quality of Healthcare provision outside hospitals is not adequate/poor 3 1 0 0 2 0 0 care Delivering patient care is more important than cost 3 2 0 1 0 0 0 efficiency/savings Other 14 5 0 2 6 0 1 Other No, none, nothing 7 2 2 1 1 1 0 Not answered 7 3 1 0 3 0 0 1 Base 151 37 24 63 6 5 6 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Beds should not be closed / previously closed beds should be reopened’ (8) and ‘Community-based care needs to improve for proposal to work’ (8)  Newcastle-under-Lyme: ‘Beds should not be closed / previously closed beds should be reopened’ (7)  Cheadle: ‘Beds need to be split geographically at more than one location’ (3); ‘Services need to be local and community-based’ (3); ‘Beds should not be closed, plus previously closed beds should be reopened’ (3) and ‘Beds are needed at Cheadle Community Hospital’ (3)  Leek and Moorlands: ‘Beds are needed at Leek Moorlands Community Hospital’ (26). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 were more likely to comment: ‘Agree with proposal for Bradwell/ need beds at Bradwell’, compared to those aged 70-79.

5.4.2.2 Feedback from the correspondence Table 94 shows the feedback from correspondence on the community rehabilitation beds proposal.

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Table 94. Feedback from correspondence on community hospitals and care home beds.

Community hospital and care home beds

Total

Trust

Clinician

Local authority Local

MPscouncillors /

Membersof the public Voluntaryorganisation Proposal does not provide enough capacity to cover needs 1 4 0 0 0 2 7 Don’t close beds/reopen previously closed beds 4 0 0 0 0 1 5 Consider the effects on readmission rates 0 2 0 0 0 1 3 Need more information/lack of reasoning/evidence/explanation for proposal 0 1 1 0 0 1 3 Consider the needs of an elderly/aging population 0 2 0 0 1 0 3 Need beds at Bradwell 0 1 0 0 1 0 2 Need beds at Cheadle 1 1 0 0 0 0 2 Need beds at Leek 0 1 0 0 1 0 2 Beds need to be split geographically 0 1 0 0 0 1 2 Reducing bed numbers could have an adverse impact on patient care 0 0 0 0 0 2 2 Make improvements to social care/homecare packages 1 1 0 0 0 0 2 Healthcare provision outside hospitals is not adequate/poor 0 1 0 0 0 0 1 Reduction of beds in community hospitals effectively results in hospital closures 0 0 0 0 1 0 1 Support for the proposed model of integrated immediate care service 0 0 0 0 0 1 1 Community-based care needs to improve for proposal to work 0 1 0 0 0 0 1 Consider patient choice 0 0 0 0 0 1 1 Consider rural / isolated patients 0 0 0 0 1 0 1 Base (correspondence numbers) 18 6 1 2 5 2 34

Feedback from correspondence relating to specific options for community rehabilitation beds has been included within the following sections. Organisational responses  The Staffordshire and Stoke-on-Trent Joint Health Scrutiny Committee (JHSC) commented that the geography of the area and accessibility from some parts, particularly Staffordshire Moorlands, should be considered when looking at the location of community beds.  Checkley Parish Council commented in support of retaining Cheadle Community Hospital, commenting that the reduction of local beds and resources in the area is not in line with housing and population growth in the area and the area’s aging population.  The Community Hospitals Association (CHA) commented in support of the integrated care service, but questioned the evidence that patients will get better sooner if they are sent home quickly. They argue that this evidence is based on acute hospital beds, which are focused on treating acute conditions, rather than rehabilitation and rehabilitation, whereas intermediate care beds provided in community hospitals offer a rehabilitation package. They also comment that patients and their relatives may prefer to be in a community hospital bed, as they would perceive this as a safer and higher quality environment. The CHA also suggest that in planning bed capacity for the future, a higher planned total number of beds is considered. They also comment that instead of providing beds at Haywood Hospital, services at Royal Stoke University Hospital could be provided in the space and the community hospital rehabilitation beds spread across the geographical area. They comment that options appraisals should be taken for beds in Newcastle-under-Lyme and Leek and reviews of services at Bradwell Community Hospital and Leek Moorlands Community Hospital.  A local councillor commented that community hospital beds should be reinstated and that the reduction of beds has been undertaken with consultation, arguing that the rationale for the reduction

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in beds is unsound and ignores deprivation in the area, the aging population and the challenge of long-term health conditions in the area arising from historic industries.  A local MP commented that community services are not yet at the standard they need to be to relive the pressure on community hospital beds with care plan taking too long to organise. They also argue that not reopening community hospital beds has created an expensive and confusing provision.  Newcastle Borough Council expressed concern over beds being closed with consultation.  North Staffs Pensioners’ Convention expressed concern with beds being closed without consultation and that the views of residents have not been considered. They argue that community hospitals are important local facilities and that closing community hospital beds increases admissions at Royal Stoke University Hospital and will put patients at risk. They also queried why beds in the area cost more than the national figure and that integrated care should have a ‘step up’ from home into rehabilitation care. They argue that there are clinical and social care staff shortages.  A local MP argued that the proposal does not provide enough beds to meet demand and risks patients being discharged before they are ready to return home. They argue that the emphasis on home-based rehabilitation does not take into account deprivation and poverty in the region. They also argue that the proposal to cut beds contradicts with the views expressed in the initial engagement survey.  A local MP commented that beds have been closed without consultation and questioned whether the proposed number of beds was adequate.

5.4.2.3 Feedback from other channels not listed above

5.4.2.3.1 Easy read report It was commented that the proposal does not provide enough capacity to cover needs and the needs of an elderly, aging population should be considered.

5.4.2.3.2 Social media Comments made relating to the proposals for community hospital beds included:  The proposal does not provide enough beds to meet demand  Beds should be provided at community hospitals  Beds are needed at Bradwell Community Hospital  The proposals will result in adverse patient outcomes; for example, during winter  Quality of care in care homes is not adequate and lacks the required services  The patient’s home environment and the impact on their family should be considered  Beds have been closed without consultation with the views of local residents on retaining beds not being considered  Closing then reopening beds is a waste of money  Services should not be privatised  The proposals will not be effective  The referral process should be considered.

5.4.2.4 Summary of feedback on the six community rehabilitation bed proposals For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, including the approach, see section 5.4.9. Key themes from the survey Key themes were healthcare provision outside hospitals is poor; services need to be local / community based with beds split at more than one location and greater public consultation is required. The need to keep

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community hospitals open was also a key theme, as well as the need for beds at Leek Moorlands Community Hospital. Key themes from social media Key themes were similar to those raised in the survey, including the proposal not providing enough beds to meet demand and the need to provide beds at community hospitals. Key themes from correspondence Key themes were similar to those raised in the survey, that the proposal does not provide enough capacity to cover needs and beds should not close / previously closed beds should reopen. Alternative options The key considerations raised when respondents were asked to provide alternative ideas about the provision of community rehabilitation beds were: the need for beds at Leek Moorlands Community Hospital; beds should not close / previously closed beds should reopen and the need to consider long-term costs.

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5.4.3 Feedback on Option 1: All 132 beds at Haywood Community Hospital This section presents the feedback on option 1.

5.4.3.1 Feedback from the survey Table 95 shows the proportion of respondents who agreed or disagreed with providing all beds at Haywood Community Hospital. Overall, 54 (15%) of respondents strongly agreed or agreed with this proposal, compared to 243 (68%) respondents who disagreed or strongly disagreed. A greater proportion of respondents in Stoke-on-Trent (18 / 26%) and Newcastle-under-Lyme (16 / 20%) strongly agreed or agreed with this proposal, compared to Cheadle (4 / 8%) and Leek and Moorlands (10 / 9%). Disagreement was much higher in Cheadle (4 / 84%) and Leek and Moorlands (10 / 83%), compared to Newcastle-under-Lyme (16 / 60%) and in Stoke-on-Trent (18 / 47%). Table 95. To what extent do you agree or disagree with the option: Provide all beds at Haywood Community Hospital (Question 22A) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 8% 11% 12% 8% 3% 15% 9% Agree 7% 14% 7% 0% 5% 0% 9% Neither agree nor 14% 26% 17% 4% 9% 23% 18% disagree Disagree 25% 30% 33% 16% 19% 23% 36% Strongly disagree 43% 17% 27% 69% 64% 38% 23% Don’t know 2% 1% 4% 4% 0% 0% 5% Base 355 70 82 51 117 13 22 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 60-79 were more likely to disagree or strongly disagree, compared to those aged 30-39.  Gender o Male respondents were more likely to disagree or strongly disagree, compared to female respondents.  Marriage and civil partnership o Married respondents were more likely to disagree or strongly disagree, compared to those who were single. Organisational responses When analysing by respondent type, a higher proportion of NHS organisations (3 / 25%) strongly agreed or agreed, compared to members of the public (48 / 15%) and patient representative groups (1 / 13%).

5.4.3.2 Feedback from the public events and focus groups This section presents feedback on option 1 for community hospitals and rehabilitation care beds from the public events and focus groups.

5.4.3.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about option 1 for community hospitals and rehabilitation care beds. Table 96 shows the themes raised.

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Table 96. (Option 1) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback Number of tables Total

mentioning this theme number of

public Option 1: All 132 beds at Haywood Community Hospital events

mentioning

Leek

Cheadle

Longton Bradwell

Haywood this theme Agree with proposal for Haywood/ need beds at 1 0 1 0 0 2 Haywood Positive Haywood Hospital is a good hospital (good 0 0 0 3 0 1 facilities / services) Proposal does not provide enough capacity to 0 1 1 0 1 3 cover needs (Inc. not enough beds) Disagreement with the proposal for Haywood 0 5 0 4 2 3 Address transportation issues (Lack of transport 0 3 0 1 4 3 options) Negative Parking is an issue/lack of parking 0 2 0 2 1 3 Don’t close beds/reopen previously closed beds 0 1 1 0 0 2 Need beds at Leek 1 0 0 0 0 1 Need beds at Longton 1 0 0 0 0 1 Disagreement with proposal about use of care 0 1 0 0 0 1 homes Consider access for residents from other areas 0 2 1 2 3 4 Beds need to be split geographically/at more than 0 2 1 2 0 3 one location Needs to be local/community-based 0 0 0 3 1 2 Enough/well trained staff to cover needs 0 1 0 0 1 2 It’s a waste of money/stop wasting money (Inc. 0 0 0 1 1 2 Considerations use financially practical options) Need to ensure services are not reduced to 0 0 0 1 0 1 accommodate beds Consider the needs of an elderly/ageing 0 0 0 0 2 1 population Public consultation/research (Talk/listen to us/find 0 1 0 0 0 1 out needs) Base (number of tables) 2 13 3 9 11

5.4.3.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about option 1 for community hospitals and rehabilitation care beds. Table 97 shows the themes raised.

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Table 97. (Option 1) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you

have raised be overcome? Focus groups feedback

Option 1: All 132 beds at Haywood Community Hospital

theme

groups groups

workshops

characteristicsfocus

Mentionsprotected at

Totalnumberof focus

groupsmentioning this

Mentions at community Mentions at carersfocus

Agree with proposal for Haywood/need beds at 2 1 2 5 Haywood Haywood Hospital is a good hospital (good facilities / 2 1 0 3 Positive services) Agree with having beds in one place 0 0 1 1 Haywood Hospital is accessible (e.g. good public 1 0 0 1 transport) Address transportation issues (Lack of transport 4 2 0 6 options) Parking is an issue/lack of parking 1 4 0 5 Proposal does not provide enough capacity to cover Negative 1 1 0 2 needs (Inc. not enough beds) Disagreement with proposal about use of care homes 0 0 1 1 Beds need to be split geographically/at more than 1 0 0 1 one location Consider access for residents from other areas 2 0 1 3 Consider the needs of an elderly/ageing population 1 0 0 1 Need to ensure services are not reduced to 0 1 0 1 Considerations accommodate beds Needs to be local/community-based 1 0 0 1 Improve communication within NHS services (Inc. 1 0 0 1 listen to staff) Base (number of events) 13 5 2 19

5.4.3.3 Feedback from the correspondence There was disagreement with this option from two members of the public and a councillor. Furthermore, the Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) commented that Members from Stoke-on-Trent City Council expressed the view that option 1 was not acceptable as having all community beds in one location would reduce accessibility for patients and family in the majority of North Staffordshire.

5.4.3.4 Feedback from other channels not listed above

5.4.3.4.1 Easy read report There was agreement with this option.

5.4.3.4.2 Hospital stand events It was commented that Haywood Community Hospital has poor transport access; parking is an issue and accessibility should be considered.

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5.4.3.5 Summary of feedback on Option 1: All 132 beds at Haywood Community Hospital For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, see section 5.4.9. In summary, 54 (15%) of respondents strongly agreed or agreed with this option, compared to 243 (68%) respondents who disagreed or strongly disagreed. Disagreement was highest in Cheadle. When reviewing the feedback by protected characteristic, males were more likely to strongly disagree or disagree, compared to females. For further detail, please refer to table 95. Organisational responses When analysing by respondent type, a higher proportion of NHS organisations (3 / 25%) strongly agreed or agreed, compared to members of the public (48 / 15%) and patient representative groups (1 / 13%). Themes from public events  Although there was some agreement with this option, there was a greater level of disagreement. Key themes not in agreement with this option were parking, transport and the proposal not providing enough beds  Key areas of consideration raised were the need to provide access for residents from other areas and splitting the beds geographically. For further detail, please refer to table 96. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  In contrast to the public events, there was agreement with this option, with Haywood Community Hospital being a good hospital a key theme  Negative themes were raised around parking and transportation issues. For further detail, please refer to table 97. Themes from correspondence There was disagreement with this option from two members of the public and a councillor.

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5.4.4 Feedback on Option 2: 77 beds at Haywood Community Hospital and 55 beds at Leek Moorlands Community Hospital This section presents the feedback on option 2.

5.4.4.1 Feedback from the survey Table 98 shows the proportion of respondents who agreed or disagreed with providing beds at Haywood Community Hospital and Leek Moorlands Community Hospital. Overall, 278 (65%) of respondents strongly agreed or agreed with this proposal, compared to 97 (23%) respondents who disagreed or strongly disagreed. This option was the most popular with survey respondents. A greater proportion of respondents in Leek and Moorlands (151 / 93%) strongly agreed or agreed, compared to in Stoke-on-Trent (39 / 53%), Newcastle-under-Lyme (30 / 37%) and Cheadle (36 / 58%). Table 98. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Leek Moorlands Community Hospital (Question 22B) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 41% 27% 15% 23% 71% 19% 33% Agree 24% 26% 22% 35% 22% 19% 20% Neither agree nor 10% 20% 16% 8% 1% 31% 13% disagree Disagree 12% 14% 27% 13% 3% 25% 10% Strongly disagree 11% 11% 16% 19% 3% 6% 20% Don’t know 2% 3% 4% 2% 0% 0% 3% Base 426 74 81 62 163 16 30 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 60-69.  Gender o Male respondents were more likely to disagree or strongly disagree compared to female respondents.  Marriage and civil partnership o Respondents living with a partner were more likely to strongly agree or agree, compared to respondents who were single or widowed. Organisational responses  When analysing by respondent type, a higher proportion of patient representative groups (8 / 89%) strongly agreed or agreed, compared to members of the public (253 / 65%) and NHS organisations (9 / 56%)  A respondent who indicated they were responding on behalf of Borderland Voices indicated that this option would ensure good geographic spread of provision  A respondent who indicated they were responding on behalf of Support Staffordshire commented that the already closed beds at Leek Moorlands Community Hospital should be reinstated.

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5.4.4.2 Feedback from the public events and focus groups This section presents feedback on option 2 for community hospitals and rehabilitation care beds from the public events and focus groups.

5.4.4.2.1 Feedback from the public events Table 99 shows the themes raised by public event participants when asked what they agreed and disagreed with about option 2 for community hospitals and rehabilitation care beds. Table 99. (Option 2) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback Number of tables Total mentioning this theme

number of

Option 2: 77 beds at Haywood Community Hospital and 55 beds at Leek public Moorlands Community Hospital events mentioning

Leek this theme

Cheadle

Longton

Bradwell Haywood Agree with proposal for Leek/ need beds at Leek 0 7 1 1 1 4 Positive Will ensure good care provision/ provide good care 0 1 0 0 1 2 Agree with proposal for Haywood/ need beds at 0 0 1 0 0 1 Haywood Address transportation issues (Lack of transport options) 1 1 0 1 4 4 Disagreement with providing beds at Leek 0 0 1 4 1 3 Healthcare provision outside hospitals is not 0 1 0 1 0 2 adequate/poor It’s a waste of money/stop wasting money (Inc. use 0 0 0 1 1 2 Negative financially practical options) Disagreement with providing beds at Haywood 0 1 0 0 0 1 Leek Moorlands Community Hospital requires 0 0 0 0 4 1 investment / refurbishment Need beds at Cheadle 0 0 0 0 4 1 Need beds at Bradwell 0 0 0 1 0 1 Need more information/lack of 0 3 1 0 0 2 reasoning/evidence/explanation for proposal Consider access for residents from other areas 0 1 0 2 0 2 Beds need to be split geographically/at more than one 0 0 0 2 1 2 Considerations location Needs to be local/community-based 0 2 0 0 2 2 Need to integrate services / beds with integrated care 0 2 0 0 0 1 hubs Consider the needs of an elderly/ageing population 0 0 1 0 0 1 Base (number of tables) 2 13 3 9 11

5.4.4.2.2 Feedback from the focus groups Table 100 shows the themes raised when focus group participants were asked what they agreed and disagreed with about option 2 for community hospitals and rehabilitation care beds.

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Table 100. (Option 2) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges

you have raised be overcome? Focus groups feedback

Option 2: 77 beds at Haywood Community Hospital and 55 beds at

Leek Moorlands Community Hospital

theme

groups groups

workshops

characteristicsfocus

Mentionsprotected at

Totalnumberof focus

groupsmentioning this

Mentions at community Mentions at carersfocus Positive Agree with proposal for Leek/ need beds at Leek 3 1 2 6 Address transportation issues (Lack of transport 2 1 1 4 options) Negative Disagreement with providing beds at Leek 0 1 0 1 It’s a waste of money/stop wasting money (Inc. use 1 0 0 1 financially practical options) Needs to be local/community-based 2 0 0 2 Considerations Consider access for residents from other areas 0 1 0 1 Base (number of events) 13 5 2 19

5.4.4.3 Feedback from the correspondence Leek Town Council commented that the beds should be situated in Leek Moorlands Community Hospital, not private care homes.

5.4.4.4 Feedback from other channels not listed above

5.4.4.4.1 Easy read report It was commented that beds are needed at Leek Moorlands Community Hospital.

5.4.4.5 Summary of feedback on Option 2: 77 beds at Haywood Community Hospital and 55 beds at Leek Moorlands Community Hospital For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, see section 5.4.9. In summary, 278 (65%) of respondents strongly agreed or agreed with this proposal, compared to 97 (23%) respondents who disagreed or strongly disagreed. This option was the most popular with survey respondents. Agreement was highest in Leek and Moorlands. For further detail, please refer to table 98. Organisation responses A higher proportion of patient representative groups strongly agreed or agreed, compared to members of the public and NHS organisations. A respondent who indicated they were responding on behalf of Borderland Voices indicated that this option would ensure good geographic spread of provision, while a respondent who indicated they were responding on behalf of Support Staffordshire commented that the already closed beds at Leek Moorlands Community Hospital should be reinstated. Leek Town Council commented in correspondence that the beds should be situated in Leek Moorlands Community Hospital, not private care homes.

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Themes from public events  Agreement was raised over the need for beds in Leek. However, there was also disagreement with providing beds in Leek, with the lack of transport options being a key negative theme. For further detail, please refer to table 99. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Similar to the public events, agreement was raised over the need for beds in Leek, but the lack of transport options was raised as a negative theme. For further detail, please refer to table 100.

5.4.5 Feedback on Option 3: 77 community hospital beds at Haywood Community Hospital and 55 beds at Longton Cottage Hospital This section presents the feedback on option 3.

5.4.5.1 Feedback from the survey Table 101 shows the proportion of respondents who agreed or disagreed with providing beds at Haywood Community Hospital and Longton Cottage Hospital. Overall, 98 (28%) or respondents strongly agreed or agreed with this option, compared to 174 (49%) respondents who disagreed or strongly disagreed. A greater proportion of respondents in Stoke-on-Trent (41 / 52%) strongly agreed or agreed with this proposal, compared to Newcastle-under-Lyme (21 / 27%), Cheadle (12 / 25%) and Leek and Moorlands (11 / 10%). Table 101. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Longton Cottage Hospital (Question 22C) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 13% 28% 9% 10% 5% 8% 24% Agree 15% 24% 18% 15% 6% 15% 16% Neither agree nor 20% 24% 23% 10% 18% 46% 16% disagree Disagree 22% 15% 31% 23% 20% 15% 24% Strongly disagree 28% 5% 17% 42% 50% 15% 16% Don’t know 2% 4% 3% 0% 2% 0% 4% Base 352 79 78 48 109 13 25 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Marriage and civil partnership o Respondents who were married were more likely to disagree or strongly disagree, compared to those who were single. Organisational responses When analysing by respondent type, a higher proportion of members of the public (91 / 29%) strongly agreed or agreed, compared to NHS organisations (3 / 21%) and patient representative groups (1 / 13%).

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5.4.5.2 Feedback from the public events and focus groups This section presents feedback on option 3 for community hospitals and rehabilitation care beds from the public events and focus groups.

5.4.5.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about option 3 for community hospitals and rehabilitation care beds. Table 102 shows the themes raised. Table 102. (Option 3) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public event feedback. Number of tables Total mentioning this theme

number of

Option 3: 77 community hospital beds at Haywood Community public Hospital and 55 beds at Longton Cottage Hospital events mentioning

Leek this theme

Cheadle

Longton

Bradwell Haywood Agree with providing beds at Longton / only option Positive 2 0 0 0 0 1 that includes Longton Disagreement with this option 0 3 0 1 2 3 Disagreement with providing assessment and beds 0 0 0 1 1 2 in different areas It’s a waste of money/stop wasting money (Inc. use 0 0 0 1 1 2 Negative financially practical options) Address transportation issues (Lack of transport 0 2 0 0 1 2 options) Need beds at Leek 1 0 0 0 0 1 Need beds at Cheadle 0 0 0 0 3 1 Consider access for residents from other areas 0 2 0 1 1 3 Need more information 0 1 0 0 0 1 Consideration Needs to be local/community-based 0 0 0 2 0 1 Public consultation/research (Talk/listen to us/find 1 0 0 0 0 1 out needs) Base (number of tables) 2 13 3 9 11

5.4.5.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about option 3 for community

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hospitals and rehabilitation care beds. Table 103 shows the themes raised. Table 103. (Option 3) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges

you have raised be overcome? Focus groups feedback

Option 3: 77 community hospital beds at Haywood Community

Hospital and 55 beds at Longton Cottage Hospital

theme

groups groups

workshops

characteristicsfocus

Mentionsprotected at

Totalnumberof focus

groupsmentioning this

Mentions at community Mentions at carersfocus

Agreement with this option 2 3 1 6 Positive Longton is an accessible location 1 1 1 3 Address transportation issues (Lack of transport options) 1 0 1 2 Negative Parking is an issue/lack of parking 0 1 1 2 Longton requires investment / refurbishment 0 0 1 1 Consider access for residents from other areas 1 0 0 1 Need more information 1 0 0 1 Considerations Beds need to be split geographically/at more than one 0 1 0 1 location Base (number of events) 13 5 2 19

5.4.5.3 Feedback from the correspondence No feedback was received on this option.

5.4.5.4 Feedback from other channels not listed above

5.4.5.4.1 Hospital stand events It was commented that Longton Cottage Hospital should be retained and used.

5.4.5.5 Summary of feedback on Option 3: 77 community hospital beds at Haywood Community Hospital and 55 beds at Longton Cottage Hospital For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, see section 5.4.9. In summary, 98 (28%) or respondents strongly agreed or agreed with this option, compared to 174 (49%) respondents who disagreed or strongly disagreed. Agreement was highest in Stoke-on-Trent. For further detail, please refer to table 101. Organisational responses A higher proportion of members of the public strongly agreed or agreed, compared to NHS organisations and patient representative groups. Themes from public events  Although there was some agreement with this option, there was a greater level of disagreement. Key themes not in agreement with this option were transport, not wasting money and providing beds and assessment in different areas  A key area of consideration raised was the need to provide access for residents from other areas.

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For further detail, please refer to table 102. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  In contrast to the public events, there was agreement with this option. A key theme was that Longton is an accessible location. For further detail, please refer to table 103.

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5.4.6 Feedback on Option 4: 77 community hospital beds at Haywood Community Hospital and 55 beds at Cheadle Community Hospital. This section presents the feedback on option 4.

5.4.6.1 Feedback from the survey Table 104 shows the shows the proportion of respondents who agreed or disagreed with providing beds at Haywood Community Hospital and Cheadle Community Hospital. Overall, 139 (38%) of respondents strongly agreed or agreed with this proposal, compared to 145 (40%) respondents who disagreed or strongly disagreed. A greater proportion of respondents in Cheadle (54 / 84%) strongly agreed or agreed, compared to Stoke- on-Trent (22 / 31%), Newcastle-under-Lyme (16 / 21%) and in Leek and Moorlands (28 / 25%). Table 104. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Cheadle Community Hospital (Question 22D) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 20% 11% 8% 61% 8% 7% 30% Agree 18% 20% 13% 23% 17% 20% 20% Neither agree nor 20% 34% 21% 3% 20% 33% 10% disagree Disagree 20% 17% 36% 3% 19% 27% 17% Strongly disagree 20% 11% 19% 6% 34% 13% 20% Don’t know 3% 6% 3% 3% 2% 0% 3% Base 367 70 77 64 111 15 30 When analysing by the nine protected characteristics, there were no significant differences identified within cohorts. Organisational responses  When analysing by respondent type, similar proportions of members of the public (125 / 38%) and NHS organisations (5 / 38%) strongly agreed or agreed, compared to patient representative groups (3 / 33%).  One person responding on behalf of Cheadle Council expressed agreement with this option, as care is required in Cheadle.

5.4.6.2 Feedback from the public events and focus groups This section presents feedback on option 4 for community hospitals and rehabilitation care beds from the public events and focus groups.

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5.4.6.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about option 4 for community hospitals and rehabilitation care beds. Table 105 shows the themes raised. Table 105. (Option 4) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback Number of tables Total mentioning this theme

number of

Option 4: 77 community hospital beds at Haywood Community public Hospital and 55 beds at Cheadle Community Hospital events mentioning

Leek this theme

Cheadle

Longton

Bradwell Haywood Will ensure good care provision/ provide good care 0 0 0 0 1 1 Agree with proposal for Cheadle/ need beds at 0 0 0 0 3 1 Cheadle Positive Option would be second favourite (behind Leek) 0 2 0 0 0 1 Cheadle is a modern, fit-for-purpose building 0 0 0 0 7 1 Cheadle is an accessible location 0 0 0 0 2 1 Cheadle is a cheaper option 0 0 0 0 1 1 Need beds at Leek 0 1 0 0 0 1 Address transportation issues (Lack of transport 0 1 0 1 0 2 options) Parking is an issue/lack of parking 0 0 0 0 1 1 Negative Disagreement with this option 0 2 0 0 0 1 No to privatisation/use of private firms for care 0 0 0 1 0 1 It’s a waste of money/stop wasting money (Inc. use 0 0 0 0 1 1 financially practical options) Consider access for residents from other areas 0 2 0 4 0 2 Enough/well trained staff to cover needs 0 0 0 0 1 1 Need more information 0 0 0 0 5 1 Consideration Beds need to be split geographically/at more than one 0 0 0 0 2 1 location Consider the needs of an elderly/ageing population 0 0 0 0 1 1 Base (number of tables) 2 13 3 9 11

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5.4.6.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about option 4 for community hospitals and rehabilitation care beds. Table 106 shows the themes raised. Table 106. (Option 4) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges

you have raised be overcome? Focus groups feedback

Option 4: 77 community hospital beds at Haywood Community Hospital

and 55 beds at Cheadle Community Hospital

groups

thistheme

workshops

community

Mentions at

focusgroups

Mentions at carers

groupsmentioning

characteristicsfocus

Mentionsprotected at Totalnumberof focus Agree with proposal for Cheadle/ need beds at 1 1 0 2 Cheadle Positive Cheadle is a modern, fit-for-purpose building 1 0 0 1 Cheadle is a cheaper option 1 0 0 1 Need beds at Leek 0 0 1 1 Negative Address transportation issues (Lack of transport 1 0 0 1 options) Consider access for residents from other areas 4 2 1 7 Beds need to be split geographically/at more than one 0 0 1 1 location Considerations Issues surrounding bed blocking/people unable to 1 0 0 1 leave beds because of lacking home care packages Need more information 1 0 0 1 Base (number of events) 13 5 2 19

5.4.6.3 Feedback from the correspondence A member of the public commented that beds are needed at Cheadle.

5.4.6.4 Summary of feedback on Option 4: 77 community hospital beds at Haywood Community Hospital and 55 beds at Cheadle Community Hospital For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, see section 5.4.9. In summary, 139 (38%) of respondents strongly agreed or agreed with this proposal, compared to 145 (40%) respondents who disagreed or strongly disagreed. For further detail, please refer to table 104. Organisational responses Similar proportions of members of the public (125 / 38%) and NHS organisations (5 / 38%) strongly agreed or agreed, compared to patient representative groups (3 / 33%). One respondent from Cheadle Council expressed agreement with this option, as care is required in Cheadle. Themes from public events  A key theme in agreement raised at the Cheadle event was that Cheadle Community Hospital is a modern, fit-for-purpose building  A key area of consideration raised was the need to provide access for residents from other areas.

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For further detail, please refer to table 105. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  A key area of consideration raised was the need to provide access for residents from other areas. For further detail, please refer to table 106.

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5.4.7 Feedback on Option 5: 77 community hospital beds at Haywood Community Hospital and 55 beds at Bradwell Community Hospital This section presents the feedback on option 5.

5.4.7.1 Feedback from the survey Table 107 shows the shows the proportion of respondents who agreed or disagreed with providing beds at Haywood Community Hospital and Bradwell Community Hospital. Overall, 168 (43%) of respondents strongly agreed or agreed with this proposal, compared to 158 (41%) respondents who disagreed or strongly disagreed. A greater proportion of respondents in Newcastle-under-Lyme (90 / 84%) strongly agreed or agreed, compared to Stoke-on-Trent (33 / 43%), Cheadle (7 / 15%) and Leek and Moorlands (16 / 15%). Table 107. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and Bradwell Community Hospital (Question 22E) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly 29% 22% 66% 9% 6% 33% 31% agree Agree 14% 21% 18% 7% 8% 20% 13% Neither agree 13% 22% 4% 9% 15% 13% 19% nor disagree Disagree 16% 17% 7% 15% 24% 27% 16% Strongly 25% 13% 4% 57% 44% 7% 19% disagree Don’t know 3% 5% 1% 4% 3% 0% 3% Base 387 77 107 46 110 15 32 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 60-79 were more likely to disagree or strongly disagree compared to those aged 40-49.  Marriage and civil partnership o Respondents who were married were more likely to disagree or strongly disagree compared to those who were single. Organisational responses  When analysing by respondent type, similar proportions of members of the public (151 / 43%) and NHS organisations (7 / 44%) strongly agreed or agreed, compared to patient representative groups (2 / 29%)  A respondent from Kidsgrove Town Council expressed support for option 5, due to the convenient locations of the two hospitals.

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5.4.7.2 Feedback from the public events and focus groups This section presents feedback on option 5 for community hospitals and rehabilitation care beds from the public events and focus groups.

5.4.7.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about option 5 for community hospitals and rehabilitation care beds. Table 108 shows the themes raised. Table 108. (Option 5) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback Number of tables Total

mentioning this theme number of

public Option 5: 77 beds at Haywood and 55 beds at Bradwell events

mentioning

Leek

Cheadle Longton

Bradwell this theme Haywood Agreement with this option 0 0 0 5 0 1 Positive Will ensure good care provision/ provide good care 0 0 0 2 0 1 Disagreement with this option 0 1 0 0 3 2 Proposal does not provide enough capacity to cover 0 0 0 1 0 1 needs Negative Need beds at Leek 0 1 0 0 0 1 Need beds at Cheadle 0 0 0 0 1 1 Care provided at Bradwell is of a poor standard 0 1 0 0 0 1 Address transportation issues (Lack of transport options) 0 2 0 0 0 1 Consider access for residents from other areas 0 1 1 1 1 4 Consideration Keep local/community hospitals open 0 0 0 1 0 1 Beds need to be split geographically/at more than one 0 1 0 0 0 1 location Base (number of tables) 2 13 3 9 11

5.4.7.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with about option 5 for community hospitals and rehabilitation care beds. Table 109 shows the themes raised. Table 109. (Option 5) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges

you have raised be overcome? Focus groups feedback

Option 5: 77 beds at Haywood and 55 beds at Bradwell

ntions at

groups groups

offocus

protected

thistheme

workshops

community

mentioning

Mentions at Me Mentions at

carers focus carers

Totalnumber

focusgroups characteristics Agreement with this option 1 1 1 3 Bradwell is the cheapest option 3 0 0 3 Positive Bradwell is an accessible location 2 0 0 2 Need beds at Haywood 0 1 0 1 Good to co-locate beds and integrated care hubs 0 0 1 1 Address transportation issues (Lack of transport Negative 0 0 1 1 options) Considerations Consider access for residents from other areas 1 1 0 2 Base (number of events) 13 5 2 19

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5.4.7.3 Feedback from the correspondence Table 110 shows the feedback from correspondence on option 5 for 77 beds at Haywood and 55 beds at Bradwell. There was agreement with this option from MPs / councillors and local councils with comments that both hospitals are good hospitals in accessible locations.

Table 110. Feedback from correspondence on option 5 for community rehabilitation beds

Option 5: 77 beds at Haywood and 55 beds at Bradwell

Total

Trust

public

Clinician

Voluntary

organisation

Local authority Local

Membersof the MPscouncillors / Agreement with this option 0 2 0 0 2 0 4 Bradwell is the cheaper option 0 2 0 0 0 0 2 Haywood Hospital is a good hospital (good facilities / services) 0 1 0 0 0 0 1 Haywood Hospital is accessible (e.g. good public transport) 0 1 0 0 0 0 1 Bradwell Hospital is a good hospital (good facilities / services) 0 1 0 0 1 0 2 Bradwell is an accessible location 0 1 0 0 1 0 2 Good parking options 0 0 0 0 1 0 1 Consider quality of care while building work takes place 0 1 0 0 0 0 1 Base (correspondence numbers) 18 6 1 2 5 2 34 Organisational responses  A local MP commented that in an ideal situation, there would be options across Northern Staffordshire with no reduction in beds, but as the proposals are limiting the number of sites, Bradwell Community Hospital would be a preferred option due to its accessible location, good reputation locally, low cost and having sufficient capacity.  Newcastle Borough Council expressed agreement with this option.  A local MP argued that option 5 would be the best choice for patient care and convenience, as Haywood Hospital is a fit-for-purpose and accessible building and Bradwell Community Hospital is cheaper than many of the other options.  Another local MP also expressed support for option 5 over option 6.

5.4.7.4 Feedback from other channels not listed above

5.4.7.4.1 Hospital stand events It was commented that Bradwell Community Hospital has poor transport access and parking.

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5.4.7.5 Summary of feedback on Option 5: 77 community hospital beds at Haywood Community Hospital and 55 beds at Bradwell Community Hospital For a summary of feedback on all of the options for community hospitals and rehabilitation care beds, see section 5.4.9. In summary, 168 (43%) of respondents strongly agreed or agreed with this proposal, compared to 158 (41%) respondents who disagreed or strongly disagreed. For further detail, please refer to table 107. Organisational responses  Similar proportions of members of the public (151 / 43%) and NHS organisations (7 / 44%) strongly agreed or agreed, compared to patient representative groups (2 / 29%).  A respondent from Kidsgrove Town Council expressed support for option 5, due to the convenient locations of the two hospitals.  In correspondence, two MPs expressed preference for this option over the other options. Newcastle Borough Council also expressed agreement with this option. Themes from public events  A key area of consideration raised was the need to provide access for residents from other areas. For further detail, please refer to table 108. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  There was agreement with this option, due to cost and location  A key area of consideration raised was the need to provide access for residents from other areas. For further detail, please refer to table 109.

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5.4.8 Feedback on Option 6: 77 community hospital beds at Haywood Community Hospital and 55 NHS commissioned assessment beds in local care homes This section presents the feedback on option 6 (the preferred option).

5.4.8.1 Feedback from the survey Table 111 shows the proportion of respondents who agreed or disagreed with providing beds at Haywood Community Hospital and at NHS commissioned beds in local care homes. Overall, 61 (15%) of respondents strongly agreed or agreed with this proposal, compared to 286 (72%) respondents who disagreed or strongly disagreed. A greater proportion of respondents in Stoke-on-Trent (20 / 24%) strongly agreed or agreed with this option, compared to Newcastle-under-Lyme (16 / 19%), Cheadle (4 / 7%) and Leek and Moorlands (11 / 9%). Disagreement was higher in Cheadle (47 / 87%) and Leek and Moorlands (110 / 85%), compared to Stoke- on-Trent (52 / 61%) and Newcastle-under-Lyme (53 / 62%). Table 111. To what extent do you agree or disagree with the option: Provide beds at Haywood Community Hospital and the remainder at NHS commissioned beds in local care homes (Question 22F) Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 6% 8% 8% 2% 3% 0% 17% Agree 9% 15% 11% 6% 5% 7% 14% Neither agree nor 8% 11% 14% 4% 3% 29% 7% disagree Disagree 12% 14% 15% 9% 12% 7% 3% Strongly disagree 60% 47% 47% 78% 74% 50% 52% Don’t know 4% 5% 5% 2% 3% 7% 7% Base 396 85 85 54 129 14 29 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 60-79 were more likely to disagree or strongly disagree, compared to those aged 40-49.  Caring responsibilities o Respondents who were not carers were more likely to disagree or strongly disagree, compared to those who cared for a young person.  Marriage and civil partnership o Respondents who were married were more likely to disagree or strongly disagree, compared to those who were single. Organisational responses  When analysing by respondent type, similar proportions of members of the public (55 / 15%) and NHS organisations (3 / 19%) strongly agreed or agreed, compared to patient representative groups (0 / 0%).  A lower proportion of NHS organisations (10 / 63%) strongly disagreed or disagreed, compared to members of the public (261 / 72%) and patient representative groups (8 / 100%).  A respondent who indicated they were responding on behalf of Support Staffordshire expressed concern that the level of care in care homes is not comparable to the care and service at Leek Moorlands Community Hospital.

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 Other comments received from organisations in relation to this option have been included in section 5.4.1.1. Concerns around option 6 During the pre-consultation engagement, people were worried about the quality of care provided at care homes. Table 112 shows the extent to which respondents felt their concerns about care provided at care homes would be reduced by the steps taken by the CCGs to alleviate concerns. Overall, 384 (77%) respondents indicated that they would still have concerns. The area with the greatest proportion of respondents who would still have concerns was Leek and Moorlands (136 / 82%), compared to Stoke-on-Trent (76 / 74%), Newcastle-under-Lyme (82 / 74%) and Cheadle (53 / 79%). Table 112. During the pre-consultation process, some people were worried about the quality of care at these homes. To what extent are the steps we would take reduce any concerns you may have about this option? (Question 26) Postcode Stoke-on- Newcastle- Leek and Other/ out Total Cheadle not Trent under-Lyme Moorlands of area provided I would still have 77% 74% 74% 79% 82% 73% 70% concerns My concerns would be alleviated 8% 8% 8% 10% 8% 7% 5% a little This would somewhat alleviate 5% 7% 6% 3% 2% 13% 8% my concerns I would support this option if these 10% 12% 12% 7% 8% 7% 16% checks were put in place Base 499 103 111 67 166 15 37 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 60-69 were more likely to still have concerns, compared to those aged 30- 59 o Respondents aged 40-49 were more likely to state that this would somewhat alleviate their concerns, compared to those aged 70-79 o Respondents aged 30-49 and 70-79 were more likely to support the option of the checks were in place, compared to those aged 60-69.  Caring responsibilities o Respondents who were not carers were more likely to still have concerns, compared to those who were carers for a young person.  Marriage and civil partnership o Respondents who were married were more likely to still have concerns, compared to those who were single o Respondents who were single were more likely to state that this would alleviate their concerns, compared to those who were married. Organisational responses  When analysing by respondent type, a higher proportion of patient representative groups (9 / 100%) indicated they would still have concerns, compared to members of the public (349 / 77%) and NHS organisations (16 / 76%).

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 A respondent who indicated that they were responding on behalf of Borderland Voices indicated that they had concerns about the availability of care homes of adequate quality in the Staffordshire Moorlands area.  A respondent from GP Services commented that care in care homes is not standardised and lacks the access the required patient teams. They commented that community beds only lead to reduction in readmissions if properly managed.  There was concern from Midlands Partnership Foundation Trust respondents that care home staff lack NHS training. Respondents were asked to outline concerns they had around option 6. Table 113 shows the themes raised by survey respondents. The top three concerns raised were: ‘Concerns over the quality of local care homes’ (194); ‘Enough/well trained staff to cover needs’ (91) and ‘Need checks/quality reviews to ensure standards are high’ (58). Concerns over the quality of local care homes was the most mentioned theme overall and in each of the respondent locations. Table 113. Option 6 proposes that 55 beds would be provided in local care homes. Please outline your concerns below.

(Question 27)

Lyme

-

Trent

Option 6: 77 community hospital beds at Haywood Community Hospital and -

Moorlands

under

on

-

55 NHS commissioned assessment beds in local care homes -

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle

Beds need to be split geographically/at more than one Access 2 0 0 0 1 1 0 location Proposal does not provide enough capacity to cover needs Capacity 56 8 8 15 22 1 2 (Inc. not enough beds) Community Keep local/community hospitals open 11 0 3 3 5 0 0 hospitals Consultation Need more information/lack of 26 2 5 5 7 3 4 process reasoning/evidence/explanation for proposal Proposal is not affordable/ costs could be more then 31 6 7 5 11 0 2 stated/increased Finance It’s a waste of money/stop wasting money 28 5 8 6 9 0 0 Will be used as a cost cutting measure/taking beds from 15 6 3 0 5 0 1 people who may still need them Care homes should be for the elderly (concerns over Particular groups 13 2 2 3 5 1 0 younger patients in care homes) Privatisation No to privatisation/use of private firms for care 53 8 10 9 22 1 3 Concerns over the quality of local care homes 194 40 41 30 70 5 8 Need checks/quality reviews to ensure standards are high 58 15 6 8 21 4 4 Healthcare provision outside hospitals is not adequate/poor 31 4 8 4 12 1 2 Quality of care Poor previous experience with my own/family’s care 23 8 2 3 8 0 2 Community-based care needs to improve for proposal to 11 3 3 1 3 1 0 work Disagreement with proposal about use of care homes 45 7 8 6 20 0 4 Service provision Lack of needed health services outside hospital settings 30 5 9 4 9 3 0 Enough/well trained staff to cover needs 91 21 20 12 35 1 2 Staffing Care staff are underpaid/should be paid more 27 4 10 4 9 0 0 Other Other 56 4 5 11 31 2 3

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No, none, nothing 1 0 0 0 0 1 0 Not answered 1 0 0 0 1 0 0 Base 377 75 75 59 134 12 22 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 40-49 were more likely to comment: ‘Disagreement with proposal about use of care homes’, compared to those aged 50-59 o Respondents aged 50-59 were more likely to comment: ‘Care staff are underpaid/should be paid more’, compared to those aged 40-49 and 60-79 o Respondents aged 70-79 were more likely to comment: ‘Poor previous experience with my own/family’s care’, compared to those aged 40-59.  Gender o Female respondents were more likely to comment: ‘Enough/well trained staff to cover needs’, compared to male respondents o Female respondents were more likely to comment: ‘Concerns over the quality of local care homes’, compared to male respondents.  Caring responsibilities o Respondents who were not carers were more likely to comment: ‘Will be used as a cost cutting measure/taking beds from people who may still need them’, compared to those who were carers for an older person o Respondents who were carers for an older person were more likely to comment: ‘It’s a waste of money/stop wasting money’, compared to those who were not carers.

5.4.8.2 Feedback from the public events and focus groups This section presents feedback on option 6 for community hospitals and rehabilitation care beds.

5.4.8.2.1 Feedback from the public events Public event participants were asked what they agreed and disagreed with about option 6 for community hospitals and rehabilitation care beds. Table 114 shows the themes raised.

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Table 114. (Option 6) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges you have raised be overcome? Public events feedback

Number of tables Total

mentioning this theme number of

Option 6: 77 community hospital beds at Haywood Community

public

Hospital and 55 NHS commissioned assessment beds in local care events homes

mentioning Leek

Cheadle this theme

Longton

Bradwell Haywood Proposal will ensure beds are provided across the 0 2 1 1 0 3 Northern Staffordshire area Positive Will ensure good care provision/ provide good care 0 0 0 1 1 2 Agree with proposal for Haywood/ need beds at 0 0 0 1 0 1 Haywood Healthcare provision outside hospitals is not 1 1 2 1 2 5 adequate/poor Concerns over the quality of local care homes 2 8 1 5 7 5 Concerns over the capacity in care homes 1 4 1 3 1 5 Disagreement with proposal about use of care homes 1 2 0 3 3 4 No to privatisation/use of private firms for care 1 0 1 3 3 4 It’s a waste of money/stop wasting money 0 2 1 4 4 4 Lack of needed health services outside hospital 1 1 1 1 0 4 settings Address transportation issues (Lack of transport 0 2 1 0 1 3 options) Negative Care homes are for / should be for the elderly 0 1 1 1 0 3 (concerns over younger patients in care homes) Proposal does not provide enough capacity to cover 0 0 0 1 1 2 needs Need beds at Cheadle 0 0 0 0 3 1 Parking is an issue/lack of parking 0 0 0 0 1 1 Community-based care needs to improve for proposal 0 1 0 0 0 1 to work Will be used as a cost cutting measure/taking beds 0 1 0 0 0 1 from people who may still need them Poor previous experience with my own/families care 0 0 0 1 0 1 Proposal will adversely impact on acute care 0 0 0 1 0 1 Need more information/lack of 0 5 1 1 4 4 reasoning/evidence/explanation for proposal Need checks/quality reviews to ensure standards are 0 3 1 2 1 4 high Enough/well trained staff to cover needs 0 1 0 3 2 3 More care homes are required in the Moorlands area / 0 7 1 0 5 3 all beds are outside Moorlands For Consider patient choice 0 1 2 1 0 3 consideration Public consultation/research (Talk/listen to us/find out 0 1 0 0 3 2 needs) Keep local/community hospitals open 0 0 0 0 1 1 Beds need to be split geographically 0 1 0 0 0 1 Caring for patients at home/in the home is best 0 0 0 0 1 1 Consider the needs of an elderly/ageing population 0 0 0 1 0 1 Beds should be provided from one location for 0 0 0 1 0 1 efficiency Base (number of tables) 2 13 3 9 11

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5.4.8.2.2 Feedback from the focus groups Focus group participants were asked what they agreed and disagreed with option 6 for community hospitals and rehabilitation care beds. Table 115 shows the themes raised. Table 115. (Option 6) What do you agree with? / What do you disagree with? How can the issues, concerns or challenges

you have raised be overcome? Focus groups feedback

ffocus

Option 6: 77 community hospital beds at Haywood Community

Hospital and 55 NHS commissioned assessment beds in local care theme

homes groups

workshops

focusgroups

Mentions at carers

characteristicsfocus

Mentionsprotected at

Totalnumbero

groupsmentioning this Mentions at community

Will ensure good care provision/ provide good care 3 0 0 3 Positive Agree with the proposal generally 1 0 0 1 Concerns over the quality of local care homes (Inc. 5 1 1 7 mentions use of bad care homes) Care homes are for / should be for the elderly 3 0 0 3 (concerns over younger patients in care homes) No to privatisation/use of private firms for care 3 0 0 3 It’s a waste of money/stop wasting money (Inc. use 3 0 0 3 financially practical options) Disagreement with proposal about use of care homes 0 1 1 2 Negative Healthcare provision outside hospitals is not 1 0 1 2 adequate/poor Proposal does not provide enough capacity to cover 1 0 0 1 needs (Inc. not enough beds) Poor previous experience with my own/families care 1 0 0 1 Beds should be provided from one location for 1 0 0 1 efficiency Concerns over the capacity in care homes (Inc. care 0 0 1 1 home closures) Need more information/lack of 6 1 2 9 reasoning/evidence/explanation for proposal Enough/well trained staff to cover needs 3 2 1 6 Consider patient choice 3 1 0 4 Considerations Need checks/quality reviews to ensure standards are 1 1 2 4 high Consider the needs of an elderly/ageing population 2 0 0 2 Need to ensure families / friends can visit 0 0 1 1 Base (number of events) 13 5 2 19

5.4.8.3 Feedback from correspondence Table 116 shows the feedback from correspondence relating to option 6 for community rehabilitation beds. There was disagreement around the use of care homes with concerns with concerns over the quality of care and comments that the required health services are not in place outside of hospitals and the need for checks and quality reviews to ensure standards are high.

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Table 116. Correspondence feedback on option 6 for community rehabilitation beds

Option 6: 77 beds at Haywood and 55 beds in care homes

Total

Trust

public

Clinician

Voluntary

organisation

Local authority Local

Membersof the MPscouncillors / Need checks/quality reviews to ensure standards are high 0 1 0 1 1 2 5 Disagreement with proposal about use of care homes 1 1 0 0 2 1 5 Lack of needed health services outside hospital settings 0 2 0 0 1 2 5 Concerns over the quality of local care homes (Inc. mentions use of bad 1 2 0 1 0 1 5 care homes) Enough/well trained staff to cover needs 0 2 0 0 1 1 4 Need more information/lack of reasoning/evidence/explanation for proposal 1 1 0 0 0 1 3 Enough/well trained staff to cover needs 0 2 0 0 0 1 3 Agree with the proposal generally 0 0 0 2 0 0 2 No to privatisation/use of private firms for care 1 0 0 0 0 1 2 Healthcare provision outside hospitals is not adequate/poor 1 0 0 0 0 1 2 Consider patient choice 0 1 0 0 0 1 2 Community-based care needs to improve for proposal to work 0 0 0 0 1 0 1 Concerns over the capacity in care homes 0 1 0 0 0 0 1 Base (correspondence numbers) 18 6 1 2 5 2 34 Organisational responses  University Hospitals of North Midlands NHS Trust expressed agreement with the preferred option.  The Staffordshire and Stoke-on-Trent-City Council Joint Health Scrutiny Committee (JHSC) highlighted concerns around the quality of care homes and the ability to monitor their stands. They comment that additional pressure on the private sector market could exasperate these concerns and that there may not be sufficient resources in the community to adequately support the proposals; for example, a lack of care and clinical staff. There was concern that care homes can have a high turnover of staff and that community hospitals are perceived to have more stable management and more access to healthcare facilities.  The Community Hospitals Association commented that evidence suggests that NHS provided community hospital beds should be used instead of care homes, as community hospital beds are focused on rehabilitation and reablement and have a greater access to health services. They also argue that there is confusion over the cost of care home beds.  A local councillor commented that care homes do not provide an equivalent level of care to community hospital beds.  A local MP commented that the 2018 Care Quality Commission (CQC) local system review highlighted inconsistences in the quality of care in Staffordshire, which should be considered and have not been fully addressed in the proposal, highlighting the issues of safeguarding and wellbeing. They also argue that staffing and the impact of Brexit on staffing should be considered. They highlight concerns over the unaccounted costs of option 6 and argues the proposal is based on costs rather than patient care. They commented that in an ideal situation, there would be options across Northern Staffordshire with no reduction in beds, but as the proposals are limiting the number of sites, Bradwell Community Hospital would be a preferred option.  North Staffordshire Combined Healthcare Trust expressed agreement with the option but argued that the quality of care homes and the need for quality checks should be considered.  North Staffs Pensioners' Convention expressed concern over the quality of care homes and private companies profiting from patient care, arguing that care should be provided at NHS community hospitals.

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 A local MP expressed caution against this option, due to the cost, potential impacts on patient care and satisfaction. They argue that care homes are not designed to care for those with acute medical needs.  Another local MP commented in disagreement with option 6, commenting that there is no guarantee of availability and that the CCGs have commissioned places at homes ‘requiring improvement’.

5.4.8.4 Feedback from other channels not listed above

5.4.8.4.1 Easy read report There was disagreement with the use of care homes, with concerns over the quality of local care homes; comments that healthcare provision outside of hospitals is poor and lacks the required health services; private firms should not be used for care; care homes should be for the elderly and are unsuitable for younger patients, and there is a need for quality checks and reviews to ensure standards are high. Considerations were also raised over the need for enough well-trained staff and that patient choice should be considered.

5.4.8.4.2 External meetings It was commented that private firms should not be used for care; improvements are needed to social care and care packages; quality checks and reviews are needed to ensure standards are high and there were concerns over the capacity in care homes.

5.4.8.4.3 Hospital stand events It was commented that quality checks and reviews are needed to ensure standards are high; there is a lack of needed health services outside hospital settings; private forms should not be used for care and improvements are needed to social care and care packages. There were also concerns over the quality of local care homes with comments that quality of care and clinical outcomes should be considered.

5.4.8.5 Summary of feedback on Option 6: 77 community hospital beds at Haywood Community Hospital and 55 NHS commissioned assessment beds in care homes In summary, 61 (15%) survey respondents strongly agreed or agreed with this proposal, compared to 286 (72%) respondents who disagreed or strongly disagreed. Disagreement was highest in Cheadle and in Leek and Moorlands. When reviewing the feedback by protected characteristic, respondents who were not carers were more likely to disagree or strongly disagree, compared to those who cared for a young person. For further detail, please refer to table 111. 384 (77%) respondents would still have concerns with this option, despite the steps taken to reduce any concerns. For further detail, please refer to table 112. Comparing feedback from the survey, public events, focus groups and correspondence A key theme across all feedback channels was disagreement with option 6, due to concerns around the use of care homes and their quality of care. Organisational responses  Similar proportions of members of the public (55 / 15%) and NHS organisations (3 / 19%) strongly agreed or agreed, compared to 0% agreement among patient representative groups.  A lower proportion of NHS organisations (10 / 63%) strongly disagreed or disagreed, compared to members of the public (261 / 72%) and patient representative groups (8 / 100%).  In correspondence, North Staffordshire Combined Healthcare Trust and University Hospitals of North Midlands NHS Trust expressed agreement with the option.

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 However, the Community Hospitals Association commented that evidence suggests that NHS provided community hospital beds should be used instead of care homes.  North Staffs Pensioners' Convention also commented that care should be provided at NHS community hospitals, expressing concern over the quality of care homes and private companies profiting from patient care.  A local councillor commented that care homes do not provide an equivalent level of care to community hospital beds.  A local MP commented that the 2018 Care Quality Commission (CQC) local system review highlighted inconsistences in the quality of care in Staffordshire, which should be considered and have not been fully addressed in the proposal, highlighting the issues of safeguarding and wellbeing.  Another local MP expressed caution against this option, due to the cost, potential impacts on patient care and satisfaction.  The Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) expressed concerns over the safety, quality and monitoring processes associated with care homes. Themes from the survey  A key concern was raised over the quality of local care homes  When reviewing the feedback by respondent characteristic, females were more likely to raise concerns over the quality of local care homes, compared to males  Other key concerns raised were over the need for enough well-trained staff to cover care needs and undertake quality checks. For further detail, please refer to table 113. Themes from public events  Although there was some agreement with this option, there was a greater level of disagreement. Key themes not in agreement were healthcare provision outside hospitals being inadequate and concerns over the quality of care and capacity in care homes  A key theme in agreement was that the proposal would provide beds across Northern Staffordshire. For further detail, please refer to table 114. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Similar to the public events, although there was some agreement with this option, there was a greater level of disagreement. The key theme not in agreement was concern over the quality of care in care homes  A key consideration was raised over the need for more information on the proposal. For further detail, please refer to table 115. Themes from correspondence  Themes raised were in disagreement about the use of care homes, including concerns over the quality of care and the lack of health services in care homes  Consideration was raised around the need for checks to ensure standards are high. For further detail, please refer to table 116.

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5.4.9 Summary of feedback on community hospital beds In summary, option 2 received the highest level of agreement in the survey, while options 1 and 6 received the lowest levels of agreement. Table 117 shows that option 6 (the preferred option) received the highest level of disagreement. Agreement with option 6 was similar among members of the public (55 / 15%) and NHS organisations (3 / 19%), with 0% agreement among patient representative groups, whereas agreement with option 2 was higher among patient representative groups, compared to members of the public and NHS organisations. Table 117. Survey respondents: Summary of agreement and disagreement with community hospital beds proposals Option 3: Option 4: Option 5: Option 6: Option 2: Option 1: Beds at Beds at Beds at Beds at Beds at All beds at Haywood Haywood Haywood Haywood Haywood Haywood and and and and care and Leek Longton Cheadle Bradwell homes Strongly agree / Agree 15% 65% 28% 38% 43% 15% Neither agree nor disagree 14% 10% 20% 20% 13% 8% Strongly disagree / Disagree 68% 33% 50% 40% 41% 72% Don’t know 2% 2% 2% 3% 3% 4% Base 355 426 352 367 387 396 Comparing feedback from the survey, public events, focus groups and correspondence Focussing on the approach to community hospital beds, the proposal not providing enough beds to meet demand was a key theme across all feedback channels. The need for beds to be provided at community hospitals, especially Leek Moorlands Community Hospital, and for community hospitals to remain open were also key themes. Although this was the preferred option, disagreement towards option 6 was a key theme across all feedback channels, with a key reason being concerns raised over the quality of care in care homes. A consideration raised across all feedback channels was the need for enough well-trained staff to cover care needs. A difference in responses from different channels of engagement was option 1 receiving positive feedback at focus groups, as it was commented that Haywood Community Hospital is a good hospital with good services and facilities. In the survey, option 1 received low levels of agreement, as it was commented that beds need to be locally-based and split geographically, with access being a key theme. Organisational responses  Option 1: A higher proportion of NHS organisations strongly agreed or agreed, compared to members of the public and patient representative groups.  Option 2: A higher proportion of patient representative groups strongly agreed or agreed, compared to members of the public and NHS organisations. A respondent who indicated they were responding on behalf of Borderland Voices indicated that this option would ensure good geographic spread of provision, while a respondent who indicated they were responding on behalf of Support Staffordshire commented that the already closed beds at Leek Moorlands Community Hospital should be reinstated.  Option 3: A higher proportion of members of the public strongly agreed or agreed, compared to NHS organisations and patient representative groups.  Option 4: Similar proportions of members of the public (125 / 38%) and NHS organisations (5 / 38%) strongly agreed or agreed, compared to patient representative groups (3 / 33%). One respondent from Cheadle Council expressed agreement with this option, as care is required in Cheadle.

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 Option 5: Similar proportions of members of the public (151 / 43%) and NHS organisations (7 / 44%) strongly agreed or agreed, compared to patient representative groups (2 / 29%). A respondent from Kidsgrove Town Council expressed support for option 5, due to the convenient locations of the two hospitals. In correspondence, two MPs expressed preference for this option over the other options. Newcastle Borough Council also expressed agreement with this option.  Option 6: o Similar proportions of members of the public (55 / 15%) and NHS organisations (3 / 19%) strongly agreed or agreed, compared to 0% agreement among patient representative groups. o A lower proportion of NHS organisations (10 / 63%) strongly disagreed or disagreed, compared to members of the public (261 / 72%) and patient representative groups (8 / 100%). o In correspondence, North Staffordshire Combined Healthcare Trust and University Hospitals of North Midlands NHS Trust expressed agreement with the option. However, the Community Hospitals Association commented that evidence suggests that NHS provided community hospital beds should be used instead of care homes. o The Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) expressed concerns over the safety, quality and monitoring processes associated with care homes. o North Staffs Pensioners' Convention also commented that care should be provided at NHS community hospitals, expressing concern over the quality of care homes and private companies profiting from patient care o A local councillor commented that care homes do not provide an equivalent level of care to community hospital beds. o A local MP commented that the 2018 Care Quality Commission (CQC) local system review highlighted inconsistences in the quality of care in Staffordshire, which should be considered and have not been fully addressed in the proposal, highlighting the issues of safeguarding and wellbeing, while another local MP expressed caution against this option, due to the cost, potential impacts on patient care and satisfaction. o Another local MP also expressed disagreement with this option.  In the survey, a respondent from North Staffordshire GP Federation strongly disagreed with the proposals, as beds should be commissioned in a community hospital setting. A respondent from Leek and Biddulph Patient Locality Group expressed disagreement with the proposals due to the need for adequate numbers of appropriately trained staff and concerns over the quality of care homes.  The Staffordshire and Stoke-on-Trent Joint Health Scrutiny Committee (JHSC) commented that the geography of the area and accessibility from some parts, particularly Staffordshire Moorlands, should be considered when looking at the location of community beds. Themes from survey  Key themes in relation to the community hospital beds approach were that the proposal does not provide enough capacity to cover needs; services need to be local or community-based, and beds are required at Leek Moorlands Community Hospital.  Key themes around the options were that healthcare provision outside hospitals is poor; services need to be local / community based with beds split at more than one location and greater public consultation is required. The need to keep community hospitals open was also a key theme, as well as the need for beds at Leek Moorlands Community Hospital.  A key theme around option 6 was concerns over the quality of local care homes. Other key themes were the need for enough well-trained staff to cover needs and for quality checks to ensure standards are high.  When reviewing the feedback by protected characteristic, female respondents were more likely to comment that beds should not close and previously closed beds should reopen, compared to males

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 When reviewing the feedback by respondent characteristic, respondents who were carers for an older person were more likely to comment in disagreement with proposal about use of care homes, compared to those who were not carers. For further detail, please refer to table 87. Themes from public events  Option 1: Although there was some agreement with this option, there was a greater level of disagreement. Key themes not in agreement with this option were parking, transport and the proposal not providing enough beds. Key areas of consideration raised were the need to provide access for residents from other areas and splitting the beds geographically  Option 2: There was agreement over the need for beds in Leek. However, there was also disagreement with providing beds in Leek, with the lack of transport options being a key negative theme  Option 3: Although there was some agreement with this option, there was a greater level of disagreement. Key themes not in agreement with this option were transport, not wasting money and providing beds and assessment in different areas. A key area of consideration raised was the need to provide access for residents from other areas  Option 4: A key theme in agreement raised at the Cheadle event was that Cheadle Community Hospital is a modern, fit-for-purpose building. A key area of consideration raised was the need to provide access for residents from other areas  Option 5: A key area of consideration raised was the need to provide access for residents from other areas  Option 6: A key concern was raised over the quality of local care homes. Other key concerns raised were over the need for enough well-trained staff to cover care needs and undertake quality checks. Themes from focus groups Focus groups were held with representatives from specific organisations and targeted, where possible, underrepresented groups. Whilst many themes are similar to those raised during the focus group and public events, often more emphasis was placed on understanding how the model would work and operate in practice and that the particular organisations (e.g. voluntary organisations) would have within the new model.  Option 1: There was agreement with this option, with a key theme being that Haywood Community Hospital is a good hospital. Negative themes were raised around parking and transportation issues  Option 2: Agreement was raised over the need for beds in Leek, but the lack of transport options was a negative theme  Option 3: There was agreement with this option, with a key theme being that Longton is an accessible location  Option 4: A key area of consideration raised was the need to provide access for residents from other areas  Option 5: There was agreement with this option, due to cost and location. A key area of consideration raised was the need to provide access for residents from other areas  Option 6: Although there was some agreement with this option, there was a greater level of disagreement. The key theme not in agreement was concern over the quality of care in care homes. A key consideration was raised over the need for more information on the proposal. Themes from correspondence Key themes were that the proposal does not provide enough beds and that bed numbers should not be cut / previously closed beds should reopen. Focusing specifically on option 6, key themes disagreement with the use of care homes, due to the concerns over their quality and a lack of the required health services outside of hospital settings. The need for checks/quality reviews to ensure standards are high was also a key theme.

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5.5 Feedback on consultant-led outpatient clinics This section presents feedback on the location of consultant-led outpatients clinics. The following Tier 4 services that have low clinic numbers are proposed to move from Leek Moorlands Community Hospital to Royal Stoke University Hospital:  Colon and rectal check ups  Dermatology (skin problems such as eczema and psoriasis)  Nephrology (kidney problems)  Neurology (issues such as headache and migraines)  Trauma and orthopaedic surgery (follow up appointments and for x-ray only)  General surgery (minor surgery such as lumps and hernias). 5.5.1 Feedback from the survey

5.5.1.1 Colon and rectal check-ups Table 118 shows the proportion of respondents who agreed or disagreed with proposed changes to colon and rectal check-ups. Overall, 149 (31%) of respondents strongly agreed or agreed with the proposals, compared to 203 (43%) respondents who disagreed or strongly disagreed. A lower proportion of respondents in Leek and Moorlands (34 / 20%) strongly agreed or agreed, compared to Stoke-on-Trent (37 / 39%), Newcastle-under-Lyme (36 / 39%) and Cheadle (34 / 37%). Table 118. To what extent do you agree or disagree with the proposed changes to move the following services: Colon and rectal check-ups (Question 28A) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 11% 10% 15% 15% 6% 24% 14% Agree 20% 28% 24% 22% 14% 29% 9% Neither agree nor 18% 21% 28% 15% 10% 24% 20% disagree Disagree 16% 17% 12% 18% 19% 6% 17% Strongly disagree 27% 16% 12% 24% 45% 6% 23% Don’t know 8% 8% 10% 6% 5% 12% 17% Base 474 96 93 67 166 17 35 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 50-59 and 70-79. Organisational responses When analysing by respondent type, a greater proportion of NHS organisations (12 / 60%) strongly agreed or agreed, compared to members of the public (134 / 31%) and patient representative groups (0 / 0%).

5.5.1.2 Dermatology Table 119 shows the proportion of respondents who agreed or disagreed with the proposed changes to dermatology. Overall, 137 (29%) respondents strongly agreed or agreed with this proposal, compared to 215 (46%) respondents who disagreed or strongly disagreed.

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A lower proportion of respondents in Leek and Moorlands (29 / 18%) strongly agreed or agreed to this proposal, compared to Stoke-on-Trent (35 / 32%), Newcastle-under-Lyme (36 / 39%) and Cheadle (22 / 32%) Table 119. To what extent do you agree or disagree with the proposed changes to move the following services?: Dermatology (Question 28B) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 11% 9% 17% 13% 5% 24% 17% Agree 18% 27% 22% 19% 13% 18% 6% Neither agree nor 18% 23% 26% 17% 9% 29% 23% disagree Disagree 19% 16% 14% 22% 22% 12% 20% Strongly disagree 27% 16% 11% 23% 48% 6% 20% Don’t know 7% 8% 10% 6% 4% 12% 14% Base 472 95 92 69 164 17 35 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 70-79. Organisational responses When analysing by respondent type, a greater proportion of NHS organisations (11 / 55%) strongly agreed or agreed, compared to members of the public (122 / 28%) and patient representative groups (0 / 0%).

5.5.1.3 Nephrology Table 120 shows the proportion of respondents who agreed or disagreed with the proposed changes to consultant-led nephrology. Overall, 150 (32%) strongly agreed or agreed to this proposal, compared to 202 (43%) respondents who disagreed or strongly disagreed. A lower proportion of respondents in Leek and Moorlands (37 / 23%) strongly agreed or agreed to this proposal, compared to Stoke-on-Trent (37 / 39%), Newcastle-under-Lyme (36 / 39%) and in Cheadle (25 / 37%) Table 120. To what extent do you agree or disagree with the proposed changes to move the following services: Nephrology (kidney problems) (Question 28C) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 11% 9% 14% 13% 7% 24% 14% Agree 21% 29% 25% 24% 16% 18% 9% Neither agree nor 17% 20% 26% 15% 11% 24% 20% disagree Disagree 16% 18% 12% 18% 16% 18% 17% Strongly disagree 27% 16% 13% 25% 45% 6% 23% Don’t know 8% 8% 10% 6% 5% 12% 17% Base 471 96 92 68 163 17 35 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age

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o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 70-79. Organisational responses When analysing by respondent type, a greater proportion of NHS organisations (12 / 60%) strongly agreed or agreed, compared to members of the public (135 / 31%) and patient representative groups (0 / 0%).

5.5.1.4 Neurology Table 121 shows the proportion of respondents who agreed or disagreed with the proposed changes to neurology. Overall, 149 (32%) strongly agreed or agreed to this proposal, compared to 203 (43%) respondents who disagreed or strongly disagreed. A lower proportion of respondents in Leek and Moorlands (37 / 22%) strongly agreed or agreed to this proposal, compared to Stoke-on-Trent (36 / 38%), in Newcastle-under-Lyme (37 / 40%) and Cheadle (23 / 34%). Table 121. To what extent do you agree or disagree with the proposed changes to move the following services: Neurology (Question 28D) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 11% 11% 15% 13% 6% 24% 14% Agree 21% 27% 25% 21% 16% 24% 11% Neither agree nor 17% 21% 27% 16% 9% 24% 19% disagree Disagree 16% 17% 11% 19% 18% 12% 17% Strongly disagree 27% 16% 12% 24% 47% 6% 22% Don’t know 8% 8% 10% 6% 4% 12% 17% Base 470 95 92 67 163 17 36 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 70-79. Organisational responses When analysing by respondent type, a greater proportion of NHS organisations (12 / 60%) strongly agreed or agreed, compared to members of the public (134 / 31%) and patient representative groups (0 / 0%).

5.5.1.5 Trauma and orthopaedics Table 122 shows the proportion of respondents who agreed or disagreed with the proposed changes to trauma and orthopaedics. Overall, 142 (30%) strongly agreed or agreed to this proposal, compared to 216 (46%) respondents who disagreed or strongly disagreed. A lower proportion of respondents in Leek and Moorlands (34 / 21%) strongly agreed or agreed to this proposal, compared to Stoke-on-Trent (33 / 35%), Newcastle-under-Lyme (36 / 40%) and in Cheadle (25 / 36%).

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Table 122. To what extent do you agree or disagree with the proposed changes to move the following services: Trauma and orthopaedics (Question 28E) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 11% 10% 14% 16% 7% 24% 14% Agree 19% 26% 25% 20% 13% 12% 8% Neither agree nor 16% 18% 24% 14% 10% 24% 22% disagree Disagree 19% 23% 14% 19% 18% 18% 22% Strongly disagree 27% 15% 12% 26% 47% 12% 19% Don’t know 7% 9% 10% 6% 4% 12% 14% Base 470 93 91 70 163 17 36 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Caring responsibilities o Respondents who were not carers were more likely to strongly agree or agree, compared to those who were carers for a young person. Organisational responses When analysing by respondent type, a greater proportion of NHS organisations (11 / 55%) strongly agreed or agreed, compared to members of the public (127 / 30%) and patient representative groups (1 / 13%).

5.5.1.6 General surgery Table 123 shows the proportion of respondents who agreed or disagreed with the proposed changes to general surgery. Overall, 148 (32%) respondents strongly agreed or agreed with the proposal, compared to 200 (43%) respondents who disagreed or strongly disagreed. A lower proportion of respondents in Leek and Moorlands (37 / 23%) strongly agreed or agreed to this proposal, compared to Stoke-on-Trent (35 / 38%), Newcastle-under-Lyme (35 / 38%) and Cheadle (23 / 35%). Table 123. To what extent do you agree or disagree with the proposed changes to move the following services: General surgery (Question 28F) Newcastle- Postcode Stoke-on- Leek and Other/ out Total under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree 12% 11% 15% 12% 10% 24% 14% Agree 20% 27% 23% 23% 13% 24% 14% Neither agree nor 17% 18% 26% 14% 11% 24% 19% disagree Disagree 17% 18% 12% 20% 18% 12% 14% Strongly disagree 27% 16% 13% 26% 44% 6% 22% Don’t know 8% 9% 10% 6% 4% 12% 17% Base 462 92 91 66 160 17 36 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 30-39 were more likely to strongly agree or agree, compared to those aged 70-79. Organisational responses

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When analysing by respondent type, a greater proportion of NHS organisations (12 / 60%) strongly agreed or agreed, compared to members of the public (132 / 31%) and patient representative groups (1 / 13%). Table 124 shows the positive, negative and for consideration themes when respondents were asked why they agreed or disagreed with the proposal for consultant-led outpatients clinics. The top three themes were: ‘Choice of location for services is poor/not convenient’ (100); ‘Parking is an issue/lack of parking’ (93) and ‘Concerns over the waiting times/effects on waiting times’ (60). Table 124. Please explain why you agree or disagree with our proposal for some of our consultant-led outpatients clinics?

(Question 29)

Lyme

-

Trent

-

Moorlands

under on

Consultant-led outpatients clinics

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle

Will provide/ensure good/efficient patient care 19 1 5 4 6 2 1 Positive Agree with the proposal generally 15 6 2 3 3 0 1 Agree with the outpatient services proposal 14 3 2 1 5 1 2 Choice of location for services is poor/not convenient 100 17 14 11 51 4 3 Parking is an issue/lack of parking 93 18 11 21 38 2 3 Concerns over the waiting times/effects on waiting times 60 10 10 8 29 1 2 Don't make changes/keep service as is 46 7 5 10 24 0 0 Negative Current services are already stretched/overburdened 28 6 2 5 13 0 2 Negative comment regarding care provision at Royal Stoke 28 8 4 2 13 0 1 University Hospital Does not consider rural/isolated patients 14 2 0 2 9 1 0 Address transportation issues 42 5 3 8 25 0 1 Needs to be local/community-based (convenient locations) 37 4 3 8 18 3 1 Complex patient needs should be taken into account 22 4 0 3 12 2 1 Consideration Consider costs to patients for excess travel 19 4 3 2 10 0 0 Consider the needs/effects on elderly/aging patients 16 2 1 2 10 0 1 Consultants should travel to patients 8 2 1 0 4 0 1 Patients should travel to consultants 1 0 0 0 0 1 0 Other 38 8 10 5 12 0 3 No, none, nothing 2 0 0 1 0 1 0 Other Don't know 4 1 0 1 1 1 0 Not answered 3 2 1 0 0 0 0 Base 335 69 55 57 129 11 14

The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Parking is an issue’ (18).  Newcastle-under-Lyme: ‘The location is poor or inconvenient’ (14).  Cheadle: ‘Parking is an issue’ (21)  Leek and Moorlands: ‘The location is poor or inconvenient’ (51). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age

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o Respondents aged 50-59 were more likely to comment: ‘Will provide/ensure good/efficient patient care’, compared to those aged 60-69. o Respondents aged 40-49 were more likely to comment: ‘Consider the needs/effects on elderly/aging patients’, compared to those aged 60-69. Organisation responses  A respondent who indicated they were responding on behalf of Cheadle Council expressed agreement with the proposals, as they would reduce waiting times.  A respondent who indicated they were responding on behalf of Support Staffordshire commented that patients struggle with travelling to Royal Stoke University Hospital from Leek and that parking is difficult at Royal Stoke. Table 125 shows the themes raised when respondents were asked how any issues or concerns they had in relation to consultant-led-outpatient clinics could be overcome. The top three themes were: ‘Keep outpatient services at Leek’ (43); ‘The need for clinics to be to be local or community-based’ (42) and ‘Don't move/reduce services’ (31).

Table 125. How can any issues or concerns you have raised be overcome? (Question 30)

Lyme

-

Trent

-

Moorlands

under

Consultant-led outpatients clinics on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle

Needs to be local/community-based (convenient locations) 42 3 2 6 29 1 1 Don't move/reduce services (Inc. clinics) 31 6 4 3 17 1 0 Address transportation issues (Lack of transport options) 30 7 4 3 11 3 2 Improvements to waiting times/appointment allocation for services 20 1 1 2 13 2 1 Access Parking is an issue/lack of parking 13 4 4 1 2 1 1 Consultants should travel to patients 12 0 0 2 10 0 0 Consider impacts to patient health/wellbeing due to extra travel 7 1 0 1 4 1 0 Does not consider rural/isolated patients 4 0 0 0 3 0 1 Community Keep/use outpatient services in Leek 43 3 3 3 33 0 1 hospitals Consultation Public consultation/research (Talk/listen to us/find out needs) 24 8 1 3 10 0 2 process Estates and Use/renovate existing site/buildings/facilities 14 0 3 4 7 0 0 buildings Funding/investment needs to be sufficient/increased 16 5 3 1 6 0 1 Finance It's a waste of money/stop wasting money 6 2 1 0 2 0 1 Privatisation No to privatisation/use of private firms for care 12 3 3 1 2 0 3 Quality of Delivering patient care is more important than cost 8 3 3 0 2 0 0 care efficiency/savings Improvements to service management 13 1 1 1 10 0 0 Provide additional NHS services at current locations/expand Service 8 2 0 1 4 0 1 services provision Need to provide community/rehabilitation beds 5 2 1 0 2 0 0 Use/improvement of IT/technology to aid service provision 5 1 0 1 2 1 0 Deal with staffing issues (need sufficient/qualified staff to cover care Staffing 6 3 1 1 1 0 0 needs)

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Other 33 6 6 7 10 3 1 No, none, nothing 1 0 0 0 0 1 0 Other Don't know 1 0 0 1 0 0 0 Not answered 10 4 5 1 0 0 0 Base 211 42 36 24 91 8 10

The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Public consultation/research (Talk/listen to us/find out needs)’ (8)  Newcastle-under-Lyme: ‘The lack of transport options should be addressed’ (4); ‘Services should not be moved or reduced’ (4) and ‘Parking is an issue’ (4)  Cheadle: ‘Clinics should be local or community-based’ (6)  Leek and Moorlands: ‘Outpatient services should remain in Leek’ (33). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 70-79 were more likely to comment: ‘Consultants should travel to patients’, compared to those aged 60-69.  Gender o Male respondents were more likely to comment: ‘Consultants should travel to patients’, compared to female respondents o Male respondents were more likely to comment: ‘It’s a waste of money/stop wasting money’, compared to female respondents.

5.5.2 Feedback from correspondence Table 126 shows the feedback from correspondence relating to consultant-led outpatients clinics.

Table 126. Feedback from correspondence on consultant-led outpatients clinics

Consultant-led outpatients clinics

Total

Trust

MPs /

public

Clinician

Voluntary

councillors

organisation

Local authority Local Membersof the Need outpatient services in Cheadle 4 0 0 0 1 0 5 Don't move/reduce services (Inc. clinics) 4 1 0 0 0 0 5 Address transportation issues (Lack of transport options) 3 0 0 1 0 0 4 Keep/use outpatient services in Leek 3 1 0 0 0 0 4 Agree with the outpatient services proposal 0 0 0 2 0 0 2 Does not consider rural / isolated patients 0 1 0 0 1 0 2 Use/improvement of IT/technology to aid service provision 0 0 0 0 0 1 1 Proposal will lead to a more effective use of resources 0 0 0 1 0 0 1 Keep/use outpatient services in Haywood 0 0 0 0 0 1 1 Need more information on the proposal 0 0 0 0 1 0 1 Base (correspondence numbers) 18 6 1 2 5 2 34 Organisational responses  The Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) commented that there was insufficient information as to why the clinics needed to be moved and that there may be better ways to use the services rather than use Royal Stoke. They also comment that

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Staffordshire Moorlands is a large area and travel to Stoke-on-Trent is difficult from some of the villages and outlying areas.  The Community Hospitals Association commented that they understood the argument for centralising services, it would be disappointing if the outcome of the consultation was a reduction in local availability of clinic in the Staffordshire Moorlands area, especially as there has been expenditure on clinical space at Leek Moorlands Community Hospital. They commented that innovative service provision (e.g. Skype consultations) should be considered to minimise the need for patients to travel long distances.  A local councillor commented that the rationale for the relocation of the six services was unsound and that low annual numbers of users are because the clinics are held weekly, fortnightly or monthly, therefore the numbers of users do not justify moving the clinics. They also comment that Leek Moorlands Community Hospital is fully equipped and has recently undergone a modernisation programme. They question whether consultants’ time would be saved in travelling if appointments were planned to occupy a full day at a single site. Leek Moorlands Community Hospital is a valuable community asset. They also argue that the aging population, deprivation in the area and access to Royal Stoke University Hospital from Leek should be considered and that relocating the clinics would be detrimental to Moorlands residents.  North Staffordshire Combined Healthcare Trust expressed agreement with the proposals, but commented that arrangements should be put in place for those patients who find accessing Royal Stoke University Hospital difficult.  University Hospitals of North Midlands NHS Trust expressed agreement with the proposals.

5.5.3 Feedback from other channels not listed above Easy read report There was agreement with the proposal, but also there were also comments that transportation issues should be addressed; parking is an issue and concerns over the effects on waiting times.

5.5.4 Summary of feedback on consultant-led outpatients clinics There were similar levels of agreement and disagreement for each of the clinics being moved. Table 127 shows between 29% and 32% strongly agreed or agreed and between 43% and 46% strongly disagreed or disagreed. Table 127. Summary of agreement and disagreement with consultant-led outpatients clinic proposals Colon and Trauma and General rectal Dermatology Nephrology Neurology orthopaedics surgery check-ups Strongly agree / 31% 29% 32% 32% 30% 32% Agree Neither agree nor 18% 18% 17% 17% 16% 17% disagree Strongly disagree / 43% 46% 43% 43% 46% 44% Disagree Don’t know 8% 7% 8% 8% 7% 8% Base 474 472 471 470 470 462 Comparing feedback from the survey and correspondence Across different feedback methods, the need to keep care in Leek and ensure easy access to services were key themes, suggesting why all of the clinics received similar low levels of agreement in the survey.

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Organisational responses  Agreement with the proposals for all of the clinics was higher among NHS organisations, compared to members of the public and patient representative groups.  In correspondence, North Staffordshire Combined Healthcare Trust and University Hospitals of North Midlands NHS Trust expressed agreement with the proposals.  The Community Hospitals Association commented that while they understood the argument for centralising services, it would be disappointing if the outcome of the consultation was a reduction in local availability of clinic in the Staffordshire Moorlands area.  A local councillor commented that the rationale for the relocation of the six services was unsound. Key themes from survey  Key themes were around access; the choice of location for services being poor and parking being an issue  To resolve issues or concerns, key themes covered keeping care in Leek and locating services in the community. Key themes from correspondence  Key themes were around access; for example, needing to provide services in Cheadle in Leek; services not moving or reducing and a lack of transport options.

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5.6 Feedback on accessing services This section presents feedback from the survey regarding access to services.

5.6.1 Feedback from the survey Table 128 shows the travel methods respondents would normally use to travel to their local NHS hospital. Table 128. How would you normally travel to your local NHS hospital? (Question 31) Postcode Stoke- Newcastle- Leek and Other/ out Total Cheadle not on-Trent under-Lyme Moorlands of area provided Own car 64% 73% 58% 68% 60% 88% 56% On foot 6% 5% 5% 1% 10% 0% 7% Public transport 11% 9% 14% 5% 10% 0% 22% Taken by a friend 2% 1% 3% 1% 1% 12% 2% Taken by a relative 8% 1% 8% 13% 9% 0% 10% Other 10% 11% 13% 11% 9% 0% 2% Base 532 107 118 76 173 17 41 Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 40-59 were more likely to travel in their own car, compared to those aged 70-79.  Caring responsibilities o Respondents who were not carers were more likely to travel by foot, compared to those who were carers for an older person.  Marriage and civil partnership o Respondents who were widowed were more likely to use public transport, compared to those who were married. Table 129 shows the themes raised when respondents were asked if they had any concerns about being able to travel to or access services and what would need to happen to make this less of a concern. The top three most mentioned themes were: ‘Lack of parking space/services (have more)’ (149); ‘Public transport services are poor/lacking (have more)’ (114) and ‘Consider the needs of non-drivers’ (72). Table 129. Do you have any concerns about being able to travel to or access any services and what would need to happen

to make this less of a concern? (Question 32)

Lyme

-

Trent

-

Moorlands

under on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle Needs to be local/community-based (convenient locations) 53 8 7 6 30 0 2 Access Distances to travel are too far 15 3 2 7 2 0 1 Lack of parking space/services (have more) 149 47 31 18 36 7 10 Parking Cost of parking 43 12 12 5 7 2 5 Particular Consider the needs of elderly/less mobile patients 65 10 6 9 32 3 5 groups Does not consider rural/isolated patients 12 1 1 1 8 1 0 Transport Public transport services are poor/lacking (have more) 114 25 25 17 36 3 8

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Consider the needs of non-drivers 72 10 7 12 36 2 5 Long journey times 27 6 2 5 13 0 1 Free/cheaper public transport 26 7 5 6 6 1 1 Using expensive taxis 23 3 3 7 8 1 1 Lack of direct public transport services (multiple buses/trains/etc) 21 2 1 5 11 1 1 Can't use public transport, too difficult 16 3 1 1 9 1 1 Difficult driving to locations (Inc. traffic) 14 1 2 1 9 0 1 Concerns over closures/cancellations to public transport routes 14 2 1 4 6 0 1 Evening/weekend/bank holiday appointments are more difficult to 8 1 2 0 4 0 1 get to on public transport Council/Local authority/CCG should have more say/control of 5 2 1 0 1 0 1 public transport schedules Other 65 17 7 13 21 2 5 Other No, none, nothing 17 4 8 1 2 1 1 Not answered 1 1 0 0 0 0 0 Base 408 89 78 61 140 14 26 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘Lack of parking and the need for more spaces’ (47)  Newcastle-under-Lyme: ‘Lack of parking and the need for more spaces’ (35)  Cheadle: ‘Lack of parking and the need for more spaces’ (18)  Leek and Moorlands: ‘Lack of parking and the need for more spaces’ (36); ‘Poor public transport’ (36) and ‘Services and consider the needs of non-drivers’ (36). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 60-69 were more likely to comment: ‘Consider the needs of non-drivers’, compared to those aged 40-59 o Respondents aged 60-69 were more likely to comment: ‘Using expensive taxis’, compared to those aged 50-59.  Disability o Respondents with a sensory disability were more likely to comment: ‘Difficult driving to locations (inc. traffic)’, compared to those with a physical disability or those with a long-term condition.  Caring responsibilities o Respondents who were not carers were more likely to comment: ‘Cost of parking’, compared to those who were carers for an older person o Respondents who were not carers were more likely to comment: ‘Long journey times’, compared to those who were carers for an older person o Respondents who were carers for an older person were more likely to comment: ‘Can't use public transport, too difficult’, compared to those who were not carers.  Marriage and civil partnership o Respondents who were single were more likely to comment: ‘Concerns over closures/cancellations to public transport routes’, compared to those who were married.

5.6.2 Feedback from correspondence Checkley Parish Council commented in support of Cheadle Community Hospital, that bus services have been reduced in the area, restricting ability for local residents to travel further afield.

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5.6.3 Summary of feedback on accessing services Table 130 shows that travelling by car was the key travel method respondents used to travel to their local NHS hospital. Table 130. Summary of travel methods Total Own car 64% On foot 6% Public transport 11% Taken by a friend 2% Taken by a relative 8% Other 10% Base 532 Key themes from survey As highlighted in feedback on the integrated care hubs options and community hospital and care home beds, parking was highlighted as an issue. The need for more public transport services and to consider the needs of non-drivers was also highlighted.

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5.7 Other comments This section presents other comments received.

5.7.1 Feedback from the survey Table 131 shows the themes raised when survey respondents were asked if they had any other views to share on the ideas described in the consultation document. The top three themes were: ‘General concerns about the consultation process’ (43); ‘Public consultation/research (Talk/listen to us/find out needs)’ (36) and ‘Needs to be local/community-based (convenient locations)’ (32). Table 131. Do you have any other views you wish to share with us on the ideas described in this consultation document?

(Question 33)

Lyme

-

Trent

-

Moorlands

under

on

-

-

Total

Cheadle

and

Stoke

Other/out of area

Leek Leek

Nopostcode provided Newcastle

Needs to be local/community-based (convenient locations) 32 2 6 6 18 0 0 Address transportation issues (Lack of transport options) 19 2 3 4 10 0 0 Parking is an issue/lack of parking 13 4 3 1 5 0 0 Access Does not consider rural/isolated patients 11 0 1 2 8 0 0 Improvements to waiting times/appointment allocation for 6 3 0 1 2 0 0 services Extend opening times 2 2 0 0 0 0 0 Care homes Disagreement/concerns about proposal to use care homes 15 2 2 1 8 0 2 Keep/use Leek hospital 27 1 1 3 22 0 0 Community Keep/use Cheadle hospital 13 1 0 9 3 0 0 hospitals Keep/use Bradwell hospital 7 0 5 1 1 0 0 Consultation General concerns about the consultation process 43 9 5 9 16 1 3 process Public consultation/research (Talk/listen to us/find out needs) 36 6 6 4 16 2 2 Estates and Future proof site/consider long-term needs 8 1 3 1 3 0 0 buildings It's a waste of money/stop wasting money 21 1 4 8 7 0 1 Finance Funding/investment needs to be sufficient/increased 4 0 0 0 2 0 2 General Generally, agree with proposals/consultation 7 2 2 1 1 0 1 positive Impact on Need to reduce pressure on other NHS services 12 3 2 1 4 1 1 NHS Consider the effects on readmission rates 3 1 1 0 0 0 1 Particular Consider the needs of elderly/less mobile patients 16 6 4 2 3 0 1 groups Consider the needs/effects on patient's carers/caregivers 9 3 2 1 2 0 1 Privatisation No to privatisation/use of private firms for care 6 2 2 0 1 0 1 Delivering patient care is more important than cost Quality of 25 4 3 7 9 1 1 efficiency/savings care Make improvements to social care/homecare packages 18 6 3 2 5 0 2 Need to provide community/rehabilitation beds 20 3 4 1 10 0 2 Service Stop/don't cut/reduce services 16 1 2 2 10 0 1 provision Provide additional NHS services at current locations/expand 12 0 2 2 7 0 1 services

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Don't change things/keep them the same 11 2 2 3 4 0 0 Need to provide help/advice/support 3 2 0 1 0 0 0 Staffing Need sufficient/qualified staff to cover care needs 18 4 8 2 3 0 1 Other 30 6 6 4 11 1 2 Other No, none, nothing 32 7 9 4 6 3 3 Not answered 4 2 1 0 1 0 0 Base 230 44 49 36 79 9 13 The most frequently mentioned theme by respondent location was:  Stoke-on-Trent: ‘General concerns about the consultation process’ (9)  Newcastle-under-Lyme: ‘Enough qualified staff to cover care needs are required’ (8)  Cheadle: ‘General concerns about the consultation process (9) and ‘Keep / use Cheadle Community Hospital’ (9)  Leek and Moorlands: ‘Leek Moorlands Community Hospital should not close’ (22). Some of the protected characteristic groups were significantly more likely to raise specific themes compared to other groups within their characteristic cohort. These have been outlined below:  Age o Respondents aged 50-59 were more likely to comment: ‘Delivering patient care is more important than cost efficiency/savings’, compared to those aged 70-79 o Respondents aged 50-59 were more likely to comment: ‘Need to provide community/rehabilitation beds’, compared to those aged 60-69 o Respondents aged 70-79 were more likely to comment: ‘Keep/use Cheadle hospital’, compared to those aged 50-59.  Gender o Male respondents were more likely to comment: ‘Parking is an issue/lack of parking’, compared to female respondents o Male respondents were more likely to comment: ‘Funding/investment needs to be sufficient/increased’, compared to female respondents.  Caring responsibilities o Respondents who were carers for an older person were more likely to comment: ‘Consider the needs/effects on patient's carers/caregivers’, compared to those who were not carers. Organisational responses A local MP expressed concern over the proposals causing greater pressure on Royal Stoke University Hospital.

5.7.2 Feedback from the postcards 2,395 postcards were received, which were produced independently by the ‘Save Leek Hospital’ campaign to support Leek Moorlands Community Hospital. The postcards had a pre-printed section of feedback on the proposals. This feedback was:  Disagreement with bed closures / closed beds should reopen  Care home beds do not provide an equivalent service  Proposals will lead to adverse patient outcomes  Disagreement with proposals to move outpatients clinics and patients having to travel to Stoke-on- Trent  The proposal does not consider the rural geography of the Moorlands and poor public transport.  Leek Moorlands Community Hospital should not be demolished.

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The postcards also had a space for respondents to write other comments. Table 132 shows the feedback received from the ‘Save Leek Hospital’ postcards in these other comments. Table 132. Feedback from the ‘Save Leek Hospital’ postcards

Total Does not consider rural/isolated patients (Inc. large area to cover, consider 277 geographical/local needs) Transport options are not sufficient (travel will be difficult) 271 Access Services need to be local/community-based 213 Suggested locations/other hospitals are too far away (issues with distance) 154 Need to resolve issues with parking/need good parking options 60 Consider the needs of non-drivers 51 Save/keep Leek (Moorland) hospital open/it's needed/necessary 406 Community hospitals Save/keep it open/it's needed/necessary inc. hospital (no location specified) 360 Consultation process Public consultation/research (Talk/listen to us/find out needs) 42 Finance Waste of money to close it (consider the money already spent) 87 General disagreement with proposal (inc. “I say no”/“agree with the no’s”) 86 General comments General agreement with proposal 5 Impact on NHS Closing will increase wait times/pressure on other NHS services 178 Particular groups Consider the needs of the elderly/an aging population 180 Respondent mentions them/their family using services 195 Quality of care Services/facilities provided are good/great/excellent 166 Services are needed/necessary (keep services open) 328 Beds are needed (don’t close/reduce them) 172 Keep minor injuries units (Inc. use/need minor injuries units) 55 Keep blood clinics/services (Inc. use/need blood clinics/services) 33 Service provision Need A&E/emergency services (inc. don’t close) 32 No to the use of care homes/care homes are not a solution 27 Keep X-ray services (Inc. use/need X-ray services) 24 Keep physio services (Inc. use/need physio services) 18 Other 84 Other No, none, nothing (Inc. not my local area) 3 Not answered 2 Base 1640

5.7.3 Feedback from events Attendees at events were asked if they had any other comments or questions on the proposals. See Appendix 9 for a summary of these themes.

5.7.4 Feedback from social media Comments were made on Facebook and Twitter by members of the public, local councillors and political representatives and patient representative groups. Key themes were around the reduction of community hospital beds and that community hospitals should not close. See Appendix 12 for examples of social media posts relating to the consultation. Community hospital beds Feedback relating to community hospital beds has been included in section 5.4.2.3.2. Community hospitals

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Comments were made supporting local community hospitals and that community hospitals should not close. There was a crowdfunding campaign against hospital closures and posts made by local councillors and political parties for Bradwell Community Hospital, Cheadle Community Hospital and Leek Moorlands Community Hospital to remain open. The Save Leek Hospital campaign was active on Facebook and promoted the ‘Save Leek Hospital’ postcards which were used to give feedback on the proposals. Consultation process Comments were made with concerns regarding the consultation process; for example, the promotional stand at Leek Market being ineffective; the survey being too complex; queries over the cost of the consultation and that the consultation should be more in-depth with more collaboration with the community.

5.7.5 Feedback from correspondence The Staffordshire and Stoke-on-Trent City Council Joint Health Scrutiny Committee (JHSC) commented that the term ‘preferred option' may have led to confusion among the public.

5.7.6 Summary of other comments Comparing feedback from survey, postcards and social media Key themes were similar to those covered in the feedback to specific proposals, with ensuring easy access to services a key theme. In the social media comments noted and in the postcard correspondence received, the need to retain community hospitals were key themes. Themes from the survey Other key themes raised were around access and the consultation process; the need for locally community- based services and concerns around the consultation process and the need for more public consultation. Themes from events Key themes were around the need to make improvements to social care; concerns over the consultation process and comments around care homes; for example, the need for quality checks and concerns over capacity. Themes from postcards Key themes were around access and community hospitals: the proposals do not consider rural/isolated patients and the need to keep Leek Moorlands Community Hospital and community hospitals open. Themes from social media Key themes were around the need to keep community hospitals open and concerns regarding the consultation process

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6 Conclusion This section summarises the key findings from the consultation. Specifically, it summarises feedback on the new model of care; the options for integrated care hubs; the options on community hospital beds and the proposals to move consultant-led outpatients clinics.

6.1 The proposed new model of care  Overall, 373 (71%) respondents indicated they strongly agreed or agreed with this approach, compared to 85 (16%) respondents who disagreed or strongly disagreed  Support was at similar levels across the Northern Staffordshire and Stoke-on-Trent area. Newcastle Postcode Stoke-on- Leek and Other/ out Total -under- Cheadle not Trent Moorlands of area Lyme provided Strongly agree / Agree 71% 79% 69% 71% 70% 88% 56% Neither agree nor 11% 10% 16% 7% 10% 6% 18% disagree Strongly disagree / 16% 11% 13% 21% 19% 6% 22% Disagree Don’t know 1% 0% 2% 1% 0% 0% 4% Base 523 107 114 72 168 17 45 There was agreement with the idea of integrated care hubs and co-locating services in one place across all feedback channels. A key theme throughout was access; for example, needing to consider poor transport access to services. The need for further information on the proposals and what services integrated care hubs provide was a key theme throughout. A difference between the feedback channels was that at the events, the need to consider to social care was highlighted.

6.2 The proposals for integrated care hubs Survey respondents and event participants were asked to provide feedback on the proposals for integrated care hubs in South of Stoke-on-Trent, Staffordshire Moorlands, Newcastle-under-Lyme and North of Stoke- on-Trent. In the South of Stoke-on-Trent, the largest proportion of respondents to the consultation survey supported option 1A (the preferred option). Option 1A: Hub services Option 1B: Hub services delivered from a new delivered from Meir Primary purpose-built site in Care Centre Longton Strongly agree / Agree 38% 35% Neither agree nor disagree 25% 28% Strongly disagree / Disagree 24% 24% Don’t know 13% 15% Base 429 357 There were similar levels of positivity for option 1A and 1B across all feedback channels. However there was more negativity around option 1B compared to option 1A in the survey comments, partly due to respondents feeling Meir Primary Care Centre is too small and lacks capacity for greater patient numbers.

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The themes raised were similar across all feedback channels, especially around access and ease of travel and the need to ensure that considering poor transport access will be addressed when locating the integrated care hub in the South of Stoke-on-Trent. Making use of existing buildings and not wasting money / using funding effectively was also a key theme throughout, suggesting why option 1A did not receive higher levels of agreement. In Staffordshire Moorlands, the largest proportion of respondents to the consultation survey supported option 2A. The preferred option was option 2B. Option 2B: Hub Option 2A: Hub services delivered Option 2D: Hub services delivered Option 2C: Hub from a rebuilt services delivered from the existing services facility at the from existing but refurbished delivered from existing Leek Cheadle Leek Moorlands a new site in Moorlands Community Community Kniveden Community Hospital site Hospital Hospital site Strongly agree / Agree 65% 44% 6% 37% Neither agree nor 16% 19% 16% 20% disagree Strongly disagree / 13% 30% 67% 36% Disagree Don’t know 6% 7% 11% 7% Base 402 403 331 353 A key theme raised across the survey and events was the need for care in Leek, suggesting why options 2A and 2B received higher levels of agreement in the survey than the other options. Needing to retain care in Cheadle (option 2D) was also frequently mentioned across all channels, with the need for more than one hub in the Staffordshire Moorlands being highlighted. Kniveden (option 2C) was considered, in the survey, focus groups and public events a bad location for a hub. Estates, finance and access were also key themes across all channels; for example, ensuring poor transport access is considered. The need to stop wasting money by using existing buildings was highlighted, suggesting why the preferred option to rebuild Leek Moorlands Community Hospital (option 2B) received lower levels of agreement than the option to refurbish the existing hospital (option 1A). In Newcastle-under-Lyme, the largest proportion of respondents to the consultation survey supported option 3A (the preferred option). Option 3A: Hub services delivered Option 3B: Hub services delivered from existing Bradwell Community from Milehouse Primary Care Hospital site Centre Strongly agree / Agree 63% 16% Neither agree nor disagree 21% 34% Strongly disagree / Disagree 4% 32% Don’t know 11% 18% Base 457 312 A key theme across all feedback channels was agreement with option 3A, due to the need to provide care in Bradwell. Across the survey and events, there was also disagreement with option 3B due to the location of Milehouse Primary Care Centre, with the need for easy access being a key theme throughout all the feedback methods.

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In the North of Stoke-on-Trent, 70% of respondents to the consultation survey agreed or strongly agreed with option 4A (the only option). Option 4A: Hub services delivered

from Haywood Community Hospital Strongly agree / Agree 70% Neither agree nor disagree 16% Strongly disagree / Disagree 6% Don’t know 7% Base 443 There was agreement with option 4A across all feedback channels due to its convenient location. Access was, however, highlighted as an issue across all channels, especially parking.

6.3 The proposals for community hospitals and integrated care hubs Survey respondents were asked to give feedback on the approach to providing out of hospital services in the community.  275 (55%) of respondents strongly agreed or agreed with this proposal  157 (31%) respondents who disagreed or strongly disagreed. When respondents were asked to give comments on the proposed change in bed numbers, the proposal not providing enough capacity to cover needs was the key theme. Option 2 received the most agreement from survey respondents. Options 1 and 6 (the preferred option) received the least agreement from survey respondents. Options 2 – 6 include 77 community hospital beds at Haywood Community

Hospital and: Option 1: Option 2: Option 6: Option 3: Option 4: Option 5: All 132 55 beds at 55 NHS 55 beds at 55 beds at 55 beds at beds at Leek commissioned Longton Cheadle Bradwell Haywood Moorlands assessment Cottage Community Community Community Community beds in local Hospital Hospital Hospital Hospital Hospital care homes Strongly agree / 15% 65% 28% 38% 43% 15% Agree Neither agree nor 14% 10% 20% 20% 13% 8% disagree Strongly disagree / 68% 33% 50% 40% 41% 72% Disagree Don’t know 2% 2% 2% 3% 3% 4% Base 355 426 352 367 387 396 Focussing on the approach to community hospital beds, the proposal not providing enough beds to meet demand was a key theme across all feedback channels. The need for beds to be provided at community hospitals, especially Leek Moorlands Community Hospital, and for community hospitals to remain open were also key themes. Although this was the preferred option, disagreement towards option 6 was a key theme across all feedback channels, with a key reason being concerns raised over the quality of care in care homes. A consideration raised across all feedback channels was the need for enough well-trained staff to cover care needs.

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A difference in responses from different channels of engagement was option 1 receiving positive feedback at focus groups, as it was commented that Haywood Community Hospital is a good hospital, with good services and facilities. In the survey, option 1 received low levels of agreement, as it was commented that beds need to be locally-based and split geographically, with access being a key theme.

6.4 The proposals for consultant-led outpatient clinics Consultation survey respondents were asked their views on the proposals to move certain consultant-led outpatient clinics. Proposals to move clinics received:  Strongly agree / agree between 29% and 32%  Strongly disagree / disagree between 43% and 46%. Colon and Trauma and General rectal Dermatology Nephrology Neurology orthopaedics surgery check-ups Strongly agree / 31% 29% 32% 32% 30% 32% Agree Neither agree nor 18% 18% 17% 17% 16% 17% disagree Strongly disagree / 43% 46% 43% 43% 46% 44% Disagree Don’t know 8% 7% 8% 8% 7% 8% Base 474 472 471 470 470 462 Across different feedback methods, the need to keep care in Leek and ensure easy access to services were key themes, suggesting why all of the clinics received similarly low levels of agreement in the survey.

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7 Appendices

Appendix 1: Stakeholder engagement

Organisation Engagement Action for Children Sent information for cascade Action on Hearing Loss Sent information for cascade Adsis / One Recovery Sent information for cascade and arranged focus group Age UK (North Staffordshire) Sent information for cascade Alliance Board - North Sent information for cascade Alsagers Bank Community Group Sent information for cascade Alton Parish Council Sent information for cascade Alzheimer's Society Sent information for cascade Apostolic Praise Centre Sent information for cascade Approach Staffordshire Sent information and attended Carers’ Cafés Arch (North Staffordshire) Sent information for cascade Arthritis Care Sent information for cascade ASHA (North Staffordshire) Sent information for cascade Asist Sent information for cascade Aspire Housing Sent information for cascade Audley Parish Council Sent information for cascade Bagnall Parish Council Sent information for cascade Basford and Cliffe Vale Residents' Association Sent information for cascade Beth Johnson Foundation Sent information for cascade and arranged focus group Betley, Balterley and Wrinehill Parish Council Sent information for cascade Biddulph and Proud Sent information for cascade Biddulph Community News Sent information for cascade Biddulph Moor Community Association Sent information for cascade Biddulph Moor Friends of Cancer UK Sent information for cascade Biddulph Moor Village Hall Sent information for cascade Biddulph Town Council Sent information for cascade Birches Head Residents' Association Sent information for cascade Bloomin' Longton Sent information for cascade Blurton Farm Residents' Association Sent information for cascade Breathe Easy Sent information for cascade and arranged focus group Brookhouse and Ubberley Village Forum Sent information for cascade Brown Edge Parish Council Sent information for cascade Bucknall New Road Estate Residents’ Association Sent information for cascade Changes Sent information for cascade Changes Health and Wellbeing Sent information for cascade Checkley Parish Council Sent information for cascade Checkley Residents’ Association Sent information for cascade Cheddleton Parish Council Sent information for cascade Chell Heath Residents' Association Sent information for cascade Citizens Advice Sent information for cascade Sent information and summary documents for cascade and City Central Mosque surveys for completion Clayton Residents’ Association Sent information for cascade Community Council of Staffordshire Sent information for cascade Community Drug and Alcohol Service (CDAS) Sent information for cascade Community Health Voice Sent information for cascade and arranged focus group Cornerstone Community Centre, Silverdale Sent information for cascade Crossroads Care (North Staffordshire) Sent information for cascade Crossways Residents’ Association Sent information for cascade

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Deafinequality Sent information for cascade Deaflinks Staffordshire Sent information for cascade Deafvibe Sent information for cascade Diabetes UK North Staffs Volunteer Group Sent information for cascade Disability Solutions Sent information for cascade and arranged focus group Douglas Macmillan Hospice Sent information for cascade Dresden Residents' Association Sent information for cascade Dyslexia Association of Staffordshire Sent information for cascade Eaton Park Residents' Association Attended meeting to raise awareness and gather feedback. Emma Bridgewater Ltd Sent information for cascade to staff Endon and District Community Forum Sent information for cascade Endon with Stanley Parish Council Sent information for cascade EngAGE Communities Sent information for cascade Florence Residents' Association Sent information for cascade Forsbrook Parish Council Sent information for cascade Friends of Biddulph Town Sent information for cascade Sent information and summary documents for cascade and Gaylife / Galaxy Youth surveys for completion Gillaninoormasjid Mosque Sent information for cascade Gingerbread Centre Sent information for cascade Goms Mill Residents' Association Sent information for cascade Great Wood Hall / Tean Village Hall Sent information for cascade Green Door Sent information for cascade and arranged focus group Guru Nanak Sikh Temple Sent information for cascade Hanford Village Residents' Association Sent information for cascade Hanley One Residents’ Association Sent information for cascade Harriseahead Homepage Sent information for cascade Hartshill and Harpfields Residents' Association Sent information for cascade Healthwatch Staffordshire Sent information for cascade and arranged focus group Healthwatch Stoke-on-Trent Sent information for cascade and arranged focus group Hollington Residents’ Association Sent information for cascade Joiners Square Residents' Association Attended meeting to raise awareness and gather feedback. Keele Parish Council Sent information for cascade Sent information and summary documents for cascade and Keele University surveys for completion Kidsgrove Town Council Sent information for cascade Knutton Neighbourhood Watch Sent information for cascade Ladies Philanthropic Committee of the Church of St Marina and Sent information for cascade St Mary Stoke Leek Town Council Sent copies of survey and summary document for cascade Let's Make Jam Sent information for cascade Lightwood Community Group Sent information for cascade Longsdon Parish Council Sent information for cascade Longton Community Partnership Sent information for cascade Longton Hall Community Association Attended meeting to raise awareness and gather feedback. Lower Tean Residents’ Association Sent information for cascade Madeley Parish Council Sent information for cascade Madeley Residents’ Association Sent information for cascade Mencap Sent information for cascade MHA Sent information for cascade and meeting attendance Midlands Partnership NHS Foundation Trust (MPFT) Sent information for cascade and attended board meeting Mill Rise Residents’ Association Sent information for cascade Milton Village Stoke-on-Trent Sent information for cascade Mind (North Staffordshire) Sent information for cascade and arranged focus group Moorlands HomeLink Sent information for cascade and arranged focus group National Ankylosing Spondylitis Society Sent information for cascade Netmums (North Staffordshire) Sent information for cascade Newchapel Residents’ Association and friends Sent information for cascade Normacot Residents' Association Sent information for cascade

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North Staffordshire Combined Healthcare NHS Trust (NSCHT) Sent information for cascade North Staffordshire GP Federation Sent information for cascade North Staffordshire LMC Sent information for cascade North Staffordshire Polish Day Centre Sent information for cascade North Staffs African Caribbean Association Sent information for cascade North Staffs and Stoke LPC Sent information for cascade North Staffs Carers Sent information for cascade and organised focus group North Staffs Orthotics Campaign Sent information for cascade Northwood Residents’ Association Attended meeting to raise awareness and gather feedback. Norton Green Residents’ Association Sent information for cascade Norton le Moors Residents’ Association Sent information for cascade OLGBT Stoke and North Staffordshire Sent information for cascade Pandas (Stoke-on-Trent) Sent information for cascade Penkhull Residents' Association Attended meeting to raise awareness and gather feedback Pensioners Convention (Greypower) Sent information for cascade Pittshill and Great Chell Residents' Association Attended meeting to raise awareness and gather feedback Porthill Residents’ Association Sent information for cascade Red House Community Trust Sent information for cascade RNIB Sent information for cascade and arranged focus group Royal British Legion Sent information for cascade Saltbox Sent information for cascade and arranged focus group Salvation Army (Stoke-on-Trent) Sent information for cascade Sanctuary / Trans Staffordshire Sent information for cascade and arranged focus group Sanctus St Marks Sent information for cascade Sandyford and Goldenhill Residents’ Association Sent information for cascade Sheen Parish Council Sent information for cascade Shelton and Etruria Residents’ Association Sent information for cascade Silverdale Parish Council Sent information for cascade Sent information and summary documents for cascade and Staffordshire University surveys for completion Staffordshire and Stoke-on-Trent Dementia Alliance Sent information for cascade Staffordshire Afghan Association Sent information for cascade Staffordshire Autistic Society Sent information for cascade Staffordshire Buddies Sent information for cascade and organised meeting attendance Staffordshire Council of Voluntary Youth Services Sent information for cascade Sent information which was distributed to schools and care home Staffordshire County Council contacts for cascade Staffordshire Housing Association Sent information for cascade Staffordshire Women's Aid Sent information for cascade Sent information which was distributed to schools and care home Stoke-on-Trent City Council contacts for cascade. Liaised with traveller liaison contact to distribute surveys to traveller community Stoke Expert Citizens Sent information for cascade Stoke Gujarati Samaj Sent information for cascade Stoke Hindu Temple Sent information for cascade Stoke Polish Catholic Centre Sent information for cascade Stoke Recovery Service / AddAction Sent information for cascade Support Staffs (Staffordshire Moorlands) Sent information for cascade The Carers' Hub Sent information for cascade and arranged focus groups The Trentham Local Sent information for cascade Thistleberry Residents' Association Sent information for cascade Tittesworth Parish Council Sent information for cascade University Hospital of North Midlands NHS Trust (UHNM) Sent information for cascade and attended board meeting Upper Tean Residents’ Association Attended meeting to raise awareness and gather feedback VAST Sent information for cascade and organised workshop Vintage Volunteers Sent information for cascade Voices of Stoke Sent consultation summaries as requested for cascade Waterhouses Parish Council Sent information for cascade Werrington Parish Council Sent information for cascade

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Westfield Children's Centre Sent information for cascade Weston Coyney Residents’ Association Sent information for cascade Whitehill Online Sent information for cascade Whitmore Parish Council Sent information for cascade Wolstanton Residents’ Association Sent information for cascade YMCA Sent information for cascade and organised focus group

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Appendix 2: Population quotas Staffs Moorlands, QUOTA: 0.5% of total population for Newcastle-under-Lyme 2017 (minus those aged under 12) and Stoke-on-Trent area divided across demographic profile characteristics Number % Number Overall population (2017 mid-year estimate) (minus under 16s) 394,123 1,971

Overall population (2017 mid-year estimate) 482,837 2,414

Base population (All those in the area aged 12-84 – breakdown below) 403,474

Age Under 12 68,194 14%

12-84 403,474 84%

85 and older 11,169 2%

more detailed breakdown Under 16 88,714 18% N/A 16-19 22,506 5% 92 20-29 66,118 14% 270 30-39 58,108 12% 237 40-49 61,194 13% 250 50-59 65,027 13% 265 60-69 55,383 11% 226 70-79 42,148 9% 172 80 and over 23,639 5% 96 Gender (2017 estimate) Female 241,930 50% 985 Male 240,907 50% 985 Ethnicity (2011 census data) % from minority group 44,600 9% 177 White: English/Welsh/Scottish/Northern Irish/British 425,389 91% 1,793 White: Irish 1,256 0% 10 White: Gypsy or Irish Traveller 267 0% 10 White: Other White 7,287 2% 48 Mixed/multiple ethnic group: White and Black Caribbean 2,695 1% 20 Mixed/multiple ethnic group: White and Black African 767 0% 10 Mixed/multiple ethnic group: White and Asian 1,994 0% 0 Mixed/multiple ethnic group: Other Mixed 1,127 0% 10 Asian/Asian British: Indian 3,402 1% 20 Asian/Asian British: Pakistani 11,001 2% 39 Asian/Asian British: Bangladeshi 1,253 0% 10 Asian/Asian British: Chinese 2,310 0% 10 Asian/Asian British: Other Asian 4,490 1% 20 Black/African/Caribbean/Black British: African 3,103 1% 20 Black/African/Caribbean/Black British: Caribbean 1,130 0% 10 Black/African/Caribbean/Black British: Other Black 456 0% 10 Other ethnic group: Arab 563 0% 10 Other ethnic group: Any other ethnic group 1,495 0% 10 Religion (2011 census data) Christian 303,686 65% 1,281 Buddhist 1,364 0% 10 Hindu 1,975 0% 10 Jewish 157 0% 10 Muslim 16,578 4% 79 Sikh 841 0% 10 Other religion 1,657 0% 10 No religion 112,879 24% 473 Religion not stated 30,848 7% 138 Sexual orientation (2015 West Midlands figures) Heterosexual or straight 95% 1,872

Gay or lesbian 1% 20

Bisexual 1% 20

Other 0% 10

Don't know or refuse 3% 59

Disability (West Midlands figures) Disability prevalence 24% 473

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Appendix 3: Press coverage

Name of publication Publication date Headline (print)

26 March 2019 The Sentinel MP wants beds to be reopened [print] 15 March 2019 The Sentinel Trying to solve problem by then creating another Health minister visits hospital as CCG consultation on future of 9 March 2019 The Sentinel community beds continues 6 December 2018 Leek Post and Times Out fight for NHS justice carries on [print] 13 December 2018 Leek Post and Times I think we have been treated very shabbily 13 December 2018 Leek Post and Times Proposals for the Staffordshire Moorlands are… 13 December 2018 The Sentinel Consultation to be held on the future of Leek Moorlands hospital 4 January 2019 The Sentinel Every bed to be axed at four hospitals in controversial NHS plan 4 January 2019 The Sentinel Uncertain future for hospitals in Moorlands as consultation begins 9 January 2019 The Sentinel Have your say on health services 17 January 2019 Leek Post and Times CCGs insist we want to know your views before any decision [print] 21 January 2019 The Sentinel Fight to save Leek hospital will go on following public council meeting 23 January 2019 Times and Echo Councillors' call to arms over plans for hospital. [print] 23 January 2019 Times and Echo North Staffordshire Consultation: What they said [print] 30 January 2019 Times and Echo ‘All is not lost’ in campaign for Cheadle Hospital, says CCG 31 January 2019 Leek Post and Times Meeting about hospital was a waste of time 31 January 2019 Leek Post and Times Our population is made of people, not numbers Campaigners fighting hospital bed closures in North Staffordshire launch 31 January 2019 The Sentinel fud to take NHS to court – here’s how you can make a pledge 31 January 2019 Leek Post and Times Leek and District Civic Society 31 January 2019 Leek Post and Times Leek Event 31 January 2019 The Sentinel 'No alternative but to take the NHS to court' 1 February 2019 The Sentinel Meeting about hospital was a `waste of time' 2 February 2019 The Sentinel It seems silly to house 2 February 2019 The Sentinel 'We would welcome the new care hub' 2 February 2019 Leek Post and Times Joining forces in bid to consider legal fight to save hospital beds 6 February 2019 Leek Post and Times Neil Podmore Councillor (Leek West) 7 February 2019 The Sentinel I want us to stand united in bid to keep our hospital open The Sentinel Campaigners step up fight to keep up to 55 NHS beds at Bradwell 7 February 2019 Hospital 7 February 2019 The Sentinel Are campaigners right to have little faith in process? The Sentinel CCG to give councillors presentation on future of health services in 7 February 2019 Moorlands 13 February 2019 Leek Post and Times Joining forces in bid to consider legal fight to save hospital beds 13 February 2019 Leek Post and Times Neil Podmore Councillor, Leek West The Sentinel NHS defends controversial plans to replace community hospitals with 14 February 2019 care home beds 14 February 2019 The Sentinel NHS bosses defend care home bed plan 16 February 2019 The Sentinel 'Patients treated with contempt' 27 February 2019 Leek Post and Times Mr McGhee’s story shows the need to fight for our beds 27 February 2019 Leek Post and Times Concerns that CCGs proposals will pit towns against each other [print] Simon Whitehouse discusses the consultation on future of health care 15 January 2019 BBC Radio Stoke in northern Staffordshire and Stoke-on-Trent [listen from 21:35 – 34:38] Matt Hill speaks to Anna Collins from North Staffordshire CCG about the 24 January 2019 Moorlands Radio future of Leek Moorlands Hospital

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Appendix 4: Press releases

Date Headline Coverage 16 November CCGs meeting on Future of Local Health Services in Northern No coverage was 2018 Staffordshire generated Governing bodies give approval for public consultation on future of 5 December 2018 Signal Radio local health services Consultation gives people a chance to have their say on future of local 7 December 2018 Stoke-on-Trent Live health services in Northern Staffordshire

4 January 2019 Your chance to have your say The Sentinel [print]

No coverage was 10 January 2019 CCGs visiting local shopping centres and holding public events generated First public consultation event gathers important feedback – more No coverage was 21 January 2019 opportunities coming up generated New Spotlight answers questions about getting home after a hospital No coverage was 25 January 2019 stay generated Extra event in Leek gives people chance to find out more and have No coverage was 29 January 2019 their say generated No coverage was 1 February 2019 Have your say before the consultation closes generated

4 February 2019 People urged to use consultation survey because cards don't cut it BBC Radio Stoke

People encouraged to participate in consultation following challenge 5 February 2019 BBC Radio Stoke response Staying in hospital beds longer than needed can do more harm than No coverage was 1 March 2019 good generated No coverage was 1 March 2019 Local NHS organisations help more people have their say generated No coverage was 11 March 2019 Have your say before the consultation closes generated New model of care will strengthen workforce in North Staffordshire and No coverage was 13 March 2019 Stoke-on-Trent generated

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Appendix 5: Press enquiries

Date Subject Organisation / Publication Proactive or reactive 4 December 2018 Extraordinary Board BBC Radio Stoke proactive 4 December 2018 Extraordinary Board ITV Central proactive 4 December 2018 Extraordinary Board Signal 1 proactive 4 December 2018 Extraordinary Board The Sentinel proactive 5 December 2018 Post board interview request BBC Radio Stoke proactive 5 December 2018 Post board interview request Signal 1 proactive 5 December 2018 Post board interview request BBC Radio Stoke proactive 5 December 2018 LD reporter request for interview The Sentinel proactive 5 December 2018 Consultation interview for weekend bulletins BBC Radio Stoke proactive 5 December 2018 Request for interview on consultation process Moorlands Radio proactive 10 December 2018 Interested in developing positive article Health Service Journal proactive 11 December 2018 North Staffs consultation feature BBC Sunday Politics proactive 12 December 2018 Request for interview about consultation Cross Rhythms City Radio proactive 13 December 2018 Offer of article on consultation in next edition National Health Executive proactive 7 January 2019 Integrated Care Teams BBC Midlands TV proactive 8 January 2019 NS Consultation Westwood Academy events Moorlands Radio proactive 10 January 2019 Invitation to media briefing BBC Radio Stoke proactive 10 January 2019 North Staffs consultation briefing invite Leek Life proactive 25 January 2019 NS consultation interview Moorlands Radio proactive 25 January 2019 Interview NS consultation workshop event Moorlands Radio proactive 25 January 2019 NS consultation interview Leek Post and Times proactive 25 January 2019 NS consultation interview BBC Radio Stoke proactive 25 January 2019 NS consultation interview The Sentinel proactive 25 January 2019 NS consultation interview Cheadle: Times, Echo and Life proactive 25 January 2019 Interview copy Cheadle: Times, Echo and Life reactive 29 January 2019 Leek Hospital MIU Leek Post and Times reactive 29 January 2019 Services currently at Cheadle Hospital Times and Echo reactive 30 January 2019 NS Pensioners Convention legal challenge Health Service Journal reactive 30 January 2019 NS Pensioners Convention legal challenge Signal Radio reactive 1 February 2019 NS Pensioners Convention legal challenge Sunday Mercury reactive 1 February 2019 NS Pensioners Convention legal challenge BBC Midlands TV reactive 1 February 2019 Readmission Rates BBC Midlands TV reactive 5 February 2019 NS Pensioner Convention legal challenge Leek Post and Times reactive 5 February 2019 Bradwell care home update Leek Post and Times reactive 5 February 2019 NS Pensioners Convention legal challenge Leek Life reactive 7 February 2019 NS Pensioners Convention legal challenge Moorlands Radio reactive 7 February 2019 NS consultation and documents Cheadle: Times, Echo and Life reactive 7 February 2019 Consultation pre-recorded interviews Signal Radio proactive 13 February 2019 Cheadle pop-up stand Leek Life proactive 13 February 2019 Cheadle public event – too difficult to register Cheadle: Times, Echo and Life reactive 18 February 2019 Complaint at Bradwell Hall Leek Post and Times reactive 26 February 2019 Interview with Anna Collins Stone and Eccleshall Life reactive 26 February 2019 Request for number of attendees Cheadle: Times, Echo and Life reactive 26 February 2019 Slide deck Cheadle: Times, Echo and Life reactive 26 February 2019 Clarification on why Cheadle Hospital is ‘older’ Leek Life reactive 26 February 2019 Leek meeting 11 March Moorlands Radio reactive 5 March 2019 Care homes and beds Parliamentary hub reactive 11 March 2019 NS consultation meetings Times and Echo reactive 13 March 2019 Post event and pre consultation closure interview Moorlands Radio reactive

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Appendix 6: Press advert

Appendix 7: Social media paid advert creative

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Appendix 8: Overview of consultation respondents and participants data notes  Data for CCGs is taken from 2011 Census data and Annual Population Survey data, extracted from www.nomisweb.co.uk  Marital status: ‘Live with partner' was an option in the consultation survey but was not collected in the Census  Disability: For the CCG data, this is the number / percentage of people with day-to-day activities limited a lot or a little in the 2011 Census and the number from in the consultation who indicated that they had one or more disability or long-term condition  Sexual orientation: The data is taken from the Annual Population Survey. The data was not published for local authorities with small sample sizes, such as Staffordshire Moorlands and Newcastle-under- Lyme, therefore the Staffordshire-wide data has been used for North Staffordshire CCG.

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Appendix 9: Other event comments

otal

RA

T

Retailstand

Publicevent

Extra meeting

Hospital standHospital

PC focus PC group Carers group focus

Integrated care hubs If it’s done right (as in the proposal), it will be good 1 0 0 0 1 0 0 2 General positive A purpose-built facility is a good idea 0 0 0 0 0 1 0 1 Location Alternative location for hub services suggested 0 0 0 0 1 1 0 2 Need to provide additional services / facilities at ICHs 0 0 0 3 1 2 0 6 Service Integrate GP services in proposal (integrated care hubs) 0 0 1 0 3 0 0 4 provision Consider voluntary services 1 0 0 0 0 0 0 1 Community hospital rehabilitation beds Need to provide community/rehabilitation beds 0 0 0 0 4 2 0 6 Capacity Proposal does not provide enough capacity to cover needs 0 0 0 0 1 0 1 2

Don't close beds/reopen previously closed beds 0 0 0 0 1 0 0 1 Need checks/quality reviews to ensure standards are high 0 0 1 5 1 1 0 8 Lack of needed health services outside hospital settings 0 0 0 5 2 1 0 8 Concerns over the quality of local care homes 1 0 0 2 1 1 0 5 Care homes Concerns over the capacity in care homes 0 0 1 0 3 1 0 5 Disagreement/concerns about proposal to use care homes 0 0 0 0 2 1 1 4 Care homes are for / should be for the elderly 0 0 0 0 1 1 0 2 Privatisation No to privatisation/use of private firms for care 0 0 1 2 1 1 0 5 Make improvements to social care/homecare packages 0 0 1 2 5 2 0 10 Quality of care Consider quality of care and clinical outcomes 0 0 0 1 1 0 0 2

Caring for patients at home is best 0 0 0 0 1 0 0 1 Service Issues surrounding bed blocking/people unable to leave beds because 0 0 0 0 2 2 0 4 provision of lacking home care packages South of Stoke-on-Trent Positive comments on Meir Primary Care Centre option 0 0 0 0 2 0 1 3 Integrated care Parking is an issue (Meir) 0 0 0 0 1 1 1 3 hubs Good parking options (Meir) 0 0 0 0 1 0 0 1 Support for beds at Longton 0 0 0 0 0 1 0 1 Community Parking is an issue (at Longton) 0 0 0 0 0 0 1 1 hospital beds Good transport access (Longton - beds) 0 0 0 0 0 0 1 1 Disagreement with beds at Longton 0 0 0 0 1 0 0 1 Use / retain Longton 0 0 0 2 2 1 0 5 General Need care in Longton 0 0 0 0 1 0 0 1 Staffordshire Moorlands Support for hub in Leek (ICH) 0 0 0 0 0 0 1 1 Kniveden is a bad location for a hub 0 0 0 0 0 1 0 1 It's a waste of money to rebuild Leek 0 0 0 1 0 0 0 1 Integrated care More than one hub is required in the Moorlands area 1 0 0 0 0 0 0 1 hubs Too inconvenient (option 4 - Cheadle) 0 0 0 0 1 0 1 2 Disagreement with beds at Leek 0 0 0 0 1 0 0 1 Poor transport access (Cheadle) (beds) 0 0 0 0 1 0 0 1 All beds are outside Moorlands 0 1 0 0 0 0 0 1 Keep/use Leek hospital 0 0 0 0 1 1 0 2 General Keep/use Cheadle hospital 0 0 0 0 0 1 0 2 Leek Moorlands Hospital is an accessible location 0 0 0 0 0 1 0 1 Newcastle-under-Lyme Positive Bradwell mention 0 0 0 0 0 2 0 2 Integrated care Parking is an issue (Milehouse) 0 0 0 0 1 1 0 2 hubs Either option is fine (in Newcastle) 0 0 0 0 0 1 0 1 Community Agreement with beds at Bradwell 0 0 0 0 2 0 0 2 hospital beds General Poor transport access (Bradwell) 0 0 0 2 1 1 1 5

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Keep/use Bradwell hospital 0 0 0 0 1 0 0 1 Parking is an issue (Bradwell) 0 0 0 2 0 0 0 1 North of Stoke-on-Trent Community Agreement with all beds at Haywood 0 0 0 0 2 1 0 3 hospital beds Parking is an issue/lack of parking (at Haywood) 0 0 0 2 1 1 1 5 Need to consider accessibility and mobility (Haywood) 0 0 0 2 0 0 1 3 General Poor transport access (Haywood) 0 0 0 1 1 0 1 3 Use / retain Haywood 0 0 0 0 1 0 0 1 General comments Address transportation issues (Lack of transport options) 1 0 1 0 2 2 0 6 Access Lack of access to appointments 0 0 0 1 1 0 1 3 Capacity Current centres too small/lack of capacity for patient numbers 0 0 0 0 2 1 0 3 Consultation Need more information 1 1 4 6 7 2 0 21 process General concerns about the consultation process 0 1 1 1 3 0 0 6 Consider environmental impact 0 0 0 0 1 0 0 1 Estates Use existing facilities 0 0 0 0 0 1 0 1 It's a waste of money/stop wasting money 1 0 0 0 0 1 0 2 Finance Proposals are driven by costs / cuts to services 1 0 0 0 0 0 0 1 General positive Generally, agree with proposals/consultation 0 0 1 0 0 0 0 1 Consider the needs of elderly/less mobile patients 0 0 0 1 1 0 0 2 Particular Consider vulnerable children and younger people (e.g. young carers, 0 0 0 0 0 2 0 2 groups CAMHS) Consider poverty in the area 0 0 0 0 0 1 0 1 Improve communication within NHS services 0 0 0 1 3 2 1 7 Quality of care Consider patient choice 0 0 0 1 0 1 0 2 Delivering patient care is more important than cost efficiency/savings 0 0 0 0 0 1 0 1 Consider patient / GP relationship 0 0 0 0 1 0 0 1 Consider voluntary services 0 0 1 0 1 1 0 3 Service Consider out of hours services 0 0 0 0 0 1 1 2 provision Consider innovative service provision 0 0 0 1 0 1 0 2 Don't close / reduce services 0 0 0 0 1 0 0 1 Consider long-term needs 0 0 0 1 0 0 0 1 Staffing Need sufficient/qualified staff to cover care needs 0 0 2 3 3 2 0 10

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Appendix 10: Example social media schedule

Day Date Twitter Facebook Topic: Survey promotion Topic: Survey promotion Image: Survey deadline Image: Survey deadline Time to go out: 9 am Time to go out: 9 am Copy: Visit our website to fill out the survey on the Copy: Visit our website to fill out the survey on the 4 Mar future of health services in north Staffordshire. Make future of health services in north Staffordshire. Make sure your voice is heard sure your voice is heard https://www.healthservicesnorthstaffs.nhs.uk/ #haveyour https://www.healthservicesnorthstaffs.nhs.uk/ #haveyo saynorthstaffsccg ursaynorthstaffsccg Topic: Leek event Topic: Leek event

Monday Image: Leek event Image: Leek event Time to go out: 8 pm Time to go out: 8 pm Copy: There’s one week left before our final public Copy: There’s one week left before our final public 4 Mar event. Visit our website to book your place at our Leek event. Visit our website to book your place at our Leek event event https://www.healthservicesnorthstaffs.nhs.uk/ #haveyour https://www.healthservicesnorthstaffs.nhs.uk/ #haveyo saynorthstaffsccg ursaynorthstaffsccg Topic: Get in touch Topic: Get in touch Image: Survey deadline Image: Survey deadline Time to go out: 8 am Time to go out: 8 am Copy: Do not hesitate to contact us if you have any Copy: Do not hesitate to contact us if you have any questions, need documents and information in other questions, need documents and information in other 5 Mar formats, help with completing the survey or booking on formats, help with completing the survey or booking on to an event. Complete the form on our website, or call to an event. Complete the form on our website, or call us on 01782 298002 to get in us on 01782 298002 to get in touch #haveyoursaynorthstaffsccg touch #haveyoursaynorthstaffsccg

Topic: Care Beds Topic: Care Beds

Tuesday Image: Survey deadline Image: Survey deadline Time to go out: 9 pm Time to go out: 9 pm Copy: We want to transform the way that community Copy: We want to transform the way that community health care is provided to help more people rehab health care is provided to help more people rehab 5 Mar and recover in their own homes and spend less time in a and recover in their own homes and spend less time in hospital bed. Visit our website to find out a hospital bed. Visit our website to find out more https://www.healthservicesnorthstaffs.nhs.uk/ #ha more https://www.healthservicesnorthstaffs.nhs.uk/ #h veyoursaynorthstaffsccg aveyoursaynor6thstaffsccg

Topic: Survey promotion Topic: Survey promotion Image: Survey deadline Image: Survey deadline Time to go out: 8 am Time to go out: 8 am Copy: You have until 17 March to complete our survey Copy: You have until 17 March to complete our survey 6 Mar on the future of health services in North Staffordshire on the future of health services in North Staffordshire and Stoke-on-Trent. Visit our website to find the survey and Stoke-on-Trent. Visit our website to find the survey

https://bit.ly/2GUijV7 #haveyoursaynorthstaffsccg https://bit.ly/2GUijV7 #haveyoursaynorthstaffsccg

Topic: Easy read documents Topic: Easy read documents Image: Survey deadline Image: Survey deadline Time to go out: 8 pm Time to go out: 8 pm Wednesday Copy: We have worked with ASSIST to create a more Copy: We have worked with ASSIST to a create more 6 Mar visual, simply worded version of our consultation visual, simply worded version of our consultation document. Read our document to learn more about the document. Read our document to learn more about the changes we are proposing to health services in north changes we are proposing to health services in north Staffordshire https://bit.ly/2NzHwVw Staffordshire https://bit.ly/2NzHwVw #haveyoursaynorthstaffsccg #haveyoursaynorthstaffsccg

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Topic: Why are we consulting Topic: Why are we consulting Image: Consultation deadline image Image: Consultation deadline image Time to go out: 7 am Time to go out: 7 am Copy: We believe that the changes we are proposing Copy: We believe that the changes we are proposing 7 Mar will help us provide the best possible health services for will help us to provide the best possible health services

the people of North Staffordshire and Stoke-on-Trent. for the people of North Staffordshire and Stoke-on-

Visit our website to find out more Trent. Visit our website to find out more https://www.healthservicesnorthstaffs.nhs.uk/ #haveyour https://www.healthservicesnorthstaffs.nhs.uk/ #haveyo saynorthstaffsccg ursaynorthstaffsccg

Thursday Topic: New model of care Topic: New model of care Video: https://youtu.be/RclE2_tZHBg Video: https://youtu.be/RclE2_tZHBg Time to go out: 9 pm Time to go out: 9 pm 7 Mar Copy: Watch: Dr Lorna Clarson, Clinical Director for Copy: Watch: Dr Lorna Clarson, Clinical Director for Partnerships and Engagement explains how our new Partnerships and Engagement explains how our new model of care would help people in North Staffordshire model of care would help people in North Staffordshire and Stoke-on-Trent. #haveyoursaynorthstaffsccg and Stoke-on-Trent. #haveyoursaynorthstaffsccg Topic: Leek event Topic: Leek event Image: Leek event promotional image Image: Leek event promotional image Time to go out: 8 am Time to go out: 8 am Copy: This coming Monday we will be holding our final Copy: This coming Monday we will be holding our final 8 Mar public event in Leek. Visit our website to book your public event in Leek. Visit our website to book your place. place. https://www.healthservicesnorthstaffs.nhs.uk/ #haveyour https://www.healthservicesnorthstaffs.nhs.uk/ #haveyo saynorthstaffsccg ursaynorthstaffsccg Topic: Documents on website Topic: Documents on website

Friday Image: Survey deadline Image: Survey deadline Time to go out: 9 pm Time to go out: 9 pm Copy: Looking for more information on the changes we Copy: Looking for more information on the changes 8 Mar are proposing as part of the consultation? We have a we are proposing as part of the consultation? We have number of informative documents and videos on our a number of informative documents and videos on our website. website. https://www.healthservicesnorthstaffs.nhs.uk/ #haveyour https://www.healthservicesnorthstaffs.nhs.uk/ #haveyo saynorthstaffsccg ursaynorthstaffsccg Topic: Care Beds Topic: Care Beds Image: Survey deadline image Image: Survey deadline image Time to go out: 8 am Time to go out: 8 am Copy: The longer a person stays in hospital when they Copy: The longer a person stays in hospital when they 9 Mar do not need to be there, the greater the negative impact do not need to be there, the greater the negative on their health leading to what is known as impact on their health leading to what is known as

‘deconditioning syndrome’. Our new model of care will ‘deconditioning syndrome’. Our new model of care will work to prevent work to prevent this https://bit.ly/2GUijV7 #haveyoursaynorthstaffsccg this https://bit.ly/2GUijV7 #haveyoursaynorthstaffsccg Topic: Bill’s Story Topic: Bill’s Story Saturday Video: Video: https://www.youtube.com/watch?v=0fUvnQhaXxI&featur https://www.youtube.com/watch?v=0fUvnQhaXxI&feat 9 Mar e=youtu.be ure=youtu.be Time to go out: 8 pm Time to go out: 8 pm Copy: Watch ‘Bill’s Story’ to find out how integrated Copy: Watch ‘Bill’s Story’ to find out how integrated care hubs would benefit people in North Staffordshire care hubs would benefit people in North Staffordshire and Stoke-on-Trent. #haveyoursaynorthstaffsccg and Stoke-on-Trent. #haveyoursaynorthstaffsccg Topic: Survey deadline Topic: Survey deadline Image: Survey deadline image Image: Survey deadline image

Time to go out: 9 am Time to go out: 9 am 10 Copy: There is one week left before the consultation Copy: There is one week left before the consultation Mar closes! Make sure you share your opinions on the future closes! Make sure you share your opinions on the

Sunday of health service in North Staffordshire and Stoke-on- future of health service in North Staffordshire and Trent by filling out the survey. Stoke-on-Trent by filling out the survey. https://bit.ly/2GUijV7 #haveyoursaynorthstaffsccg https://bit.ly/2GUijV7 #haveyoursaynorthstaffsccg

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Topic: Leek event Topic: Leek event Image: Leek event promotional image Image: Leek event promotional image Time to go out: 7 pm Time to go out: 7 pm 10 Copy: This is your last chance to book your spot at our Copy: This is your last chance to book your spot at our public event in Leek tomorrow evening. Book your place public event in Leek tomorrow evening. Book your Mar to ensure your opinions on the future of health services place to ensure your opinions on the future of health are heard. services are heard. https://www.healthservicesnorthstaffs.nhs.uk/ #haveyour https://www.healthservicesnorthstaffs.nhs.uk/ #haveyo saynorthstaffsccg ursaynorthstaffsccg

Appendix 11: Gunning Principles Requirements for conducting a public consultation lawfully are informed by an extensive and growing body of case law, including the four Gunning Principles. I. Proposals must be at a formative stage II. Consultors must provide sufficient information to allow consultees ‘intelligent consideration of the proposals’ III. Consultors must allow sufficient time for consideration IV. Consultors must conscientiously consider the output of the consultation.

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Appendix 12: Example social media feedback

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Appendix 13: Organisations responding to the survey There were 37 respondents who stated they were responding on behalf of an organisation. 30 of these stated the organisations they were responding on behalf of. In some cases respondents stated that they worked at the organisations rather than officially responding on the organisation’s behalf. This has been reflected in the report. Organisations with representatives responding to the survey Total number of Number of respondents who indicated they were Organisation respondents employees or members of the organisation Biddulph Valley Surgery 1 0 Borderland Voices 1 0 Cheadle Council 1 0 GP Services 1 0 Kidsgrove Town Council 1 0 Leek and Biddulph Patient Locality Group 1 0 Leek Health Centre PPG 4 0 Meir Primary Care Centre PPG 1 0 Midlands Partnership Foundation Trust 6 1 North Staffordshire GP Federation 1 0 Staffordshire County Council 1 0 Stoke Health Centre 1 0 Support Staffordshire 1 0 Wolstanton Medical Centre 1 0 Unstated 7 -

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Appendix 14: Organisations with representatives attending events These tables include organisations that were named in demographic profiling questionnaires, where respondents indicated they were responding on behalf of the organisation. Organisations with representatives attending focus groups and community workshops Approach North Staffs Mind Biddulph Carers Hub North Staffs Carers Brighter Futures NRAS Changes Health and Wellbeing One Recovery Cheadle Town Council P.I.E.R. Diabetes UK North Staffs Rethink Mental Illness Disability Solutions Silver Tree Home Support Green Door STAND Healthwatch Staffordshire The Carers Hub – Peoples Plus Healthwatch Stoke-on-Trent Vast Home Instead Senior Care Voices Partnership Moorlands Homelink YMCA Newcastle Hub

Organisations with representatives attending public events Borderland Voices Moorlands Locality Changes Health and Wellbeing Post and Times Newspaper Cheadle District Foodbank South Moorlands Labour Party Cheadle Labour Party Staffordshire County Council Cheadle Town Council Staffordshire Moorlands District Council Checkley Parish Council Tardis Surgery PPG Citizens Advice Therapy North Staffordshire Community Hospitals Association Thistleberry Residents Association Healthwatch Times, Echo and Life Leek Health Centre University Hospitals North Midlands Leek Health Centre PPG Well Street PPG Midlands Partnership Foundation Trust

Organisations with representatives attending Residents’ Association meetings Fenton Events Board Northwood Residents Hamford Village Residents Association Red House Community Trust Holy Trinity Church, Northwood St Clare’s Church Centre, Meir Park Longton Community Partnership Stoke-on-Trent City Council Normacot Residents Association

Appendix 15: Organisations and MPs / councillors sending correspondence Organisations and MPs / councillors sending correspondence Checkley Parish Council Newcastle Borough Council Community Hospitals Association North Staffordshire Combined Healthcare NHS Trust 1 local councillor North Staffs Pensioners’ Convention 4 local MPs Staffordshire and Stoke-on-Trent Joint Health Scrutiny Committee Leek Town Council University Hospitals of North Midlands Full correspondence will be available to Governing Body members on request. Alongside organisational correspondence, there were 18 pieces of correspondence from members of the public, which were read, analysed and included in the report. See table 20 for full breakdown. Some organisations sent more than one piece of correspondence. Both have been read, analysed and included in the report.

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Appendix 16: Geographic groupings in the survey  Survey respondents were asked to provide their postcode. This was then used to understand where respondents lived.  Using the ‘postcode district coverage’ and ‘Local Authority area’, four geographies were created (see assigned geographies in the table below).  When creating these ‘assigned geographies’ the following was considered: the number of responses/postcodes within a geography, the Local Authority Area and the need to understand the viewpoints of respondents from across the consultation area. Consequently, respondents from the Cheadle area have been shown separately from the rest of Staffordshire Moorlands (described below as Leek and Moorlands).  It was also important to understand survey respondents in the context of the Index of Multiple Deprivation (IMD). When looking at the IMD rank of average score, Stoke-on-Trent is ranked 14th most deprived area in the country. Newcastle-under-Lyme is ranked 156 and Staffordshire Moorlands is ranked 207. (Please note: 1 is most deprived and 326 is least deprived).  The assigned geographies produced for this report of findings, as far as possible, using the postcode districts, have been created to allow comparison with the IMD for the local authority areas. Consequently, when comparing the responses by ‘assigned geography’ this is, as far as possible,

Number of survey Number of Postcode Postcode district responses Assigned responses Local authority area district coverage within geography within postcode geography district Hanley, Cobridge, Sneyd ST1 Green, Birches Head, Stoke-on-Trent 17 Shelton Bentilee, Abbey Hulton, Stoke-on-Trent, Staffordshire ST2 12 Bucknall Moorlands Stoke-on- Longton, Meir, Blurton, Stoke-on-Trent, Stafford, Staffordshire 108 ST3 37 Trent Weston Coyney Moorlands Stoke, Fenton, Penkhull, ST4 Stoke-on-Trent, Stafford 21 Trentham Tunstall, Burslem, Stoke-on-Trent, Staffordshire ST6 21 Smallthorne, Brown Edge Moorlands Newcastle-under-Lyme, ST5 Newcastle-under-Lyme, Stafford 105 Keele, Chesterton Newcastle- Kidsgrove, Talke, Talke Newcastle-under-Lyme, Cheshire East, under- 124 ST7 Pits, Alsager, Mow Cop, Stoke-on-Trent, Staffordshire 19 Lyme Audley Moorlands Cheadle, Church Leigh, Staffordshire Moorlands, East ST10 70 Tean, Alton Staffordshire ST11 Blythe Bridge Staffordshire Moorlands, Stafford 3 Cheadle 76 ST12 Barlaston Stafford, Stoke-on-Trent 1 ST15 Stone Stafford, Staffordshire Moorlands 2 ST13 Leek Staffordshire Moorlands 139 Staffordshire Moorlands, Stoke-on- ST8 Biddulph 14 Trent Leek and Staffordshire Moorlands, Stoke-on- 173 ST9 Werrington, Endon 15 Moorlands Trent Buxton, Tideswell, Hartington, Longnor, SK17 Buxton 5 Chelmorton comparing areas by deprivation.

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IMD - Rank of proportion IMD - Rank of average Local Authority District name of LSOAs in most score deprived 10% nationally* Stoke-on-Trent 14 13 Newcastle-under-Lyme 156 148 Staffordshire Moorlands 207 200 *where 1 is most deprived and 326 is least deprived https://www.gov.uk/government/statistics/english-indices-of-deprivation-2015

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