Argyll and Bute CHP OUTCOME of the SHORT LISTING
Total Page：16
File Type：pdf, Size：1020Kb
Argyll and Bute CHP OUTCOME OF THE SHORT LISTING OF THE SERVICE OPTIONS 24 / 7 REVIEW OF GP OUT OF HOURS AND GP HOSPITAL SERVICES Version 5 02/05/12 1 Contents Page No. Summary of short listed options 3 1 Introduction 5 2 Methodology 5 3 Steps to filling in the Matrix 6 4 Short Listing Workshop 19/04/12 6 5 Option Long List and Existing Service Feedback and Comments 7 6 Option Short Listing Outcome 7-9 7 Next Steps 10 9 Appendices • Appendix 1 Table Option Assessment Matrix • Appendix 2 Table Voting on the Options to include in the short list of options Cowal 24 / 7 Review Group Short Listing Options Workshop 19/04/12 • Appendix 3 Table Characteristics of Options • Appendix 4 - Workshop Attendees and Submissions Received 2 Option Description Table Summary of Short Listed Options 1 Community Health Partnership (CHP) employed Doctors based in Cowal Community Hospital (CCH) provide the following in the Hospital; Casualty, cover for patients (in patients) Out of Hours ie after 6pm and weekends/bank holidays. They provide the Out of Hours service for Dunoon and South Cowal from the Hospital . The 3 GP practices based in Dunoon cover inpatients during the day Mon-Fri 8am to 6pm. 3 Centre Options3 Centre Rural GPs provide Out of Hours services in rural Cowal. A contract with NHS Greater Glasgow &Clyde (NHS GG&C) provides a service to Lochgoilhead from the Vale of Leven Hospital ( VoL). 2 CHP employed Doctors based in CCH provide the following in the Hospital; Casualty, in patients during Out of Hours including weekends/bank holidays. They provide the Out of Hours service for Dunoon and South Cowal from CCH GPs contracted to cover inpatients during the day Mon-Fri 8am to 6pm. Rural GPs provide Out of Hours services in rural Cowal - Tighnabruaich, Strachur and extend the coverage to Ardentinny (currently covered by CCH OOH) Contract with NHS Greater Glasgow &Clyde providing OOH service to Lochgoilhead from the Vale of Leven Hospital 4 CHP employed Doctors based in CCH provide the following in the Hospital; Casualty, inpatients during Out of Hours and weekends/bank holidays. They provide the Out of Hours service for Dunoon and South Cowal from CCH. The 3 GP practices based in Dunoon cover inpatients during the day Mon-Fri 8am to 6pm. Rural GPs provide Out of Hours services in rural Cowal, Tighnabruaich, Strachur and Lochgoilhead 6 CHP employed Doctors based in CCH provide the following in the Hospital; Casualty, in 2 Centre Options2 Centre patients during Out of Hours including weekends/bank holidays. They provide the Out of Hours service for the whole of Cowal. Enhanced nurse or paramedic practitioner to provide initial response Contract with GPs to provide inpatient hospital service Monday to Friday 8am – 6pm. In rural Cowal Saturday & bank holiday ‘drop in’ out of hours GP surgery in one of Strachur/Tighnabruaich/Lochgoilhead 7 CHP employed Doctors to provide hospital inpatient and casualty service GP practices form consortium to provide GP Out of Hours service via a contract for the whole of Cowal 8 CHP employ Doctors to provide hospital inpatient (out of hours, weekends & bank holidays) and casualty service GP practices form consortium to provide hospital inpatient service Mon-Fri 8am to 6pm GP practices form consortium to provide GP out of hours service via a contract for the whole of Cowal 3 Option Description Table Summary of Short Listed Options Option Option Centre Centre 11 1 CHP employed Medical Staff based in Cowal Community Hospital cover the Casualty, Inpatient and Out of Hours service for the whole of Cowal from the hospital 4 1 Introduction The 24/7 Review Group met and assessed the long list of 17 options to reduce them to a short list. This shortlist will be put through an options appraisal process to decide which option is best. The short listing of options was done by assessing the option against: • Project objectives • Key features expected from the new model • Service principles • Project boundaries or parameters • Feedback received from the public events, staff and stakeholders. It is a “reality check”, assessing which options are viable and should be put through a formal appraisal process. The characteristics of the 17 “Long Listed” options are detailed in Appendix 3. The full description of the long list of options can be found at http://www.nhshighland.scot.nhs.uk/CHP/ArgyllandBute/PPF/Pages/CowalGPS ervices.aspx However, an option does not have to be assessed as viable using simply this process as there are other considerations to take into account including: • The existing service model to be considered and also used as a benchmark- Option 1 is always included • Objective evidence that comes from formally appraising a model favoured by some stakeholders to ensure transparency, fairness and inclusion This initial assessment, feedback and consideration process will also clarify and develop further the short listed options. This is through working up the detail of each option, or by highlighting issues that require consideration. 2 Methodology The methodology used is a “matrix”, a clear way of comparing how each option rates against the project objectives, boundaries and key features. The matrix • is colour coded • rates how each option would perform in practice against the project objectives, boundaries and key features • is a first step in assessing the viability of the options • is subjective – those rating options have to make judgements about the performance of each option The rating takes account of the following: • Service description and operating profile of each option • Feedback and comments received from the public, users, stakeholders and staff • Information which has been presented to the Project Group regarding the current service and how it is provided re types and number of staff and shift patterns • The activity and demand profile of the service i.e. the Cowal Community Hospital and Out of Hours Service Activity Profile as well as other information • Benchmarking information on other service models 5 • The comments log informing the development of the options Some of the above is factual information and considered to be objective, some are opinions based on experience and is considered to be subjective. Appendix 1 details the matrix used as part of the process. The following rating using colour coding was used. • The rating least likely, occasionally, etc , which is felt to be the most accurate for the service objective, boundary or key feature is chosen • The colour that indicates that rating is then used to insert into the matrix, e.g. least likely is red and red is inserted into the matrix. Matrix Key Least Likely Occasionally Likely Most of time All the time 3 Steps to Filling in the Matrix Cowal 24 / 7 Project Group members were asked at the Project Group meeting 29 th March 2012 to do some “homework” as an individual or as a group (a group is recorded as such) as follows : • The matrix template should be filled in with the individuals or groups assessment of the options • Once the rating and colour coding of all the options has been completed, a judgement is made on which options individuals or groups feel should be short listed or not • This is recorded by indicating Yes or No in the final row of the matrix • The results of this assessment to be brought to the project short listing workshop (19 th April 2012) 4 Short Listing Options Workshop 19/04/12 At the short listing meeting on the 19 th April the project group collated and examined the results of their “homework” recording their choice of options to include. They were then put into three categories: a) consensus agreement to include b) consensus agreement to exclude c) consensus that there is uncertainty to include / exclude The results of this stage of the assessment are detailed in Appendix 2. They are summarised in preference ranking order below. 6 Table short listing ranking Agreement to No of votes for Rank of include in short Option each option options listing 1 Existing service Agreed by all to automatically short list these selected 1 options 4 11 2 2 9 3 8 8 4 3 7 5 Uncertain whether 7 to include or 6 6 exclude these 6 5 7 options so further 9 discussion 5 8 needed 11 4 9 13 4 10 15 4 11 12 3 12 Agreed by all to exclude these 5 2 13 options 14 1 14 10 0 15 16 0 16 17 0 17 5 Option Long List and existing service feedback and comments As part of the Review programme, a number of information events for local communities and NHS staff were held providing the opportunity to look at the long list of options. People were asked to make comments, decide which options would best meet their needs and ask questions. Local communities were also encouraged to share their experience of using the current Out of Hours Service and medical cover in Cowal Community Hospital. The ‘Your Stories’ feedback form was used to capture these stories and the Voxcer, a computer video recorder. The full report detailing this feedback is appended as a separate document ‘Cowal 24 / 7 Review Community and Staff Feedback on the Long List of Options & “Your Stories”’ The workshop group considered these comments and feedback on the existing service and option preferences made by the public. 7 A number of specific points were noted by the members as important consideration in the finalisation selection process: • Options 1, 4 and 3 were the most popular selections from submissions. • Tighnabruaich residents submitted the most responses • Importance of having a doctor in the hospital and a doctor covering the out of hours work rural and urban • Concern