Consultation Summary Moor to Sea.Indd

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1. Consultation and beneﬁ ts Into the future 2. A new approach and delivering change Re-shaping community-based health services 3. The potential impact 4. Taking part and ﬁ nding out more in the Moor to Sea locality 5. Complete the questionnaire A public consultation: Thursday 1 September to Wednesday 23 November 2016

South Devon and Torbay Clinical Commissioning Group is responsible for planning and organising health services for local people. Driving quality, delivering value, improving services It is divided in to fi ve localities – each led by www.southdevonandtorbayccg.nhs.uk/community-health-services local GPs. Into the future Re-shaping community-based health services in the Moor to Sea locality 1. Consultation and benefi ts Consultation and benefi ts 2. A new approach and delivering change 3. The potential impact 4. Taking part and fi nding out more 5. Complete the questionnaire A public consultation: We want to hear the views of those • Earlier identifi cation of those at risk who may be affected and who live of becoming more unwell through Thursday 1 September to in the four localities – Moor to Sea, focusing on prevention and self-help Wednesday 23 November Newton Abbot, Paignton and Brixham, care and to make services greater than the sum of their parts 2016 and Torquay – which are part of this • Properly staffed and resourced consultation. (Our Coastal locality is community hospitals able to deliver quality, safe care • Reduced demand for services as a e’re asking people in South not part of this process because we result of helping people live independent consulted there in 2015 and WDevon and Torbay what Safe, high-quality hospital care lives for longer. improvements are currently being • they think of proposals for more when needed but keeping people out implemented.) Find out how to take Since last summer, the CCG, supported community-based healthcare and of hospital when they don’t need to part in this consultation on page 4 and by TSDFT, has engaged with groups support, closer to their homes. be there We want our services to be available complete the feedback questionnaire across the area to discuss how best to when people need help and to make (pages 5-12). • Reduced ‘bed blocking’ in hospitals deliver services which would meet the sure that patients don’t have to go into as a result of effective alternative future needs of our local population. hospital unnecessarily. The benefi ts we want to see community-based support These engagement discussions involved a range of interests and expertise and The CCG is seeking feedback on its We asked people in 2013 what they • Treatment and recuperation at looked at, for example, the predicted proposals and listening to alternative wanted from their health and care home, recognising that ‘the best bed health needs of our population, the use ideas for strengthening services. Any services. We have been exploring how is your own bed’ of hospital beds to look after people proposals must meet increasing health we can best respond to what people who can no longer live on their own, needs, be clinically sound, sustainable said, most recently working with Torbay • Reduced pressure on A&E by ways of providing more care in the and affordable. and South Devon NHS Foundation strengthening minor injuries units (MIUs) local community and the diffi culties of Trust (TSDFT) which provides most of to treat a wide range of problems, attracting specialist staff to the area. The consultation proposals respond to our community-based services. By keeping Torbay’s A&E service free to increasing demand for healthcare, the changing the way we do things and by deal with life-threatening issues In parallel with these discussions, need to strengthen services that most working more closely with social care, representatives of the CCG, Torbay people use and the benefi ts to we believe our new way of working will • Greater investment in local services Council, Devon County Council, TSDFT be gained from switching resources deliver benefi ts such as: by switching funding from hospital to and primary care, including senior from bed-based hospital care to community-based care clinicians, have drawn on the feedback community-based care, enabling more • Easier access to a wider range provided and informed also by TSDFT • Closer working by different people to be supported in or near their of community-based services to help staff, considered how best to provide organisations which support people’s own homes. people stay well and to support them future services. when they are not wellbeing to provide local, seamless

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 1 Into the future Re-shaping community-based health services in the Moor to Sea locality 1. Consultation and beneﬁ ts A new approach and delivering change 2. A new approach and delivering change 3. The potential impact 4. Taking part and ﬁ nding out more 5. Complete the questionnaire A new approach (MIUs). The hubs would be provided people recover more quickly, in buildings that are of a high clinical maximising their independence and f implemented, our proposals would standard and, where necessary, helping them to resume normal activities. support they need is not available. Isee GPs, community health and social additional investment would be made to Intermediate care also supports more We are therefore proposing to close care teams and the voluntary sector improve the quality of environment and timely discharge from hospital and four community hospitals (Ashburton and working together to provide for the vast range of services offered. helps to avoid unnecessary hospital Buckfastleigh, Bovey Tracey, Dartmouth majority of people’s health and admissions by supporting people in their and Paignton) so that more money can wellbeing needs. Accessing services Local health and wellbeing centres: local communities, either at home or be invested in local community teams. would be made simpler through a these would be linked to the clinical in another care setting. By switching Community hospital beds would central contact point. hub and see community staff based resources to home-based care, we continue to be available in Brixham, locally and working alongside GPs, would be able to strengthen intermediate Newton Abbot, Totnes and Dawlish for The four core elements to deliver this pharmacists and voluntary-sector care teams, with seven-day cover and patients who need them. approach locally are: organisations to provide the health input from doctors, pharmacists and and wellbeing services most frequently personal care teams. Stronger minor injuries units (MIUs): Clinical hubs: In each locality there used by local people. They would be people can’t rely on MIUs being open would be a clinical hub providing located in Ashburton/Buckfastleigh, Delivering these changes at present because staff and resources people with better access to medical, Bovey Tracey/Chudleigh, Brixham, are spread too thinly. By reducing them clinical and specialist services. These Dartmouth, Newton Abbot, Paignton, Investment: strengthening community- to three and concentrating our staff in hubs would offer a broad range of Totnes and Torquay. based services by investing in: Newton Abbot and Totnes, as well as services to people and, although one Dawlish, MIUs would open 8am to is proposed in each locality, they could Health and wellbeing teams: these are • Wellbeing coordinators 8pm, seven days a week and would be used by everybody irrespective of made up of the staff based in these have x-ray diagnostic services. • Clinics and services for people where they live. centres and would include community This means that MIUs in Ashburton, with multiple long-term conditions health and social care staff, mental Dartmouth (both currently suspended), The clinical hubs would offer services health professionals and voluntary Additional intermediate care Brixham and Paignton would close. such as outpatient appointments, organisations. Together they would • services to support people to return to specialist conditions clinics and organise and deliver services to meet maximum independence, in or close to Intermediate and domiciliary care inpatient services. By bringing services most of the local population’s health people’s own homes, in local residential together in a single location we would and social care needs. Discussions have already taken place reduce the need for people to travel and nursing homes. with local authority colleagues and with to Torbay Hospital to access services. Intermediate care provision: this is some care home operators to see how Fewer, safer community hospital beds: provided to people who need extra we can stimulate this market to provide Totnes and Newton Abbot would also many patients remain in hospital too support and care following a period greater provision. long because the community-based offer access to minor injuries units of ill-health. It is designed to help

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 2 Into the future Re-shaping community-based health services in the Moor to Sea locality 1. Consultation and benefi ts Moor to Sea: the potential impact 2. A new approach and delivering change 3. The potential impact 4. Taking part and fi nding out more 5. Complete the questionnaire MOOR TO SEA What would be different? community nursing, physiotherapy, For those whose GP is based in occupational therapy and social care Chillington, the proposals have little The Trust is not the main provider of support. impact other than if adopted, the A clinical hub would be established at community services in this area. Totnes Community Hospital that would nearest MIU and community hospital Community inpatient care and specialist include community inpatient beds and run by Torbay and South Devon NHS outpatient clinics for the population of a range of specialist services to reduce Foundation Trust would be in Totnes. Dartmouth, Ashburton and Buckfastleigh the need to travel as far for specialist would be provided at their nearest What could services look like and where would they be? care. These would include a new multi clinical hub in Totnes, Brixham or long-term conditions service, extended Clinical hub in Totnes (currently Totnes Health and wellbeing centre in Newton Abbot. MIUs would be x-ray diagnostic services, specialist Hospital) Ashburton or Buckfastleigh (options provided in Totnes and Newton Abbot. outpatient clinics and the existing are being explored to co-locate with gym-based rehabilitation services and To deliver more expert care to people • MIU 8am-8pm GPs in either of the local towns or in minor injuries unit. in their own homes, we would invest • X-ray diagnostic services other facilities) money into more community-based staff • New multi long-term conditions Totnes Community Hospital currently and enhanced intermediate care clinic • Community clinics provides 18 beds, which would slightly services. We would work in • Specialist outpatient clinics • Health and wellbeing team reduce to 16 to meet safe staffi ng partnership with local care home • Community beds (16 beds) ratios. The MIU would open between Health and wellbeing centre in providers to provide more local • Rehabilitation gym 8am and 8pm (currently 9pm), seven Totnes (options are being explored intermediate care beds. • Pharmacist days a week, refl ecting the times of to co-locate with GPs) greatest demand and in line with the Health and wellbeing centre in Providing much more care to people in • Community clinics planned opening times of MIUs in or near their own home means that the Dartmouth (plans are being developed • Health and wellbeing team Dawlish and Newton Abbot. X-ray buildings from which we currently to co-locate with Dartmouth Medical diagnostic services would also be provide inpatient and community Practice in new premises) available during these times. services – including Dartmouth Community Hospital (16 beds), • Community clinics For the population of Totnes, Dartmouth Dartmouth NHS Clinic and Ashburton • Rehabilitation gym and Ashburton/Buckfastleigh, local and Buckfastleigh Community Hospital • Pharmacy health and wellbeing teams would be (10 beds) – would no longer be • Enhanced primary care MIU co-located, where possible, with GP required and would close if these services services. These teams would provide proposals are approved. • Health and wellbeing team

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 3 Into the future Re-shaping community-based health services in the Moor to Sea locality 1. Consultation and benefi ts Taking part and fi nding out more 2. A new approach and delivering change 3. The potential impact 4. Taking part and fi nding out more 5. Complete the questionnaire How to take part in this is practical, so if you would like us to by Torbay and South Devon NHS present our proposals and answer your Foundation Trust, and will include consultation questions, just get in touch. these in its consultation report. Other correspondence and petitions or, if this is not possible, fi ll it in on the • Read up on the detail: this pamphlet • Follow on Twitter or Facebook: we will also be noted by Healthwatch. following pages and return it to us by summarises a more detailed document will post information on our Moor to post at: Healthwatch Torbay, Freepost- which, with other material, is available Sea Facebook page (facebook.com/ Anonymity RTCG-TRXX-ZZKJ, Paignton Library & to download from: ccgmoortosea) and hold Information Centre, Great Western www.southdevonandtorbayccg.nhs.uk/ question-and-answer sessions on No information which could identify an Road, Paignton,TQ4 5AG or hand it to community-health-services. Twitter (twitter.com/sdtccg). individual will be passed to the CCG, Healthwatch at a meeting. Paper copies are available on request. other than where it is necessary to • Ask to receive our regular briefi ng: follow up alternative proposals. Any questions? • Come to a public meeting to discuss an email briefi ng will keep people in these proposals: the meetings in the touch with developments, so please let Make sure your views count Take a look at our website, where you Moor to Sea locality are listed below. us have your email address if you will fi nd Frequently Asked Questions: A full list of public meetings is want to receive it. We would like your individual views www.southdevonandtorbayccg.nhs.uk/ included in the main consultation on the issues which underpin the community-health-services. If you can’t document and online at: What happens next? consultation. For your views to be fi nd what you are looking for, can’t fi nd www.southdevonandtorbayccg.nhs.uk/ registered as part of the consultation, the link to the questionnaire, want community-health-services. Healthwatch will coordinate all views please either complete the questionnaire another document, would like to request expressed at public or community at www.communityconsultation.co.uk our regular briefi ng or would like to Invite us to a meeting in your • meetings attended by the CCG or invite us to a meeting, please get in community: we will attend as many as touch: Location Date Time Venue • Email [email protected] Ashburton 20 Sept 1pm, 4pm and 7pm Ashburton Town Hall, North Street, Ashburton, TQ13 7QQ • Write to South Devon and Torbay CCG, Pomona House, Torquay, TQ2 Buckfastleigh 22 Sept 6.30pm St Lukes Church, Plymouth Rd, Buckfastleigh, TQ11 0DA 7FF Dartmouth 15 Sept 4pm and 7pm Dartmouth Academy, Milton Lane, Dartmouth, TQ6 9HW • Call 01803 652511 during offi ce Totnes 11 Oct 6.30pm Totnes Civic Hall, High Street, TQ9 5SF hours. Widecombe 12 Oct 6.30pm Widecombe Church House, TQ13 7TA

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 4 Seven: Complete the consultation feedback questionnaire To formally take part in the Service preferences and challenges

consultation 1. Do you think that what people told us they wanted from health services Don’t Yes he questions here are presented in 2013 still applies today? No know Tin sections covering people’s preferences for health services and the Accessible services – convenient opening hours, transport and accessible buildings challenges we face, the proposed new Better communication – between clinician and patient, and between clinicians themselves model of care, and the best way we think it can be implemented. Each Continuity of care – to allow relationship-building with clinicians and carers question provides an opportunity to comment on a number of areas and Coordination of care – including joined-up information systems we would like you to give your views Support to stay at home – with a wide range of services and support on each. Question 13 enables you to comment Is there anything else you would want to see? Please list: more generally on the consultation proposals or to expand on the reasons for any of your answers. The ﬁnal section seeks more general information, designed to enable us to assess whether the responses received are representative of our diverse communities. It is easier – and cheaper – to complete Please continue, if necessary, on a separate sheet our feedback questionnaire electronically

at www.communityconsultation.co.uk.

2. Do you feel that the NHS needs to change the way it delivers services Don’t If completing this printed version, Yes No please send it to Healthwatch Torbay, so as to: know Freepost-RTCG-TRXX-ZZKJ, Paignton Establish better joint working between services? Library & Information Centre, Great Western Road, Paignton,TQ4 5AG. Look after the rising number of elderly people, many with long-term conditions? If there is not enough room for you to Tackle differences in life expectancy between afﬂuent and deprived areas? provide comments, please do so on a separate piece of paper and give Provide alternatives to A&E for non-emergency care? the number of the question to which Ensure that we have enough appropriately experienced staff to look after patients safely? you are responding Make best use of the money available?

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 5 Feedback form continued...

3. Do you think that we should develop more community health services to help keep people out of hospital and Don’t Yes avoid unnecessary use of hospital beds? No know

New model of care

4. The NHS should support people to keep well and independent for as long as possible by: Strongly Strongly Agree Disagree agree Disagree

Investing in health promotion activities (eg exercise classes for those with heart and lung disease) Providing support nearer to where people live Developing more out-of-hospital care and treatments, especially for older, frail people Funding more community services by reducing the number of hospital beds

5. Hospital beds are for patients requiring medical and nursing care that cannot be Strongly Strongly Agree Disagree provided elsewhere and should not be used for people: agree Disagree

Who no longer need nursing or medical care Who feel lonely or isolated Who have medical needs that can be managed at home Who have medical needs that can be met in a care home Whose family feel unable to look after them

6. When resources are limited, the NHS should prioritise the use of staff and funding to: Strongly Strongly Agree Disagree agree Disagree

Help keep more people well for longer Treat people with the most complicated health conditions Care for people in their own homes or close to where they live Keep open all community hospitals

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 6 Feedback form continued... Implementing the model of care

7. If you need to see a specialist (eg at an outpatient clinic), the most important aspects to Strongly Strongly Agree Disagree you are: agree Disagree

The time I have to wait for an appointment The distance I have to travel The expertise of the specialist that I see

8. Minor injuries units, which provide treatment for non-life-threatening problems and less Strongly Strongly Agree Disagree serious injuries (such as suspected broken bones and sprains, burns and scalds) should: agree Disagree

Be open consistent hours Be open seven days a week Have x-ray diagnostic services Be staffed by specialists experienced in dealing with minor injuries Be easily reached and have good car parking Operate different hours in different locations Offer different services in different locations

9. If the choice is between: Using resources to keep open community hospitals which look after people from across the CCG area

OR Using these resources to expand community health services by recruiting trained nurses and therapists to help keep people Yes No healthier, out of hospital and supported closer to their homes do you agree that it is better to do the latter? If you answered ‘yes’, please go to question 10 (pages 30 and 31). If you answered ‘no’, please go to question 11 (page 32).

Into the future: Re-shaping community-based health services in Moor to Sea locality. A public consultation: Thursday 1 September to Wednesday 23 November 2016 7 Feedback form continued...

10. If your answer to Question 9 is ‘yes’, please respond to the statements below:

Close Ashburton and Buckfastleigh Hospital Yes No Don’t know

Please give the reason for your choice: