Western Sussex Hospitals NHS Trust Service Redesign for Quality
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Agenda Item No. 5 Appendix B Service Redesign for Quality Response to the Public Consultation – May 2011 1 Introduction The joint Service Redesign for Quality (SRfQ) programme has been under development for the last two years. The programme has involved Coastal West Sussex healthcare commissioners and providers, together with the local authority social care departments who are responsible for the development and provision of community care. The programme’s overall aim is to ensure that local people receive safe and high quality care in the most appropriate setting, and particularly to improve safety for people currently treated as inpatients at Southlands Hospital. The programme follows the direction that NHS policy has set – to implement models of care that meet the needs of an ageing population in which chronic medical conditions are becoming increasingly prevalent. In practice, these models of care will focus more on preventing ill health, on supporting self-care and on providing more care at home and in the community. To be successful and effective they will require health and social care specialists from all areas to work more closely together to coordinate services so that patients’ needs are met. The SRfQ programme will enable Western Sussex Hospitals to move the inpatient services that are currently at Southlands Hospital, to the safer environment of Worthing Hospital, next to vital services such as critical care, theatres, and complex imaging equipment. They will also enable the provision of better facilities for the Trust’s Ophthalmology (Eye) Services by creating a new department at St.Richard’s Hospital and by moving the Worthing service to new premises at Southlands. The wider SRfQ programme will support an overall shift of care from the acute hospital setting to alternative models of care in the community, for some people with acute medical conditions. On 7th February this year the organisations involved launched a programme to consult with the public and with all local stakeholders on the changes that are being proposed. The aim of the consultation was to listen to the views of as many people and organisations as possible and to then address, in the plans, the key issues that arose. The feedback from the consultation has now been independently collated and evaluated and the themes that have emerged have been considered by the programme Steering Group – The Western Sussex Coastal Cabinet - which comprises the lead directors of all health and social care organisations in the area. This paper summarises our response to the issues that have been raised and our proposals for the way forward. 2 The Consultation Programme – facts and figures 2.1 The consultation lasted for 12 weeks – from 7th February to 29th April 2011. 1 Item 5 - Appendix B WSHT & NHSWS response.doc Agenda Item No. 5 Appendix B During that time - • Over 5000 documents describing the proposals were distributed – 4500 in print form, 180 downloaded online, 483 downloaded by hospital staff and more than 500 given out at public meetings and information stands • Over 700 organisations, including GP surgeries, opticians, libraries, local authorities and community groups, were sent information about the consultation • 3692 people viewed information about the consultation online • 1765 hospital staff viewed the information online on the hospital intranet • 361 people took part in public meetings • 176 people took part in staff meetings • 5 press releases were provided to the media and stakeholders • 12 meetings were held for the public or for specific interest groups • 3 information stands were manned in the Shoreham area • 503 individual responses were received to the proposals – 73% were paper or online responses, 19% were in the form of letters or emails, and 8% were notes from meetings or telephone calls • 91% of the responses came from individuals • 27% of the responses came from Shoreham; 40% came from Worthing; 4% came from Chichester; the remainder came from other areas or the area was not stated 2.2 What did people think about the way we conducted the consultation? The feedback Some people felt that we should have held the public meetings at different times, provided more publicity and made materials more widely available in different formats. Our response– We held 7 public meetings in total and, in response to concerns expressed about the scheduling of these meetings, we offered to meet separately with any specific groups of people at a time and venue of their choosing - four groups took up this offer. The consultation was publicised multiple times on local radio and televisions, in local newspapers, in the hospitals and on our websites. However, we accept the point that some people made that we need to keep pace with modern methods of communication and are planning to set up a Western Sussex Hospitals Trust Facebook page in the near future. NHS West Sussex established its Facebook page some time ago and updates about the meetings were added to the page during the consultation period. We made it clear that the consultation document was available in different formats on request. We provided the document in large font, Braille and in an audio version in response to the only requests that were made for different formats. Key stakeholders such as LINk acknowledged the amount of work that had been put into the consultation process and thought that the public meetings 2 Item 5 - Appendix B WSHT & NHSWS response.doc Agenda Item No. 5 Appendix B had been well structured and facilitated. 3 What did the feedback say overall? The aim of our consultation was to be inclusive – to gain as wide a range of views as possible - and we were pleased to receive feedback from a large span of organisations and individuals. Three key organisations in West Sussex – the Health Overview and Scrutiny Committee (HOSC), the Local Involvement Network (LINk), and the Patient and Public Council (PPC) – expressed broad support for the proposals although all asked for further reassurance around the shift of care from the acute to the community setting. We have summarised below the major themes of feedback that we received overall as - • The need for us to provide more clarity and detail around the reduction in the number of hospital beds, and about the plans for the community care that will reduce admissions to hospital and will reduce the overall length of stay in hospital beds • The public need for assurance that we are taking account of the growth in the local elderly population and their needs for the future • The problems that people with special needs – including people with visual impairment – will have in getting to Southlands for Eye Clinic appointments • Car parking at both Worthing and Southlands • The concerns that people have about the future of the Harness Block at Southlands Hospital These key messages were made clear in the feedback from both individuals and from local organisations. We have considered each of these themes carefully and our response is detailed in the following sections. 3.1 Our plans for hospital beds and alternative community care The feedback By far the largest concern that people raised during the consultation was a lack of confidence in our plans to reduce the number of hospital beds in the area and to replace them with services that support people in their own homes. Our response Our plans are founded in the expert knowledge of our clinicians – our GPs and hospital and community doctors – who believe that people should spend only the time they need to in hospital. Over the last few years we have admitted more and more people to hospital and many stay in longer than they need to. Doctors agree that this is not the best way to help people stay healthy and independent for as long as they can. We need to ensure that people receive the right level of care, at the right time, in the right place and for the right length of time and the SRfQ programme will make sure that there are credible alternatives in place to help us achieve this. 3 Item 5 - Appendix B WSHT & NHSWS response.doc Agenda Item No. 5 Appendix B What do our proposed bed reductions mean in terms of acute hospital capacity? Our plans to reduce the number of admissions and the length of hospital stay will affect our entire range of beds - apart from those ring-fenced for maternity and children’s services. The 60 beds that we are proposing to take out will come from all of the medical and surgical specialties and not just from Elderly Care. The 60 beds represent 12% of the total of Worthing & Southlands beds or 7% of all of the Trust beds at Worthing, Southlands and St.Richard’s. How are we going to reduce our need for hospital beds? The consultation about moving services between Worthing and Southlands hospitals has come at a time when, as a local health economy, we have been working together to improve services for the large group of patients who need attention for sudden (acute) medical conditions. Our plans focus on three areas – • Reducing the need for some people to be admitted to hospital • Improving the way that we treat people in hospital to make sure that they stay only as long as they need to • Making sure that there are good support services in the community so that people can go home from hospital as soon as they no longer need the day to day care of hospital doctors The following sections detail some examples of the work that we are doing. Reducing admissions Our medical teams have reviewed patients’ records over a period of time and have agreed that on average, around 260 patients a month are admitted to hospital when, with the right resources and expertise to hand in the community, they could be treated at home or in the care/nursing home where they live.