Argyll & Bute Community Health Partnership (CHP)

CHANGES TO CAMPBELTOWNHOSPITAL

PUBLIC EVENT 14 th MARCH 2103

COMMUNITY FEEDBACK

REPORT

Final Version 17th April 2013

Background

Argyll and Bute Community Health Partnership (A&B CHP) has been developing services in for a number of years now, in line with national policy. The NHS must provide services that will meet the needs of local people but also in a way that services can adapt to changes in how best to provide the most appropriate care. More people than ever before are receiving the care they require at home or in the community and as such there have been changes within .

The review and redesign of services provided at Campbeltown Hospital are based on principle objectives to ensure that services are sustainable, meet local health needs and also meet NHS ’s characteristics of service delivery for the next five years. The main objectives are :

• Promoting good health, self care and independence • High quality, integrated, equitable, needs and evidence based and cost effective service • Increasingly community based with hospital beds preserved for the most acutely ill and those with special needs • Integrated with, and complementary to, the local authority, voluntary and independent care sector • Run by healthy, flexible, well motivated and well trained staff working to their maximum potential and capacity • Using modern, flexible, efficient and green assets to maximum effect • Zero wastage and inefficiency across all services with no unnecessary overheads

Community Engagement

In response to a request from the local community and in an attempt to appease anxieties about the proposed changes, an information event was held on 14 th March 2013 in the Town Hall, Campbeltown, 2pm – 8pm. The event provided an opportunity for local people and staff to find out about the proposed changes in Campbeltown Hospital and better understand why these changes are necessary. A total of 59 people attended the event.

Community Feedback – “Your Views”

Members of the public and staff who attended the event were handed a copy of the Feedback Form (Appendix 1) and encouraged to either complete it on the day or return to the Freepost address supplied. In addition, people were invited to complete the feedback form online.

A dedicated email address was used for anyone wishing to share their views, concerns or provide general comments.

Community Feedback Results

The evaluation of the feedback and general comments received has provided both a quantitative and qualitative feedback.

A total of 19 forms were returned by the deadline, Friday 29 th March 2013.

The following provides a brief summary of the quantitative feedback, referring to Questions 1 and 2.

1. Before this event, were you aware of changes proposed within Campbeltown Hospital?

No of Responses % Yes, a little 3 17% Yes, considerably 13 72% No, not at all 2 11% n= 18 100%

1 respondee declined to answer this question therefore control total will not match the actual number of feedback forms received (19).

If so, where did you learn about this?

No of Responses % Through the media 12 60% Through the Public Partnership Forum 4 20% Other 4 20% n= 20 100%

Some respondees ticked more than one box while two declined to answer this question therefore the control total will not match the actual number of feedback forms received (19). Of the 4 respondees who ticked “other”, one had heard through work, one was a hospital employee, one had heard “people speaking about it” and one knew “as the wife of a patient who had regular need of the hospital”.

2. Do you feel informed about the range of health and social care services available in Kintyre?

No of Responses % Yes, a little 10 56% Yes, considerably 7 39% No, not at all 1 5% n= 18 100%

1 respondee declined to answer this question therefore control total will not match the actual number of feedback forms received (19).

In terms of qualitative analysis, respondees were asked some general questions as follows :

3. Please tell us how you feel about the proposed changes in the way services are provided in Kintyre.

• There has been no talks about another ward closure of Campbeltown Hospital. The hospital is at the heart of peoples welfare. While its ok to have back-up you must have fully trained assessment staff i.e. – doctors, nurses, an x ray dept 24 / 7. I understand if I have a broken limb on a Sat I would need to go to a trip of 100 miles. This is a case for a National Newspaper to take up the concerning problem facing what I would hope is a growing town. If this is SNP policy god help us. • Community Care is a good model if the correct resources are placed in the community to carry it out effectively and responsibly and without neglect to elderly and vulnerable people. What the NHS does not seem to appreciate is that if done properly, community care can be more expensive than hospital care (where most of the resources are in one place). In a rural area there needs to be extra resources freed up to community care due to recruitment, travelling and distance covered. There have been problems with recruitment of adequate staffing levels in an isolated community. There are concerns that in these times surreptitious savings will be made in the transfer of care from hospital to community. That bed usage may have been artificially manipulated to demonstrate a lesser need. That community care statistics will not demonstrate adequately the shortfalls that need addressing. That much credence has been given to historic bed usage but no credence has been given to future bed usage with the predicted increase in the elderly population and increases in attendance at A&E departments by the elderly. • Feel quite worried about old people who may be separated from family if they are not able to be at home and will be sent away from Campbeltown due to closures in hospital etc. • I do not agree with cutting back 11 beds, not asking patients you can make up as many graphs and figures as you want. But if beds are not there when needed or staff, then its to late by then? I cannot protest any more strongly. I am totally against these cuts in beds and being under NHS Highland is to far away! Our consultants come mainly from Glasgow whom we should be under. • Do not like bed modelling. • I feel very unhappy about it all. • I am concerned that a reduction of beds means a reduction in patient numbers which may risk the reduction of kitchen staff and introduction of frozen meals. • I am concerned about the cut in hospital beds considering how far away we are from Glasgow. Also how this is going to impact on people with Dementia and their carers / family in the future as well as the here and now. • I think a lot of people will benefit from 11 regardless of age. • Feel very strongly about all this especially where we are so far away from other hospitals and are isolated. We need to keep our local hospital open for the communities. • Worried about lack of provision for emergency care. Concerned that patients will have to travel to Oban or Glasgow more often. • A little worried about the number of beds available in the hospital. • Ok. • Not sure care in the community is actually working well at this point, a bit hasty to be cutting beds in local hospital.

4. What do you like about these proposed changes and why?

• Community care, if resourced properly, can prevent institutionalisation, can increase independence by keeping people in their own familiar environment and can reduce chances of hospital infections. • The changes benefit people who always wished to stay at home and not be hospitalised. • Efficiency. • Integrated care with all professionals seems very efficient. • Increased care in the community possible. • Can’t make my mind up about it all. • That if people want to stay at home to be looked after for the rest of their life. • I’ll see how it goes at the minute I’m not sure that I do like the proposed • changes but am prepared to give it a fair chance. • I don’t like them. • None. • Not a lot. • Nothing. Care at home is not professional care all the time with access to doctors. Local doctors don’t do any call outs, therefore delay in seeing a doctor when in a crisis time is essential. A carer or nurse isn’t a doctor.

5. Do you have any concern or comments that you would like to make regarding the future of services in Kintyre?

• Yes beside bed modelling I do not know if enough carers for community. • I was disgusted with some of the answers I got at the meeting, such as head of the carers told me there was 5 nursing homes in C/town and there is two and she didn’t know that. • There seems to be an opinion that the care packages are not easy to set up and that the time allocated is not sufficient. • At home. • Very concerned that out of hours x-ray provision could be cut. Support with social care being provided at home is the best option and what most of us would aspire to but only if it is suitable and in quite a few cases it is not. This area has a woeful shortage of carers. • If they want to live with them they can take the methadone programme to their own area. We are fed up with this being pushed down our gullets. A vote in Campbeltown would not be passed. • Give what is best for the patient and if they need special care hospital is best place for them. • None • Depending on what the needs are : high needs = hospital / low needs at home. • I believe there are a number of people in the community that the system has failed. • In Bengullion Ward : provided by nurses and doctors not well meaning carers trained on courses. Concerns listed in Q4 : all this about services is to save money and to hang with the patients and will lead to poorer services in our area : what happens when carers and nurses are gone for the day and something happens? In a ward regular checks and help is there all night. It’s called the National Health Services for patients. I think these cuts are a disgrace. • It will not be funded adequately. In a remote community it will be difficult to recruit adequate staff of the right calibre. That real problems are not identified publicly and are swept under the carpet so that they are not addressed. That in these austere times inappropriate savings will be made resulting in community neglect. That people will have to travel large distances to see their relatives if transferred to other hospitals. That there are delays back from other hospitals because there is a lack of beds at Campbeltown Hospital. That there is a lack of coordination with ambulance services and transfers are delayed or postponed. That there are not enough specialists to provide adequate cover in a remote area e.g. physiotherapists, stoma care etc. That terms and conditions of employment do not allow for consistencies in staffing and that people may be visited by different carers (not conducive to continuity of care). That the care is rushed because of pressure on time. There is not a delivery service for prescriptions, incapacitated people have to rely on family, neighbours or friends. That bureaucratic hurdles are put in the way of quickly designing appropriate and responsible care plans.

Please indicate if your interest is as :

No of Responses % A service user 4 17% A member of public 10 42% NHS Highland staff 3 12% A member of Community Council 5 21% A&B Council staff 1 4% Other 1 4% n = 24 100%

Some respondees ticked more than one box therefore the total will not match the number of responses received (19). Having ticked “other”, 1 respondee stated they were a member of ACUMEN.

Summary

A total of 19 responses were completed and returned.

The majority of feedback received suggests that the direction service provision is moving in is not supported by the wider community. With the perceived level of disapproval through media, local Community Council and political interest, it is disappointing that more people didn’t attend the event on 14 th March (59) and that so few feedback forms were returned (19).

There is fear that the proposed loss of beds in Campbeltown Hospital will result on patients having to go to either Oban or Glasgow to receive care, more so than before, separating them from family, carers and friends which is important to people.

Some respondees suggest that community care is a good model but that this will not be adequately resourced to meet local demand and with fewer beds in the hospital patients will not receive the care they require.

Some people are suspicious that the proposed reduction in beds is to save money rather than following national guidance on how care should focus less on hospitalisation but more on keeping people at home.

There are concerns that the proposed model will fail to be adequately resourced, recruitment to the area will be a problem compromising patient care.

To balance this view, some respondees were positive about the proposed changes, suggesting that they will result in less institutionalisation and promote independence. Integration is a good idea resulting in a more cohesive, efficient service for patients.

In an attempt to summarise the key points, these are listed below.

Key Issues / Concerns / Comments 1 Reduction of beds at Campbeltown Hospital is not widely supported 2 Community care is a good model if correctly resourced – additional resources required, expensive model 3 Adequate beds available for those who need it, including patients awaiting transfer back from Oban or Glasgow hospitals 4 Patients being separated from family, carers and friends 5 Insufficient carers available to support the proposed model 6 Recruitment and retention of appropriately trained / skilled care staff

The results of the feedback received will be reported to the Kintyre Redesign Group and Mid Argyll, Kintyre and Islay Local Management Group with the recommendation that there is a need to carry out further work with the communities and staff.

The feedback received is very important and of great value. Many thanks to all those who returned their completed forms.

Caroline Cecil Planning and Public Involvement Manager Argyll & Bute CHP

17th April 2013

APPENDIX 1

Highland Quality Approach Update to Changes at Campbeltown Hospital Public Event 14 th March 2013

FEEDBACK FORM

Argyll and Bute Community Health Partnership (CHP) has been developing services in Kintyre for a number of years now, in line with national policy. The NHS must provide services that will meet the needs of local people but also in a way that services can adapt to changes in how best to provide the most appropriate care. More people than ever before are receiving the care they require at home or in the community and as such there have been changes within Campbeltown Hospital.

GIVE US YOUR VIEWS!

The CHP wants your views on the best way to provide services in Kintyre in the future. To do this you can :

Complete the feedback form and post it to us FREEPOST to the address at the end of this form

Complete the feedback form online at http://bit.ly/ZFw9L2

Email your completed form or share your views or comments to [email protected]

Forms must be returned by Friday 29 th March 2013

Q1. Before this event, were you aware of changes proposed within Campbeltown Hospital?

Yes – a little Yes – considerably No, not at all

If so, where did you learn this from?

Through the media Other ______Through the Public Partnership Forum

Q2. Do you feel informed about the range of health and social care services available in Kintyre?

Yes – a little Yes – considerably No, not at all

Q3. Please tell us how you feel about the proposed changes in the way services are provided in Kintyre.

Q4. What do you like about these proposed changes and why?

Q5. Do you have any concerns or comments that you would like to make regarding the future of services provided in Kintyre? For example, for people who need support with social care, in your opinion where is this best provided?

Please indicate if your interest is as (tick one box):

A service user A member of a Community Council A member of the public Argyll & Bute Council staff NHS Highland staff Other (please state) .…………………………

Please post to : Caroline Cecil Planning & Public Involvement Manager FREEPOST RRYT-TKEE-RHBZ NHS Highland (Argyll and Bute CHP) Blarbuie Road, , Argyll, PA31 8LD

Feedback forms returned by post must arrive no later than Friday 29 th March 2013

MANY THANKS INDEED FOR TAKING THE TIME TO COMPLETE THIS FORM