Improving Health Services in Kirkham and Wesham and the Surrounding Areas Public Engagement on Proposals to Move Local Health Services Into a New Facility

Improving health services in Kirkham and Wesham and the surrounding areas Public engagement on proposals to move local health services into a new facility

For NHS Fylde and Wyre Clinical Commissioning Group

October 2017

1 Contents

1. Executive summary ...... 3 2. Background and objectives...... 8 3. Promotion of the engagement exercise ...... 10 4. Process and methodology ...... 11 5. Key findings ...... 14 5.1 Survey sample profile...... 14 5.2 Views on developing a new facility for the Kirkham and Wesham area ...... 17 5.3 Views on bringing services together at one site ...... 19 5.4 Perceived benefits of proposed changes ...... 20 5.5 Issues for further consideration...... 21 5.6 Service priorities...... 23 5.7 Other comments ...... 25 5.8 You said, we listened ...... 27 6. Engagement by others ...... 28 7. Conclusions...... 28 8. Next steps...... 28 9. Appendices ...... 29 9.1 Engagement booklet and survey...... 29 9.2 Media coverage...... 45 9.3 Advertising/promotion...... 47 9.4 Stakeholders written to...... 51 9.5 Kirkham Town Council public meeting and survey...... 53

Project number: HEALT04-7901 Title: Kirkham and Wesham Engagement S:\ProjectFiles\F\Fylde_Wyre_CCG\HEALT04- Location: 7901_Engagement_Kirkham_Wesham\Reports\7901_Engagement_K irkham_Wesham_report_structure_v1.doc Date: October 2017 Report status: Final Approved by: Julie Wrigley Authors: Kay Silversides

Comments: [email protected] This research has been carried out in compliance with the International standard ISO 20252, (the International Standard for Market and Social research), The Market Research Society’s Code of Conduct and UK Data Protection law

2 1. Executive summary

Introduction

The proposal

NHS Fylde and Wyre Clinical Commissioning Group (CCG) has worked closely with Kirkham Health Centre and Ash Tree House Surgery, as well as Blackpool Teaching Hospitals which runs Kirkham Clinic, to come up with proposals for a new health facility for local people.

The proposal would see part of the NHS offices at the former Wesham Park Hospital site in Derby Road demolished to make way for a new primary care centre that would house the two individual GP practices and services currently run at Kirkham Clinic. This state-of-the-art building could also host a pharmacy and other community services as part of the CCG’s plans to bring more services into community settings.

As well as providing a modern space for people in the area to see their family doctor, the proposed facility would also help the local NHS in its development of new ways of working by housing services that bring together health and social care services under one roof. While work was ongoing, care would continue to be provided as normal at the existing GP practices and clinic.

The need for change

With growing populations across the area and improved regulations to ensure public buildings are safe and accessible for everyone, there is a need for change. The facilities currently on offer to patients in Kirkham and Wesham have been of the required standard for the local population in years gone by. But to continue providing services on these current sites would require major investment to make improvements to the buildings. They also offer no room for expansion for additional services to provide better care in a community setting.

Over the next five years the number of patients registered with the practices is set to grow by up to 6,000 due to the large number of housing developments in the area. The current premises do not allow for this increase.

The CCG believes investment would be better spent on developing a purpose-built modern facility to provide services fit for future generations of local residents.

The bigger picture

In 2014, NHS Fylde and Wyre Clinical Commissioning Group, which buys and organises healthcare services in the area, published its 2030 Vision for Health and Care in Fylde and Wyre.

This was the result of conversations with thousands of local people and organisations. It describes a shared vision for what healthcare will look like by 2030 and includes:

 More support to help people keep mentally and physically well;  More support to help people manage their conditions at home;  More community and home-based care;  Care in hospital for services which can only be carried out safely there.

Since 2014, the CCG, GP practices and other partners have made significant progress in developing ‘new models of care’ to improve community-based services. These new services require working in a much more coordinated way with partners such as councils, the voluntary sector and a range of healthcare providers.

3 The proposed new development at the former Wesham Park Hospital site would provide the community with purpose-built space for some of these new services where staff from different organisations could work together. This would address one of the main issues patients have told us they face – that services need to be more joined-up.

Public engagement

Before taking the proposal any further, the views of local people living in the area were sought to make sure any development met the needs and aspirations of the community. If public opinion was mostly against the proposals, the project would not be taken any further. However, if the project was to be progressed, the general opinions expressed during the engagement exercise would be needed for the planning application.

Full details of the proposal were outlined in a printed booklet and also published online at www.fyldeandwyreccg.nhs.uk/derbyroad. Details on how the proposals were publicised are included within the full engagement report.

Engagement response

 1,191 surveys were analysed, 891 online and 300 by post;  116 surveys from an additional question asked at three public events organised by the CCG;  Four public meetings were held, three organised by the CCG and one by Kirkham Town Council, as well as briefings for local councillors. 379 people attended in total;  Two letters and one email from the public were received;  Two emails from statutory bodies;  Reach of more than 170,000 on social media;  Other engagement activity took place – please see the full report for further detail on this.

Data was received by the CCG and passed in anonymised format to Qa Research for collation, processing and independent analysis prior to the production of this report.

Key findings

Survey sample

In total, 1,191 responses were received to the online and paper version of the engagement survey. The majority (98%) of respondents reported they were responding as an individual, and 2% were responding on behalf of an organisation or group.

Views on developing a new facility for the Kirkham and Wesham area

The engagement survey asked, ‘how do you feel about developing a new state-of-the-art healthcare facility for the Kirkham and Wesham area?’

Overall, 89% of respondents stated that they were happy/very happy with the proposal, 6% were neither unhappy nor happy, and 4% were unhappy/very unhappy.

Respondents living in Medlar-with-Wesham ward were significantly more likely to be happy with the proposals (97%) compared with 87% in Kirkham North and 80% in Kirkham South.

Generally, the proposals were well received in the public meetings. However, some issues were raised including concerns over whether the Derby Road site was the best one given its

4 location on a road some felt was already busy. Also, some participants queried whether there would be parking charges at the new facility and expressed dissatisfaction if this proved to be the case.

Suggestions for other locations were raised in the public meetings along with responses/rationale from the CCG on their suitability (or lack of), for example, the Wesham Rehabilitation Unit in Mowbreck Lane was mentioned frequently. People were keen to see old/unused NHS buildings being put to positive use.

Views on bringing services together at one site

The engagement survey asked, ‘how do you feel about bringing a range of health and care services together at one site?’

The majority (91%) of respondents were very happy/happy with this proposal, 6% were neither unhappy nor happy, and 3% were very unhappy/unhappy.

Again, those living in Medlar-with-Wesham were significantly more likely to be happy with this proposal (97%) compared with those resident in Kirkham North (89%) and Kirkham South (84%).

Within the public meetings, the question was raised as to whether a satellite surgery will be made available in Kirkham, and concerns were also voiced on the potential for the loss of pharmacy services in Kirkham, and the loss of street footfall more generally in an area which was perceived by some to have already lost a number of services and shops from its central thoroughfare.

From the email/letter responses, questions were raised in relation to the identification of other options. For example, the option of keeping things as they are and adding a local GP centre for Wesham, or taking a partnership approach to redevelopment including other local buildings and services.

Perceived benefits of proposed changes

The engagement survey asked, ‘thinking about you and your family, please name up to three things that you think will be better as a result of these proposed changes.’

The perceived benefits mentioned most frequently included:

 Less congestion due to more parking;  More centralised or combined services;  Improved purpose built and modern facilities;  Access to a better range of services.

Issues for further consideration

The engagement survey asked, ‘thinking about this proposal, are there any issues that will affect you and your family that we need to consider when further developing our plans?’

Nearly half of the responses (46%) indicated that people could not identify any specific issues or concerns. However, the issues mentioned most frequently included concerns about travel to and from the facility (particularly bus travel), and concerns that the proposed location of the facility might lead to increased distances meaning that, for some, the journey could no longer be made on foot.

Respondents felt that the travel implications could have the most significant impact for older people and those with disabilities, e.g. longer journeys by public transport or difficulties parking, and families

5 with children, again the main reason being longer public transport journeys with babies and children in prams and pushchairs.

The key issues raised within the public meetings related to concerns about the potential for increased travel to access the new facility. Several questions were raised around the adequacy of current bus services, e.g. frequency of services, number of changes required, and potential difficulties for parents travelling to access weighing services as buses had a limit on the number of prams that could be accommodated.

Other participants commented that Derby Road itself was very narrow and could get very congested, and as such were keen that the proposals took these issues into account in the design of the site, access points, and location of the bus stop.

Suggestions included:

 NHS shuttle bus service (particularly for older people/those with limited mobility).

 Renovation of the existing footway from the site to Kirkham, via the far end of Derby Road, would improve the journey for people travelling from Kirkham, and this could also be used as a cycleway.

Service priorities

The engagement survey asked, ‘thinking about health services you and your family travel outside of Kirkham and Wesham to access, please name up to three services you would like to see in the proposed new health facility.’

The three services mentioned most frequently were x-ray/scanning, dental services, and physiotherapy/rehabilitation services. A walk-in or drop-in centre, pharmacy, and eye clinic were also popular choices.

Other general suggestions raised within the public meetings on what could be provided within the centre included a ‘health hub’ with a fitness centre, or an older people’s day centre.

Conclusions

Overall, the response to the proposals is positive with a new facility being welcomed by most residents and stakeholders. Clearly, residents and stakeholders in Kirkham are more likely to have concerns about the proposals as there is the potential, as the CCG acknowledges, for increased travelling distances for some. Travel is one of the key concerns highlighted, and residents appear keen for reassurance on the provision of bus services and positioning of bus stops near to the facility. The provision of NHS shuttle buses was mentioned fairly frequently, and another suggestion made related to the refurbishment of the walkway between Kirkham and the proposed new facility.

Concerns were expressed about the potential for impact on Kirkham overall, in terms of street footfall and particularly the impact on local pharmacies. There were a number of suggestions/questions regarding the provision of a satellite surgery in Kirkham.

Generally, the response to the proposed location was positive. A number of alternative locations were mentioned, particularly Wesham Rehabilitation Unit and there is a sense that people are keen to see disused buildings being put to positive use particularly if they are/were NHS owned. The main concern in relation to the proposed location is that some people feel Derby Road is already busy and it would be necessary for the CCG to work closely with partners to ensure that roads, access, and parking is sufficient.

6 In terms of the services that people would like to see available in the new facility, x-ray/scanning facilities, dental services, physiotherapy and rehabilitation, a drop-in/walk-in service, and onsite pharmacy appear to be the priorities.

Next steps

Feedback from the engagement exercise will be used to help the CCG and the wider NHS determine whether to proceed with the proposals and, if they are progressed, help shape them to meet the needs and desires of the local population.

The CCG’s Primary Care Commissioning Committee will make a decision on whether the GP practices in Kirkham are allowed to relocate.

The CCG Governing Body will ratify the Primary Care Commissioning Committee’s decision and also decide whether or not to officially sponsor the practices in requesting permission from NHS England and NHS Property Services (which owns the Derby Road building) to develop the new health centre in Derby Road. This decision will be taken using the information provided in this report.

Following this, the future of the development will lie in the hands of the NHS England and NHS Property Services and will be subject to local authority planning permission being granted.

7 2. Background and objectives

The proposal

This state-of-the-art building could also host a pharmacy and other community services as part of the CCG’s plans to bring more services into community settings.

The proposed new facility could provide:

 Healthcare provision on one site in the local community;  Access to a broader range of community-based health services;  Space for different health and care teams to be located together to make sure services are more joined up;  A patient-friendly accessible environment;  Parking for 140 cars – almost double the current provision across the three sites;  A holistic approach to healthcare that focuses not just on people’s physical health but also how mental and social factors affect them;  Modern health facilities fit for the 21st-century;  Opportunities for mobile screening units on site.

While work was ongoing, care would continue to be provided as normal at the existing GP practices and clinic.

For the purposes of this exercise, ‘Kirkham and Wesham’ is used to describe a wide geographical area covering a number of rural villages where people who are registered with the Kirkham GP practices live. These include Clifton, Newton-with-Scales, Freckleton, Wrea Green, Warton, Weeton, Singleton, Treales, Wharles, Lea Town, Great Plumpton, Esprick, Elswick and Great Eccleston.

The need for change

With growing populations across the area and improved regulations to ensure public buildings are safe and accessible for everyone, there is a need for change.

Kirkham Clinic in Moor Street was built in the 1960s and housed Kirkham Health Centre when it first opened in 1969. In 1991, Kirkham Health Centre moved to its current location, a former home for orphaned and neglected children built in the 1860s adjacent to the clinic.

Ash Tree House was formerly a private home and dates back to 1765. It became the home of Ash Tree House Surgery in 1985.

8 The facilities currently on offer to patients in Kirkham and Wesham have been of the required standard for the local population in years gone by. But to continue providing services on these current sites would require major investment to make improvements to the buildings. They also offer no room for expansion for additional services to provide better care in a community setting.

The CCG believes investment would be better spent on developing a purpose-built modern facility to provide services fit for future generations of local residents.

The bigger picture

In 2014, NHS Fylde and Wyre Clinical Commissioning Group, which buys and organises healthcare services in the area, published its 2030 Vision for Health and Care in Fylde and Wyre.

This was the result of conversations with thousands of local people and organisations. It describes a shared vision for what healthcare will look like by 2030 and includes:

The proposed new development at the former Wesham Park Hospital site would provide the community with purpose-built space for some of these new services where staff from different organisations could work together. This would address one of the main issues patients have told us they face – that services need to be more joined-up.

Public engagement

Before taking the proposal any further, the views of local people living in the area were sought to make sure any development met the needs and aspirations of the community.

If public opinion was mostly against the proposals, the project would not be taken any further. However, if the project was to be progressed, the general opinions expressed during the engagement exercise would be needed for the planning application.

Full details of the proposal were outlined in a printed booklet and also published online at www.fyldeandwyreccg.nhs.uk/derbyroad

An initial equality impact and risk assessment was also carried out to identify any groups or areas that could be negatively affected by these proposals. This enabled the CCG to meet the needs of the population across the whole area both with the proposal and its impact and throughout the engagement exercise to ensure anyone who wanted to contribute their views could do so. Based on the information gathered during the engagement exercise the equality impact assessment will be reviewed.

9 3. Promotion of the engagement exercise

Prior to launching the engagement exercise, the CCG was in contact with Healthwatch Lancashire, Lancashire County Council’s Health Overview Scrutiny Committee, Fylde Council’s democratic services team and the Ash Tree House Surgery Patient Participation Group (PPG) for initial thoughts on the proposed engagement process and the draft engagement booklet to make sure it was written in a way that was easy to understand for all members of the local community.

The CCG also sought legal advice to ensure the planned activity would meet its statutory responsibilities.

A large-scale promotion of the public engagement exercise was undertaken from 26 June 2017 to 15 September 2017. This included:

 Printing 4,000 information booklets which included a freepost survey for people to fill in and return to give their views. These were distributed widely in the local area. The survey was replicated online and a web page created at http://www.fyldeandwyreccg.nhs.uk/derbyroad/ for people to complete. o There were almost 4,000 unique visitors to the webpage during the exercise.

 Information boards were put up in the practices and Kirkham Clinic, as well as in Kirkham Morrisons and Kirkham Library, with copies of the booklet for people to pick up to help spread the message. Booklets were also placed in shops in rural locations across the area. These included Clifton, Newton-with-Scales, Treales, Freckleton, Wrea Green, Wesham and Weeton. They were also made available in areas to target ehthnic minority groups, such as the Sverida shop (which sells a variety of goods from eastern Europe) in Wesham and at Weeton Barracks for civilians living on the site. o It was felt that including community venues such as the library and in particular Morrisons was important as these act as a community hub linking all the rural communities and are accessed by many of those registered at the Kirkham GP practices.

An equality impact and risk assessment was carried out and this identified that an area of Freckleton, known as the Lower Lane Estate, had high levels of deprivation and that residents in this area could feel more of an impact than other parts of the Kirkham and Wesham area. A specific event was held on the estate, which was widely publicised, as well as a dedicated door drop with booklets posted through the front door of most houses to make sure people living on the estate had an opportunity to respond to the engagement exercise. The engagement events and survey were also promoted in the housing association newsletter and on its website.

 Public meetings were organised in Kirkham, Wesham, and at Lower Lane Community Centre. Kirkham Town Council also organised its own public meeting at which the CCG gave a presentation. A separate meeting to brief district and county councillors took place at the CCG. o 379 people attended the meetings in total.

 The CCG invited a range of local groups and organisations to contact them should they want officers to attend a meeting. The CCG presented to the executive steering group of Lancashire County Council’s health scrutiny committee, Wesham Town Council and the Fylde and Wyre Health and Wellbeing Partnership. The CCG also went to meet with pharmacists working in Kirkham and Wesham.

10  There was significant social media activity on Facebook and Twitter. The initial posts had a reach of more than 15,000 in the first week alone and, by the conclusion of the engagement activity, social media reach had surpassed 170,000.

 A news release was written and distributed to local media. Press coverage was universally positive, with Fylde MP Mark Menzies quoted in stories in The Blackpool Gazette and Lytham St Annes Express supporting the move. The story was also featured on BBC Radio Lancashire’s drive time programme and local TV station That’s Lancashire.

 The CCG took out a half-page advert on the front page of the Kirkham and Wesham Advertiser, a freesheet newspaper delivered to 9,000 homes throughout the area.

 A text message was sent by the practices to all patients for whom they had mobile numbers. This reached more than 10,000 people across the two practices. This was repeated towards the end of the exercise in an effort to encourage more people to take part while there was still an opportunity to comment. o The first text message read: ‘We want to hear your views on our proposal to relocate to a brand new purpose-built health facility in Derby Road, Wesham. We believe this is the best option that will enable us, along with our neighbouring practice Ash Tree House/Kirkham Health Centre and Kirkham Clinic, to provide healthcare in a facility fit for the 21st century with opportunities to expand the range of services on offer to local people. Please visit www.fyldeandwyreccg.nhs.uk/derbyroad to read the details in full and to complete an online survey.’ o The second message read: ‘There is still time for you to have your say on our proposal to relocate to a brand new purpose built health centre in Derby Road, Wesham. Read all about this exciting proposed development and complete our survey by visiting www.fyldeandwyreccg.nhs.uk. The survey closes on Friday 15 September.’

 A letter was emailed to a wide range of professional stakeholders, including district and county councillors, school headteachers, parish and town councils, community groups and groups representing those with ‘protected characteristics’ informing them of the proposal and asking them to share the message with their contacts.

 Internally, practice and clinic staff were kept informed by their line managers, who were in turn briefed by the CCG’s head of estates. Tenants of the NHS Wesham Offices were kept up to date through regular meetings with the head of estates while CCG staff received information through an internal staff bulletin and team briefings from the CCG’s clinical chief officer. 4. Process and methodology

4.1 Data sources

A range of engagement opportunities were open to public and patients over a twelve-week period.

Online and paper survey

Fylde and Wyre CCG designed an engagement survey and accompanying booklet explaining the proposals. These were made available online at http://www.fyldeandwyreccg.nhs.uk/derbyroad/. In addition, 4,000 paper versions of the documents were distributed widely to shops, supermarkets, and libraries, in Kirkham, Wesham, Newton, Clifton, Treales, Freckleton, Wrea Green and Weeton.

11 The CCG also took out a front cover half page advert in the Kirkham and Wesham Advertiser which is delivered to 9,000 households.

Following the briefing for local councillors, an additional one question survey was made available at subsequent public meetings in response to concerns that the CCG’s survey questions did not make the proposed location of the new facility explicit, although the proposed location is explained in full within the accompanying booklet.

Public meetings

Three public meetings were hosted by NHS Fylde and Wyre CCG in the following locations:

 Public meeting – Lower Lane Community Centre, Freckleton – 17 July 2017;  Public meeting – St Michael’s Church, Kirkham – 20 July 2017;  Public meeting – Christ Church, Wesham – 20 July 2017.

A public meeting was also organised by Kirkham Town Council and took place at Kirkham Community Centre on 12 July 2017.

The CCG also hosted a special briefing for local councillors in advance of the public meetings. This took place at the CCG on 13 July 2017.

In addition, CCG officials attended a meeting with Wesham Town Council at Wesham Community Centre on 25 July 2017.

The CCG compiled detailed notes from all of these meetings which are available here: http://www.fyldeandwyreccg.nhs.uk/derbyroad/

Other meetings/engagement

 Lancashire Council Council Health Overview Scrutiny Committee executive steering group – Preston County Hall – 4 July 2017;  Fylde Council Environment Health and Housing Committee chair and vice-chair – Fylde Town Hall – 6 July 2017;  Lancashire Health and Wellbeing Board chair – CCG offices, Wesham – 10 July 2017;  Fylde and Wyre Health and Wellbeing Partnership – Wyre Civic Centre – 27 July 2017.

Social media

A range of comments were made via the CCG’s Facebook page and via other associated Facebook pages, including Kirkham Town Council. In total, 27 positive comments, and 13 negative comments were made.

Letters, emails from individuals

One email and two letters were received from individuals in response to the proposals.

Media coverage

The proposals were featured in a number of local newspapers including Lytham St Annes Express and Lancashire Post – copies of the articles are included in the Appendices. The proposals were also featured by That’s Lancashire at https://www.youtube.com/watch?v=DmiO55e_4dk

12 4.2 Data analysis and report structure

Data was received by the CCG and passed in anonymised format to Qa Research for collation, processing and independent analysis prior to the production of this report. This report is divided into broad sections which align with the questions from the engagement survey.

Each section starts by examining the survey responses. Responses are analysed quantitatively and illustrated by tables or charts. Please note that when interpreting results throughout this report not all percentages will equal 100% due to rounding (with any figures of 0.5 or higher being rounded up). Where respondents had the option of giving more than one response, the percentages may be higher than 100%. Where the figure is shown as 0% at least one respondent gave this answer but the total count makes up <0.5% of the overall total; a blank shows no-one has given this answer. Where NET figures are referred to this is where scale responses have been netted into one response to show overall levels of agreement and disagreement. Open ended verbatim questions (i.e. with no predefined responses) have been coded, with responses grouped together and shown as percentages. Sub-group analysis has been undertaken by examining differences in survey responses by ward.

Where sub-group analysis has been performed, findings and commentary on any statistically significant differences follow the initial survey findings commentary.

Other data sources (e.g. public events, emails/letters and social media) have been analysed thematically. Sections of the report describing the issues raised are clearly indicated by their presentation within a grey shaded box.

The appendices contain:

 The engagement booklet and survey;  Media coverage of the proposals;  Examples of promotion;  Details of all stakeholders the CCG wrote to;  Materials from engagement by others.

13 5. Key findings

5.1 Survey sample profile

In total, 1,191 responses were received to the online and paper version of the engagement survey. This is more than six per cent of the combined number of people registered with Kirkham Health Centre and Ash Tree House Surgery. The majority (98%) of respondents reported they were responding as an individual, and 2% were responding on behalf of an organisation or group. Due to this engagement exercise largely being undertaken via a self-completion survey the base size (that is the number of valid responses to each question) will vary as not all 1,191 respondents chose to answer every question; the base size can be found at the bottom of each chart/table. The following tables show the profile of respondents.

Table 1 Gender Gender Count Percentage Male 428 37% Female 720 63% Transgender 4 0% Base 1152 100%

Females account for a larger proportion of the patient population (51%) and males (49%)1, therefore females are slightly over represented (63%) and males underrepresented (37%) within the survey responses.

Table 2 Age Age range Count Percentage Under 16 3 0% 16-24 35 3% 25-34 97 8% 35-44 153 13% 45-64 457 39% 65-74 317 27% 75-84 102 9% 85+ 12 1% Base 1176 100%

In terms of the CCG population profile overall2:

 26% of the population is aged 65 or over;  24% are aged 24 or under;  50% are aged 25-64.

Therefore, in terms of the survey responses, the 25-64 age group is broadly represented, however under 24s are underrepresented, and the over 65s slightly over represented.

1 http://www.lancashire.gov.uk/lancashire-insight/area-profiles/clinical-commissioning-groups/nhs- fylde-and-wyre-ccg.aspx

2 Op. cit

14 However, the information was viewed on Facebook by 305 people between the ages of 13 and 24 and there was active engagement, in the form of comments, clicks, likes and replies to posts, with 20 people in this age range.

Table 3 Ethnicity

Ethnicity Count Percentage Asian or Asian British 9 1% Black or Black British 2 0% Mixed Black 4 0% White British 1096 96% White European 28 2% Other 6 1% Base 1145 100%

The survey responses are broadly representative of the wider CCG profile. Based on 2011 Census figures, it is estimated that around 4% of the population are from a BME (including white non-British) ethnicity3.

Table 4 Sexual orientation Sexual orientation Count Percentage Bisexual 7 1% Gay 15 1% Lesbian 4 0% Straight 1095 98% Base 1121 100%

Table 5 Disability Disability Count Percentage Yes 205 18% No 943 82% Base 1148 100%

The survey responses broadly reflect the profile of Fylde and Wyre, e.g. according to the 2011 Census 23% of the population has a limiting long-term illness or disability4.

3 http://www.lancashire.gov.uk/media/898217/fylde-wyre-ccg-mini-summary-profile-2017-18.pdf 4 https://www.england.nhs.uk/wp-content/uploads/2017/07/cfv-fylde-wyre-mhidp.pdf

15 Table 6 Responses by ward Ward Count Percentage Medlar-with-Wesham 287 24% Kirkham North 214 18% Kirkham South 128 11% Newton and Treales 130 11% Refused 140 12% Ribby-with-Wrea 80 7% Freckleton East 50 4% Warton and Westby 39 3% Freckleton West 18 2% Singleton and Greenhalgh 29 2% Under 10 responses 23 2% Part postcode 23 2% Lea 10 1% Staining And Weeton 17 1% Base 1188 100%

16 5.2 Views on developing a new facility for the Kirkham and Wesham area

The engagement survey asked, ‘how do you feel about developing a new state-of-the-art healthcare facility for the Kirkham and Wesham area?’

As illustrated below, 89% of respondents stated that they were happy/very happy with the proposal, 6% were neither unhappy nor happy, and 4% were unhappy/very unhappy.

Analysis of the comments made by people who stated they were happy with the proposals has shown that the majority of people understood the proposals and the location of the proposed facility. Most people who said they were happy or very happy were also happy with the location being at Derby Road, Wesham.

Figure 1

Q1. How do you feel about developing a new state-of-the- art healthcare facility for the Kirkham and Wesham area? 89%

4% 6%

Net - Unhappy Neither unhappy nor happy Net - Happy

Source: Qa Research 2017 Base: 1188 (all respondents)

Sub-group analysis

Respondents living in Medlar-with-Wesham ward were significantly more likely to be happy with the proposals (97%) compared with 87% in Kirkham North and 80% in Kirkham South.

Generally, the proposals were well received in the public meetings. However, some issues were raised including concerns over whether the Derby Road site was the best one given its location on an already busy road. Also, some participants queried whether there would be parking charges at the new facility and expressed dissatisfaction if this proved to be the case.

The social media response was also broadly positive with a new facility (with more parking) welcomed. For the small number of people who expressed concerns, the increased travelling distance/time was mentioned.

17 5.2.1 Additional survey question

Following the briefing for local councillors, a supplementary survey question was developed for circulation at public meetings. This additional question was developed in response to concerns that the CCG’s survey question, as outlined in section 5.2, did not make the proposed location of the new facility explicit, although the proposed location is explained in full within the accompanying booklet. As stated in section 5.2, analysis showed little evidence to suggest those who said they were happy had misunderstood the proposed location.

The question posed was ‘considering the need to change to meet the needs of future healthcare in this area, how do you feel about relocating the GP practices in Kirkham and services provided at Kirkham Clinic to a new purpose-built facility in Derby Road, Wesham?’

The table below shows the responses given. As illustrated, the majority of respondents (97%) in Wesham were very happy/happy with the proposals. In, Kirkham, 64% were very happy/happy, and 25% were very unhappy/unhappy.

Table 7 Considering the need to change to meet the needs of future healthcare in this area, how do you feel about relocating the GP practices in Kirkham and services provided at Kirkham Clinic to a new purpose-built facility in Derby Road, Wesham?’

Kirkham Wesham Count Percentage Count Percentage Net: Very happy/happy 34 64% 61 97% Neither happy nor unhappy 6 11% 2 3% Net: Very unhappy/unhappy 13 25% 0 0 53 100% 63 100%

18 5.3 Views on bringing services together at one site

The engagement survey asked, ‘how do you feel about bringing a range of health and care services together at one site?’

As shown below, the majority (91%) of respondents were very happy/happy with this proposal, 6% were neither unhappy nor happy, and 3% were very unhappy/unhappy.

Figure 2

Q2. How do you feel about bringing a range of health and care services together at one site? 91%

3% 6%

Net - Unhappy Neither unhappy nor happy Net - Happy

Source: Qa Research 2017 Base: 1188 (all respondents)

Sub-group analysis

Again, those living in Medlar-with-Wesham were significantly more likely to be happy with this proposal (97%) compared with those resident in Kirkham North (89%) and Kirkham South (84%).

19 5.4 Perceived benefits of proposed changes

The engagement survey asked, ‘thinking about you and your family, please name up to three things that you think will be better as a result of these proposed changes.’

The responses have been analysed and coded into different themes which are displayed in descending order of frequency in the table below.

Table 8

Q3. Thinking about you and your family, please name up to three things that you think will be better as a result of these proposed changes Percentage Less congestion due to more parking 45% More centralised or combined services 32% Improved purpose built and modern facilities 32% Access to a better range of available services 20% Faster care due to more available appointments 17% Reduced travel or expenses 14% Accessibility (not otherwise specified) 11% Longer opening times 6% Access for older people, people with disabilities, or children's prams 6% Access to a Walk-In centre 5% Access to a onsite pharmacy 4% No answer 4% Nothing positive 3% Better environment for staff and patients 2% Other 1% No relevant answer 0% Base: 1,188

As shown above, the three perceived benefits mentioned most frequently included: less congestion due to more parking, more centralised or combined services, and improved purpose built and modern facilities. The following examples illustrate the range of comments made:

“A range of services all under one roof as opposed to having to travel to different clinics to other health centres”

“A larger and modern space with parking facilities”

“Better access for disabled persons”

“Full access to a range of healthcare professionals”

“Ease of parking”

“More services so less trips to hospitals”

“Convenience”

20 The main benefits identified in the public meetings included improved access for wheelchair users, being able to access up-to-date modern facilities – which may also serve to attract qualified GPs and other skilled clinicians to the area. Participants responded positively to the idea that they would not have to travel to Lytham and Blackpool to access some services.

5.5 Issues for further consideration

The engagement survey asked, ‘thinking about this proposal, are there any issues that will affect you and your family that we need to consider when further developing our plans?'

The responses have been analysed and coded into different themes which are displayed in descending order of frequency in the table below.

Table 9

Q4. Thinking about this proposal, are there any issues that will affect you and your family that we need to consider when further developing our plans? Percentage Nothing 46% Concerned about transport to and from the facility (bus services) 11% Concerned about distance I have to travel (no longer walkable) 10% Concerned about the amount of parking available 5% Concerned about older people (increased travelling/lack of parking) 5% Concerned about traffic problems (congestion) 4% Concerned about appointment making and waiting times 3% Positive comment 3% Requested a specific service 3% Other 3% Do not know 3% No answer 3% Concerned about people with disabilities (increased journey time and parking problems) 2% Potentially a problem with easy access 2% Concerned about the local area and how business could be affected (pharmacies) 2% Concerned that the transfer process will affect my relationship with my current GP 2% Concerned about the quality and amount of staff and equipment available 2% Worried about the price of parking 1% Concerned about the amount of disabled parking available 1% Concerned about families/children (increased journey times/public transport/prams) 1% Facilities on site needed (cafe, nursery etc) 1% Concerned about specific medical problems (mental health) 1% Base: 1,185

As shown above, nearly half of the responses (46%) indicated that people could not identify any specific issues or concerns. However, the issues mentioned most frequently included concerns about travel to and from the facility (particularly bus travel), and concerns that the proposed location of the facility might lead to increased distances meaning that the journey could no longer be made on foot. Respondents felt that the travel implications could have the most significant impact for older people and those with disabilities, e.g. longer journeys by public transport or difficulties parking, and families with children, again the main reason being longer public transport journeys with babies and

21 children in prams and pushchairs. People with disabilities made positive comments about the potential for improved disabled access in the new facility but emphasised the need for sufficient, free disabled parking spaces. Some people with disabilities also had concerns about whether bus routes were adequate, or had concerns about the cost of public transport or found public transport difficult.

People aged 65+ were the group most likely to be concerned about bus services to and from the facility. In addition, respondents living in Medlar-with-Wesham ward were more likely than those in the Kirkham wards to express concerns about traffic problems and congestion. Slightly more respondents in the Kirkham wards were concerned about older people having to travel further and increased walking distances.

The following examples illustrate the range of comments made:

“Level of traffic around the area, already very busy”

“Public road layout - traffic lights needed at the junction of Derby Road and Station Road in Wesham”

“The centre needs to be accessible by public transport. It will not be walking distance for many in Kirkham who can currently walk to their surgery”

“I may have more difficulty getting to the clinic as the bus service from Weeton doesn’t go through Wesham”

“An extended bus route on to Derby Road for people with walking disabilities”

“I suffer panic attacks; also mental health problems. I have problems going on public transport”

Suggestions included:

NHS shuttle bus service (particularly for older people/those with limited mobility).

Renovation of the existing footway from the site to Kirkham, via the far end of Derby Road, would improve the journey for people travelling from Kirkham, and this could also be used as a cycleway.

22 5.6 Service priorities

The responses have been analysed and coded into different themes which are displayed in descending order of frequency in the table below.

Q5. Thinking about health services you and your family travel outside of Kirkham and Wesham to access, please name up to three services you would like to see in the proposed new health facility. Percentage X-ray or scan department 32% Dental care 21% Physiotherapy or rehabilitation department 19% A walk-in or drop-in centre 16% No answer 10% A pharmacy or chemist 9% An eye clinic 8% A minor surgery or injuries department 7% Chiropractor 7% Longer open hours or out of hours service 6% Mental health support 5% Diabetes support 5% Ear treatment 4% A blood clinic 4% Transportation or parking 4% Other 4% No more services needed 4% Counselling 3% Hearing tests 3% A paediatric care unit 3% A breast screening department 3% A sexual health clinic 2% Dermatology unit 2% More doctors 2% A specific cancer department 1% A cardiovascular unit 1% Do not know 0% Base 1,188

As illustrated above, the three services with the most mentions were x-ray/scanning, dental services, and physiotherapy/rehabilitation services.

The issue of a lack of dental services in the area was raised within the public meetings, with the suggestion that these services could be accommodated within the new facility. Other service specific suggestions included:

23 Audiology Minor surgery Diabetic retinopathy Screening X-rays Physiotherapy Breast screening

Other general suggestions on what could be provided within the centre included a ‘health hub’ with a fitness centre, or an older people’s day centre.

24 5.7 Other comments

The engagement survey asked respondents to provide any further comments on the proposals. The responses have been analysed and coded into different themes which are displayed in descending order of frequency in the table below.

Table 10 Q6. Any other comments Percentage General positive comment 25% No answer 17% Other 11% Concerned about transport to and from the facility 9% Facilities are in need of an expansion or modernisation 8% Long overdue - the sooner the better 6% Concerned local pharmacies could be affected 4% Disappointed the old site at Mowbreck Lane (Wesham Rehab Unit) is not being used 4% Problems with getting an appointment 3% Concerned about the amount of staff and equipment available 3% Moving out of Kirkham will have a negative effect on the local community 3% Concerned about the distance I have to travel 2% Problems with opening times (hope to be suited to those who work full time) 2% Concerned for older people accessing the new site 2% Would like to have multiple sites open (retain existing sites) 2% Concerned that space for parking will be an issue 2% Concerned the new larger site will feel impersonal 2% Waste of public money (not using existing buildings that have had a lot of investment) 2% Concerned the new site will not have the capacity for the growing local population 2% Important to provide all the facilities Lytham Health Centre offers 2% Ash Tree offer a great service and I hope this will continue 2% Concerned about waiting times 1% Concerned for those with a disability accessing the new site 1% Would like a walk-in centre 1% Would like access to a chemist or pharmacy at the new site 1% Concerned that the transfer process will affect keeping my current GP 1% Would like free parking at the new site 1% New facilities not needed when existing ones are adequate 1% Would like access to an area for X-rays or surgery at the new site 1% Would like more privacy when speaking to reception at the new site 1% Problem with the location of the new site 1% Survey seems biased or our opinion does not matter 1% Plans seem to be motivated by money 1% No relevant answer 1% Base 565

25 As shown in table 10, a quarter of responses were positive comments in support of the proposals. In terms of concerns or issues, transport was the most frequently cited. The following examples illustrate the range of comments made:

“It would be appreciated if local pharmacy businesses could have the opportunity to relocate with you”

“Hopefully a bright new state-of-the-art surgery”

“I am disappointed that the Wesham Rehabilitation Unit is not being used for this as it is a fairly new build, internally it was ideal in my opinion. It is being left to deteriorate and it would be criminal and an extreme waste of public/NHS funds if it were to be demolished for housing land”

“I can understand why it is felt Ash Tree House is now no longer able to serve its purpose but it would be very sad to lose the friendly, caring ethos of the practice in a new building. This happened to our practice in Lytham and it became very impersonal and uncaring”

“Ample car parking will be essential to the facility in this location. Please don't treat this requirement lightly”

“Fantastic plans, the area is in desperate need of newer, modern facilities to take us into the 21st century as the existing Kirkham centres are crumbling and not fit for purpose. Looking forward to this state-of-the-art facility being developed for our area”

26 5.8 You said we listened

You said We listened Suggested alternative sites. All alternative sites were investigated and discounted for various reasons. These included: Kirkham Community Centre The former school site in Barnfield, Kirkham The former social services building in Station Road, Kirkham The former Hillside Restaurant in Preston Street, Kirkham The Fylde Motor Company site in Preston Street, Kirkham What is happening to Wesham Rehabilitation Unit? The CCG is looking at options for bringing Wesham Rehab Unit back into use in some way. Distance from the bus stop in Station Road. The CCG has spoken to Coastal Coaches about amending the bus route to include the proposed new site. The CCG will work with local residents close to the site to minimise traffic issues. The footpath from Derby Road to St Michael’s Church The CCG is looking at options for improving this pathway and incorporating this into the would provide a better way for people walking or cycling overall project proposal. to and from Kirkham, but it needs improving. The new centre should include a dentist. The CCG has spoken to NHS England, which is responsible for commissioning NHS dentist services. At this stage NHS England says there is insufficient demand but discussions will continue. The CCG hasn’t explained what services will be offered The CCG has provided information to this effect in public feedback meetings in October from the proposed new centre. 2017. This information will also be available on the CCG’s website from 9 October 2017.

The survey question was written in an overly positive way The CCG asked all public meeting attendees a second question specifically about the and did not ask people specifically whether they are happy proposed site. Also the CCG commissioned independent market researchers Qa Research to carry out a full evaluation of the survey responses to ensure they were with the proposal on the actual location suggested. properly interpreted.

Derby Road is already busy and potentially dangerous The CCG will work with local residents close to the site to minimise traffic issues. What about putting a satellite surgery in Kirkham to The CCG will work with the practices to see if there are any feasible options to take this maintain some sort of service in the town? forward.

27 6. Engagement by others

Kirkham Town Council arranged its own public meeting and also ran its own survey, the results of which were unknown at the time this report was published.

Its public meeting was advertised in the local free advertiser newspaper (see appendix 9.5). CCG staff attended the public meeting and delivered a presentation to an audience of around 240 people. 7. Conclusions

Overall, the response to the proposals is positive with a new facility being welcomed by most residents and stakeholders. Clearly, residents and stakeholders in Kirkham are more likely to have concerns about the proposals as there is the potential, as the CCG acknowledges, for a slight increase in travelling distances for some. Travel is one of the key concerns highlighted, and residents appear keen for reassurance on the provision of bus services and positioning of bus stops near to the facility. The provision of NHS shuttle buses was mentioned fairly frequently, and another suggestion made related to the refurbishment of the walkway between Kirkham and the proposed new facility.

Generally, the response to the proposed location was positive. A number of alternative locations were mentioned, particularly Wesham Rehabilitation Unit in Mowbreck Lane and there is a sense that people are keen to see disused buildings being put to positive use particularly if they are/were NHS owned. The main concern in relation to the proposed location is the fact that some feel Derby Road is already busy and it would be necessary for the CCG to work closely with partners to ensure that roads, access, and parking is sufficient.

In terms of the services that people would like to see available in the new facility, x-ray/scanning facilities, dental services, physiotherapy and rehabilitation, a drop-in/walk-in service, and onsite pharmacy appear to be the priorities. 8. Next steps

The CCG’s Primary Care Commissioning Committee will make a decision on whether the GP practices in Kirkham are allowed to relocate.

Following this, the future of the development will lie in the hands of the NHS England and NHS Property Services and will be subject to local authority planning permission being granted.

28 9. Appendices

APPENDIX 9.1 Engagement booklet and survey

Improving health services in Kirkham and Wesham Proposals to move your local health services into a new state-of-the-art health facility

HAVE YOUR SAY - 26 June to 15 September 2017

If you need this booklet in another format or language, please contact our customer care team on freephone 0800 032 2424 or email [email protected]

Introduction As your local NHS, we want to build a state-of-the-art health centre at the current NHS offices site on Derby Road. This proposed modern building would provide a new home for your local doctors and other local health teams. The need for this proposed development is set out in this booklet.

We want you to have your say. Whether you agree with us or not, we want you to let us know. Your views will help to make sure this proposed new development meets the needs of you and your family for years to come.

Please read through this document and if you would like to know more, come to one of our public meetings in July. Details of these are available in a number of locations in the local community or from www.fyldeandwyreccg.nhs.uk/derbyroad.

Thank you for your help with this very important project.

Dr Tony Naughton Wendy Swift Dr Stephen Hardwick Dr Jon Brown Clinical Chief Officer Chief Executive Kirkham Health Centre Ash Tree House Surgery NHS Fylde and Wyre Blackpool Teaching Clinical Commissioning Hospitals NHS Group Foundation Trust

www.fyldeandwyreccg.nhs.uk Improving Health Services in Kirkham and Wesham 1 Our proposal

NHS Fylde and Wyre Clinical to make way for a new primary care Commissioning Group (CCG) has centre that would house the two worked closely with Kirkham Health individual GP practices and services Centre and Ash Tree House Surgery, as currently run at Kirkham Clinic. well as Blackpool Teaching Hospitals NHS Foundation Trust which runs This state-of-the-art building could also Kirkham Clinic, to come up with host a pharmacy and other community proposals for a new health facility for services as part of the CCG’s plans to local people. bring more services into community settings. It could also provide a future The proposal would see part of the base for seven-day services and a walk- NHS offices at the former Wesham Park in centre. Hospital site in Derby Road demolished

Artist’s impression of the proposed new facility

2 Improving Health Services in Kirkham and Wesham www.fyldeandwyreccg.nhs.uk The proposed new facility As well as providing a modern space for would provide: people in the area to see their family doctor, the proposed facility would help • Healthcare provision on one site in the the local NHS in its development of new local community. ways of working by housing services that • Access to a broader range of bring together health, social care and community-based health services. other relevant services under one roof. • Space for different health and care teams to be located together to make This proposal does not mean your sure services are more joined-up. GP practice is closing down. Nor • A patient-friendly environment. would the two GP practices merge. • Parking for 140 cars – almost double They would continue to operate as the current provision across the separate practices and you would three sites. remain a patient registered at your • A holistic approach to healthcare that current practice. focuses not just on people’s physical health but also how mental and social The doctors, nurses and staff would factors affect them. not change as a result of this proposed • Modern health facilities fit for the move. You would continue to enjoy the 21st-century. excellent, personal and friendly service your current doctors provide; however, it would be in a modern, state-of-the-art environment fit for future generations. Artist’s impression of the proposed new facility While work was ongoing, care would continue to be provided as normal at the existing GP practices and clinic.

www.fyldeandwyreccg.nhs.uk Improving Health Services in Kirkham and Wesham 3 The need for change

With growing populations across the been of the required standard for the area and improved regulations to ensure local population in years gone by. But to public buildings are safe and accessible continue providing services on these for everyone, there is a need for change. current sites would require major investment to make improvements Kirkham Clinic in Moor Street was to the buildings. They also offer no built in the 1960s and housed Kirkham room for expansion for additional Health Centre when it first opened in services to provide better care in a 1969. In 1991 Kirkham Health Centre community setting. moved to its current location, a former home for orphaned and neglected Over the next five years the number of children built in the 1860s adjacent to patients registered with the practices is the clinic. set to grow by up to 6,000 due to the large number of housing developments Ash Tree House was formerly a private in the area. The current premises do not home and dates back hundreds of years. allow for this increase. It became the home of Ash Tree House Surgery in 1985. We believe investment would be better spent on developing a purpose-built The facilities currently on offer to modern facility to provide services fit for patients in Kirkham and Wesham have future generations of local residents.

“The building that is Kirkham Health Centre is “We know that this is not the case. reaching the end of its useful life. With increasing numbers of patients, plus the expansion in the “In the future, GP surgeries, community staff and number and range of staff we employ, we are social care staff are going to have to work closer increasingly short of clinical rooms and parking together to meet the needs of a growing and spaces. Over the last few years both local practices ageing local population, so we are excited at the have been working together to try to further prospect of a new custom-built local health centre increase the range of services provided locally, that will help this, with a better environment such as a same day and weekend primary care for patients and staff, better parking and the service, but adequate premises has always been opportunity to draw together services to meet the the stumbling block. future needs of all our patients.”

“Too often in the past, local services have been Dr Stephen Hardwick moved away from our area to places like Lytham Senior partner, and Freckleton. Because they were still in Fylde Kirkham Health Centre they were said to be near enough for our patients.

4 Improving Health Services in Kirkham and Wesham www.fyldeandwyreccg.nhs.uk “Ash Tree House has been the much- loved setting of our medical services for approximately 30 years but is sadly no longer able to be extended. We want to provide a wealth of services to our patients but are unable to do so to our full ability due to lack of space. Therefore the proposed move to a purpose-built medical centre, we feel, is the best option for Steep steps and long stepped ramp at the our patients. front of Kirkham Clinic “Along with our neighbouring practice we have been working hard to expand the services that local residents receive and this proposed move is a natural next step to achieve that. We want to be a hub for health care, a centre of excellence, and retain services in Kirkham and Wesham rather than patients having to travel outside of the town to have their health needs met. Disabled access only available from the rear of Ash Tree House Surgery “The proposed move would enable us to work more closely with community and social care staff to provide a better service to all. Improved parking and in-house facilities are also an added bonus to the move.

“We look forward to sharing our plans and excitement with you as we move forward through this exciting phase of Ash Tree House’s history.”

Access ramp to Kirkham Health Centre has only Dr Jon Brown one handrail, no contrast and is too narrow Senior partner, Ash Tree House Surgery

www.fyldeandwyreccg.nhs.uk Improving Health Services in Kirkham and Wesham 5 The bigger picture

In 2014, NHS Fylde and Wyre Clinical Since 2014, the CCG, GP practices and Commissioning Group, which buys and other partners have made significant organises healthcare services in the area, progress in developing ‘new models published its 2030 Vision. of care’ to improve community-based services. These new services require This was the result of conversations working in a much more coordinated with thousands of local people and way with partners such as councils, organisations. It describes a shared the voluntary sector and a range of vision for what healthcare will look like healthcare providers. by 2030 and includes: The proposed new development at the • More support to help people keep former Wesham Park Hospital site would mentally and physically well. give us purpose-built space to be able to • More support to help people run some of these new services where manage their conditions at home. staff from different organisations could • More community and home-based work together. This would address one care. of the main issues patients have told • Care in hospital for services which us they face – that services need to be can only be carried out safely there. more joined-up.

6 Improving Health Services in Kirkham and Wesham www.fyldeandwyreccg.nhs.uk 1. Ash Tree House Surgery Map of the area showing the current practices and 2. Kirkham Health Centre and health centre, and the site of the proposed new facility Kirkham Clinic 3. Proposed location of new facility

Bus services to stops in Station Road and Fleetwood Road (0.2 miles from proposed site)

61: Blackpool, Peel Hill, Wrea Green, Wesham, Kirkham, Clifton, Preston – runs half-hourly in both directions;

61c: Wrea Green, Wesham, Kirkham, Clifton, Preston College – 8.13am Monday to Friday on college days only;

78: St Annes, Ansdell, Lytham, Freckleton, Kirkham, Wesham – runs half-hourly in both directions.

1 2

Approx scale in miles 0 0.25 0.5

www.fyldeandwyreccg.nhs.uk Improving Health Services in Kirkham and Wesham 7 Other options

The CCG, alongside NHS Property Services which owns many NHS buildings nationwide, has looked at a range of options. These are outlined below with an explanation about why they are not our preferred option.

Do nothing Doing nothing is not an option. It would lead to GP practices that are not big enough to cope with the numbers of patients they need to look after. It might also result in buildings that do not comply with Government regulations on health, safety and disabled access.

Make improvements to the current buildings This would require significant investment that would not represent value for money in the long term. An independent survey of the current buildings identified that £350,000 of remedial works was required to bring the practices in line with modern standards. In addition, there is limited space on the sites to provide the services we would like to, particularly as the population grows.

Demolish and redevelop the existing buildings Knocking down the existing buildings to develop new facilities on the current sites would cost a lot of money. The issue of where services would be based while the development work was undertaken is a major reason for this option being discounted. In addition, Ash Tree House is a listed building and as such it is questionable whether this option would even be possible.

8 Improving Health Services in Kirkham and Wesham www.fyldeandwyreccg.nhs.uk Find new land in the area and develop it No pieces of land of the right size have been found. Buying and developing new land would also cost a significant amount of money. Given that the NHS already owns two sites in the area, it would not represent value for money to acquire further property without first considering land that the NHS owns.

Convert the former Wesham Park Hospital site in its existing form The shape of rooms and layout of the building are not suitable in its current form. There would also be an issue with the ongoing cost of maintaining a 100-year-old building.

Convert Wesham Rehabilitation Unit in Mowbreck Lane Wesham Rehabilitation Unit is not big enough to house the facilities that would be incorporated into the proposed scheme on the former Wesham Park Hospital site. There is also not enough room for adequate car parking. The narrow main road was also deemed problematic as it could become dangerous and congested.

www.fyldeandwyreccg.nhs.uk Improving Health Services in Kirkham and Wesham 9 Your views matter We have looked at the options and have outlined in this booklet a proposal which we believe will improve local health services for years to come. Now we want you, the people of Kirkham and Wesham who use these services, to tell us what you think.

There are some questions we want you to think about which will help us to further develop our ideas: 1. How do you feel about developing a new state-of-the-art healthcare facility for the Kirkham and Wesham area? 2. How do you feel about bringing a range of health and care services together at one site? 3. Thinking about you and your family, please name up to three things that you think will be better as a result of these changes. 4. Thinking about this proposal, are there any issues that will affect you and your family that we need to consider when further developing our plans? 5. Thinking about health services you and your family travel outside of Kirkham and Wesham to access, please name up to three services you would like to see in the proposed new health facility. What’s next? • We are seeking your views from 26 June to 15 September 2017. • Our ideas will be shaped by your feedback. • Assuming there is agreement to progress these proposals, we will need to develop a business case and submit a planning application to Fylde Council. • If it does go ahead, the development of the proposed new health facility may begin in 2018.

10 Improving Health Services in Kirkham and Wesham www.fyldeandwyreccg.nhs.uk Who’s involved?

NHS Fylde and Wyre Clinical Blackpool Teaching Hospitals NHS Commissioning Group Foundation Trust Clinical commissioning groups, or CCGs, As well as running Blackpool Victoria buy and organise health services for Hospital, Blackpool Teaching Hospitals local people. provides many of the local community health services used across the They are led by GPs who understand the Fylde coast. health needs of their local population. Community staff employed by Blackpool NHS Fylde and Wyre CCG is one of Teaching Hospitals provide a number of 207 CCGs in the country. It buys clinics at Kirkham Clinic in Moor Street, health services for patients living next door to Kirkham Health Centre, across Kirkham and Wesham; Lytham these include speech and language St Annes, Ansdell and Freckleton; therapy, stop smoking services and Poulton, Thornton and Over Wyre; family planning. and Fleetwood. NHS Property Services Your local GP practice NHS Property Services owns thousands Ash Tree House in Church Street of buildings across the UK. Its portfolio and Kirkham Health Centre in is worth more than £3billion and Moor Street are the two practices represents around 10 per cent of the serving patients in the Kirkham and entire NHS estate. Wesham neighbourhood. Most of its sites are used for healthcare Between them they have just under purposes as either health centres 20,000 registered patients, 10 GPs, 14 or GP surgeries, hospitals and NHS nurses, three healthcare assistants and office buildings. two phlebotomists (someone who takes blood samples from patients). NHS Property Services owns Kirkham Clinic and the former Wesham Park The practices also host a variety of Hospital site which is currently used as other healthcare professionals such office space for local NHS organisations. as community midwives, community nurses, health visitors and counsellors and provide a variety of other community health clinics.

www.fyldeandwyreccg.nhs.uk Improving Health Services in Kirkham and Wesham 11 Have your say Questionnaire To share your feedback with us please visit www.fyldeandwyreccg.nhs.uk/derbyroad and fill out an online questionnaire. Alternatively, please fill out the form at the back of this booklet, cut along the dotted line, fold in half, sticky-tape the edge closed and pop it in the post (you do not need to add a stamp).

If you have more comments than is possible to include in the comments box on the form, you can include additional sheets of paper and return to us in an envelope to: Freepost Plus RTST-ZCEK-CBLH, NHS Fylde and Wyre CCG, Derby Road, Wesham, PR4 3AL.

Public events We would like to know what you think about this proposal. We would like to invite you to a public meeting where we will share this proposal in full and answer any questions you may have. Details of public meetings are available on our website (see below) and on posters around Kirkham and Wesham.

If you work for a local organisation or are a member of a local group and would like a member of the team to come to one of your meetings, please do get in touch.

Information displays The plans will be on display at the following venues:

• Morrisons supermarket, Poulton Street, Kirkham • Kirkham Library, Station Road, Kirkham • Kirkham Health Centre, Moor Street, Kirkham • Kirkham Clinic, Moor Street, Kirkham • Ash Tree House Surgery, Church Street, Kirkham Please send your comments back no later than Friday 15 September 2017.

Get in touch Website: www.fyldeandwyreccg.nhs.uk

Email: [email protected]

Twitter/Facebook: twitter.com/fyldeandwyreccg Facebook.com/fyldeandwyreccg

Phone: 0800 032 24 24 or 01253 956 400

12 Improving Health Services in Kirkham and Wesham www.fyldeandwyreccg.nhs.uk Your response Please cut along dotted line How do you feel about developing a new state-of-the-art healthcare facility for the Kirkham and Wesham area?  Very happy  Happy  Neither happy nor unhappy  Unhappy  Very unhappy

How do you feel about bringing a range of health and care services together at one site?  Very happy  Happy  Neither happy nor unhappy  Unhappy  Very unhappy

Thinking about you and your family, please name up to three things that you think will be better as a result of these proposed changes. 1. 2. 3.

Thinking about this proposal, are there any issues that will affect you and your family that we need to consider when further developing our plans? Fold this sheet in half, tape it closed and put the post

Thinking about health services you and your family travel outside of Kirkham and Wesham to access, please name up to three services you would like to see in the proposed new health facility. 1. 2. 3.

Any other comments:

To help make sure we are successfully reaching all parts of the community we would like to ask a little bit about you, but you can choose not to answer some or all of the questions. Any personal information that you supply will be kept confidential.

What is your postcode? Age:  Under 16  16-24  25-34  35-44  45-64  65-74  75-84  85+ Gender:  Male  Female  Transgender Please cut along dotted line Do you consider yourself to have a disability?  Yes  No Sexual orientation:  Bisexual  Gay  Lesbian  Straight Ethnic origin:  Asian or Asian British  Black or Black British  Mixed Black  Mixed Asian  White British  White European  Other, please specify

Would you like to be kept up to date on developments and projects across Fylde and Wyre? Why not join our Influence membership scheme? All you need to do is provide an email address: APPLY STICKY-TAPE

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FOLD HERE FOLD HERE APPLY STICKY-TAPE APPLY APPENDIX 9.2 Media coverage

APPENDIX 9.3 Advertising/promotion

APPENDIX 9.4 Stakeholders written to

Name Title Allan Oldfield Chief executive, Fylde Council Community engagement manager, Age UK Ben Wallace MP Wyre constituency MP Local co-ordinator, Home Start family support charity Moor Villa Residential Care Home, Kirkham Clerk Bryning with Warton Parish Council Clerk Elswick Parish Council Clerk Westby-with-Plumptons Parish Council Clerk Weeton-with-Preese Parish Council Clerk Treales, Roseacre and Wharles Parish Council Clerk Singleton Parish Council Clerk Ribby-with-Wrea Parish Council Clerk Geenhalgh-with-Thistleton Parish Council Cllr Alan Clayton Medlar with Wesham councillor, Fylde Council Cllr Albert Pounder Staining & Weeton councillor, Fylde Council Chair of Envirionment, Health and Housing Cllr Ben Aitken Committee, Fylde Council Cllr Elaine Silverwood Kirkham North councillor, Fylde Council Cllr Frank Andrews Ribby-with-Wyre councillor, Fylde Council Cllr Heather Speak Newton and Treales councillor, Fylde Council Cllr John Singleton Staining & Weeton councillor, Fylde Council Cllr Julie Brickles Warton & Westby councillor, Fylde Council Cllr Keith Beckett Kirkham North councillor, Fylde Council Cllr Kiran Mulholland Freckleton East councillor, Fylde Council Cllr Linda Nulty Medlar with Wesham councillor, Fylde Council Cllr Liz Oades Fylde East councillor, Lancashire County Council Cabinet member for health, Lancashire County Cllr Lorraine Beavers Council Cllr Louis Rigby Freckleton West councillor, Fylde Council Cllr Maxine Chew Singleton & Greenhalgh councillor, Fylde Council Cllr Michael Cornah Warton & Westby councillor, Fylde Council Cllr Paul Hayhurst Fylde West councillor, Lancashire County Council Cllr Paul Hodgson Kirkham North councillor, Fylde Council Cllr Paul Rigby Fylde South councillor, Lancashire County Council Chair of Health Overview and Scrutiny Committee, Cllr Peter Britcliffe Lancashire County Council Cllr Peter Collins Newton & Treales councillor, Fylde Council Cllr Peter Hardy Kirkham South councillor, Fylde Council Cllr Thomas Threlfall Freckleton East councillor, Fylde Council Cllr Trevor Fiddler Freckleton West councillor, Fylde Council Cllr Vivien Taylor Chair of Lancashire Health and Wellbeing Board David Houston Chief executive, Trinity Hospice Derek Cartwright Chief executive, North West Ambulance Service Dr Amanda Doyle Clinical lead, Healthier Lancashire and South Cumbria Clerk Kirkham Town Council Heather Tierney-Moore Chief executive, Lancashire Care Foundation Trust Janet Hale Chair, New Fylde Housing Clerk Wesham Town Council Jo Turton Chief executive, Lancashire County Council The Old Vicarage Care Home, Freckleton Karen Partington Chief executive, Lancashire Teaching Hospitals Disability First

Milbanke Care Home for Older People Residential Care Home Croft House Residential Care Home, Freckleton Senior development officer, N Compass carers Lorraine Morris support charity Thistleton Lodge Care Home Freckleton Lodge Care Home Manager, The Manse Care Home, Kirkham Mark Menzies MP Fylde constituency MP Clerk Blackburn Diocese

Sheralee Turner-Birchall Chief executive, Healthwatch Lancashire Suzy Layton Chief executive, Fylde Coast Medical Services Ltd LGBT Lancashire

Kirkham and Wesham Primary School The Willows Catholic Primary School St Joseph’s Wesham Catholic Primary School Medlar with Wesham CofE Primary School Kirkham Grammar Junior School Kirkham Grammar Senior School Carr Hill High School, Kirkham Kirkham St Michael’s CofE Primary School Ribby with Wrea Primary School APPENDIX 9.5 Kirkham Town Council engagement KIRKHAM TOWN COUNCIL IMPROVING HEALTH SERVICES IN KIRKHAM AND THE RURAL FYLDE

Fylde and Wyre Clinical Commissioning Group recently consulted on the future provision of health services in our area.

Now that residents have had the opportunity to attend Public Meetings and peruse informationprovided by the Commissioning Group, the Town Council is interested in your views, we would be obliged if you could take a fewminutes to fillin the questions below:-

Considering the need to change to meet the needs of future healthcare in the area, how do you feelabout closing all the medical facilitiesin Kirkham and merging them in one healthcare centre at Derby Road, Wesham?

Very Happy Happy Neither Happy or Unhappy Unhappy VeryUnhappy

If the new Centre is located at Derby Road, Wesham, would this cause you any problems, if so what would these be?

Has the Commissioning Group made you aware of exactly what the "State of the Art" facilities they propose to provide are likely to be, or are you still vague about what services will be offered?

Town where you live ______

Name and Address (optional)

Please returnthis form to Kirkham Town Council, Community Centre Mill Street PR42AN or to the place you collected it from.