Albert Road Surgery Relocation Patient and Public Engagement Report

July – August 2017

Introduction Newham CCG is proposing to relocate the Albert Road Practice from Albert Road and Britannia Village to a new development site located near Pontoon Dock DLR station, planned to open September 2018. The provider will remain the same, and all the services patients currently receive will continue.

The new building will allow the CCG to offer a modern and accessible practice to all patients in the Royal Docks ward. Over the next ten years the population of this ward is predicted to increase by 20,000 as outlined in our strategic estates plan and already the current sites are nearing full capacity. The new site will be able to serve 30,000 patients, providing additional appointments and opening hours, as well as space for community groups to run health and wellbeing activities.

Following a request from the Primary Care Commissioning Committee, the CCG developed an engagement action plan in order to get people involved and have their say about the relocation. Over July and August 2017 the CCG’s patient and public engagement team and the primary care commissioning team spoke to over 114 people about the relocation, received 557 survey responses, and attended 14 community engagement events. Both teams attended local community events alongside community engagement activities in the Royal Docks ward, focusing mainly on North Woolwich. A separate engagement plan was also developed for the 34 housebound patients registered at the practice.

Methodology An online survey was developed to ask people for their views about the proposed relocation and hardcopies were also distributed at the practice and at community events. The survey was launched on the 10th July and closed on the 7th August. 557 people completed the survey; 99.63% of respondents were registered at the practice.

78.1% of respondents completed the online survey, 21.9% of respondents completed a paper copy

See engagement tracker below, and appendix 1, for more details about how and who we engaged with in the Royal Docks ward. We have also captured in the tables in the following sections the key issues raised by patients at each engagement platform.

Date Community Event Engagement Activity

Wednesday 12th July - Monday Royal Dock Ward Promote online survey through 7th August their local networks Thursday 13th July Patient Participation Group Presentation and discussion at members Patient Participation Group meeting Saturday 15th July, 11am to 3pm Summer Reading Challenge at One to one, surveys. North Woolwich Library Wednesday 19th July, 11am to Job Fair Event at Royal Docks Hand out flyers 2pm Learning and Activity Centre. Spoke to volunteers, stall holders, and participants. Thursday 20th July, 5pm to Discussion with North Woolwich Discussion with core group 6.30pm residents, North Woolwich Library Thursday 20th July, 1.40pm to Older Women's Group at Royal Hand out flyers and surveys 2pm Docks Learning and Activity Centre Saturday 22nd July, 1pm to 6pm Food Festival in Royal Victoria One to one, surveys. Gardens 3

20th July Text message to patients text message to patients sent by practice to inform them of the move and questionnaire Saturday 5 August, 12pm to 4pm Event on Britannia Village Green One to one, surveys

Approximately once a week 13th Engagement at Albert Road One to one, surveys. July to 4th August Practice site during opening hours Approximately once a week 21st Engagement at Britannia Village One to one, surveys July to 7th August site during opening hours. Sent 27th July, with a deadline Engagement with Housebound Tailored surveys sent through the for responses of Friday the 25th Patients post. August

Engagement with Housebound Patients A tailored survey was developed for the 34 housebound patients served by Albert Road Practice.1 These surveys were sent out to them by mail with a stamped addressed envelope, or the option to give their feedback to the practice manager over the phone. In order to ensure they had enough time to respond the deadline for this survey was set as the 25th of August. A separate short report will be prepared and shared with commissioners after this date.

Six surveys have already been returned. All respondents so far have said no, they don’t think the proposed move will be good for patients. Three included comments which all gave as their reason that it would be harder for elderly and disabled patients to visit the Pontoon Dock site. One respondent said that they struggle to get to Albert Road, and would like to have more home visits.

Update 04/09/2017: This report has now been completed and is included in this document as Appendix 1.

Key findings

1. 48.46% of respondents said that they thought moving the two practices to Pontoon Dock would be a good idea, 31.83% said no they didn’t think it would be a good idea, and 19.71% said maybe it would be a good idea. 2. 68% of respondents said that they would be willing to travel further to a GP Surgery that had more health and care services, and 32% said that they would not. 3. Many North Woolwich residents feel that this is yet another service that is being taken away from them, and that the move is part of ‘social cleansing,’ taking the practice away from local residents who will now have to travel and pay for transport in order to situate it near to the new, ‘rich’ residents moving into the new developments at Pontoon Dock. 4. Respondents recognised the need for bigger facilities and improved services with many describing difficulties in getting appointment, and long appointment waiting times. However, the most commonly highlighted barrier was the increased distance, travel time, and being unable to walk to the practice. 32.2% of commenters said that the new site would be further for them to travel to and more difficult for them to get to. Users of both Albert Road and Britannia Village highlighted issues with the increased travel. 5. The increased travel distance and the requirement to use public transport was particularly highlighted as a barrier for elderly people, people with mobility issues, and people with young children. Residents argued that the communities around Albert Road practice had many elderly

1 The Practice reports that 29 housebound patients live close to Albert Road, 4 housebound patients live close to Britannia Village, and 1 housebound patient lives in East Ham. 4

people and people with mobility issues who would struggle to use public transport. Other transport issues highlighted by respondents included: a. the proposed rerouting of the 474, meaning that Pontoon Dock will not be served by a bus b. that the new practice site is not pedestrian friendly c. that residents need to have free parking by the practice, and the fact that they won’t be able to use their parking permits at Pontoon Dock d. the increased cost of travelling to the practice site for low income residents 6. 15% of commenters said that they supported the move because the new practice will be closer to their home, and 4.9% said public transport would be better at the new site. 7. The potential for greater appointment availability, being able to get an appointment more quickly, improved services, and new facilities were seen as potential benefits or incentives for the move if they happened. Some respondents were concerned that increased patient numbers would mean it would be harder to get appointments, and some expressed doubts that the move would result in improved services. Some respondents also expressed the hope that the move would result in longer opening hours and Saturday openings. 8. Opinion on moving from two sites to one site was divided; some respondents felt it was better to have two geographic locations, but more felt that having one centralised site would reduce the confusion that patients currently experience when they end up at the wrong site for appointments, or when information is not communicated clearly. 9. Phlebotomy, ultrasound, ECG, optician’s service, and maternity service were the top 5 services people said they would like to at the new practice site out of a suggested list. Commenters also suggested a range of additional services, of which a pharmacy was the most popular. 10. Residents wanted to know what would happen to the old Albert Road site, and what would happen when development at the North Woolwich end of the ward begins in a few years’ time. 11. 76% of respondents agreed with the proposed new name of Pontoon Dock Surgery. 24% disagreed. 9% suggested alternative names of which the most popular was Royal Docks Surgery. 12. Many respondents argued that Albert Road should be kept open as an additional site.

What matters most to Why? How many people told people us? Travel time and transport was the Negative: 57% of the comments on this most frequent issue raised. It was  Patients will have to travel question discussed travel to also the most frequent reason further to the practice, and will the practice. Approximately two people gave for not being willing to have longer travel times, thirds of respondents said they travel further for more services, which will mean that their will see their travel time and suggesting that location was visits to the GP will take distance increase, and one valued more. longer overall. third will see it decrease.  Patients will no longer be able to walk to the practice but will 9.2% specifically raised that have to take public transport. the travel distance would be a  This will mean there is a cost barrier to the elderly and those to travelling to the practice. with mobility restrictions.  Some respondents also noted that the new practice site isn’t 44% of those who said they pedestrian friendly. would not be willing to travel  Some respondents also further for additional services highlighted that travelling by gave the increased distance as DLR or bus can be difficult if their reason. you are ill.  Respondents highlighted travel and transport as an issue for elderly or disabled patients, or for parents of 5

young children, who would struggle or be unable to use public transport.  Some respondents noted that the 474 bus is to be rerouted, meaning that there would be no bus access to the new practice site.

Positive  Patients will have less far to travel.  The new site is seen as having better public transport access. Availability of free parking spaces  There are patients who would 4.9% of commenters said that at the new practice site. struggle to use public there would need to be parking transport and/or can only at Pontoon Dock for it to be access the practice by car. good for patients.  Because of the parking zones many patients will not have a 5.6% of commenters said that permit to park near to the new they would be willing to travel practice site. further for additional services if there was parking. Being able to get a physical  Many respondents are 23.3% commenters thought appointment easily and quickly unhappy with the long waiting that moving would be good for was the second most frequent times for appointments patients if it meant that there issue raised by respondents. currently, and the lack of would be more appointments availability of physical available. appointments. More appointments and shorter 6% of commenters said they waiting times was highlighted would be willing to travel as a benefit and incentive for further if availability of the move. appointments improved.  Other respondents saw the move as making it more 22.5% of the comments left in difficult for them to get response to the ‘any other appointments, as there will be comments’ question concerned more patients at one practice. the need for more  Some respondents were appointments. concerned that they would no longer be able to get appointments as they wouldn’t be able to physically queue up at the practice first thing in the morning.  Some respondents were concerned that because they would have to use unreliable public transport they would be more likely to be late for appointments. Improved services and facilities  To have more and improved 21.9% thought that moving services. Some respondents would be good for patients if expressed unhappiness with the services and facilities the current services. improved. 6

 To have better ‘new and modern’ facilities. 6.6% of commenters said they would be willing to travel further for additional services, and 4.2% said they would be willing to travel further for additional services but not for core GP services. Longer and more flexible opening 3.8% of the comments on the hours, including Saturday opening questions ‘do you think moving hours to Pontoon Dock will be good for patients’ mentioned the possibility of longer opening hours as an incentive. Opinion on whether moving to a  Some respondents viewed 4.1% of commenters said that single site was a positive or a having two geographical sites two sites would be better for negative was divided. as a positive because it gave patients, and 8.8% said one patients two options and two centralised site would be sites they could be close to. better.  Other respondents viewed moving to one centralised site as a positive as it could reduce confusion, e.g., about which Pharmacy  Important to have a pharmacy A pharmacy was the most at the new site. popular additional service suggested under question 5.

Breakdown of survey questions

Question 3: Do you think moving the two practice sites to Pontoon Dock will be good for patients?

Yes No Maybe

48.46% of respondents said that they thought moving the two practices to Pontoon Dock would be a good idea, 31.83% said no they didn’t think it would be a good idea, and 19.71% said maybe it would be a good idea.  57% of the comments on this question raised the issue of travel to the practice. Of those, 36% saw the move as a benefit as it would mean less travel time, and 64% saw the move as a negative as it would mean longer travel time. 21% raised that the increased distance and travel 7

time, and no longer being able to walk to the practice, would be an issue for the elderly, the disabled, those with small children, etc.  4.9% of commenters said that there would need to be parking at Pontoon Dock for it to be good for patients.  23.3% of commenters thought that moving would be good for patients if it meant that there would be more appointments available.  21.9% thought that moving would be good for patients if the services and facilities available to them improved; commenters also welcomed new and modern facilities.  3.8% of commenters mentioned the possibility of longer opening hours as an incentive.  4.1% of commenters said that two sites would be better for patients, and 8.8% said one centralised site would be better.

Sample Comments

“I feel that the present Albert Road and Britannia are better placed for being in the community and serving the local community. It's going to be rich people in Pontoon Dock. They will only have to roll out of bed to see the GP while poor me have to sacrifice once again for the rich. Do not believe it will make any difference you have decided already. My strong objection is not about change per se it’s more about my GP services being based in my community. You can make a separate one for the rich.”

“The proposed closure of the surgery at Albert Road will be a great inconvenience to local residents. At the moment, the Albert Road surgery is within walking distance from the North Woolwich foot tunnel to Connaught Bridge. The proposed new location at Pontoon Dock will not be as accessible. I appreciate the bus routes (not very reliable) but by foot it is not accessible. I am very concerned especially for the elderly and not as mobile residents. At its core, the proposal will result in less accessible health services for poorer and older residents in Silvertown/North Woolwich in favour of richer newcomers at the new flats in Pontoon Dock. That is grossly unfair.”

“We won't have a Doctor down here at all? There has always been a Doctor. Not fair. Got all this end as far as Silvertown, big estate, there's plenty of people down this end. Been at practice since Dr Clark had it when I was born. Been there 90 years. Don't think it’s fair to take it all up to Pontoon Dock. I can't drive. I'm 90 - don’t want to move. They should make a practice at Pontoon for new people and leave practice here.”

“Having to travel by DLR or Bus for an appointment or just to pick up a prescription will a hindrance especially for disabled or elderly people living in Britannia Village.”

“Soon the bus route is changing, so they'll be no bus going directly from Woolwich to your new site. So getting to an appointment for the elderly or vulnerable will be more difficult and more costly. Also due to the new parking restrictions in the area, people will struggle to park without receiving parking fines as they have permits for this area and not there. It really isn't what local residents want! We have already had the upheaval of the two surgeries merging and never being able to get an appointment easily and having to chop and change between the two surgeries depending where you have placed the doctors on that day, this is just another annoyance for us all. Please reconsider (that won't happen because you have invested money in the relocation already and this survey is just a tick boxing activity for your paperwork)”

“I will need to walk to Pontoon Dock and there are a lot of constructions sites with trucks coming in and out, which is not safe as not long ago a cyclist was killed by on of this trucks. And on the other side of the road the pathway does not go all the way to Pontoon Dock and it will be dark in the winter, and as a woman I wouldn't feel safe walking there.”

“The practice in Britannia village is located in an ideal place for people who can’t walk to well to get to. If the practice moved all the way over in pontoon dock it could make life hard for those who can’t walk too far, it’s the same for those who live in Albert Road area, but on the flip side it would be good to have a bigger 8 practice, with Drs who are working every day. As a few times I've gone to the practice for an emergency appointment to find there's no Drs available.”

“Because there new site will be easier to reach by DLR and buses. Also, there will be thousands of people moving to this area very soon due to new developments and the GP needs to be able to provide the service for everyone. It's already too slow and difficult to get an appointment, so it will be chaotic if the service doesn't improve and change.”

“Only if we are able to get GP appointments more easily and with less of a wait. No point having more services if GP/nurse waiting times are the same or increase!”

“We can hardly get an appointment at one, now two in one with so many new people live in the community. Waiting is too long.”

“It will be good for patients if services are improved, especially appointments and opening hours, and if the building is fit for purpose overcoming the issues with patient confidentially at both the current practices (private reception/not being able to hear conversations in consultation rooms in waiting area).”

“Extra appointments and additional opening hours would be very much welcomed. Pooling the funding and having one high quality, modern location is a good idea.”

Question 4: Would you be willing to travel slightly further in order to access a GP practice that offers patients more health and care services?

Yes No

68% of respondents said that they would be willing to travel further, and 32% said that they would not.  44% of those who said they would not be willing to travel further for additional services gave the increased distance as their reason.  6% of commenters said they would be willing to travel further if availability of appointments improved.  6.6% of commenters said they would be willing to travel further for additional services, and 4.2% said they would be willing to travel further for additional services but not for core GP services.

Sample Comments

“The commute itself will add to more time to add into scheduling of your appointment. There will also be practicality based issues e.g. parking and added costs (public transport costs if not driving).”

“I'm 90 years old. This means I have to get on a bus if I'm ill, there's no one to take me. I've always been with the practice at Silvertown.”

“As long as it's mentioned, this will increase the capacity to cope with the area. I definitely think we do need better and more flexible opening hours to cope with the demand and working hours to have as many physical appointments as possible (and not just lots of telephone ones). There could also be machines such as blood pressure to avoid taking nurse/doctor appointments for repeat pill prescription. Also good if we please keep the pharmacy as there is no other close by!!!”

“Good if the facilities are modernised and improved and if there are more GPs to improve waiting times but if this doesn't happen then might as well stay in the same locations.”

“There is nothing more important than my health, and there is such a low number of adequate and caring practices in the area, that I would be more than happy to travel further for better services (in fact I already do, as the Albert Road practice is where I go yet it's not the closest)”.

"It is important to have basic GP services kept local. We use the current surgery for regular check-ups, prescription reviews and blood tests. This is very convenient. We are also happy to travel a little further for 10 referrals to specialist screening and treatment, but for us and I suspect most people these are less frequent so the extra travel time is acceptable. "

“Why would I want to travel by bus or DLR at my own expense to access a GP service that has always been a 2 minute walk from the home I've lived in for the last 22 years?”

Question 5: We are exploring the possibility of offering additional new services at the new site, Pontoon Dock Surgery. Please tell us which services do you think should be located at the site (please tick your top three choices).

80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% Responses 0.00%

We asked respondents to tick their top three services to be provided at the new site out of a list of possible services. These options, and the responses, are shown above. The five most popular proposed services for the new site were phlebotomy, ultrasound, ECG, optician’s services, and maternity services.

We also included an ‘other’ option and asked respondents to let us know if there were any other services, not listed, that they would like to see provided at the new site. 20% of respondents suggested other services. These included:

Additional suggested No. who Additional suggested No. who services. suggested it. services suggested it. Pharmacy 16 Paediatric Services 1 Dental Services 6 Weight Loss Clinic 1 Physiotherapy 5 Sterilisation Services 1 Mental Health for Young 1 Mental Health 5 People X Ray 4 Child Services 1 Diabetic Clinic 3 Counselling Services 1 Emergency Appointments 3 Cancer Testing 1 Asthma Clinic 2 BV Testing 1 11

Stoma Nurse 2 Mammograms 1 MRI 2 Healthy Eating Programme 1 Sexual Health Testing 2 Children Stay and Play 1 Walk In Clinic 2 Chiropody 1 CT 2 Pain Control 1 Ophthalmology 2 Children Centre 1 Minor Surgery Wart, Mole, and Celiac 1 Cyst Removal, Skin tag removal 2 Blood Pressure Tests 1 ENT Service 1 Sexual Health 1 More female doctors 1

Question 6: Currently we are proposing the new practice name should be Pontoon Dock Surgery as the site is located near Pontoon Dock DLR. Do you agree?

Yes No

76% of respondents agreed with the proposed new name. 24% disagreed. We asked those who disagreed to suggest alternatives. Of those who disagreed, 4% used the question to say that the location is more important and/or that the practice should not move. 9% suggested alternative names. These included:

Suggested Alternative Name No. who Suggested Alternative Name No. who suggested it suggested it Royal Docks Surgery 15 Pontoon Doctors Surgery 1 Royal Wharf Health Centre/Surgery 4 Thames Barrier Park Surgery 1 Pontoon Dock Health Centre 4 Royal Docks Practice 1 The Docklands Surgery 3 Thames Surgery 1 Silvertown Surgery 3 Dockside Surgery 1 Britannia Village 2 The Practice Pontoon Dock 1 Albert Road Surgery 2 West Silvertown Surgery 1 Thames Side Health Centre 1 Royal Docks Medical Centre 1 Waterside Surgery 1 Royal Docklands Surgery 1 North Woolwich Surgery 1

Question 7: Do you have any other comments?

27% of respondents left comments.

 22.5% concerned the need for more appointments.  8.6% concerned the need for parking  6.6% concerned the greater travel distance  4.6% concerned the benefit of improved services  4.6% concerned having a pharmacy at the new site.

Additional reflections from community engagement

Community group / Key issues raised platform Patient Participation  The PPG felt that overall the move was a good idea but were Group concerned about the transport system most particularly the rerouting of the 474 bus, the traffic management, and the lack of bus shelters on the road towards Pontoon Dock. They also asked about parking facilities. Stall at the Summer Community members raised issues including: Reading Challenge at  Perception that the move to Pontoon Dock was to make the practice North Woolwich Library more accessible for private patients at the expense of local residents.  Increased time and cost of attending practice for those who have to attend regularly. (one person had to go to surgery once a week for medication)  Traffic jams from people waiting to get on the ferry mean delays, increasing likelihood of missing an appointment.  Public transport will be crowded.  Recognise need for more services and more appointments, but why can’t we have this at Albert Road?  Keep it Albert Road so people who can’t travel can go there. Job Fair at Royal Docks  If the lifts at Pontoon Dock Station stop working how will the elderly Learning and Activity and disabled get to the practice? Centre  Residents from Royal Albert Wharf, a development area near Gallions Reach, are being told to register at Albert Road.  Practice should link up to the new arts and community studios being developed opposite Pontoon Dock.  There should be a free for all community board at practice.

Discussion with North  Residents recognise the need for a bigger practice and more Woolwich Residents, services but the issue is the distance to ravel and the increased North Woolwich Library cost.  A lot of services are being taken away from this area. Feel that it is social cleansing, moving the practice to within walking distance for rich people while local residents pay for transport.  The new site is not halfway between current sites, it’s closer to Britannia Village  There will be an increased cost to get to the practice – for a patient and someone to support them it would be £6 for round trip.  If the lifts on DLR are out of order people with mobility issues won’t be able to get to their appointments. The ramps at King George V 14

are difficult for people with walkers.  Albert Road serves the community. Residents would accept referral to Pontoon Dock for additional services.  Can’t park at Britannia Village – the Parking Zone stops at Connaught Bridge. Older Women’s Group at  Felt that the move to Pontoon Dock wasn’t fair and were concerned Royal Docks Learning and about the amount of time it will take it get there, particularly for the Activity Centre elderly, and that people who cannot drive and don’t have anyone to drive them won’t be able to access the practice. Food Festival at Royal  Request to know what will happen to the old Albert Road site. Victoria Gardens  Whether housebound patients will be affected by the relocation.  Need for more pedestrian crossings in Pontoon Dock; getting there on foot is a hassle because there is no footbridge, and the roundabout has little visibility.  What will happen when the developments at the North Woolwich end of Royal Docks begins.

Who did we speak to? Newham’s hugely diverse population speaks over one hundred different languages and is highly transient - 20% of Newham’s population moves in or out of the borough every year. It is also a very young area. At the time of the 2011 census, it had the youngest population of any borough in the country. Due to this diversity, our engagement approach included strong community engagement as outlined in the engagement tracker.

Key demographic highlights include:

Gender

Male Female Prefer not to say

Age Groups 40.00%

35.00%

30.00%

25.00%

20.00%

15.00% Responses

10.00%

5.00%

0.00% Under 18-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Prefer 18 not to say

Disabilities

9.00% 8.00% 7.00% 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00%

Ethnicity

White Mixed Asian Black Chinese Other

Recommendations and next steps

 The Primary Care Committee will need to consider the issues raised by local residents and take them into account when making decisions on the business case.

 In particular, the Primary Care Committee will need to consider the impact of the move of Albert Road Practice on local residents, particular on those who would come under the equality impact assessment, and consider options for mitigation.

 The Primary Care Committee will need to put into their plans when they will feedback to local residents on the results of the engagement, and how their contributions have influenced the decisions on this project. The Primary Care Committee may also wish to consider that 30% of respondents said that they wished to be involved and engaged in the relocation going forward, and to consider how local communities can continue to be engaged as the plans progress.

 As over 50% of residents who responded to this survey said they didn’t, or maybe didn’t, think that moving the two practices to Pontoon Dock would be good for patients, the Primary Care Committee may want to consider an ongoing communications strategy and change management project with local residents.

Appendix

Appendix 1: Housebound Patient Survey Report

Albert Road Surgery Relocation Housebound Patient Survey Report

July – August 2017 19

Introduction

Newham CCG is proposing to relocate the Albert Road Practice from Albert Road and Britannia Village to a new development site located near Pontoon Dock DLR station, planned to open September 2018. The provider will remain the same, and all the services patients currently receive will continue.

Following a request from the Primary Care Commissioning Committee, the CCG developed an engagement action plan in order to get people involved and have their say about the relocation. The main engagement activity was carried out over July and August 2017. The CCG’s patient and public engagement team and the primary care commissioning team spoke to over 114 people about the relocation, received 557 survey responses, and attended 14 community engagement events. The results of this engagement have been presented in the Engagement Report.

In order to engage with the 34 housebound patients registered at the practice a separate engagement plan was developed. A tailored survey was developed for the 34 housebound patients served by Albert Road Practice. The Practice reports that 29 housebound patients live close to Albert Road, 4 housebound patients live close to Britannia Village, and 1 housebound patient lives in East Ham.

7 Housebound patients, 21% of the total housebound patients, returned their survey.

These surveys were sent out to them by mail with a stamped addressed envelope, or the option to give their feedback to the practice manager over the phone. In order to ensure they had enough time to respond the deadline for this survey was set as the 25th of August was agreed that this separate short report would be prepared for commissioners to complement then main engagement report.

Key Findings

Housebound Patients Survey Main Engagement Survey 6 out of the 7 respondents felt that the move 48% of respondents to the main survey thought it would be bad for patients, with the final would be good for patients, 32% said they thought respondent saying ‘maybe’ the move would be it would be not be good for patients, and 20% said good for patients. maybe it would be good for patients. 3 respondents made suggestions for additional Phlebotomy, ultrasound, ECG, optician’s service, services. All 3 named Phlebotomy, 2 named and maternity service were the top 5 services Opticians Services, and 2 named Ultrasound. 1 people said they would like to at the new practice respondent suggested the additional services of site out of a suggested list. Commenters also respiratory nurse and nurses to do home visits for suggested a range of additional services, of which blood tests for certain medication they are on. a pharmacy was the most popular. The main reasons given by respondents for being Travel time and transport was the most frequent against the move was that they would struggle to issue raised. It was also the most frequent reason get to the new site due to being elderly and people gave for not being willing to travel further disabled. They also highlighted the 424 bus for more services, suggesting that location was service being diverted. valued more.

The information provided alongside the survey 57% of the comments on this question discussed reassured patients that their services they travel to the practice. Approximately two thirds of 20 currently receive in the home and in the practice respondents said they will see their travel time would continue. However, this increased travel and distance increase, and one third will see it distance was still the main concern raised. decrease.

9.2% specifically raised that the travel distance would be a barrier to the elderly and those with mobility restrictions.

44% of those who said they would not be willing to travel further for additional services gave the increased distance as their reason.

Issues respondents highlighted with the current 23.3% commenters thought that moving would be service included very long waits for referrals to be good for patients if it meant that there would be followed up and long waiting times. more appointments available. 3 respondents said they agreed with the 76% of respondents agreed with the proposed proposed name of Pontoon Dock and 2 said they new name of Pontoon Dock Surgery. 24% did not. disagreed. 9% suggested alternative names of which the most popular was Royal Docks Surgery.

Full Comments

Responses to the question: Do you think moving the two practice sites to Pontoon Dock will be good for patients? Please tell us why. “North Woolwich/Silvertown has few facilities and we need a doctor locally. Older patients can't travel that far. The bus service is stopping via cross rail start,” “I am severely ill on oxygen with COPD have chrr's (sp)? In a wheelchair oxygen 24 hours a day. I don't condone the move at all.” “Because I suffer with arthritis” “Housebound”

Responses to the question: Do you have any other comments about the current service or about the proposed relocation? “The 424 bus service will be stopping on crossrail is opened so DLR will be the only transport. How far is the walk for the station going to be. This relocation will benefit the new housing estate not the current users. It a long walk for an appointment already this will make it worse.” “Lets hope that the doctors can accommodate the elderly when requiring home visits. And that when referrals are made from hospitals they are followed through as I have been waiting since last November for physiotherapy and hydrotherapy!!!!” “Yes for me I struggle to go to Albert Road. I am housebound would like more home visits. Would like nurse to come to me when I have to do routine blood tests for certain medication I am.” “We are not happy at all regarding the service you provide us at North Woolwich long wait for appointments when we come to the surgery there are less than ten people waiting some times less than five with only one doctor on duty. If this proposal goes through disabled and elderly people will find it very difficult to get there, also we have just heard the 474 bus route may be converted to serve 'Crossrail' at custom house great news it gets better.”

Demographics

 2 respondents said they lived in Royal Docks ward, and 3 said they didn’t.  6 respondents said they lived closest to Albert Road practice site; no respondents lived closest to Britannia Village.  6 respondents were female, 1 was male.  3 respondents were 65 to 74, 3 were 75 to 84, and 1 was 85+.  All respondents report a mobility impairment. 4 also had a physical impairment, 1 had a hearing impairment and mental illness, and 2 had a health condition.  3 identified as White British, 1 as White Canadian, 1 as Black Caribbean, and 1 as Mauritian. 1 ticked both the White Irish and the Asian British box.

Recommendations and next steps

The Primary Care Committee will need to consider the issues raised by the housebound patients alongside those raised by the wider patient population and take them into account when making decisions on the business case. In particular:

 The Primary Care Committee will need to consider the impact of the move of Albert Road Practice on local residents, particular on those who would come under the equality impact assessment including housebound patients, and consider options for mitigation.

 Additionally, despite the fact that the survey reassured patients that the services they currently receive at home and in the practice would continue, the main reason given for objecting to the move was the increased travel distance. This suggests there is a need to build targeted communications to housebound patients in to any communication strategy or change management programme. We should also note that the housebound patients who responded are not completely housebound, and that they do visit practice sites if supported by carers and patients, and that therefore moving the practice will have an impact on them which needs to be considered.

 Some patients have raised issues about the long waiting times for home visit appointments. (This was also raised in community meetings). The Primary Care Committee will need to consider the impact of moving to a new site on the ability of the practice to perform home visits, particularly given the controlled parking zones and restrictions on parking.

Housebound Patient Survey

Dear Patient,

You may have already heard that there is an opportunity for NHS Newham Clinical Commissioning Group and AT Medics, who provide GP services from Albert Road and Britannia Village to relocate all the primary care services to a new development site located near Pontoon Dock DLR station. Should the proposed relocation of Albert Road Practice, then we are hoping to open the new in September 2018.

We wanted to take this opportunity to reassure you that the provider will remain the same, and all the services you currently receive at home and in the practice will continue. The new site is between Albert Road and Britannia Village and is served by the DLR and regular bus services (see map below).

For the past few weeks we have been talking to local people in the Royal Docks ward to find out what they think about our plans. We have attended community events as well as held drop-in sessions at both Albert Road and Britannia Village practice to talk to people about the relocation.

Over the next ten years the population in the Royal Docks ward is predicted to increase by 20,000 as outlined in our strategic estates plan and already the current sites are nearing full capacity. The relocation of this practice to the new building presents us with a once in a life time opportunity to affordably transform and improve primary care services in this area. The new site will have the capacity to serve 30,000 patients. The GP practice will be required to provide additional appointments and opening hours to meet the needs of the residents.

We want to make sure that we provide an opportunity for you to have your say. Your feedback will be used to make sure we make the right decision for local people.

To give your feedback, please complete the feedback form below by Friday 25th August 2017. Once you have completed the form please place it in the envelope provided and call Margaret Pollard on 0208 104 2222.

Yours sincerely,

Sabeena Subba, Patient and Public Engagement Manager NHS Newham Clinical Commissioning Group

Feedback Form: Relocation of Albert Road Practice

The new development site located near Pontoon Dock DLR will create a modern and state of the art GP practice transforming primary care for thousands of patients

1. Are you a resident in the Royal Docks ward?  Yes  No

2. Which site do you live closest to? a) Albert Road site  b) Britannia Village site 

3. Do you think moving the two practice sites to Pontoon Dock will be good for patients? Yes  No  Maybe  Please tell us why:

4. We are exploring the possibility of offering additional new services at the new site Pontoon Dock Surgery. Please tell us which services do you think should be located at the site (please tick your top three choices). Mother and baby group Phlebotomy (Blood Tests) ECG Ultrasound IAPT (Talking Therapies) Maternity services Coils and contraceptive Podiatry Opticians services Meeting space for community groups Other (please specify): …………………………………………………………………………………

5. Currently we are proposing the new practice name should be Pontoon Dock Surgery as the site is located near Pontoon Dock DLR. Do you agree? Yes  No  Any other suggestions:

6. Do you have any other comments about the current service or about the proposed relocation? Please turn over

About You

Helping us to understand more about the patients and the community we serve NHS Newham CCG is committed to eliminating discrimination and promoting equal opportunities. We want to deliver and improve our services and ensure they are available to all members of our community. The data from this form will help us achieve this aim. We will also use this data to report the needs of different groups of people. The information you provide on this form will remain confidential and only used for monitoring.

Q9. Are you:

Male Female Prefer not to say

Q10. What age group are you in?

Under 18

18-24

25-34

35-44

45-54

55-64

65-74 26

75-84

85+

Prefer not to say

Q11. It helps us to know whether we are reaching all disabled people. Can you please select the relevant impairment (disability) group below? You can tick more than one box, if appropriate.

Physical impairment

Hearing impairment

Learning difficulties

Mental illness

Mobility impairment

Visual impairment Please turn over

Deaf BSL user

Blind

A health condition e.g. HIV, multiple sclerosis or cancer

Other

Prefer not to say

Not applicable

Q12. How would you describe your ethnic origin?

A. White

British Irish

Polish

Lithuanian

Romanian

Other Eastern European (specify) ______

Any other white background (specify) ______

B. Mixed

White and Black Caribbean

White and Black African

White and Asian 27

Any other mixed background (specify) ______

C. Asian

British

Indian

Pakistani

Bangladeshi

Sri Lankan Tamil

Any other Asian background (specify) ______

Please turn over D. Black

British

African

Caribbean

Nigerian

Somali

Ghanaian

Any other Black background (specify) ______

E. Chinese

British

Chinese

Other (specify) ______

F. Other ethnic groups

Irish Traveller

Roma Gypsy / Traveller

Other (specify) ______

Prefer not to say

Appendix 2: Engagement Tracker

Date Community Engagement Numbers Key points and issues Group Activity engaged Wednesday Royal Dock Promote online 12th July - Ward survey through Monday 7th their local August networks

Thursday Patient Presentation and 6 Overall think it’s a good idea. Only fear is transport system. 13th July Participation discussion at • It is important that the practice is accessible by bus – the council is planning to change Group Patient the bus route to link with the new Elizabeth Line. members Participation • Are you planning to have regular doctors or locums? It’s important to have regular Group meeting doctors. • The DLR is getting more and more congested. • Traffic Management – will they be improving this? There’s been accidents at traffic lights. • Victoria Gardens to Pornell Bus Stop going west have no shelters or sittings. This is not good for elderly people who are feeling sick. They were taken away – they must be put back. This is a temporary situation that has gone on five years. All this (the move) depends on the buses. • Commissioner asked if people would like a dial a bus - not easy, they don’t come around any time people want them. Worth looking in to. • Will there be parking facilities? • This all sounds good and is what is needed in the area. My worry is patient capacity and doctors. I find it impossible to get an appointment now. • Worried new people who are clued up on technology will get ahead and other people will be left behind. • Good to have the name go with the DLR station. Is it a health centre? You want people to know what it is.

Saturday 15th Summer One to one, 12 On the move: July, 11am to Reading surveys. • They want to get more private patients, and we’re the ones who have to pay more to 3pm Challenge at travel to the new surgery ‘we knows it for private patients’. North • All but one of my medicines isn’t available on repeat prescription - I have to go to the Woolwich surgery once a week. I’ve been in agony sometimes when I couldn’t make it. Daunting Library to travel to Pontoon. Plus will have to get two buses. £3 a week out of my money is a lot. • Will there be disabled car parking? Will it be by the practice? • There are traffic jams of people waiting to get on ferry - tail backs up past the current practice - so it’s difficult to get to the practice. If you get there 6 minutes late the appointment is cancelled. If the Dr is 15 minutes late you have to accept that. • If we could travel that far, we’d go to Cyprus. • Transport will be very crowded at times of appointments - buses and DLR crowded with children going to school. • The Elderly and Mums with babies - I saw a Mum with three children struggling in reception the other day, how will she get to Pontoon Dock? • I recognise that we need something like this with more doctors and appointments, but why does it have to be here? Why can’t we have it at Albert Road? • Keep it open on Albert Road site so patients who can’t travel can go there/ Patients who go on a regular basis, who are there once a week, who have mobility issues.

On the Surgery: • You call on Monday and they’ve no or appointments, never any appointments. • You can’t get through at 8am and then they’re all gone by 8.30am - receptionist wants to know what you need the appointment for - there’s inconsistency - was told there was no appointments but after they said it was urgent the receptionist had an appointment for 10.30am • New company is taking in private patients you see them coming in and out. • The mental health team asked if I wanted to continue going to them or go to GP. I said GP, but I haven’t been able to get an appointment in five weeks. 30

Wednesday Job Fair Hand out flyers 15 Improved services and more appointments are good and necessary, but ensuring that 19th July, Event at transport is right, and giving assurance of that to local residents, is key to making this 11am to 2pm Royal Docks work. Learning and - Important that here is a good number of parking spaces close to the practice – Activity people’s parking permits won’t reach that far. Centre. - At the moment get appointments by visiting the practice at Albert Road – won’t be able to do that at Pontoon dock. Spoke to - Pontoon Dock station is high up – if the lifts stop working how will the elderly and volunteers, disabled get to the practice? stall holders, - Residents from Royal Albert Wharf, which is a development area near Gallions Reach, and are being told to go and register at Albert Road as it is the closest practice to them. participants. - With the new community and old community coming together in practice there should be a space for a free for all community board where people can find out what’s going on, and connect with each other. - There are new arts and community studios being develop opposite pontoon docks – good to link up http://www.v22collection.com/silvertown/ - It’s shame if people can’t make it to their appointments in time because of the bad traffic are then penalised. - Concerned this isn’t joined up with TFL - Concerned there’s is a lot of elderly who use Albert Road. Could you have a small satellite for the elderly who don’t have a car to touch base with the Doctor? - Other services – Arts Therapy, Young People Psychological Services, Parenting Support/Education, engagement with behavioural chance, mental health. 31

Thursday Discussion Discussion with 9 • Travelling to the Practice will take longer on less reliable transport, increasing the risk 20th July, with North core group that a patient will be delayed and will lose their appointment. 5pm to Woolwich • The 474 bus route is being permanently diverted up and will not go past the new 6.30pm residents, Practice Site. North • The new site is not halfway between the current sites, it’s closer to Britannia Village. Woolwich There will be an increased transport cost to get to the new practice. For one patient and Library someone to support them it will cost £6 for the round trip. • If the lifts on the DLR are out of order, people with mobility issues won’t be able to get to appointment. The ramp up to the lift at King George V is difficult for people with walkers. There are lots of people with mobility scooters around here. • Albert Road serves our community. We would accept a referral down to Pontoon Dock for an additional service. • There are only limited time slots in morning and afternoon when I would be able to travel in between school and nursery runs. • This is a multi-generational community which seems to be forgotten. A lot of services have been taken away. • We’re not saying we don’t need bigger practice and more services, we’re saying the trouble is the distance we’ll have to travel and the cost. • Concerned, if Practice moves to Pontoon Dock, what other catchment areas will this area fall in and what choices will be available. • Lloyds Pharmacy in North Woolwich will lose customers if there is a chemist next to Pontoon Dock. • Services are being moved away. Feel that it is social cleansing, moving the practice to in walking distance for rich people while local residents pay for transport. • Albert Road Practice isn’t falling down. Why can’t it be developed? • There was a suggestion of a shuttle bus, but majority felt that this would be too expensive and the practice won’t. • Can’t park at Britannia Village – the Parking Zone stops at Connaught Bridge. One resident said that if she can’t park at Pontoon Dock she would have no way to get there. Thursday Older Hand out flyers 10 People reported that there is a lack of appointments at Albert Road, and that people go 20th July, Women's and surveys and queue in the morning to get an appointment. One woman was offered a telephone 1.40pm to Group at consultation between 9am and 5pm which meant she had to stay in the house all day. 2pm Royal Docks People felt the move to Pontoon Dock wasn't fair they were concerned about the extra Learning and time it will take to get there, particularly for the elderly, that they wouldn't be able to Activity queue for appointments at Pontoon Dock, that parking permits don't extend that far, that Centre people who cannot drive and don't have anyone to drive them won't be able to access the practice. 32

Saturday Food Festival One to one, 17 If Albert Road is relocated what are the plans for the old site and who owns it? 22nd July, in Royal surveys. Concerned what will happen with the building - the community centre was built taller 1pm to 6pm Victoria than they said and blocks the light, concerned they will mirror this on the other side of Gardens the ward. Will housebound patients be affected by the relocation i.e. controlled parking zone in North Woolwich? Need more pedestrian crossings in Pontoon Dock. Getting there is a hassle - no footbridge. No crossings until Pontoon Dock. Roundabout has little visibility. Albert Island is up to be renegotiated for residential development. What will happen when there are developments around the other end of Royal Docks ward? Text text message to Sent to People asking why, some saying okay/ good as it’s not as far from them as Albert Road, 20th July message to patients sent by 6,429. 35 people saying that they are not happy because it is too far for them. patients practice to inform replies via them of the move text and message. questionnaire Saturday 5 Event on 0 face to August, 12pm Britannia face; to 4pm Village information Green One to one, shared over surveys PA system to approx. 50 Bad weather meant the event was rained off. NCCG spoke to the approximately 50 adults and adults and 30 children in attendance over the PA system about the relocation and 30 children. invited them to engage at their stall, but no one approached the stall. Approximately Engagement One to one, 43 people in once a week at Albert surveys. total 13th July to Road Access, decision already made. 4th August Practice site during Didn't agree with it as further to travel; some people refused to do the questionnaire as opening 'you're going to do it anyway.' One person said wouldn't mind travelling further as long hours as the additional services were there. Approximately Engagement One to one, 11 people in once a week at Britannia surveys total 21st July to Village site 7th August during Majority on board with the move. Issue of being unable to get an appointment currently opening raised, asking would there be more doctors/better able to get an appointment at the hours. new site. Some of the people spoken to had already done the questionnaire Sent 27th Engagement Tailored surveys 34 surveys All respondents so far have said no, they don’t think the proposed move will be good for July, with a with sent through the sent out; 6 patients. Three included comments which all gave as their reason that it would be deadline for Housebound post. surveys harder for elderly and disabled patients to visit the Pontoon Dock site. One respondent 33 responses of Patients received said that they struggle to get to Albert Road, and would like to have more home visits. Friday the back as of 25th August the 11th A full report will be prepared for commissioners after the deadline has passed. August.

Appendix 3: Survey

Albert Road and Britannia Village GP Practice Relocation Survey

Why are we doing this survey? The Albert Road Practice run by AT Medics is currently located at Albert Road and Britannia Village. NHS Newham Clinical Commissioning Group are planning to relocate all the primary care services to a new development site located near Pontoon Dock DLR station. The planned opening will be September 2018. The provider will remain the same, and all the services you currently receive will continue. The new site is halfway in between Albert Road and Britannia Village and is served by the DLR and regular bus services.

Please see the map below to see where we will be.

The new building will allow us to offer a more modern and accessible practice to all our patients. We may also potentially offer new services such as minor surgery as well as space for community activities. Over the next ten years the population in the Royal Docks ward is predicted to increase by 20,000 as outlined in our strategic estates plan and already the current sites are nearing full capacity. The relocation of this practice to the new building presents us with a once in a life time opportunity to affordably transform and improve primary care services in this area. The new site will have the capacity to serve 30,000 patients. The GP practice will be required to provide additional appointments and opening hours to meet the needs of the residents.

We want to find out what patients think about the preferred move. Your feedback will be used to help us develop a new practice site that meets patients’ needs.

Please complete the survey by 7th August 2017. You can also complete the survey online https://www.surveymonkey.co.uk/r/pontoondocksurgery

For more information please contact: [email protected] or [email protected] at NHS Newham Clinical Commissioning Group.

The new development site located near Pontoon Dock DLR will create a modern and state of the art GP practice transforming primary care for thousands of patients

1. Are you a resident in the Royal Docks ward?  Yes  No

2. Are you a: a) Patient registered at this b) Carer of a patient c) Both  practice  registered at this practice 

3. Do you think moving the two practice sites to Pontoon Dock will be good for patients?

Yes  No  Maybe  Please tell us why:

4. Would you be willing to travel slightly further in order to access a GP practice that offers patients more health and care services? Yes  No  If no please tell us why:

5. We are exploring the possibility of offering additional new services at the new site Pontoon Dock Surgery. Please tell us which services do you think should be located at the site (please tick your top three choices). Mother and baby group Phlebotomy (Blood Tests) ECG Ultrasound IAPT (Talking Therapies) Maternity services Coils and contraceptive Podiatry Opticians services Meeting space for community groups Other (please specify): …………………………………………………………………………………

6. Currently we are proposing the new practice name should be Pontoon Dock Surgery as the site is located near Pontoon Dock DLR. Do you agree? Yes  No  Any other suggestions:

7. Do you have any other comments?

8. Would you be interested in getting involved? Yes (This could involve attending engagement meetings to receive an update about the relocation or giving feedback through an online survey or by email.)

No

If yes please provide your contact details below:

Name: ………………………………………………………………………………………..

Email address: ………………………………………………………………………………..

Phone Number: ……………………………………………………………………………….

Post Code: …………………………………………………………………………………….

About You

Q13. Are you:

Male Female Prefer not to say

Q14. What age group are you in?

Under 18

18-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

Prefer not to say

Q15. It helps us to know whether we are reaching all disabled people. Can you please select the relevant impairment (disability) group below? You can tick more than one box, if appropriate.

Physical impairment

Hearing impairment

Learning difficulties

Mental illness

Mobility impairment

Visual impairment

Deaf BSL user 38

Blind

A health condition e.g. HIV, multiple sclerosis or cancer

Other

Prefer not to say

Not applicable

Q16. How would you describe your ethnic origin?

A. White

British Irish

Polish

Lithuanian

Romanian

Other Eastern European (specify) ______

Any other white background (specify) ______

B. Mixed

White and Black Caribbean

White and Black African

White and Asian

Any other mixed background (specify) ______

C. Asian

British

Indian

Pakistani

Bangladeshi

Sri Lankan Tamil

Any other Asian background (specify) ______

D. Black

British

African 39

Caribbean

Nigerian

Somali

Ghanaian

Any other Black background (specify) ______

E. Chinese

British

Chinese

Other (specify) ______

F. Other ethnic groups

Irish Traveller

Roma Gypsy / Traveller

Other (specify) ______

Prefer not to say

Appendix 5: Full Ethnicity Breakdown

Ethnicity

White British

Irish

Polish

Lithuanian

Romanian

Other Eastern European or other white background White and Black Caribbean 15 9 8 10 White and Black African 6 15 White and Asian 7 2 5 7 Any other mixed background 9 Asian British

32 201 Indian Pakistani

Bangladeshi

35 Sri Lankan Tamil

Any other Asian background

11 Black British 3 7 African

12 Caribbean

Nigerian 35 6 Somali 8 11 Ghanaian 22 11 Any other Black background 19 7 8 8 59 British Chinese Chinese

Any other Chinese background

Irish Traveller

Roma Gypsy / Traveller

Prefer not to say

Other