Argyll & Bute Health & Social Care Partnership Consultation on the Strategic Plan 2016 - 2019 Page | 1 Page | 2 Contents (1) Executive Summary 4 Introduction 7 Challenges What will it all look like in 2019/20 Reading the Report 9 (2) Methodology 10 (3) About Survey Respondents 11 Section 1 : Qualitative Feedback (4) Future Services 13 (5) Finance 19 (6) Composition on Local Planning Groups 24 (7) Operation of Local Planning Groups 27 (8) Comments and Suggestions 33 Section 2: Quantitative Feedback (9) Service Groups 36 (10) Children and Young People 39 (11) Everyone 43 (12) Population 46 (13) Adults with Learning Disabilities 49 (14) Older People 53 Section 3: Additional Responses /Appendices Additional Responses 58 Appendix A: Questionnaire 61 Appendix B: Non-analysed Feedback 72 Appendix C: Non-analysed Additional Responses 115 Page | 3 1 Executive Summary 1.1. Argyll & Bute Council on behalf of the NHS commissioned an independent consultant to coordinate and facilitate a programme of community engagement to support the formal consultation on the Argyll & Bute Health and Social Care Partnership (HSCP) Strategic Plan 2016 – 2019. 1.2. The consultation built on the feedback and comments captured in a previous consultation on the outline strategic plan, and focused on the planning within each of Argyll and Bute’s localities: Bute; Cowal; Helensburgh and Lomond; Islay and Jura; Kintyre; Mid-Argyll; and Oban, Lorn and the Isles. 1.3. The data was gathered via a number of complementary methods. This included a structured questionnaire administered hard copy and online, and a series of consultation events held in each of the seven identified localities. 1.4. A minimum total of 394 people participated. 105 responses were made via the hard-copy and online questionnaire, and the local events were attended by a minimum of 289 people. Respondents were a combination of public, staff, service users and carers. 1.5. Additional comments were gratefully received from a variety of organisations including: Argyll and Bute TSI; Carers’ Representatives; ENABLE Scotland; West Dunbartonshire Health and Social Care Partnership; Scottish Health Council; Scottish Water; Struan Lodge Development Group; Learning Disability Management; Pharmacy Representatives; Ardrishaig Community Council; Kilfinan Community Council; Dunoon Autism Support Group; Bute and Cowal Learning Disability Locality Forums; Cowal Community Care Forum; South West Division & National Air Ambulance Service; Scottish Environment Protection Agency. 1.6. There are key themes emerging from the data collected across the consultation period which provide additional insight on the priorities and perspectives of people living and working in Argyll & Bute. Local people want their health and social care service to be: Page | 4 There when you need it Across all localities, people want local to mean local. Local people are very encouraging of GP services and nursing care that is available at scheduled times on weekends and weekday evenings. Many people also reported their worries about the distance from their home to an A&E service. Throughout this consultation respondents consistently rated GP and A&E services as very important. It was recognised that some specialist services cannot be provided within every community, and for those cases the need for improvements to patient transport services was very frequently reported. There was also a lot of support for increasing the range of specialist mobile or ‘pop up’ clinics in communities at scheduled times. As with the strategic plan’s objectives, respondents across every locality saw Preventative measures as a very important priority. Caring and Preventative There was high level of feedback on the role of paid carers and their pivotal role in the health and wellbeing of many individuals and families across Argyll and Bute. It was reported that carers are often low paid, the time spent with clients too short, and the quality of care varied. There was strong support for the new Health and Social Care Partnership to pay quick attention to this service, to ensure that standards are consistent and that great carers are retained, properly rewarded and supported. Support for families and unpaid carers was seen as very important throughout as a key part of sustained and comfortable independent living. This linked to the regular feedback on the need to focus on preventative measures and having services in the community that can identify and support needs early on. Integration was considered a key opportunity to progress this. Involving Local people want to continue to be consulted on how the new plan is implemented and to be equal partners in their health and social care. People want a service where they are listened to and respected and where they have some control over how services are planned and delivered. More engagement and consultation with rural and remote communities is especially required. People are very supportive of helping social isolation and loneliness by having more local activities and opportunities to get involved in communities. Across Argyll and Bute, people prioritised support to live independently and to remain socially active. There was a consistent message that people of all ages should feel they are valuable members of their community for as long as possible. People across all localities expressed a desire to recognise and support the effort and good work that is already being done across all sectors – and to look beyond Argyll and Bute for good practice to be learned from. Page | 5 About People It was frequently suggested that local people should benefit most from the integration of health and social care services through better partnerships with better information sharing and cooperation. People want an efficient service with less bureaucracy and more frontline workers - which provides a single, joint assessment of what people need, resulting in a single, joint package of care. Local people reported that they do not want efficiencies that come at the expense of adequate treatment and care - people are at the heart of the service and need to come first. Throughout the consultation it was often said that services should better meet the needs of people. Respondents regularly stated the need for more focus and resources towards Mental Health services – for people of all ages. People placed great value on being engaged in an accessible and meaningful way with a priority on providing information that is widely available and in plain language. Focused on What’s Important Across the consultation period, people were offered the opportunity to rate the importance of different types of health and care services. The purpose was to understand what’s really important to local people, so as to assist Locality Planning Groups. These groups - made up of people living and working in Argyll & Bute - will have to make decisions on how to plan health and care services and prioritise what is most important. It should be noted that all current health and care services are felt to be important and were almost entirely rated at 4 or 5 out of a 5-point rating system. This was also the main reason given by the number of respondents who chose not to compare the relative importance of services. However, there are clear themes that arise from this prioritisation exercise that are common across each of the 7 locality areas. Specifically, the mainstream services that are available across the full population of Argyll & Bute are prioritised as important, which includes A&E and GP out of ours services and GP services. In addition, supporting the good mental health and well being of local children and adolescents was valued very highly. For adult health and care, mental health services, preventative health screening and support to manage long term conditions was considered important. And for the community’s older people, support to live at home, to be valued in the community and to reduce loneliness were consistently rated as very important. Page | 6 Introduction 3. Support unpaid carers, to reduce the impact of their caring role on their own health and “People in Argyll and Bute will live longer, healthier wellbeing independent lives.” 4. Institute a continuous quality improvement This report follows consultation carried out across Argyll management process across the functions and Bute on the Health and Social Care Partnership delegated to the Partnership (HSCP) Strategic Plan 2016 – 2019 which provides an overview of how Health and Social Care will be 5. Support staff to continuously improve the integrated and the changes that can be expected by information, support and care that they 2019/20. deliver Challenges 6. Efficiently and effectively manage all resources to deliver Best Value Argyll & Bute faces a number of key challenges. So taking all this into account we expect to see the • With many remote and rural communities local following changes in health and services are limited and people have to travel care services over the next 3 years considerable distances for treatment and support. What will it all look like in 2019/20 • The population is living longer, but declining in numbers. There is a greater demand for services, GP and other ‘front-line’ services will continue to be with a reduced budget to provide them. provided locally through local surgeries. However we expect that, through mergers and federations, there • The workforce is ageing and there are difficulties in will be fewer GP practices. This will provide a greater recruiting suitably experienced and skilled younger choice to patients e.g. a male or female doctor and offer people to fill the expected vacancies. you a range of GPs and nurses with special interests and training. As a result there is a recognised need to change the way services are provided and accessed and the integration • Most hospital treatments will not require a stay in of health and social care provides an opportunity to do hospital, with hospital beds being used only for this.