Future plans

Transforming Care Services in north and mid Hampshire

Since March this year, West Hampshire CCG, North Hampshire CCG and Hampshire Hospitals NHS Foundation Trust have been working on a joint programme to develop health care for the population of North and Mid Hampshire. 

This programme will ensure that the health and social care system can meet the many opportunities and challenges facing it around the need to empower people to stay well and to provide safe, high quality, consistent and affordable health and care to everyone. 

It has included looking at the centralisation of some acute services, particularly those services for patients who require the most complex care, and how more services could be provided locally within the community rather than in hospital.

To date, a number of options have been considered, informed by public research, and are being evaluated against agreed criteria. The work remains ongoing at present.

The local NHS is not yet in a position to indicate a preferred option, which may be subject to consultation when the required assurance processes have been completed.

It is envisaged that, in the autumn, the two CCG Governing Bodies will review all the work carried out to date and agree the next steps towards the development of a preferred option with local health and care organisations, who have been partners in the process to date.

 

Gathering local views

In June and July, a programme of intensive independent research was undertaken to reach a representative sample of local people, based on demographic factors, including age group, gender and socioeconomic group. 

The key objectives of this research were to:

  • Gather and understand the views of local people in relation to the possible outcomes of changes to acute services
  • Understand any concerns the public may have about service change
  • Engage with hard to reach and seldom heard groups within local communities

This was carried out through a statistically valid series of on-street surveys based on strict sampling quotas and six deliberative focus groups, also based on demographic factors, which gathered qualitative feedback around the views and concerns of local people with regards to possible changes in local health care services. 

The survey and focus groups were supported by an online version of the survey that was shared internally and externally by the two CCGs and the Trust and by focus groups and face to face meetings with traditionally hard to reach groups.

The results of this engagement are now available in the full report and in a summary report and slide pack.

The key conclusions of the report were:

  • Overall, there was a majority of support for the principle of acute service centralisation; two thirds (66%) of public online and 64% of on-street respondents stated they had a positive or very positive view of bringing together the specialist teams and equipment needed to treat patients who are critically ill or injured in one place, while 73% of NHS staff who took part in the online survey also had a positive or very positive view. There was a general consensus that all patients should receive the best care possible and many stated that the availability of consultant-delivered treatment at all times would benefit patients in this way.
  • Response to the centralisation of consultant-led maternity services was mixed, and over a third (37%) of public participants in the online survey reported their view to be negative or very negative.
  • Concerns about centralisation overall were largely centred on the possibility of extended travel times and distances, for patients, those in labour, and visitors. Concerns expressed also included possible impacts on existing services, such as the closure of existing local facilities or redirection of resources away from local areas.
  • Despite concerns around travel and access, when asked to choose their highest priority in a scenario in which they or a loved one required centralised critical care, ‘good car parking and public transport for visitors’ was overwhelmingly the lowest priority for respondents compared to factors such as ‘being able to see the right specialist with the right equipment’ and ‘knowing a specialist doctor will be readily available to treat the sickest and most injured patients 24/7’. Only 1% of respondents from each set gave ‘good parking and public transport for visitors’ as their highest priority.
  • In discussion of provision of care services within communities and dissemination of information, GP surgeries were seen as an important touch point for local people. They were considered a reliable source of information pertaining to healthcare services in the region and also appropriate alternative sites for provision of some services currently provided at local hospitals.
  • It was noted that more detailed plans would be required for the public to give truly informed responses, and local people and organisations expressed a desire to be involved in shaping future outcomes. It was suggested that a varied approach to communication and engagement around any service changes would be needed to reach all members of local communities, to include traditional media, online channels, and dissemination of information through third parties and established community groups.
  • It was suggested that a varied approach to communication and engagement around any service changes would be required to reach all members of local communities, to include traditional media, online channels, and dissemination of information through third parties and established community groups.

Examples of literal comments about potential benefits to centralisation included:

“Having the right equipment and doctors in the right place. The more times they carry out this type of care, they can only get better at it and it could be more efficient and saves money not having such specialist equipment everywhere”

“Cost saving, critical need. All best specialists in one area means you get the best care.”

“Concentrated specialist knowledge and education centres. Promote research projects and develop research strategies.”

“All equipment and staff are in one place, improved care and education in health care. Centre of excellence.”

Comments about concerns over travel times and distances included:

“It won't work, it’s a cost cutting measure. Increases transport time putting lives at risk.”

“The location would be too far away and because of this it wouldn't work. How would visitors get there, I have no transport.”

“If this means increased travel to reach care then this could have a negative effect.”

“The travel time in an ambulance will be increased for many patients; some will not make it alive to a central unit. We have good local services like A and E, and obstetrics is far superior.”

 

What happens next?

The report has been received by the Joint Programme Board that oversees Transforming Care Services programme. It will form an important part of the Board’s ongoing work to reconfigure acute services in north and mid Hampshire.

If you have any queries, email West Hampshire CCG via whccg.takepart@nhs.net.  

 

Documents

Transforming Care Services in North and Mid Hampshire - August 2017

Full report 

Summary report

Slide pack

 


updated 18 September 2017

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