AN independent report looking at responses to the Your Care in the Best Place consultation has been published today (May 22 2018).
The report, produced by specialist consultation analysts, The Campaign Company, provides a breakdown of responses to proposals aimed at strengthening and improving health and care services in the community and in the three hospitals serving mid and south Essex.
The analysis indicates there is broad agreement with the overall principles described in the consultation which were:
The majority of hospital care will remain local and each hospital will continue to have a 24-hour A&E department that receives ambulances
Certain more specialist services which need a hospital stay should be concentrated in one place, where this would improve your care and chances of making a good recovery
Access to specialist emergency services, such as stroke care, should be via your local (or nearest) A&E, where you would be treated and, if needed, transferred to a specialist team, which may be in a different hospital
Planned operations should, where possible, be separated from patients who are coming into hospital in an emergency
Some hospital services should be provided closer to you, at home or in a local health centre.
The specific proposal within the consultation concentrated on moving services currently provided from the Orsett Hospital site into centres closer to where people live, enabling the closure of Orsett Hospital
However in line with the conversations had during both pre-consultation engagement and the consultation process itself, the analysis identifies some local differences, particularly around the proposals relating to the future of Orsett Hospital from those living in the Thurrock CCG area and less general agreement with the proposals from those living in the Southend CCG area.
A majority of Thurrock residents who took part in a consultation process about changes to local health care provision have stated they want Orsett Hospital to stay open – and many have rejected the idea of integrated medical centres being built in four alternative locations across the borough.
Many expressed concern that the medical centres approach was a downgrading of health services in the borough and there was wider concern about locating other specialist care services in hospitals away from Thurrock.
Many of the concerns in Thurrock were encapsulated in a report by Thurrock Healthwatch to the consultation process.
Its submission commented a number of emerging key themes had been identified.
Service accessibility – concerns mainly focused on the travel between sites and some regarding fragmented service provision.
Funding and finances – concerns largely relating to funding being reinvested into Orsett Hospital and some which felt it was a cost saving exercise.
Capacity – concerns that the closure of Orsett would create capacity challenges elsewhere.
Quality of service – comments recognising the quality of the service provided by Orsett Hospital.
Concerns that the decisions had already been taken by the Mid and South Essex Sustainability and Transformation Partnership.
The survey of Thurrock residents showed that 75 per cent expressed disagreement (including 57 per cent saying they disagreed strongly) with the proposed transfer of services from Orsett Hospital to the outlying borough integrated centres.
While most of the responses disagreed with the proposal, there were some who supported it for the following reasons:
it was better for those who struggled to get to Orsett Hospital due to its location and poor transport links
providing more services in community settings and therefore closer to people’s homes was a good idea particularly for older and more isolated people and would more likely lead to better patient care and improved health outcomes
Orsett Hospital was not a fit for purpose building anymore and alternatives were needed
Tilbury and Purfleet would benefit from this approach.
However, the majority of comments were against the proposal with a number of anecdotal stories being shared about the valued services received at Orsett Hospital and the potential impact of no longer being able to be treated there.
Some felt this was particularly important given the growing local population and the plans to have 32,000 homes in the area which would have an additional effect on local health provision.
There was also a perception that Basildon Hospital is already overstretched.
A number of people maintained that one central ‘one-stop-shop’ service similar to what was currently provided at Orsett Hospital would be better for current users – particularly older local people.
They felt that instead of spending money on developing new integrated medical centres that the money should be invested in making Orsett Hospital fit for purpose since it already had comprehensive and valuable services, was in a reasonable location with good parking facilities (unlike the proposed new centres).
Some also felt that dispersal of services might lead to a dilution of care.
There was a feeling that there would be an overall loss of current services since the proposals were not clear where some of the services currently available at Orsett Hospital would be transferred to including kidney services, eye clinic, MS support and the minor injuries unit.
The analysis report has also shown key themes of concern particularly in the areas of:
• Transport and accessibility of services
• Shortages in workforce to deliver a sustainable service
• Financial constraint
Following an extensive pre-consultation engagement period over two years, the Your Care In the Best Place consultation took place between 30 November 2017 and 23 March 2018.
The 16-week consultation saw 16 large scale public meetings with almost 700 people attending in total, and over 40 deliberative workshops and specific events for people who were most likely to be affected by the proposals.
A further 750 people took part in an independently commissioned telephone survey conducted with a demographically-balanced section of the population across Mid and South Essex.
A separate questionnaire was also made available following feedback to focus specifically on the issues relating to Thurrock residents which was completed by 276 people.
In total it is estimated that more than 4,000 people took the opportunity to participate.
Professor Mike Bewick, independent chair of the joint committee of the five clinical commissioning groups in mid and south Essex, said:
“It is clear from the volume and the quality of the responses we received that people across mid and south Essex gave the issues very serious thought.
I would like to say a huge thank you to everyone who took part in the process.
“It demonstrates that people care a great deal about their health and care services and that is a great endorsement of the NHS care they receive and a compliment to the staff on the front line delivering services every day.
“The primary aim of consultation is not to undertake a referendum but to gain better understanding of any potential impact proposed changes may have.
The outcome of the public consultation is an important factor in decision making which needs to be fully taken into account. It is, however, one of a number of important factors for which will be considered.”
The Joint Committee of the five clinical commissioning groups will review the findings of the outcome report as part of its decision making process in the summer, alongside evidence and reports which review clinical, financial and practical considerations, including the findings a further review of the proposals by the East of England Clinical Senate.
Implementation of any changes agreed could then begin in the autumn of 2018 and would take place over a number of years to ensure any new models of care were introduced safely and effectively.
The full independent report into the Your Care in the Best Place consultation responses can be read online on the Mid and South Essex STP website