Appendix 5.23

Mind your health Project

Consultation Evaluation

Proposed location of inpatient mental health services

Public, Patient and Staff Consultation

19 May 2008 – 12 September 2008

Compliance with HDL (2002) 42

Table of Contents

1Introduction

2Communications Plan

3Timeline of Events

4Consultation

4.1Information Sharing and Awareness Raising

4.2Consultation

5Information sharing

5.1Consultation booklet

5.2Information DVD

5.3 Internet Page

5.4Communication notice boards

5.5Bus Headliners

5.6Gaiety Theatre Projector

5.5Map and option posters

5.6Structured questions

5.7Outpatient appointment letters

5.8Wage slips

5.9Information Poster displays at NHS sites

6Consultation Meetings

6.1Focus group meetings

6.2Staff Meetings

6.3 Professional Committees

6.4Local Authority Members

6.5 MSPs and MPs

6.6Consultation information meetings

7Focus Group Evaluation forms

8Communications

8.1Mind your health – newspapers

8.2Posters

8.3Press Releases

8.4Stop Press

8.5Dialogue

9Assessment of Comprehensiveness of Consultation

10Assessment of Effectiveness of Consultation process

10.1Framework for Assessment

10.2Analysis of Compliance

10.3Conclusion

Appendix One – Summary of Meetings

1Introduction

On 2 May 2008, a draft communication plan on the proposed future location of acute mental health inpatient services was presented to members of the Ayrshire and Arran NHS Board. Following discussion, the Board agreed to approve the plan and proceed to wider public consultation on the future location of acute mental health inpatient services.

The purpose of this report is to examine the process of public consultation and to evaluate it against the National Guidance for Consultation and Public Involvement in Service Change, Draft Interim Guidance for Consultation, HDL (2002) 42[1], herein referred to as the National Guidance.

The report includes:

  • a high level summary and timeline for the key elements of the Mind your health Project, focusing on public, patient and staff involvement in context of the consultation process as defined in the National Guidance; and
  • an in depth description of the Mind your health Project in terms of public, patient and staff involvement; and
  • an evaluation of the level and method of public, patient and staff involvement throughout the Mind your health Project in relation to the National Guidance.

In addition to this paper, a Communications Pack has been developed which provides hard copies of all staff internal communications, press releases, posters and public information on the Mind your health project. The full Communications Pack is available on request.

Details of all the events and meetings that took place during the consultation period of the Mind your health project are listed in Appendix One.

2Communications Plan

The purpose of involving service users, families, carers and the public was to ensure that views on the future location of acute adult inpatient mental health services in Ayrshire and Arran reflected what is required now and in the future. Involving service users, carers and voluntary organisations gave an invaluable perspective of service provision which could not have been provided by any other source.

The specific aim of this participation process was to securemeaningful discussion around the future location of mental health inpatient services in Ayrshire and Arran.

Built into this process were the agreed principles:

  • Fairness, equality and inclusion will underpin all aspects;
  • There will be clear and agreed purposes to public involvement, and methods that achieve these purposes;
  • There will be a commitment to improving the quality of community engagement throughout the process, learning from experience;
  • There will be a recognition that all parties possess knowledge based on study, experience, observation and reflection, effective participation processes will share and use that knowledge;
  • All participants will be given the opportunity to build on their knowledge and skills; and
  • Accurate, timely information will be available at all levels. Enquiries will be responded to quickly and appropriately as they arise.

The participation from staff, voluntary and statutory organisations, service users, carers and their families will be continued and enhanced through the process of further engagement into detailed planning, implementation and beyond.

The Consultation Plan which was submitted to the NHS Board on 2 May 2008 described the aims and methods of consultation, the timeline, identified stakeholders and target groups and methods.

As well as the specific aim of the consultation process, a number of main objectives for the consultation process were identified:

  • First, the process must seek to actively involve service users, carers, families, voluntary organisations, members of the public and staff.
  • Second, the process will consider previous consultation exercises, learn the lessons from these and seek to deliver higher levels of engagement and dialogue.
  • Third, the process will use a variety of environments and media conducive to the needs and preferences of stakeholders.
  • Fourth, the process must provide the opportunity for those leading the Mind your health Project to listen to stakeholders and act appropriately on the information gathered.
  • Fifth, the process will seek to build relationships with key stakeholders to secure their ongoing input into mental health services planning in Ayrshire and Arran.
  • Sixth, the process must ensure that any information is provided in plain, jargon free language and in ways which meet all needs and preferences.

Throughout consultation, the Project Team can demonstrate that the objectives identified above have been thoroughly taken into consideration and acted upon during the consultation phase of the mental health services review. Further evidence of this can be found throughout this paper.

More than 1000 service users, carers, families, voluntary organisations and staff have been involved in working up the options for inpatient mental health services.

The Project Team and Communications Department considered and, where appropriateincorporated, all the comments and suggestions made at staff and public meetings on the mental health services review.

In implementing the key aspects of the process, the Communications Department was committed to:

  • Adopting an open, honest and transparent approach to all communication and engagement activities;
  • Providing accurate, timely and easily accessible information on options for the future delivery of mental health services;
  • Encouraging open dialogue with the public, partner organisations, media, politicians, etc.;
  • Responding quickly and appropriately to enquiries from stakeholders and the media as they arise; and
  • Being responsive and dynamic, ensuring plans are adapted to meet stakeholder need.

3Timeline of Events

4Consultation

The Process

The process involved consultation on the options for the future location of acute mental health inpatient services.

Existing stakeholders, including staff, local authority partners, voluntary sector and service users, carers and families will continue to be actively involved in the process as partners.

Information gathered from the involvement and engagement activities undertaken during Mind your health thus far will be maintained and built on with further information from the later stages.

Continued engagement will be sought with the three Public Partnership Forums in Ayrshire and Arran as consultation sources for Patient Focus and Public Involvement.

During consultation there were a number of additional groups who were targeted during the process. These groups represent a wide range of previously identified stakeholders, and are detailed below:

  • Additional service users including existing patients who have not yet participated. These included service users supported by partner organisations;
  • Community Planning Partners, in addition to those who have been involved to date;
  • Public organisations, such as community groups, community councils, youth forums and other groups with a local focus;
  • Public representatives including local authority councillors, MPs and MSPs;
  • Contact with media as a means to reach wider public awareness and understanding; and
  • Targeted consultation with children and young people, older people, travelling people and black and ethnic minorities through commissioning of experienced practitioners in this field. This provided the Project Team with the opportunity to ensure that the traditionally “hard to reach” groups had an input into the development of mental health services.

4.1Information Sharing and Awareness Raising

Enhanced information sharing and awareness raising started following the decision by Ayrshire and Arran NHS Board to go out to formal consultation. A variety of means were employed to communicate the key issues widely to all stakeholder groups and to the public. The communication methods included:

  • a consultation booklet, which was widely circulated on the options for the future location of acute inpatient mental health services in formats that were accessible to the full range of interested people and with oportunities for question and comment available;
  • proactive press releases;
  • reactive statements as required;
  • advertising on local radio;
  • open meetings for staff;
  • targeted meetings for staff;
  • e-mails to all staff;
  • information poster displays at NHS sites;
  • posters and flyers providing information and meeting details;
  • Stop Press and Dialogue Articles;
  • meetings with local authorities;
  • meetings with MPs and MSPs;
  • direct communication with other relevant groups; and
  • sharing of documentation and meetings with Community Planning Partners.

4.2Consultation

A programme of more formal interactive discussions was undertaken on the options on the future location of inpatient mental health services. There were a number of activities designed to engage all stakeholders in meaningful dialogue around the key issues and proposed responses.

These included:

  • open focus groups in communities;
  • specific focus groups as required;
  • targeted meetings with community groups;
  • targeted meetings with the Public Partnership Forums;
  • targeted meetings with other service user groups;
  • open and targeted meetings with staff groups;
  • targeted meetings with Local Authorities
  • targeted meeting with MPs and MSPs
  • drop in sessions;
  • consultation information meetings;
  • poster displays; and
  • freephone telephone line.

5Information sharing

5.1Consultation booklet

Over 18,000 consultation booklets were circulated to NHS sites, GP surgeries, Pharmacists, Clinics/Health Centres, Dental Surgeries, Opticians, three local authorities, libraries, Leisure Centres, Community Councils, Voluntary Organisations etc. An electronic version of this booklet appeared on all local authority websites and NHS Ayrshire and Arran mind your health site.

The consultation booklet was translated into Cantonese and circulated to the Chinese community prior to their targeted focus group.

A large print version of the consultation booklet was requested and provided.

5.2Information DVD

500 copies of an information DVD was directly mailed to NHS staff, GP surgeries, Public Partnership Forum members, Mind your health – Reference Group members, MPs and MSPs, Voluntary Organisations and Local Authorities.

The DVD was based on the consultation booklet and provided a consistent message on the options. It described the need for change, standards of care, proposed options for the location of acute mental health inpatient services, things to consider – for example accessibility of the options, junior doctors out-of-hours medical cover, small specialist services and described who would make the final decision.

The DVD was produced to be as accessible as possible by visual and hearing impaired members of the public.

Each focus group meeting started with the DVD to help inform those attending.

The DVD was displayed on the NHS website, Intranet and LCD screens through Ayrshire and Arran (Over the course of the campaign period, the MYH Inpatients content was played a total of 4,634 times across the 11 sites. As the length of each play was 879 seconds, MYH Inpatients was on screen for a total of 1,131 hours (67,888 minutes). As a result, MYH Inpatients was visible for 43.40 per cent of the time.)

5.3 Internet Page

An internet page within the NHS Ayrshire and Arran website was developed and provided at a glance all publications and information relating the Mind your health Project. All correspondence and printing literature made reference to this website address.

An intranet page was provided for members of staff and contained the same information as the internet page. An internet forum was developed with contained questions on the options for the future location of acute mental health inpatient services.

5.4Communication notice boards

The Communication Department updated dedicated communications noticeboards at NHS locations. These notice boards were sited at Crosshouse, Ayr, Ailsa and BiggartHospital. Any information that was published during that week was displayed on these notice boards. E-news, a weekly email bulletin on news also circulated updated information on the Project when appropriate.

5.5Bus Headliners

All 300 Ayrshire buses displayed an advert inside the bus on the Mind your health consultation during July and August 2008. The advert included the Mind your health branding and a message to get involved by phoning the freephone number.

5.6Gaiety Theatre Projector

During August and September 2008, NHS Ayrshire and Arran had an advert projected onto the side of the Gaiety Theatre in Ayr. The adverts message was to inform people that mental health services were changing and asked them to inform us where they thought mental health inpatient services should be based by phoning the freephone number.

5.5Map and option posters

1400 posters were printed during May 2008. These posters contained a map of Ayrshire with the 5 options out to consultation. The posters were widely distributed to Hospitals, GPs, Health Centres, Dentists, Opticians, Pharmacies, Local Authority Councils, Leisure Facilities, Community Leisure Clubs and were displayed on the Website and Intranet.

5.6Structured questions

During July 2008 questions on where mental health inpatient services should be located appeared on the internet and intranet site. An all staff email was sent to encourage staff to comment on the proposals.

The questions posed included:

  • Would you prefer all adult inpatient mental health services to be provided on one site at: AilsaHospital or AyrshireCentralHospital and why?
  • If all adult inpatient services were provided at one location – either AilsaHospital or AyrshireCentralHospital, would you and your family be prepared to travel further to that site which would have all available services needed for the patient?
  • If adult inpatient services are located on one site, what do you think about acute services for older people remaining on two sites at AyrshireCentralHospital and AilsaHospital?
  • If we provided services at both AilsaHospital and AyrshireCentralHospital, where would you like the main services to be located and why?
  • If adult inpatient services were provided from both AilsaHospital and AyrshireCentralHospital what do you think about: Patients having to travel between sites to receive specialist care, for example Intensive Psychiatric Care Unit (IPCU) and Out-of-hours medical cover for the second site being provided from the main site.

5.7Outpatient appointment letters

5000 A4 fliers were distributed with outpatient appointment letters. These fliers were double sided and contained the map with the options and the public information event dates in August.

5.8Wage slips

12,500 NHS Ayrshire and Arran wage slips had a message printed inside, asking staff to comment on where they thought acute mental health inpatient services should be based.

5.9Information Poster displays at NHS sites

During consultation 13 information poster displays showing the proposals for the future location of acute mental health services took place. The Project Team and Mental Health staff were available to answer questions at a specified time.

6Consultation Meetings

6.1Focus group meetings

14 community focus groups were held throughout Ayrshire and Arran, each with up to ten people taking part in structured discussions. The focus groups were widely advertised in the local press, by 1400 posters in community and NHS locations, and by invitation letters to over 700 community organisations. Mind your health project team members, Mental Health staff and members of the reference groups attended these events.

Following discussion with existing groups affiliated with mental health services, the Project Team organised 19 targeted focus groups. These included meetings with young people, older people, BME communities and travelling people.

All focus groups lasted up to 2 hours, were recorded and transcribed verbatim for analysis of themes and facilitated independently.

An evaluation of the focus groups can be found in section seven.

6.2Staff Meetings

The Mind your health Project Team issued a general invitation through Managers and by email to all staff offering to attend their department staff meetings. The Project Team and Mental health staff attended over 16 staff meetings during the consultation period. 18 open staff meetings were held around Ayrshire and Arran and were attended by hospital and community staff of all disciplines.

6.3 Professional Committees

11 Professional Committees were attended by the Mind your health Project Team and members of the Director of Mental Health Services senior management. At these meetings they were provided with a formal presentation on the proposals for the location of acute mental health inpatient services, a question and answer session then followed. All Professional Committees were asked to provide a formal response on the options. The formal responses can be found in Supporting Paper 2.

6.4Local Authority Members

All Local Authorities were contacted by the Project Team to offer a formal presentation on the future location of acute mental health services. Following the presentation each Authority was asked to provide a formal response on the options.

6.5 MSPs and MPs

All MSPs and MPs received copies of the consultation booklet and information DVD. They were also invited to attend a formal presentation on the future location of acute mental health services and encouraged to comment on the options.

6.6Consultation information meetings

Three consultation information meetings were held at the end of August 2008. The purpose of these meetings was to provide members of the public, service users, carers, voluntary organisations and staff the opportunity to comment on the proposed location for acute mental health inpatient services. Posters on the themes that emerged from the focus groups were printed these provided direct quotes on three themes, stigma, positive environment and transport and access. A number of members of the public who attended, commented on their quotes appearing on the posters. Everyone who contacted the Project Team during consultation received a personal invite to attend and radio and newspaper adverts were also used.