Appendix 7 (a)

Notes of the FyldeCoast Health Economy task group – 25.10.11

Present:

  • CC Paul Rigby (Chair)
  • CC Geoff Roper
  • CC Clive Grunshaw
  • CC Bill Winlow

From Blackpool Council

  • Cllr Martin Mitchell
  • Cllr David O'Hara

Officers

  • Helen Skerritt, Director of Nursing & Quality - NHS Blackpool
  • Ian Treasure, Deputy Director of Partnerships - NHS Blackpool
  • Caroline Hastie, Head of Communications – Blackpool, Fylde & WyreHospital Trust (BFWHT)

Apologies from:

  • CC Mike Devaney
  • CC Carl Crompton

Disclosure of personal/prejudicial interests

CC Paul Rigby declared a personal interest as he is a Governor of the Hospital Trust

Background

Wendy explained the background to the creation of the task group

At the Health Committee in February members decided to refer the closure of Wesham Rehabilitation Unit by BFWHT to the Secretary of State for re-consideration.

The response from Andrew Lansley indicated that the Committee should await the outcome of the consultation exercise due to be undertaken as the future of WeshamHospital would be included within that process.

Members felt however that due to the fact that the hospital had previously decided to take a decision without public consultation that it would be beneficial to determine what the intended process for the forthcoming consultation would be and consider how robust those plans would be and ensure it was a transparent and inclusive approach.

FyldeCoast Consultation Delivery Plan document

Officers from NHS Blackpool and the Hospital Trust then discussed the consultation delivery plan with members. A detailed discussion took place, the main points being:-

  • Lots of rumours circulating and the Trust officers requested any comments as helpful to guide them through the process
  • Members were particularly disappointed that North Lancashire PCT was not represented and asked the officers to feed back those views. An officer from NLPCT had been invited and would be also invited to future meetings. Officers from Blackpool informed members that due to the clustering of the PCTs there were reduced staff available at NL but would seek a representative for future meetings.
  • Disappointment was expressed that there is very little mention of integration with soc services – issues that the Safeguarding Adults task group had identified were around concerns about the lack of integrated computer systems. Officers responded that this was a priority and possibly did not come across as clearly as it should within the documentation.
  • Officers stated that the clinical evidence base documentation is being worked on separately
  • 3 CCGs on the Fylde coast – already attended a clinical event about the consultation in September with clinical reps from the Acute Trust and Lancashire Care Trust
  • Priority is looking at new care pathways/models and making sure that they engage the right people.
  • Different approaches include community events,( good parking, public transport links and accessible times) – comment made not much for the rural areas, also people don't want to travel too far
  • Members thought that the events should include Kirkham, Garstang, Poulton etc – but still need good bus routes – officers agreed to expand the number/range of events.
  • Also planned to have a series of smaller events – to be held in the Primary Care Centres
  • Lot of engagement work already carried out in Blackpool (hospital membership scheme for example)
  • LINks - both Blackpool and Lancashire to be formally consulted - radio and press adverts, different forums.
  • Need to also make it accessible to those who don't want to come out -i.e. online access
  • NHS officers had contacted Fylde and Wyre democratic services for the contact info for the parish councillors (LALC) - CC Roper offered the services of his PA's contacts – Wendy to provide Jo's contact details to Ian
  • Providing envelopes to enable people to provide responses at a later date
  • Using new media – members felt that if Radio Lancashire is aware of a story it will share it with Look North West.
  • Staff will be engaged very early in the process – need to make sure that LCC and BC staff who cover that area are also informed.
  • Clinical engagement has taken place – final plan and preparation of report in terms of how feedback from the consultation will be fed into the process.
  • The scrutiny of the consultation will be carried out by who? – according to the SHA it is Health Scrutiny and that can be done either separately or jointly.
  • Members need to be satisfied that the process is all fair and open.
  • There may be delays to the sign off of the consultation due to NHS reorganisational issues at the SHA, PCTs and Lancashire Cluster
  • How long will it take to compile a report on the analysis – an external company will be employed to do this – they will be given 2 weeks to pull together the info from the end of the consultation. They will be picking up the data throughout the process – analysing as they went along.Members felt this was a very tight timescale
  • Concern that the quick turnaround make affect the quality of the information by focusing too much on the quantity.
  • The NHS need to demonstrate that they have listened to the views and taken them on board – officers agreed to take those comments away to ensure that they get a robust analysis. – may look at adding another week to enable a more robust analysis. It was agreed that Members would see the document when it is published – Wendy to check with Ian when this would be available
  • The analysisneeds to be split into the different geographical areas. – as they will have different needs in rural areas
  • Need to know what different types of public views are – particular issues in parts of Blackpool – pockets of disadvantage
  • Will be approaching supermarkets to use their foyers as an attempt to access the harder to reach.
  • Members suggested that housing associations could help with access to the more disadvantaged people – Officers to take this forward. It was acknowledged that the more disadvantaged often make greater use of the NHS services
  • Members wondered whether the GPs will have the last say – Helen responded that they clearly have a vested interest as both commissioners and providers. Concerns around whether they will be in agreement. Initial views are whilst they are keen to get the services right, but not as strict about where physically they are delivered. GPs also need to be tied into the social care element.
  • NL have done a piece of work with clinicians and it was agreed that the task group would receive this document as part of their evidence gathering.
  • The officers felt that they are not going to get all the GPs to agree to one/the same solution.
  • Concerns around the discharge from hospital element to ensure that community and social care support is available.
  • There is a recognition that care pathways need to be improved
  • When talking about outcomes need to make sure that there are smart targets in place – need to make sure that the social care support element is explicit within the proposals. Also concerns about the staff capacity of social care
  • Members felt that even those well off needed help (ie dementia) so don't forget about those.
  • The 2006 consultation demonstrated the evidence of clinical improvement. – Detail from that can be made available to members for information. Helen felt that all those lessons learned and developments need to feed into this consultation process.
  • In the past investment has been delivered differently due to 2 PCTs and differing priorities – summary of the 2006 consultation to be provided as background to why we are where we are.
  • Clear explanation is needed as to why the consultation is taking place. – to enable member to track the entire process and consider that all areas of the geographical are included.
  • Big socio-economic differences within small areas.
  • GPs need to support both as a commissioner and a provider
  • Can't be about "he who shouts loudest" – must be based on need and best evidence.
  • Need to make sure that the sample population is significantly representative
  • Use of council newspapers, Blackpool and the Districts – Ian to find out publication dates.
  • Posters to be provided to parish council clerks to put in local notice boards
  • Social media is a good way of reaching younger people – although caution should be expressed in terms of meaningful engagement. – more to raise awareness and signpost rather than capture concerns and feedback
  • The hospital trust has done some research on the different age groups of the people who use social media
  • The dates are not yet known when the events will be held (will be sometime in January – members still felt that they need to hold more than 3 – strongly felt (as above plus Over Wyre)
  • Discussion took place on what information and delivery style would be provided at the public events – try to make as informal as possible – must include the extra locations as specified by members
  • How will the impact of bad weather to taken into consideration in terms of people not wanting to attend events – officers need a backup plan.
  • GP commissioners will determineand agree what proposals will actually go out to consultation. This information is not yet available and therefore officers felt it was difficult to comment. – this should be available within the next 2-3 wks
  • Work has been done with LCC staff around commissioning development and the role of GPs and community services
  • Members to possibly look at sample work of the independent organisation that will compile the results of the consultation. – to gauge the quality of the analysis. Members need reassurances that this will be robust.
  • What about the money? – staff that can provide financial responses must be made available at the public events as members felt that this would be an area of questioning by the public. – however the nature and amount of funding may be unclear due to changes within the NHS.It is complex and the public have a right to know how much things cost.
  • Concerns that we don't just end up shuffling around what we've already got – needs a proper organisational review to see if every part is working efficiently and effectively and jointly
  • Danger is that the old service will continue and that a new service will just operate also. – need to avoid duplication and services that doesn't have any clinical evidence to demonstrate they work..The easy part is commissioning new services – the hard part is decommissioning
  • Need to take account of the other specialist services available across the county.

Next Steps

Date of next meeting – 14.11.11, Cabinet room B, 9.30am. This is an opportunity for the task group to listen to the views of other stakeholders.eg

  • District members, other CCs
  • Blackpool LINk
  • Lancashire LINk

Wendy to invite a number of representatives from the above list.