Success Regime Questions

The delivery of health and care services in Cumbria faces many challenges. For example it needs to improve the quality of care, recruit more staff and ensure that patients are seen as quickly as possible. Feedback from people who use services is essential. The questions we are asking you are in response to the Success Regime Progress Report and will be used torecordwhat you think of the main themes around the work of the Success Regime. The main themes will be explained in the questionnaire below.

If you would like to read the Public Progress Report February 2016 it is available on the Success Regime website

Completion of this questionnaire is entirely voluntary. If you don’t wish to take part, you don’t have to give a reason. Your comments will be treated in confidence and all responses will be completely anonymous.
Section One: About You

  1. I filled this questionnaire: [CHOOSE ONE]

On-line

With Healthwatch

  1. I live in: Carlisle

Eden

Allerdale

Copeland

  1. My Gender is:

Female

Male

Transgender

Prefer Not to Say

  1. My Age is: Under 18

18-30

31-40

41-50

51-60

61-70

70+

  1. Is your main current occupation within the NHS or social care?

Yes/No

Prefer not to say

Section Two: The Success Regime

The following are the main themes being considered by the Success Regime in West, North and East Cumbria. We are aware that some areas may not be applicable to you or you may not want to answer questions about them.

Community Hospitals

Urgent Care, Emergency Care and Acute Medicine

Maternity Services

Children’s Services

Planned operations, procedures and outpatients

Specialised Services

Mental Health Services

General Practice, (GP’s) – Your Local Doctor

Workforce and Leadership

Transport

Organisational Form

What follows is a summary of the key emerging ideas and proposals in each area of health and care services as above.

Note: we have coded these by letter; this is to assist us with data analysis, and should not be seen as any form of ranking or prioritisation.

6.Community Hospitals

There are currently 9 community hospitals in North, West and East Cumbria, each with a small number of beds. Emerging ideas are to:

a.Concentrate inpatient beds on fewer sites and offer a wider rangeof health andcare services – includingoutpatient appointments – at the other community hospitals which would have no inpatient beds.

b. No inpatient beds in any of the community hospitals. – These would all become health and care hubs from which more extensive care would be provided in the community.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Urgent Care, Emergency Care and Acute Medicine

Acute medicine at the West Cumberland Hospital is fragile due to high levels of consultant and doctor vacancies resulting in a large reliance on locum staff. This is especially a concern overnight when senior clinical decisions are needed. Emerging ideas are:

  1. Fewer patients being treated at nights and weekends in West Cumberland Hospital to help reduce safety risks.
  2. A Hyper-Acute Stroke Unit at Cumberland Infirmary Carlisle – this would be put in place alongside enhanced stroke rehabilitation services.
  3. Potential changes to which hospital patients are taken to, dependent on postcodes, to manage the number of patients at WCH more safely.
  4. More health and care services delivered in the community meaning fewer beds needed at hospitals.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Maternity Services.

There are a number of maternity options currently being considered to ensure a sustainable and safe model of care. The North, East and West Cumbria area has a relatively small number of births annually. Emerging ideas are:

  1. Consultants on call overnight at the West Cumberland Hospital.
  2. A new consultant led and 24 hour resident consultant on-call at both West Cumberland Hospital and Cumberland Infirmary Carlisle.
  3. Higher risk births identified and booked at Cumberland Infirmary which has more robust clinical support.
  4. A midwife led unit at West Cumberland Hospital and all other births booked at Cumberland Infirmary.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Children’s Services

Working towards a whole system plan of an integrated model of care involving care closer to and at home. Emerging ideas are:

  1. A single joined up child health team involving Cumbria County Council children’s services and NHS children’s services working across West, North and East Cumbria.
  2. 14 hour short stay Children’s assessment unit at West Cumberland Hospital, with a maximum stay of 24 hrs.
  3. 14 hour short stay children’s assessment unit with no overnight inpatient beds.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Planned Operations, Procedures and Outpatients

Emerging thinking is towards utilising the better facilities at the West Cumberland Hospital for more elective surgery:Emerging ideas are:

  1. More day case operations/procedures with less overnight stays at both the West Cumberland Hospital and Cumberland Infirmary Carlisle.
  2. Changes to outpatient services – using technology such as electronic referrals and tele-consultations.
  3. Outpatients clinics closer to home/in the community rather than at Cumberland Infirmary.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Specialised Services

Most of West, North and East Cumbria is an hour away from specialised centres for certain cancers and circulatory diseases – the 2 main causes of mortality in Cumbria.An emerging idea is:

  1. Agreement with Newcastle NHS Foundation Trust to develop enhanced and new links to increase benefits for patients and staff in initially three specialised services – cancer, children’s services and trauma.

This is an emerging idea, and not a finalised proposal. With this in mind,

What do you think about this?

How could any of this idea be shaped or improved?

Do you have any other ideas?

  1. Mental Health Services

There are plans to deliver Mental Health Services through a multi-agency community team and focus on urgent Mental Health Services delivered appropriately in hospital.Emerging ideas are:

  1. A multi-agency crisis assessment centre at Cumberland Infirmary Carlisle providing urgent care for Mental Health patients who don’t need to go to Accident and Emergency.
  2. A Mental Health Services Triage phone line allowing professionals to get important information about patients with mental health issues quickly.
  3. Consolidate mental health beds to fewer sites.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. GP’s - Your local Doctor

Emerging thinking is to use current investment to set up a local improvement scheme for 2016-18. This would focus on interventions at GP level to make a difference to patient outcomes.

  1. Offer bursaries to attract more GP’s to train in Cumbria.
  2. Considersupporting GP practices to work together more effectively in the community through Integrated Care Communities.
  3. Consider using GP premises more effectively.
  4. A minor ailments service to be made more available across West, North and East Cumbria for self-care and management of conditions in order to relieve capacity pressure on GP’s and wider health economy.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Workforce and Leadership

There is a need for the development of the current and a new workforce for Cumbria against a challenging recruitment and retention issues in the NHS. Emerging ideas are:

  1. A new workforce strategy and investment plan for the next three years to compliment the proposed draft clinical strategy.
  2. Idea of a Clinical Task Force to be piloted in Cumbria called P.O.S.T. (Post Operational Support Team). This would address short term recruitment challenges.
  3. A new education, training and development plan with aspirations to be the first “Associated University Teaching System” in the country supported by new centres of excellence for staff and a new rural clinical school at University of Central Lancashire.
  4. Consider a rebalance of the workforce by employing more staff in the community as services move into community settings and have fewer staff in hospitals.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Transport.

There is public concern involving Ambulance response times across North, West and East Cumbria. Emerging ideas are:

  1. A Helicopter service based at the West Cumberland Hospital- providing rapid access to emergency medicine and treatment.
  2. Treating more people at home by reiniforcing current transport capacity to increasing “see and treat” services in order to lessen hospital admissions.
  3. The possibility of using telemedicine more – such as consultations over the telephone or via video links.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to:
  1. Organisational Form

It is critical that North Cumbria University Hospital Trust demonstrates improved leadership and strong organisational form. However, due to the risks associated with the financial deficit in NCUHT, the takeover by Northumbria Healthcare Foundation Trust is no longer an option. Other organisation plans are:

  1. A legal agreement between NCUHT and Northumbria Healthcare Foundation Trust to make the current “buddying” relationship clearer.
  2. Northumbria Healthcare Foundation Trust to provide specific clinical services and also manage some services and work on joint clinical appointments
  3. New organisational form in line with the proposed new integrated service models.

These are emerging ideas, and not finalised proposals. With this in mind,

What do you think about this?

How could any of these ideas be shaped or improved?

Do you have any other ideas?

Please say which idea each comment is referring to: