Appendix 1

Health and CareVillage

Communications and InvolvementReport

July 2006 - December 2010

1 Aim

The aim of this report is to provide an overview of all involvement and communication activity in relation to the Aberdeen Health and Care Village Project.

2Background and Strategic Context

All NHS Boards have a legal duty to involve people in designing, developing and delivering healthcare services. Board’s responsibilities in this area were initially set out in the policy document, Patient Focus and Public Involvement (PFPI). However to reflect the importance of this agenda, duties of public involvement and equal opportunities were placed on NHS Board in the NHS Reform (Scotland) Act 2004.

NHS Grampian is committed to listening and responding to the views of patients and carers and involving the public to ensure:

  • we provide the best possible care and experience for patients.
  • we take account of public opinion when we plan and develop current and future health services.

This report summarises the involvement and communication activitiesfor the HealthVillage project from 2006 to 2010. It lists the processes used and comments on the impact that public engagement has had on the project to date.We remain commitment to informing, engaging and consulting all stakeholder groups - staff, public, and service users - in the development of the proposed Health and CareVillage.

3Project Structure

3.1 Project Board

The Project Board was set up in 2006 and has a wide ranging remit to discuss all aspects of the HealthVillage development including the communication and involvement activities. Membership has included representatives from staff groups that it is proposed will move into the Village, clinical and managerial representatives, including a general practitioner,representation from corporate communications and public representatives. This group met monthly between 2006 and early 2010 andcontinues to meet bi-monthly.

3.2 Project Reference Group

The Project Reference Group was established in 2006 to involve clinical staff from a wide variety of professions in the scoping, briefing, design, operation and when appropriate the commissioning of the Health Village. Each service/department to be included in the HealthVillage identified a designated representative. The Area Clinical Forum was also invited to nominate a representative to join the group. The group met regularly during 2006 and 2007 to help scope the project, develop the initial schedule of accommodation and high level operational policies. The group were actively involved again during 2009 to revise the schedule of accommodation and work with the design team to produce a concept and detailed design.

3.3Communications Group

The Communications group was set up in January 2009. Membership includes Jackie Bremner, Service Planning Lead for Aberdeen City CHP, Lauren Tweedley, Public Involvement Officer, two public representatives and a Scottish Health Council (SHC) Local Officer.The group reviews regularly communication and involvement activities and ensures their implementation.

3.4Scottish Health Council

The Scottish Health Council was established to ensure NHS Boards meet their patient focus and public involvement responsibilities, and to support them in doing so. NHS Grampian has kept the local office of the SHCinformed about the project and has sought and listened to their opinion on the communication and involvement process. Copies of involvement activities and reports have also been shared with local officers.

NHS Grampian will continue to liaise with the SHC ensure communication and involvement activities associated with this project are proportionate. There has been Scottish Health Council representation on the Communications Group since January 2009.

3.5Public Representatives

Since 2007 two members of the public have been involved withthe project. This has included being members of the Project Board and Communications Group, carrying out patient interviews, spending time at the two most likely potential sites, observing the frequency of public transport passing each site, attending option appraisals and design workshops, commenting on public information, attending the open day and speaking to the public and staff during road show events.

In 2007, when asked to comment on their involvement, they said:

“I have felt very much involved in this project from interviewing patients to attending the various meetings - including the option appraisals. I felt that my contributions to the discussions were considered as valid as those of anyone else at the meetings and I certainly did not consider myself, as a lay representative, to be in any way sidelined in the discussions.”

“I am really enjoyingmy involvement with the project as I feel that my contribution is both valued and worthwhile. Sometimes our (public representative) views are sought specifically, whilst we are in general treated as contributing members of the project.As I go about day to day I am actively seeking individuals' opinions regarding the situation.”

In 2010 one of the representatives added:

“I have enjoyed being part of the Health Village Project Team, which has involved discussions and design workshops, surveying patients and even counting the number of buses going past potential sites for the Village. I feel my involvement as well as the wider patient and public involvement has influenced the location and layout of the building.”

4Involvement Activities

In 2006 a communication and involvement framework was written to provide an agreed and transparent approach to informing patients and the public and involving them in the project. The framework was discussed and agreed at the Project Board. As part of the framework, the Project Board carried out a stakeholder analysis. Detailed action plans were developed to support the delivery of the framework.The Patient Focus and Public Involvement (PFPI) Committee of the Board has responsibility for providing assurance to the Board on all aspects of PFPI. The HealthVillagewas discussed at the PFPI Committee in May 2010; this gave an overview of the involvement activities.In 2010 a case study about the communication and involvement work around the HealthVillage project was shortlisted in the Mutuality section at the annual NHS Scotland national event.

4.1 Patient Interviews

During February 2007, 125 patient interviews were carried out at WoolmanhillHospital and Denburn Health Centre to help inform the project. Interviews were carried out by three members of staff and one of the public representatives.

The results gave an insight into the views of the people attending Denburn and Woolmanhill and have been used to inform the Project. For example:

  • Recognition that current facilities are old and outdated.
  • Importance of location/ accessibility of Village building – this influenced discussion/outcome of Option Appraisal Workshops.
  • Services and accessibility being rated as more important than the physical building
  • Concerns about Woolmanhill acute clinics moving to Foresterhill (e.g. parking) - passed on to Project Manager for Foresterhill developments
  • General lack of awareness about proposed closures - wider public communication was subsequently included in second Project Action Plan.
  • Ideas for informing patients and public about project (e.g. newspaper article and newsletter) - included in second Action Plan.

4.2 Citizen’s Panel Survey

As well as patient views, in 2007 it was recognised that it would be important to ensure a wider public perspective was also gathered in the early stage of engagement. Therefore, it was agreed that questions about the project would be included in the Citizen’s Panel Survey issued to 790 citizens across Aberdeen. The main responses were quite similar to those of patients interviewed. For example:

  • General lack of awareness of proposed closures, particularly in younger age groups.
  • Main aspects of current facilities that are liked – location, easy access, parking
  • Main aspects of current facilities that are disliked – old/outdated facilities, lack of parking at Woolmanhill, intimidating/unpleasant parking at Denburn, interior of Woolmanhill, exterior of Denburn.
  • Out of a list of 13 possible features in new building, the following were the ones most commonly chosen as “very important” - easy access to bus routes (559 respondents); disabled access throughout building (511); well lit, safe access to building (490); clear signposting (480); helpful, welcoming staff (459); easy access to parking (430).
  • When asked how they would like to be kept informed about the project, the two most popular options chosen were newspaper article (430 respondents) and newsletter (382).

The results from the Citizen’s Panel Survey give an insight into the views of a representative sample of the population of Aberdeen, and like the patient interview results, informed the Project.

4.3 Involvement in Sexual Health Services

A focussed piece of patient involvement activity was carried out for sexual health services because the proposed changes include integrating family planning (Square 13) and genitor-urinary medicine (GUM) services. There is therefore likely to be a greater potential impact on patients using sexual health services than on patients using the other services included in the HealthVillage project.

In a survey carried out in October 2007 survey, most Square 13 patients (70%) and nearly half (48%) of City Clinic patients, thought that integration of clinics would be a good development. However, key points in relation to the building and environment emerged from patient consultations regarding integration and location of sexual health services, these included:

  • Privacy remains a significant concern. 61.4% of patients at City Clinic and 61.3% at Square 13 regarded a separate reception desk for sexual health services as either essential or important in the new building.
  • The importance of patients having their own waiting area within the HealthVillage was regarded as essential or important by 63.3% of patients at the City Clinic and 51.2% at Square 13.
  • The Sexual Assault Referral Centre (SARC) is planned to be situated in the HealthVillage building. SARC requires 24 hour access and it will be essential for the route to SARC and actual access to be as discreet and private as possible particularly during the day when the building will be at its busiest.
  • A large healthcare building could be intimidating to some young people (particularly under 16s). It can take a lot of courage for a young person to attend a sexual health service. Within the building it will be essential that any route to the service does not pass areas where people congregate such as a café, Healthpoint etc. Glassed areas where people can see between areas will also be off-putting to patients.
  • There were some mixed thoughts on separate entrance for the sexual health service. A minority of patients commented on this but some thought that this would reinforce stigma and segregation.
  • Access to toilets within the sexual health service is crucial to aid privacy (and more of them than there currently is). Layout of toilets needs to take into account process of patients who need to give urine samples.
  • Cleanliness and feeling of cleanliness (this was expressed by a number of patients and may be to do with sexually transmitted infections being viewed as dirty).
  • Feeling of space, easy to find sexual health services without having to ask someone is essential.

These points have been taken into consideration as part of the HealthVillage design.

4.4 Board Discussions

Heather Kelman, General Manager, Aberdeen City CHP, presented papers on the HealthVillage to the Grampian NHS Board in October 2008 and December 2008 when the Board approved the Outline Business Case (OBC) as a capital project. The Board considered and approved a revised OBC in February 2010 as a hubco revenue funded project. Heather Kelman presented a revised OBC to the Board Seminar in November 2010, it will be considered formally by the Board in December 2010.

4.5Workshops

Currie and Brown were appointed to assist NHS Grampian with the development and submission of an outline business case for the project by autumn 2007. To inform this work, 3 workshops were held between May and June:

a)Options Generation and Benefits Criteria/ Weightings

b)Creating a Risk Plan

c)Options Scoring and Identify Preferred Option(s)

Staff that could potentially move to the HealthVillage, CHP managers, clinical staff and three members of the public attended the workshops.

4.6Staff Briefings

In 2007 four staff briefing sessions were advertised and held in July in a variety of venues (DHC, Woolmanhill, Westburn Centre and Woodend). The aim of each one hour awareness session was to provide staff with information regarding the context and background to the project and information about what was going to happen over the next few years, invitations to participate in the sessions were sent to all staff including general practice in the city. The sessions included a presentation and the opportunity to ask questions. To follow on from the 2007 briefings a series of six staff awareness sessions were held in May and June 2008 to update staff on developments and to ensure staff had an opportunity to raise any concerns or questions.(Sent to same distribution).

In May 2008 and August 2010 Jackie Bremner attended the Grampian Area Partnership Forum meeting to discuss the plans for the HealthVillage and to give an opportunity for staff to ask questions about the project.

4.7 City Primary Care Redesign

In January 2008 and again February 2009 the HealthVillage was discussed by CHP staff and General Practitioners when meeting at Dounside to scope the City Primary Care Redesign Programme. In February and November 2010 presentations about the HealthVillage were made to the Primary Care Redesign Design Team to raise awareness about the HealthVillage project and to consider how the HealthVillage and Primary Care will work together in the redesigned service for the benefit of the people of Aberdeen and beyond. Another session has been arranged for December 2010.

4.8Newsletters

Newsletters were written and disseminated during March and October 2008 to staff, including general practice and interested public groups, raising awareness of the HealthVillage and progress with the development.

4.9Design Workshops

Throughout summer 2009 a series of departmental meetings with the design team were held followed by five all day design workshops which were held with clinicians and staff from a wide variety of professions and three public representatives to take into account what the services and the public need and want from the Health Village. These workshops generated the concept design, outline floor plans and artist impression of the HealthVillage internally and externally.

4.10Meetings with Interest Groups

In 2009 meetings were held with disability groups and those using sexual health services to produce a design features list. This exercise was carried out with these groups to ensure the building was accessible, easy to navigate around and patient privacy was considered. NHS Grampian’s Equality and Diversity Manager also gave feedback on the design features which were fed in to design discussions.

In October 2009 meetings were held with the Aberdeen Learning Disabilities Group and the Physical Disabilities Group to further inform the design and raise awareness of the proposed HealthVillage.

In April 2010 Jackie Bremner and Lauren Tweedley were invited back to the Learning Disabilities Group to give an update and to allow the group to comment on the design.

A meeting with the Older Peoples Consultation and Monitoring Group was also held in April 2010 to allow the group to comment on the design and to raise awareness.

Jackie Bremner met with MPs and MSPs to discuss the HealthVillage in January 2008 and October 2009.

In April 2008 Heather Kelman gave a HealthVillage presentation at the City CHP Committee, involving community planning partners and it was discussed again in June 2010.

4.11HealthVillage Web Page

In December 2009 aHealthVillage web page was set upto introduce another method of communication. This can be accessed from the NHS Grampian homepage via this link:

The web page includes information about the HealthVillage, presentations, copies of the proposed floor plans, an advertisement for the open day that was held in January 2010, a link to the council web page to allow people to keep up to date with the planning stages and a copy of the information booklet. This will continue to be used and updated as the project develops.

4.12Open Day andRoad ShowEvents

An open day was held on 19January 2010 at Satrosphere Science Centre, Aberdeen to share plans with stakeholders and the general public. As well as presentations throughout the day, detailed plans and drawings were displayed and Project Board members, including the public representatives, were available to discuss the plans and answer questions. Attendees were also able to leave comments and leave their contact details to ensure they can be kept informed of the project developments.

The event was widely advertised, including posters around NHS Grampian sites, in community centres, local pedestrian areas, libraries and local newspapers. Over 400 letters were sent to service users, interest groups, MPs/MSPs, councillors and local residents.

About 50 people representing a range of stakeholders attended the open day including both members of the public and healthcare professionals.