Consulting the Community

Better Care Closer to Home

Public Consultation

North Derbyshire Clinical Commissioning Group and

Hardwick Clinical Commissioning Group

Feedback REPORT

29th June 5th October 2016

Dr Steven Wilkinson

Consulting the Community

October 2016 (final version 7th December 2016)

Executive SummariesProposal 1

There was support for the Care at Home teams. The Beds with Care proposal raised concerns about the quality of care and the availability of nursing or care homes. There was disagreement with moving Dementia Day Units out of community hospitals. The Dementia Rapid Response Team proposal had broad agreement. There was acceptance of the Community Hubs proposal, however the locations of these hubs raised concern. Common themes across all of these proposals included care quality, staffing (levels and skills) the use of community and acute hospitals and hospital beds, costs and funding, management and organisation, location, carers and respite, travel, transport and access. In every case there were requests for further detailed information and a range of questions about the proposals.

Proposal 2

There was broad disagreement with the proposal to close beds in any of the 5 nominated community hospitals. It was thought these beds would be needed to serve the local (and remote) communities. The introduction of Specialist Rehabilitation beds in both suggested locations was considered a good idea, however the locations raised travel and transport concerns. The number of proposed beds was also considered to be low. There was broad disagreement with the proposal to close OPMH community beds at the two nominated sites. The establishment of a Centre of Excellence at Walton Hospital met with broad approval, however the location was an issue for some. In each case there was discussion around the themes of the use of hospitals and hospital beds, management and organization of services, locations travel and transport, nursing and care homes (capacity and care quality), carers and respite, estates (building use) staff (levels and qualifications). In every case there were requests for further detailed information and a range of questions about the proposals.

Proposal 3

There was broad disagreement with the proposal to close either hospital. These hospitals were considered to be needed by the local communities. Common themes in both cases included, patient care and quality concerns, management and organisational issues including a timetable for the proposed changes, issues around costs and funding, the location of alternative services and the inherent issues around travel and transport. The use of community hospitals including the range of services provided through these hospitals. Concerns about staff, carers and respite and access to services were also raised. The use of the estates (buildings) was discussed. In every case there were requests for further detailed information and a range of questions about the proposals.

Dr Steven Wilkinson

Consulting the Community

October 2016 (final version 7th December 2016)

Contents

Executive Summaries2

1 Background5

2 Process5

3 Proposal One Executive Summary7

3.1 Proposal One8

Care at Home Teams8

3.2 Care at home teams summary8

3.3 Beds With Care Summary17

3.4 Dementia day units Walton Summary24

3.5 Dementia day units Newholme Summary27

3.6 Dementia day units Bolsover Summary30

3.7 Dementia Rapid Response Teams Summary33

3.8 Community Hubs Summary40

4 Proposal 2 - Executive Summary47

Proposal 248

4.1 Community Hospitals Bolsover Summary48

4.2 Community Hospitals Clay Cross Summary52

4.3 Community Hospitals Newholme Summary56

4.4 Community Hospitals Whitworth Summary.60

4.5 Community Hospitals Cavendish Summary65

4.6 Specialist Rehabilitation Hospital Beds Cavendish Hospital Summary69

4.7 Specialist Rehabilitation Hospital Beds Chesterfield Royal Hospital Summary72

4.8 OPMH Community Hospital Beds Cavendish Summary76

4.9 OPMH Community Hospital Beds Newholme Summary80

4.10 Centre of Excellence at Walton Community Hospital Summary84

5 Proposal 3 - Executive Summary89

5 Proposal 3 89

Bolsover Community Hospital and Newholme Community Hospital90

5.1 The closure of Bolsover Community Hospital Summary90

5.2 The closure of Newholme Community Hospital Summary94

6 Consultation Clarification98

7 Report Outcomes100

1 Background

The CCGs of North Derbyshire and Hardwick embarked on a 14 week formal consultation process which closed on 5th October 2016 to help assess the views of service users, health and other care professionals and the wider public, on three broad proposals.

Proposal 1

a) forming Integrated Care at Home Teams,

b) establishing Beds with Care

c) moving services out of Dementia Day Units

d) introducing Dementia Rapid Response Teams, and

e) setting up local Community Hubs

Proposal 2

a) Permanently closing16 beds at Bolsover, 16 beds at Clay Cross,16 beds at Newholme, 20 beds at Whitworth, 16 beds at Cavendish

b) Providing 8 specialist rehabilitation beds in the west of North Derbyshire & 20 at Chesterfield Royal Hospital.

c) Permanently closing older persons mental health community hospital beds; 10 beds at Cavendish, and 10 beds at Newholme,

d) Establish a centre of excellence at Walton Hospital

Proposal 3

Closing Bolsover and Newholme community hospitals

http://www.joinedupcare.org.uk/ (Accessed September 2016)

2 Process

A database of feedback was developed. A First Stage Analysis was then undertaken, which coded responses. A Second Stage Analysis was then developed which organised the codes into themes. The first and second stage analysis documents are working documents and were used in the construction of this report.

This Consultation had three key proposals, which were explained in a consultation document accompanied by a feedback questionnaire. Further feedback to these proposals was collected via written and email correspondence and recordings and notes from public meetings. All feedback was included into the analysis and has been represented in this report.

This report has been written using (as far as possible) the words and phrases used in the responses. No corrections of fact, grammar or syntax have been made.

This report summarises the themes. The themes with the most responses are discussed first followed by the next in descending order. This provides a relative indication of the weighting of each theme. Every attempt has been made to report the feedback provided for each of the respective questions, therefore there is some repetition within this report.

Questions raised by respondents have been summarized and are reported at the end of each element of each proposal.

None of the views expressed in this report are those of the author or any organisation for whom the author may work.

The following table indicates the number of responses received (rounded up);

Table 1 Response count

Questionnaires2,260

Correspondence (email & hard copy)c.100

Public meetings18 x 2 hour meetings

+ Additional information including petitions, on-line comments, & media.

3 Proposal One Executive Summary

Proposal 1

Proposal one is a combination of;

a) forming Integrated Care at Home Teams,

b) establishing Beds with Care

c) moving services out of Dementia Day Units

d) introducing Dementia Rapid Response Teams, and

e) setting up local Community Hubs

The word cloud[footnoteRef:1] illustrates the 100 most often occurring words within the responses. The larger the word, the more often it occurred. [1: http://www.wordle.net/]

There was support for the Care at Home teams. The Beds with Care proposal raised concerns about the quality of care and the availability of nursing or care homes. There was disagreement with moving Dementia Day Units out of community hospitals. The Dementia Rapid Response Team proposal had broad agreement. There was acceptance of the Community Hubs proposal, however the locations of these hubs raised concern. Common themes across all of these proposals included care quality, staffing (levels and skills) the use of community and acute hospitals and hospital beds, costs and funding, management and organisation, location, carers and respite, travel, transport and access. In every case there were requests for further detailed information and a range of questions about the proposals.

3.1 Proposal One

Care at Home Teams

The proposed service changes would include significantly expanding 'care at home' teams. These are community-based teams of health and care staff who will work together locally, to care seamlessly for older people in or near their own homes.

What do you think about this proposal to expand community-based care teams?

3.2 Care at home teams summary

There was broad agreement to this proposal. Concerns were expressed about the quality of patient care and staffing levels. Those who disagreed lacked confidence in community care. There were concerns that this proposal would be sufficiently funded and about the management and organisation of the service. A preference for locally provided care was expressed and carers should also be considered in this model particularly with respect to respite. Travel concerns took account of distances and weather and roa