Independent reports summarising the responses to the north Derbyshire Better Care Closer to Home consultation have been published at www.joinedupcare.org.uk.
The Better Care Closer to Home public consultation ran from 29 June to 5 October 2016, with an additional clarification exercise in November. The consultation focused on care closer to home in place of services for:
- older people receiving inpatient care in a community hospital, usually following a spell in an acute hospital because of an illness or accident, and
- older people with dementia who currently receive services in community hospitals.
The Hardwick and North Derbyshire Clinical Commissioning Groups (CCGs), who led the consultation, have acknowledged the volume and richness of responses. 2,260 questionnaires were received, as well as other correspondence, petitions, on-line comments and good attendance at public meetings.
The consultation responses have been analysed by an independent academic, Dr. Steven Wilkinson. The consultation had three key ‘proposals’, which were explained in a consultation document accompanied by a feedback questionnaire. All feedback, including other correspondence and notes from public meetings, was included into the analysis and has been represented in the Feedback Report.
Dr Wilkinson confirmed that out of the 27 consultations he has been involved with, this had by far the most responses.
The reports have been written using (as far as possible) the words and phrases used in the responses. They summarise the themes, and those themes with the most responses are discussed first followed by the next in descending order.
The Stakeholder Report provides a summary of which stakeholder groups responded and gives a short summary of their views. Please note however the Feedback Report includes all responses including those given by individuals and stakeholders.
From individuals there was support for the Care at Home teams. However, the Beds with Care proposal raised concerns about quality of care and the availability of nursing or care homes. The Dementia Rapid Response Team proposal had broad agreement, but there was disagreement with moving Dementia Day Units out of community hospitals. There was also broad disagreement with the proposal to close beds in the five nominated community hospitals and with the proposed closure of Bolsover and Newholme Hospitals.
Common themes across all of the 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.
The main points raised by the stakeholder groups included concerns about closure of hospitals and loss of hospital wards and beds; staffing and general capacity issues; the resources needed for the changes; distances to the newly proposed services; care quality; end of life care and support for carers. There was a general concern that these proposals were based on the need to save costs.
However, there was support for the intention of the proposals and recognition of the need for change and an ongoing need for existing community hospitals. There was also support for the suggestion of Beds with Care and Community Hubs located in community hospitals.
The next steps in the process will be to examine the reports in detail. Cross system review meetings, including all of the 21c Joined Up Care partners, will be held over the coming weeks. These reviews will use the same methodical process as was used to develop the original proposals. The CCGs are keen to give sufficient time to consider all of the responses in detail. This means also giving time to the consideration of any alternative proposals which have been put forward. The final decisions will be taken by the Governing Bodies of Hardwick and North Derbyshire Clinical Commissioning Groups in the Spring.
Dr Ben Milton, Chair of North Derbyshire Clinical Commissioning Group, commented, “We are very grateful to everyone who took the time to attend meetings and give us their feedback. We now want to give this very rich and detailed feedback the attention it deserves as we revisit our proposals and make our decisions.”
Chair of Hardwick Clinical Commissioning Group, Dr Steve Lloyd, added, “We know that change is often difficult for staff, patients and the public, but it is now our duty to consider the feedback from local people, groups and clinicians so that we can agree the next steps.”