Contents

1Background
  1. Main proposals for changes as a result of the public survey

  1. Summary

Appendix 1 – Potential solutions to issues raised by the public consultation
1. Environment and Capital Planning issues
2. Department Management and Staffing Issues
  1. Background

The public consultation on theproposals to improve the emergency department and day surgery unit ran from 29th March 2010 to 9thMay 2010. A total of 1921 returns were received by the Trust: 95 from the internet survey and the remaining 1826 from the paper consultation documentation. The demographic profile of those responding has been fully reported to the internal steering group and has been deemed representative of the catchment area covered by the service. The survey had a greater response from: females, older persons and the disabled.

The headline results from the main part of the survey were as follows:

90% or more overall believed the development will make the departments more welcoming, help waiting times, make it more pleasant.

96% of those responding felt privacy would be improved, and this was expressed as important.

60% felt the improvements would improve access to the site by car

80% of those who were disabled felt they would get better care in the new departments.

The following summary contains the main issues raised and potential solutions to these issues. The Trust and the Developers will need to arrive at a decision about what they may change within the design in order to ‘solve’/resolve as many issues as possible.

  1. Main proposals for changes as a result of the public survey

Appendix 1 shows the potential solutions to issues raised by the public consultation.

The section is split into two main areas:

1. Environment and Capital Planning issues

2. Department Management and Staffing Issues

3. Summary

The solutions to the issues raised are outlined in the following tables. These tables have been debated by the Project Steering Group and some areas will need further consideration by the Trust. In summary, most of the issues raised by the public will be accommodated.

Kathryn Stuart

Head of Planning and Corporate Services.

1

Environment and Capital Issues
Issues put forward by the Public during the consultation / Solution recommended by internal advisers or managers / Decision by Steering Group
Access and Traffic
1. Traffic flow and Car Parking Capacity
Major congestion on Portsmouth Road
  • Access into hospital grounds from main road needs to be addressed
  • Access for emergency vehicles/public transport
  • Parking a major issue
/
  • Car Park Adviser and Highways Agency involved in trying to work out the best solution.
  • New access road will help with congestion.This will be used for ambulances and buses improving access on to site
  • Following consultation with bus companies a new bus stop will meet their requirements.
  • Constantly reviewing how parking can be improved.
/ Agree with the solutions suggested
2. Widen the main road as promised by Surrey County Council (last year of five year plan). / Request Surrey Heath BC make available money put aside to complete this section of road widening / Formal correspondence to follow to Surrey County Council/Surrey Heath Borough Council to confirm position.
3. Building Traffic Congestion - whilst work in progress /
  • Must warn the public via mass media communications about what will happen and ask them to use alternative means of transport if possible.
  • Information already available on the website and in front entrance on the touchscreens.
  • Using traffic consultant to minimise congestion and optimize traffic flow.
  • Considering Park and Ride
/ Agreed – need to ensure public are completely aware of the need to limit the use of car to the site whilst the work is in progress.
A management solution with the contractors will be sought – weekly meetings to monitor the situation will take place to consider key areas of risk.
Travel Plan will consider alternative ways to decrease car park usage.
4. Not enough disabled parking or drop off zone
  • Distance from car park to A&E/hospital is a long way if parked at the back with wheelchair user
/
  • Consider providing more drop off spaces. Plans to provide more drop off spaces and to ensure ‘drop off only’ not abused as at present
  • DDA survey confirms provision of disabled spaces is correct.
  • Consider providing a ‘wheelchair station’ in the car park?
  • Consider providing more wheelchairs.
  • Consider providing a volunteer service to push wheelchairs
/ Agreed.
There will be the provision of new disabled spaces outside the Physiotherapy Department
The Trust will need to consider the necessary action in this area.
5. CarDrop off for A&E - for patients who cannot walk or are emergencies not brought in by ambulance / This is part of new layout design.
(Ensure drop off spaces for patients not coming in by ambulance). / Agreed
6. Location of the bus stop- to be near hospital entrance / This is part of new layout design.
(Location of bus stop to be as near hospital entrance as possible to assist elderly and infirm using this method of transport). / Agreed
7. Car drop off for Eye Clinic – for infirm or elderly patients. Many elderly people use eye clinic. / Dedicated drop of to be provided
Drop off spaces to be provided next to the Eye Clinic. / Agreed
8. Safe routes for wheelchairs and slow walkers / There will be enhanced ‘Crossing Points’ as part of new layout. / Agreed
Inside the department
9. Appearance - The overall appearance of the department is important. /
  • New departments need to look welcoming and clean.
  • Housekeeping have an input into flooring finishes
  • The departments design needs to make them feel ‘light and airy’
  • Maximum light and ventilation to be applied
  • Ceiling heights to be as high as practically possible
/ Agreed
10. Draughts - Check new department will not suffer draughts from the doors opening and closing in waiting areas. /
  • Ensure all doorways are sheltered or curved away from patient waiting areas
  • DSU wait area on first floor is away from draughts
/ Agreed – will ensure the departments are appropriately designed.
11. Storage - Good design and storage leading to a ‘tidy’ work environment. /
  • Department needs to have sufficient storage to remain looking ‘uncluttered’.
  • ED (Emergency Department) and DSU (Day Surgery Unit) managers are ensuring sufficient storage is designed in from the beginning.
/ Agreed – will ensure the departments are appropriately designed.
12. Seating – very important for long waits, mentioned by many people /
  • Enough comfortable seating in sub-waiting rooms
  • Consider providing seating in a less regimented structure and greater variety of seating for different groups of the population
  • Check if different seating for different disabilities can be made available.
  • Space for wheelchairs to be checked with design team
/ Agreed – will ensure the departments are appropriately designed. Please see new OPD department.
13. Good Signage - Patients/Visitors worried about not being able to find their way around /
  • Need to ensure professional help is sought when planning signage. Many new buildings suffer from this not happening.
  • Install Makaton Symbols when putting up new signage
/ Agreed – all to be considered when internal and external signage and ‘way finding’ is being drawn up.
14.Privacy - must be maintained where ever possible – sound and sight /
  • Privacy within all departments is important
  • Check for ‘sound transmission’ from areas and also ‘sight lines’.
  • Does white noise need to be used anywhere to mask conversations?
  • Patients need assurance that the cabins are not isolating and there is a call mechanism.
/ Agreed - A key driver for the new development is the need to improve privacy and dignity – the ethos of the departments is to ensure this happens.
15.TV area - Some people wanted distraction, whilst others wanted reduced noise levels. /
  • Consider a ‘TV area’ for those wishing to have distractions.
  • Waiting and Discharge Areas to have TV; Consider option for headsets to avoid disturbance to other patients
  • Internet access to be provided & WIFI
/ Agreed - The Trust has agreed to TV in Emergency Department.
There will be consideration given for what is provided in the Day Surgery Unit.
16.Refreshments– Availability of food and drink in emergency department and day surgery department /
  • Consider where refreshments can be placed for carers and escorts (vending machines etc)
  • Consider extending Café Glade physical space and hours of service. Proposal to be considered for this finance permitting.
  • Pantry with limited facility to provide refreshments to those who have to remain with patient (DSU) and ED Unit.
  • Drinks machine in DSU discharge area
  • Vending machines in public areas on main site.
/ The Trust wil continue to provide refreshment to patients as appropriate within the units.
The Trust to consider physically extending current facilities and opening hours if financially viable.
  1. Wheelchair parking in ‘waiting areas’ -Need to plan in wheelchair parking positions into waiting areas
/
  • Wheel chair spaces within Emergency Department and Day Surgery Units - waiting areas need to be marked on the floor (see OPD 1).
/ Agreed
  1. Disabled Toilets and enough toilets – make sure the disabled toilets are ‘fit for purpose’ and large enough (not just national guidelines)
/
  • Disabled group have been consulted on the plans for these areas.
  • HBN advises on the layout necessary for these facilities.
/ Disabled toilets to be built to HBN.
  1. Adult ‘change stations’ - needed as well as ‘nappy change stations’.
All new public buildings encouraged to have at least one of these stations. /
  • Adult change station needed (at least one in the trust building). This is a dignity issue.
/ This proposal is being considered more widely in the trust building as it is about to become a necessity for public buildings.
  1. Sub-Wait–Separate area for those who are drunk or have substance misuse related issues
/
  • Consider having a separate area for those with alcohol and drug related behaviour away from public areas. The public get frightened.
/ Agreed – there will be some separate sub-waits which can be utilised.
  1. Sub-Waits for disabled patients (autism/learning disability) – these patients will get distressed easily and respond better if in a side room.
/
  • Consider having a separate area for those whose behaviour is likely to deteriorate if they are in a public area.
/ Agreed – there will be some separate sub-waits which can be utilised.
  1. Cabin design – Day Surgery Unit
/
  • Cabin design needs to be checked – may be too confined for those with behavioural problems.
  • Cabin design needs to be checked that it can hold the larger wheelchairs
/ It would need to be considered if it is clinically suitable to use the cabins for patients with these issues. If it looks inconvenient or unsafe for the patient they will be seen on the main site.
  1. Public address system – need a clear way of ‘calling in’ patients to consultation rooms.
/
  • This may not be universally needed if sub-waits are smaller.
  • Those with hearing problems need a visual or ‘vibrating disk system’ so they don’t get missed out.
  • Need to consider a method for ‘calling back’ those with small children or those with behavioural problems (who are walking around) – mobile units have been trialled elsewhere in the hospital.
  • Hearing loop system needed in all departments
  • Public information system to advise patients to proceed to designated areas e.g. pre-op assessment
  • Consider bleep system for carers and escorts
/ There are a wide variety of solutions, the trust needs to consider the options with patient representatives.
  1. Décor – to be bright and cheerful
/
  • Most people mentioning it felt it should be bold and cheerful
/ Agreed
  1. Bariatric Furniture – for the larger patients
/
  • Ensure enough appropriate furniture is purchased
  • Electric DSU trolleys support up to 350kg
  • Bariatric operating table (attachments) to be procured
/ Agreed
Department Management and Staffing Issues
Issues put forward by the Public during the consultation / Solution recommended by internal advisers or managers / Decision by Steering Group
Staff in Departments
  1. Reception staff - The person who receives you at the door is important. It is important for those welcoming to be upbeat and friendly.
/
  • All staff who meet patients at the door to receive ‘customer care’ training for the new departments.
  • In general, will need to give the public more information about how the new unit will function. Further information leaflet to follow and articles for local press.
  • The use of clear English to be encouraged by all staff.
/ Agreed.
  1. A streaming nurse (senior nurse) - receiving patients.
/
  • Streaming Nurse to be ‘obvious’ by their uniform and presence.
  • Privacy for ‘clerking in’ is seen as important, need to check where the streaming nurse will interview new arrivals.
/ Agreed
  1. Direction finders -Staff or volunteers needed within the departments to direct patients to next area.
/
  • Staff to be provided with maps for patient usage for the new department to aid the patients getting to the next area/investigation.
  • Consider trained volunteers in the Emergency Department to escort and help patients.
/ Trust to consider its options
  1. Disability Etiquette - Further training in disabled etiquette needed (poor hearing/ deaf mentioned/poor sight)
/
  • Further training in approaching and communicating with disabled patients needed.
/ Agreed
  1. Disabled ‘Escort’ System – person independent from the normal carers for a disabled person (to maintain privacy around medical condition)
/
  • Trust needs to look into whether this is possible or if a volunteer could be used for this kind of undertaking.
/ The Trust does have a duty to chaperone if patient requires/requests this. The Trust would need notice of patient wishing to have this service ifthey were travelling to more than one area of the hospital. To investigate with Volunteer Manager.
Keeping patients informed
6. Queue Updates – patients are informed about the delays in the departments /
  • Patients need to feel they have not been forgotten – communicate with them as frequently as possible about likely wait times.
  • Consider electronic boards showing patient reference number
/ There wil be an electronic ‘Patient Update System’ within the new departments.
Booking of Patients
7.Block Bookings- of patients not supported or welcomed / Can we look again at staggering appointment times for Day Surgery? / The Trust has considered this, but in order to extract maximum usage of theatre capacity the patient needs to be ready to ‘go in’. If patients don’t arrive the trust needs to re-use their theatre slots.
8.Letters out to patients – central number needed to ring if you have special needs to alert clinic/day surgery etc / Need to look at having a central number for all clinics and surgery – so patient’sdetails are recorded and acted on to prepare for their visit. / Agreed - The Trust is looking at how special needs can be recorded and prepared for in advance of the patient arriving at the site.
Other
9.Local Population and expanding local numbers / Some public re-assurance that the departments can cope with the population numbers we serve after the local building development. / Future growth assumptions have been taken into account.
  1. Magazines or newspapers(Up-to-date) for waiting areas
/ Can the departments concerned update the reading matter in their waiting rooms?
Voluntary donations welcomed. / Agreed. Will need to source frequent changes.

1