Proposed major service change in Skye, Lochalsh and South West Ross: Analysis of the responses to the public consultation survey /
November 2014
CONTENTS
Page
1.0INTRODUCTION
2.0RESULTS
2.1Overall response rate
2.2Response rates by gender, age and by area
2.3Representativeness of responses by age and gender
2.4Ratings of aspects regarding the proposed changes (question 1 in the survey)
2.5Preferred Option (question 2 in the survey)
2.6Preferred site (question 3 in the survey)
2.7Individual direct response or on behalf of another/others/groups (question 6 in the survey)
2.8Self declared category of responder (question 8 in the survey)
2.9Inpatient status of the responder within the last 12 months (questions 9 & 10 in the survey)
2.10Residential status of responders (question 11 in the survey)
2.11Carer status of responders (question 14 in the survey)
2.12Transport and access status (questions 15; 16; 17; 18 in the survey)
2.13Self-reported prevalence of Long-term (over 12 months) conditions or disabilities amongst the responders (questions 19 & 20 in the survey)
3.0SUMMARY
Epidemiology & Health Sciences Team (Public Health)
1.0INTRODUCTION
The surveyas part of the Skye, Lochalsh and South West Ross (SLSWR) public consultation on proposed changes to Health Services was undertaken during 2014 and had been designed on the recommendations of the Clinical Governance team. The Epidemiology & Health Science team were asked to analyse and report on the responses it received. The survey was sent to all households in SLSWR, providing the opportunity for as many as possible to respond to it. In the event 2,273 responded, equivalent to just under one fifth (19%) of the population aged 16 years and over.This briefing presents the results of the analysis of these responses with the following notes applying to it.
- Responses from responders who provided addresses or the place where they live,are presented under the relevant geographies of Skye South; Skye Central; Skye North, Lochalsh or South West Ross according to the map below. Responses were also grouped as all SLSWR (n = 1,911) or overall (n = 2,273) which included the responders who did not indicate where they lived.
- The results have been presented in the same order as they appeared in the actual survey.
- For all questions, percentages were calculated using the numbers responding to the survey as a whole or by geographic areas and not the number responding to a particular question as the denominators. This method is appropriate to this particular survey design.
Map 1:Distribution of survey respondents by place of residence across the Skye, Lochalsh and South West Ross public consultation area
2.0RESULTS
2.1Overall response rate
Overall, less than one fifth (19%) of the population living in SL & SW Ross aged 16 years & over responded to the survey (table 1). The highest response rate was Skye South with 23% response rate.
Table 1: Response rate by geographical area of responders’ residence
2.2Response rates by gender, age and by area
Although the highest response rate was from Skye South, relatively greater rates in all areas were by females. Overall the response rate of females was 22% and that of males, 14%. This disparity by gender was highest in Skye North and Skye Central with an almost 2:1 ratio in female to male rates (chart 1).
Chart 1: Response rate by area and gender
Generally, the highest response rates were in the older age groups, particularly in Skye South and Skye North where the highest response rate was in the 80 years and over age group (chart 2).
Chart 2:Survey response rate by age-band within each area
2.3Representativeness of responses by age and gender
Disproportionate to the underlying population profile,older age groups responded more, the highest percentage of total responses was by those aged 60-69years (chart 3). This was more so in males where over 30% of male responders were aged 60-69years compared to around 20% in the population. The 16-29year age group was the least represented in the responses.
Chart 3: Response profile by age group and gender compared to the underlying population profile
2.4Ratings of aspects regarding the proposed changes (question 1 in the survey)
The responders were asked to rate each of twelve different aspects in relation to proposed changes to the NHS Service provision in Skye, Lochalsh & South West Ross. With the exception of only one of these aspects, the majority of respondents were in support, ranging from 59% to 91% (table 2). The only aspect not associated with a majority in support was the ‘closing in-patient beds in Portree Community Hospital’. The majority (53%) of respondents did not support this aspect of the proposed change (table 2).
Table 2:Percentage ratings of aspects relating to proposed changes for all survey respondents
2.5Preferred Option (question 2 in the survey)
The options given in the public consultation for survey respondents to select their preference from were:
Overall for all respondents to the survey the majority (57%) had selected the Community Resource Centre and Hospital Hub in Broadford with a spoke in Portree (option 2a, chart 4).The ratio of those selecting option 2a versus those selecting option 2b (Hospital Hub in Portree and spoke in Broadford) was approximately 2:1 with support for the other options offered being much lower at 1-2%.
Chart 4:Percentage preferred option (as per Q2) of all survey respondents1
1Includes all responders to the survey whether question 2 (preferred option) of the survey was answered or not (n=2,273)
When only those respondents who gave an answer to the preferred option question (Q2) were included in the analysis, the profile of preferred options selected remained very similar. Option 2a (Community Resource Centre and Hospital Hub in Broadford with a spoke in Portree) remained as the preferred option of the majority (62%) with the ratio of those selecting option 2a versus those selecting option 2b staying at 2:1 (chart 5).
Chart 5:Percentage preferred option (as per Q2) of survey respondents who gave an answer1
1Includes only responders to the survey who gave an answer to question 2 (preferred option) of the survey (n=2,096)
Note:All further analysis to follow will use all respondents to the survey (n=2,273) as the denominator, whether they answer the relevant question or not. This will ensure that the full picture of how people responded to the survey questions is provided.
Option 2a was also selectedby the majority (i.e. >50%) of those from Skye South (92%), Lochalsh (91%) and South West Ross (80%). In contrast, for Skye Central and Skye North, the majority selection (60% & 66% respectively), was for the option 2bin which the Community Resource Centre and Hospital Hub would be in Portree and the spoke in Broadford (table 3).
Table 3: Percentage preferred option (as per Q2) of all survey respondents: overall and by area of residence
2.6Preferred site (question 3 in the survey)
For the option of a community resource centre and hospital hub at Broadford with a spoke in Portree, one quarter of the overall responders from Skye, Lochalsh and South West Ross, selected a site on the land between the existing hospital and health centre in Broadford, (see as site 4 in Table 4).However a larger proportion had selected “no preference” (42%). Amongst the areas, the majority of responders from Lochalsh (54%) and South West Ross (61%) had also selected no preference. The majority of responders in Skye South (53%) had selected site 4 whilst 42-43% of those from Skye North & Central had selected “no preference”.
Table 4: Percentage preferred site of option 2a selected by all respondents: overall and by area of residence
2.7Individual direct response or on behalf of another/others/groups (question 6 in the survey)
Table 5:Status of responder (Q6)
* groups noted were: /Note: it was made clear in the consultation survey that if responding on behalf of a group, then the response and the name of that group would be published.
2.8Self declared category of responder (question 8 in the survey)
Most of the responders indicated they were members of the community (71%) with 61% as a patient, carer or service user. As responders were asked to select as many of the categories that best described them, the frequency of responses are not mutually exclusive.
Table 6: What categories best describe you? (Q8)
*Note: responders could select more than one category, so these are not mutually exclusive and the percentages will not add up to 100%
2.9Inpatient status of the responder within the last 12 months (questions 9 & 10 in the survey)
Overall, 12% of the responders had reported being an inpatient in the MacKinnon Memorial Hospital within the last 12 months (table 7). The proportion ranged from the lowest in South West Ross (7.6%) to the highest in Lochalsh (16%).
In contrast, only 4% of the overall responders had recorded having been an inpatient in Portree Community hospital (table 8). The highest percentages were amongst the responders from Skye North and Skye Central (9%).
Table 7: Have you been an inpatient in Dr Mackinnon Memorial hospital in the last 12 months? (Q9)
Table 8: Have you been an inpatient in Portree Community hospital in the last 12 months? (Q10)
2.10Residential status of responders (question 11 in the survey)
Three quarters (75%) of responders indicated they did not live on their own, over one fifth (21%) lived on their own and 4% did not answeror did not wish to answer (table 9).
Table 9: Do you live on your own? (Q11)
2.11Carer status of responders (question 14 in the survey)
Most of the responders (83%) stated they were not carers, 12% stated they were carers and of these, 60% were part-time and 40% full-time (table 10).
Table 10: Are you a carer? (Q14)
2.12Transport and access status (questions 15; 16; 17;18 in the survey)
Responders were asked about car ownership or access to a car. Overall 84% indicated they did have a car or had access to one. The proportion with access/ownership was the most in Skye South (89%) and Skye North (87%) and the least in Skye Central (84%) and Lochalsh (85%). The proportion indicating they did not have access/ownership was the highest in Skye Central and Lochalsh (13% in both areas) (table 11).
Table 11: Access to a car or car ownership (Q15)
Responders were also asked about public transport access to Portree and Broadford.In relation to the ease of accessing public transport to and from Portree, the overall selection was one third (33%) answering “not really”, 30% answering “not at all”, one fifth answering “to some extent” and only 5% selecting “to a great extent” (table 12). Amongst the areas, Skye North and to a lesser degree, Skye Central recorded having the most access to public transport for getting to/from Portree (45% and 36% respectively)according to the selection of “to some extent” or “a great extent”. In contrast, 66-91% of the responses from the other areas had indicated “not really” or “not at all” for access, the highest proportion pertaining to responses from South West Ross (table 12).
Table 12:Is it easy to access public transport to get to and from Portree? (Q16)
In relation to access by public transport to Broadford,the overall selection was almost one third (32%) answering “not really”, 28% answering “not at all”, 26% answering “to some extent” and only 5% selecting “to a great extent” (table 13). Amongst the areas, Skye North and to a lesser degree, South West Ross and Skye Centralrecorded having the least access to public transport to/from Broadford (83%,73% and 67% respectively) according to the selection of “not really” or “not at all”. In contrast, 50% of the responses from Skye South indicated “to a great extent” or “to some extent” (table 13).
Table 13: Is it easy to access public transport to get to and from Broadford? (Q17)
In relation to accessingcommunity transport, the overall selection was one fifth (21%) answering “not really”, 28% answering “not at all”, 11% answering “to some extent” and only 2% selecting “to a great extent” (table 14). Amongst the areas, Skye North and to a lesser degree, Skye Central recorded having the least access to community transport of 66% and 56% respectively according to the selection of “not really” or “not at all”. In contrast, 53% of the responses from South West Ross indicated “to a great extent” or “to some extent” (table 14).
Table 14: Is it easy to access community transport e.g. a ‘community car’? (Q17)
2.13Self-reported prevalence of Long-term (over 12 months) conditions or disabilities amongst the responders (questions 19 & 20 in the survey)
Approximately 40% (n = 851) stated they had a condition or disability (table 15).
Table 15: Do you have a long-term health condition or disability (lasting or expecting to last for over 12 months)? (Q19)
Those who had indicated as having a condition/disability were asked to answer question 20. The answers to this question were not mutually exclusive i.e. a responder could select one or more of the options that best described their particular long-term condition. Nearly 60% indicated a long-term illness and just under 30%, a physical disability (table 16). Nearly 9% indicated a mental health problem (table 16).
Table 16: Which conditions/disabilities apply? (Q20)
3.0SUMMARY
Overall response rate of 19%, highest in Skye South (23%)
The female response rate (22%) was higher than that of males (14%) with the greatest disparity in Skye Central and Skye North with nearly a 2:1 ratio
Higher response rates were in older age groups ( 60y&over), particularly for Skye South and Lochalsh
Older age groups were over-represented; particularly males aged 60-69 years (30% versus 20% in the population). The 16-29y age group was the least represented in the responses.
Responders on being asked about certain aspects of the proposed changes had returned a majority response in favour (as per support to great extent or support to some extent) for eleven out of the twelve aspects. The exception was in response to closure of beds in Portree where the overall support proportion was 23%. The strongest support was returned for (1) improving inpatient medical cover (91%); (2) Providing services from modern hospitals (91%); (3) Improving community transport (91%) (4) Better joint working (90%).
The majority (57%) selected the option of a Community Resource Centre and hospital hub in Broadford with spoke in Portree. This majority selection applied to all areas other than Skye Central and Skye North in which 60% and 66% respectively preferred the Community Resource Centre and hospital hub in Portree with spoke in Broadford.
Only responders in Skye South gave a majority selection (53%) for the land between existing hospital and health centre for the Broadford Hub option. For all other areas, the majority had selected either no preference or had not given a selection.
96% of responders responded on behalf of themselves with 2% responding on behalf of others
The majority of responders considered themselves as patient/service user/carer (61%) and as a member of the community (71%).
In the last 12 months, 12% and 4% of overall responders had been an inpatient in the MacKinnon Memorial or Portree Community hospitals respectively. Amongst the areas, the highest percentage in relation to MacKinnon was 16% in Lochalsh whilst the highest percentage in relation to Portree hospital was 9% in both Skye South and Skye Central
Three quarters (75%) of responders indicated they were not living on their own, whilst over one fifth (21%) were living on their own. 4% either did not answer or preferred not to answer.
Most of the responders (83%) stated they were not carers, 12% stated they were carers and of these 60% were part-time and 40% full-time
Overall 84% had access to or ownership of a car. The highest percentage was in Skye South (89%) and Skye North (87%) and the least in Skye Central (84%) and Lochalsh (85%). The proportion indicating they did not have access/ownership was the highest in Skye Central and Lochalsh (13% in both areas)
The majority (62%) overall indicated that access to public transport to and from Portree was either “not really” or “not at all” with only 27% indicating that to “a great extent” or to “some extent”. Amongst the areas, most access was indicated in Skye North (45%) and Skye Central (36%).
The majority (59%) overall indicated that access to public transport to and from Broadford was either “not really” or “not at all”. Amongst the areas, one half of responses from Skye South indicated that there was access. 83% of responses from Skye North indicated no or not really access.
Just under one half of responders overall had indicated that there was “not at all” or “not really” access to community transport with only 13% indicating there was. Amongst the areas, the least access was from Skye North and Skye Central (66% and 56%). SW Ross responded the most access (53%).
Approximately 40% (n = 851) stated they had a long-term condition or disability. Of these, nearly 60% indicated a long-term illness, just under 30% a physical disability and nearly 9% indicated a mental health problem. These proportions are not mutually exclusive.
Epidemiology & Health Sciences Team(Public Health)1
As part of the Directorate of Public Health & Health Policy of NHS Highland, the Epidemiology & Health Science team provide specialist skills in the areas of:
Epidemiology, Evaluation, Literature Review, Health Economics and Database design for Public Health functions
Public Health Intelligence & Epidemiology
Epidemiology and Health Sciences Team
Directorate of Public Health and Health Policy
NHS Highland
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Report prepared by: Susan Vaughan & Sara Huc
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