NHS Grampian
Summary of NHS Grampian Consultation on the Proposed Key Priorities
Introduction
On the 7th April 2009, the Grampian NHS Board endorsed the high level process and timescales for the development and agreement of the three year Grampian Health Plan (GHP), which would focus on the period 1st April 2010 to 31st March 2013. As per the agreed process, the Grampian NHS Board approved a consultation document and supporting consultation plan on the 6th October 2009, with the primary aim of gathering views on the proposed vision and key priorities for 2010 to 2013. A full report on the consultation will be available via the NHS Grampian Health Plan webpage in late April 2010.
Aim
The aim of this paper is to provide Grampian NHS Board members with a summary of the consultation process undertaken, the key themes which emerged, and the next steps.
Summary of Consultation and Key Themes
1. Aim of Consultation
Key to developing the three year GHP for 2010-13, was gathering the views of the public, staff and our partners on NHS Grampian’s proposed vision and priorities to improve the health of people who live or access care in Grampian.
The specific aims of the consultation were to:
· raise awareness of the vision and values, the challenges ahead, and the key priorities for NHS Grampian for the period 2010 to 2013, by widely circulating the GHP consultation document to staff, public and partners.
· gain feedback from staff, the public and partners on the key messages outlined in the GHP consultation document by making available a variety of feedback methods and mechanisms.
· ensure the GHP for 2010-13 submitted to the Board in April 2010, reflects the views and priorities expressed as appropriate.
· reduce the barriers to anyone participating in the discussions about the GHP consultation document, and that all views expressed are given equal consideration.
The formal consultation period commenced on the 19th October 2009 and closed on the 11th December 2009, however we did accept responses which were submitted in late December 2009 and early January 2010.
2. Consultation Methods
There were a number of activities undertaken to gather views from NHS Grampian staff, members of the public and partners. There were three main methods which are encapsulated in appendix 1. Supporting the launch of the consultation in mid-October 2009, was a media release detailing how people could give their views, including details of the public consultation meetings.
The three main methods were:
a. Consultation Document
A consultation document entitled ‘What Are Your Views On NHS Grampian’s Proposed Key Priorities For The Next Three Years?’ was produced and approved by the Grampian NHS Board on the 6th October 2009. This document was developed based on pre-consultation meetings with members of the public (through public focus groups), staff and our partners to establish what they felt should be NHS Grampian’s key priorities for the coming years.
The consultation document was widely circulated as per the consultation and engagement plan, which was also approved by the Grampian NHS Board on the 6th October 2009. A summary is provided below.
· Hard copies were available in NHS premises for staff and members of the public.
· Circulation of electronic copies to staff.
· Circulation of hard and electronic copies to partner organisations.
· Accessible via the NHS Grampian Website, Intranet and Hi-net sites.
· Accessible version for those with communication difficulties and also translated into non-English languages upon request. We were specifically asked to translate the document into Polish which was circulated to Polish user-groups.
Various mechanisms were in place to facilitate feedback such as a feedback questionnaire (paper-based and electronic), e-mail, text, and open sessions.
b. Formal Meetings
At least 40 meetings were held which formally discussed the consultation. A large number of these meetings were supported by Board members. A breakdown of these meetings is contained in appendix 2. A summary is provided below.
· Four public meetings. Seven were organised but due to little interest, three were cancelled. Over 109 members of the public attended these meetings.
· 25 NHS Grampian staff meetings were held, with over 443 staff in attendance.
· 11 meetings were held which involved NHS Grampian staff, members of the public and members from partner organisations. Examples are Managed Clinical/Care Networks (MCNs) and Community Health Partnership Committees. Over 151 staff, public and partners attended these meetings.
A generic GHP consultation presentation for both the public and staff sessions was produced and utilised. This set out the challenges facing NHS Grampian, the proposed vision, and the key priorities in the context of the five strategic themes. Examples of local developments and good practice was also incorporated in order to set a meaningful context, but also to ensure that the GHP was not seen as a separate entity.
c. Informal Discussions/Consultation
In order to gather as many views as possible, and to ensure we sought views from people who were unlikely to have engaged in the consultation, we undertook an informal consultation. Several members of NHS Grampian staff spent several hours in the Aberdeen Royal Infirmary concourse, the Dr Grays Hospital concourse, the Healthy Hoose in Aberdeen and the Peterhead Health Centre, and approached members of the public and staff, and asked them what they thought should be NHS Grampian’s priorities and also what they thought of NHS Grampian’s proposed priorities. The informal consultation was undertaken using a generic questionnaire.
Mr Raymond Bisset was particularly active in this component of the consultation.
Chart 1 below provides a breakdown of the number of responses received by consultation mechanism. It can be concluded that the largest percentage of responses were from the informal discussions/consultation and the formal consultation questionnaire.
Chart 1: Breakdown of the number and percentage of responses received by consultation mechanism
3. Who Contributed To The Consultation?
It is very difficult to say the exact number of people who gave up their valuable time to take part in the consultation, but we can say that we know it was over 939 people. A breakdown of numbers and gender of those who took part are outlined in table 1 below.
Method / Total Number of People Attended orResponded / Number of Males & Females / Comments
Males / Females / Unknown
Formal Questionnaire / 125 / 40 / 57 / 28
Meetings / Over 703 / 48 / 61 / Over 594 / Breakdown of gender for public meetings only
Informal Consultation / 111 / 37 / 72 / 2
Total / Over 939 / 125 / 190 / 624
Table 1: Breakdown of the number and gender of people who took part in the consultation
Of the 939 people who took part in the consultation, 755 (80%) people advised us they were a member of NHS Grampian staff, a member of the public or a member of a partner organisation. 66% (502) people who took part were staff and 32% (240) were members of the public. Table 2 below, breaks this information down further in relation to the three consultation mechanisms.
Method / Public / Staff / Partner Organisation / No Response / TotalFormal Questionnaire / 40 / 42 / 13 / 30 / 125
Meetings / 109 / 443 / Unknown / 151 / 703
Informal Consultation / 89 / 19 / 1 / 2 / 111
Total / 238 / 504 / 14 / 183 / 939
Table 2: Breakdown of the nature of respondents in relation to the three consultation methods
Out of the 939 people who took part in the consultation, 209 (22%) people told us which age group they were from. Unfortunately the age groups requested in relation to the formal consultation questionnaire and the informal consultation questionnaire were different. Overall findings from this information show that over 70% of respondents were aged 45 years and over, with only 4 people being 18 years or under.
4. Number of People Aware of the NHS Grampian Health Plan, prior to being involved in the
Consultation.
As part of the formal and informal consultation questionnaires, we asked a total of 236 people if they had been aware of the GHP prior to the consultation. A total of 40% (94) said they were aware of the GHP. Chart 2 below, provides a breakdown of the responses. This can be further broken-down by formal and informal consultation methods - 68% of people in the informal consultation were not aware of the GHP, compared to 46% in the formal questionnaire.
Chart 2: Breakdown of the number and percentage of people who said they were aware of the GHP
5. What Did People Say About The Proposed NHS Grampian Vision?
We asked people via the formal consultation questionnaire if they understood the vision and priorities as set out in the consultation document. Overall 5% (6) felt that they did not understand the vision and priorities set out in the document. A further 59% (45) felt that it could be better explained.
As part of the formal consultation questionnaire and the consultation meetings, we asked people to tell us what they thought of the proposed NHS Grampian vision. We received a total of 138 responses (114 from questionnaires and 24 from meetings), these showed that 80% (110) of people agreed with the vision and the remaining 20% (28) agreed in part, or said they did not agree with it.
General comments regarding the vision:
· Many responses stated that the vision was overall unchanged from previous visions.
· It was difficult to disagree with the vision, but it was highlighted by many that the important element is delivering the vision.
· Some felt the vision was very vague and that this could be any healthcare organisation’s vision.
· Some people felt that the vision required to be more realistic than aspirational.
· Some people felt that more emphasis was required on public responsibility and a shift towards prevention and self care.
· Unclear regarding who is ‘working together’.
· There were split views on the words, ‘proudly’ and ‘best possible services’.
· It was suggested that the vision should incorporate ‘within the resources available’.
· It was suggested that a ‘more outcome flavour’ to the vision should be considered.
· Some individuals felt that it was not clear how the vision would be delivered.
6. What Did People Say About The Proposed Priorities For The Next 3 Years?
Around three quarters of people who responded to the consultation said they agreed with the proposed priorities. The most common comments received regarding the proposed priorities set out in the consultation document are outlined below.
· Priorities require to be more specific – it is not always clear what the real priorities are.
· Can’t disagree with the priorities but there are too many priorities. How can we deliver all of these in the current climate and challenges?
· Harder messages re financial position – be honest about the position.
· What can we do and not do?
· Access and patient safety were expressed as the highest priorities.
· Clear support for shifting the balance of care, but concerns were expressed regarding the infrastructure and resources to support this.
· How can we keep improving care and services if we are going to reduce our staff and staff training?
· The terms ‘inequalities’ and ‘mutuality’ are not very meaningful to most people and it was suggested these should be changed.
· How are we going to communicate the NHS Grampian’s responses to the consultation feedback?
The consultation feedback on the priorities has been broken-down by strategic theme. These are summarised as follows:
i. Improving Health & Reducing Health Inequalities
· Need to be clearer about how we support/enable self care and self management.
· More emphasis on problems relating to the changing demographics?
· Mental health and dementia both need to feature in the GHP.
· More focus on deprived/disadvantaged areas – how are we actually going to reduce inequalities?
· A few remarks re terminology of ‘inequalities’ – making it more meaningful for staff and public.
· Working with partners is key to improving health.
· Screening - greater focus required?
· Harm reduction/reducing risky behaviours.
· Mixed views on the focus on alcohol and drugs (also apparent in safe, effective and timely care in the right place).
ii. Involving Patients, Carers, the Public, Staff and Partners
· Mutuality – need to say this in another way as not meaningful to staff and the public.
· Public need to be able to access accurate, consistent information on conditions, treatments etc.
· Carers need to feature as a higher priority, particularly with the future challenges.
· Need to improve staff communication about patient care.
· Need to improve communication with staff.
· Need to consider ways to involve/engage people which are more age specific – young to the old, different methods required.
· Balance of rights and responsibilities – general theme of increased public responsibility required throughout consultation feedback in most strategic themes.
· NHS Grampian needs to act on/consider the consultation feedback and demonstrate/communicate this.
iii. Delivering Safe, Effective and Timely Care in the Right Place
· Public/Staff support locally delivered care but concerns about building infrastructure, equipment, staff etc in order to be able to deliver this. How do we shift the resource to do this? How do we do this with the current and future financial challenges?
· Specific concerns were raised about accessing GP practices within 48 hours.
· Lack of mention of how contractors currently and in the future can support this agenda.
· Transport/Parking highlighted.
· Specific references were made to Moray in relation to Mental Health, Maternity and Paediatric services – being clear about the plans for these and Dr Grays.
· References were also made to Children’s Services, Palliative Care/Resuscitation, Aberdeen Maternity Hospital, Raeden, Mental Health, Podiatry and Learning Disability services.