Appendix 5

RESPONSES TO ON-LINE SURVEY

For the duration of the engagement period an on-line survey was available via partner websites for anyone to complete with an interest in the draft STP. The survey was promoted via media releases, social media and partner organisations communication tools and networks.

The survey posed the same five questions that were asked at engagement events and a total of 94 people and/or organisations took the time to respond to the survey. Each was asked to identify their gender and of the 69 who answered the question 37.7% said they were male, 52.2% identified themselves as female and 10.1% preferred not to say.

The majority of responders were individuals but the following organisations also took part in the survey:

  • Newburn Surgery patient participation group
  • Tyne and Wear Fire and Rescue Service
  • Women’s commissioning support unit
  • North Tyneside VODA
  • National Shop Stewards Network North East

ROUND-UP OF RESPONSES

Question 1

What do you think about the draft STP vision for our area? Is there anything missing or more we should be aiming for?

Of the 94 people/organisations who responded to the survey, 86 answered this question:

  • Excellent aims but How do the funding cuts relate to this? In reality, as much of a hoax as the '7 day claims'. Unevidenced, unfounded, are you part of a lie?
  • Vision is admirable - BUT how on earth will savings be made with these goals above? sounds like you need extra funding... not finding ways to get by on less. Closer to home.... one huge emergency A&E in Cramlington... with transport needed for people ....how to get there easy by bus or taxi? And ambulances need to travel further for some people. And what if you can't afford taxi or car? And three walk in centres going but replaced by one 24/7 urgent care centre...how is this closer for everyone? ....very convenient that the A&E n walk ins not part of the STP... or are they? Walk ins part of QIPP but still happened in 2015 and STPs were started two years ago. And new model of urgent care?based on what evidence? and I'm pretty clued up...and first I hear about walk ins is in Dec last year and that it's decided...they are going. You had responses from 768 people...surely there must be some threshold for supposed consultation that has to be reached? Even IF an urgent care centre is good... only 768 is not good enough or high enough...out of 1000s who live in N Tyneside. So very convenient to have economically viable above on point two. Mental health...yes good vision again...but where is the ring fencing of funds or guarantee of it?And forums and health watches and My NHS need to be promoted more. In the past I was confident that the NHS was in good hands - I'm not any longer .
  • Very visionary and equitable. I would not use "will" realise their potential as things outside the STP affect this . STP is about health and social care not things such as equity of access to schooling Safe& sustainable services are not the same as good services. It's safe & sustainable to strap people at risks of fall in bed but it is not legal/good practice
  • Difficult to argue with these aspiration. However point by point:difficult for everyone to "equally" enjoy positive health and well-being if some are sick and others aren't. Do we have to make the healthy sick to achieve this?Safe and sustainable is a little unambitious?Play a role is a little unambitious?
  • The aims are laudible but they do not represent what the proposals will really mean for health services in our area. In reality, services will be cut and people's health will be put at risk by the increased rationing of provision.
  • I would question whether Northumbria NHS Trust provides sufficiently prompt assessment and treatment for myocardial infarction and suspected stroke for people living in outlying rural areas of Northumberland. The outcomes for patient with MI or ischaemic stroke are now greatly improved with prompt treatment but this is only available at Cramlington. I would like to see an audit of the time between 999 call and the start of treatment for all patients. If there is a significant delay in the start of treatment for these patients, appropriate risk mitigation measures should be put in place or people told honestly that there risk of delayed treatment if they live in outlying areas. There are potentially similar problems with acutely ill children and it should be made clear to all parents (ante natal sessions?) when they should take children straight to Cramlington, having called 111 first.
  • While the vision is laudable and would be hard to disagree with, it is written in language that is understood by health care professionals, language that would be difficult to understand for the ordinary patient in their GP surgery, outpatient clinic waiting area or an A&E department. The graphic illustration of the proposed model (page 7 of the summary document) looks pretty but is hard to understand unless you are familiar with such illustrations.The illustration showing the gaps to be addressed in the STP (page 9) is easier to understand and might make a better starting point for non health professionals to understand the context in which changes are proposed.
  • Underlying the current plan is the money available to deliver better health outcomes and the current concerns that the government is not prepared either to provide the funding or the policy context in which sustainable improvements in health and well-being can be delivered. This is hinted at in the second bullet point by the two words "economically viable". Such words are not neutral in the context of past and current government policy in relation to the NHS and social care - if the money and the policy are not available, then the ambitions will founder.
  • Encouraging citizens to take responsibility for their own health and well-being is fine, but it not an abstract concept - it requires good knowledge and information, good support services, access to facilities and so on. Yet since 2010, resources that could be applied to all of these areas have been sucked out of our region.
  • Our experience in Newburn PPG with the development of a new surgery that would have allowed our practice to provide more services to our patients that would have improved health outcomes, demonstrates what happens when the money is pulled.
  • Only recently, one of the local authorities in the STP footprint area - Newcastle - announced the closure of its Sure Start centres, critical infrastructure that would help citizens starting out on parenthood understand the skills and choices that allow them to take meaningful responsibility for their own and their families health.
  • Looks rather vague in many respects. I am concerned about the possible bullying that may occur eg mothers being put under pressure to breast feed....in some parts of the country Trusts have tried to make mothers sign forms to the effect that if they fail to breast feed they are jeopardizing the baby's health. Any Trust doing this is actually guilty of a criminal offence...Harassment. So I think you need to be very clear about your methods of so called support and empowerment.
  • Great aims. But point 2: explain, exactly, how a ~900 000 000 real terms CUT in funding across the whole region in the next 5 years makes that "aim" anything other than a cynical - empty hot air - contradiction? 'Economically viable'? According to whom - please spell it out. Who voted for the current wave of un-mandated policies from our anti-piblic-sector government? Nowadays, not even Mr Hunt bangs on about evidence for 7-day services anywhere that anyone can question him. It was a cynical, hollow lie. Let's have the debate in terms of % GDP, number of doctors, nurses, beds: population.Aim for better- funded- supported- education and healthcare. Not at this price.
  • I do not believe that this cuts-driven plan is a single iota about better access/better patient care/better wealth and prosperity for anyone outside those in the health insurance business, and other business investors (I specifically am thinking about CDDFT's PFI outgoings) and private healthcare.
  • Increase investing in schools, education, social care - don't pretend that cutting healthcare will have the same de facto outcome. Risible.
  • Better access? I want to see explained how the population of- say- Shotley Bridge and Consett benefit from having their hospital removed? What access to transport have they (public or private)? How relatively comfortably off are they- and what is the mean age- compared to the rest of the county? How far will they have to travel for GP-led hospital beds? Maternity care?Emergency assessment? Let's address nursing homes and care-at-home, too. Let's look at hospital waits e.g. The ambulance waits over Christmas and New Year : I am ashamed at the "patients-should-not-be-so-stupid" recent news statement from the CEOs of our region: how do trivial illnesss impact in-patient bed capacity? Not at all. It is hurtful; message to genuine people is that they shouldn't come unless dying. I have seen first-hand the calamitous effect of that fear. And where are we going to get more GPs, more nurses- or just endless dilution of skill and money? I speak specifically about the experience of NHSP in our hospitals - making millions of profit; proudly putting in all their literature and board reports their claim to be re-investing it straight back into the public's NHS. Their email response to my questions says they are simply putting more people through 2-day training to be an HCA; nothing to do with qualified nurses, professions allied to nursing, and medics. But they've spent millions on developing a 'great IT platform' - making them easier to use. Who owns the recently sold 40% stake in NHSP?!) ? We have a catastrophic shortage of permanent staff already. The older generations have paid in for all of their lives - we treat them deplorably by destroying their healthcare.
  • This will only be achieved by a massive injection of funding from the Governement
  • It is how you implement your vision that is important. The Plan as it stands lacks specifics about what will happen to healthcare services in the STP area. One huge issue is how will moving care into the community actually succeed when local authority funding has been cut to the bone and social care is in crisis. Concentrating care in specialist centre will place huge demands on the ambulance service which will need increased resources in terms of equipment and numbers of staff and increases in skilled paramedics who can carry out procedures in the person's home or on the ambulance.
  • These aims may be laudable but they are meaningless when divorced from the detailed content of the draft STP, which is full of impenetrable jargon and manages to be very specific in some parts and very vague in others. Despite claims to the contrary, in practice the STP is about making cuts to accommodate services to the chronic underfunding and defunding of the NHS and social care by the government when it is glaringly obvious that, as many health professionals and experts have said, funding should be increased to ensure people's needs are properly met.
  • The current crisis in the NHS is particularly acute in but not confined to A & E and hospitals partly because of cuts in government funding to local authorities to provide adequate social care for elderly and vulnerable people but also because there are too few beds and staff in hospitals and GP services are overstretched. Health and care services do need to be more joined up but without more funding they will still be inadequate. Even Surrey County Council plans to hold a referendum on increasing its council tax by 15% to fund social care because the government refuses to increase funding enough and because cuts have left it unable to cope. This is not an option in a poorer part of the country like the North East and if it became more common would increase health inequalities not decrease them.
  • Under your plans many services will not be closer to people's homes but concentrated in larger centres (specialised hospitals and Primary Care Centres), a big problem in rural areas where travel and transport are often difficult. In Northumberland people in Hexham, Wansbeck and Morpeth are unhappy about the downgrading of A & E services in their local hospitals and their transfer to the new Emergency Care Centre in Cramlington, which has proved disastrous. People in Rothbury have protested over the loss of services from their local hospital because they know the serious consequences this could have for people there.
  • How are local people going to be empowered and supported to play a role in improving their health and well being when public health provision has been decimated by cuts and the Royal Pharmaceutical Society has warned that many local pharmacies will close because of cuts in government funding?
  • The idea that rearranging services at the same time as saving £641m by 2021 (£904m including social care) will improve them when the overall population of England is growing and the number of frail elderly people with multiple conditions is going up at an even greater rate is simply not credible and means that your vision is pie in the sky.
  • Tyne and Wear Fire and Rescue Service welcome the vision as set out in the STP and would also welcome the opportunity to discuss how we could work together with the Health community
  • It looks reasonable..but....you state that GP services have not always kept up....well a case in point is Browney House Surgery Langley Park....closed every Thursday afternoon so working 4.5 days a week...so....if a person is discharged from hospital on a Thursday...no contact possible before Friday....is this representative of 7 day services in the 21st century? I imagine other surgeries are also working these short hours. Also you can't empower people if they are sent to inaccessible venues for screening etc...eg Stanley for breast screening rather than the nearest venue. Will you address these issues?
  • If you want joined up services you need to consider Geographical distance....eg why was my husband sent an UNSOLICITED appointmnent for Aortic Aneurism screening in PETERLEE when we live in Langley Park??? We considered he was being used for research a!though why we don't know as he has no relevant medical history AND there is NO evidence of the existence of such a screening programme. We nearly informed police as we thought it was a scam but did manage to authenticate the letter...however... Who sent such a ridiculous letter.... To get from Langley Park to Peterlee means 2 buses and 2 hours travelling time!!! He was offered an appointment at Stanley.....no buses there either. He told the relevant person that he would not attend and felt he was not being told the truth about why he was sent the appointment....? Mistaken identity....? Research which is unethical as it had not been declared as such...? I think a senior manager and our GP should have issued a written apology for using his details without an opportunity for inforned consent
  • It says nothing about mental health services, problems with discharging patients from hospital back to their own homes in the community or difficulties for the ambulance service being able to process patients at A&E
  • I think you miss the obvious....people in the Langley Park areas who have been placed in the non existentDerwentside then northDurham are not going to go to Hexham General.... No transport!!! You are proposing to further reduce facilities at Shotley Bridge when the population is growing in that area.Have you ever attempted to get over to Hexham in winter without a 4 wheel drive vehicle and snow chains????? Sunderland has abysmal parking....poor transport links to the Langley Park area...2 buses needed if you travel by bus....this hardly supports or empowers people or facilitates health...why do people from Langley Park get sent to Stanley for breast screening when there us no public transport.... Why can't they go to Durham...15 mins on a direct bus!!!!!! Sheer madness. I don't believe it will happen
  • Please proof read your wording...how can you assess the potential of VISITORS???? This is nonsense.
  • Empowering and supporting means NOTHING unless people accept responsibility for themselves! They can't play a part in anything if they are not informed and given fair access and opportunity...eg transport to health facilities only available if you live in social housing??? (Durham Health Link never goes near private housing let alone offering lifts to private householders...) Review the stupid mass screening eg the invented disease of pre-diabetes which does noitexist according to WHO."
  • Sorry but this is simply meaningless jargon! How can you 'empower' anyone regarding health when cutbacks are unrelenting....what do you mean by wellbeing??? Places like Langley Park have NO access to leisure facilities...