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Better Care Together next steps

In the autumn of 2018 we shared our partnership’s progress with local people and listened to their views on our proposed next steps.

Autumn 2018

We asked

In October and November 2018 the Better Care Together (BCT) partners, including ELR CCG, undertook engagement to discuss the proposals for acute and maternity reconfiguration in Leicester’s Hospitals.

Nine public events provided opportunities for patients, the public and wider stakeholders to discuss changes to the care they receive through primary and secondary care services in ways that suit them.  This included talking through the rationale for the proposed changes and what it would mean in practical terms for patients using services – particularly those being provided by the three hospitals in Leicester run by University Hospitals of Leicester NHS Trust and those provided in community settings. The events also discussed and answered questions and responded to concerns regarding changes to the Intensive Care Services in Leicester.

The events were held in community venues in East Leicestershire and Rutland, West Leicestershire and Leicester City. Around 350 people attended the nine events, which were held between 5pm and 7.45pm.  People dropped in for the first hour to informally discuss with NHS teams the plans for improvements across all Better Care Together work streams including acute reconfiguration.  This session was followed by a formal presentation and question and answer session.  One event was held as an informal drop-in session only (in Eyres Monsell, Leicester).

While the number of people attending the events wasn’t large, the reach of the promotional activities was significant. The events were promoted through the stakeholder databases of the two county councils and the city council, two provider trusts and three clinical commissioning groups.  It received wide coverage, both pre and post events, on social media (BCT account: 31 tweets sent to 1482 followers – 118 retweets and 172 likes and generation of 24 comments.  UHL account: 15 tweets generating 31,343 impressions and 714 comments.  In addition 40 likes on Instagram), as well as in print and on broadcast media including coverage on BBC East Midlands Today and in the Leicester Mercury, Melton Times and Harborough Mail.

We would particularly like to acknowledge the support we also received to promote the events from voluntary and community sector groups, many of whom promoted them in their online newsletters and the wide range of public and patient groups including patient participation groups.

Information about Better Care Together Next Steps, including the Next Steps document and an easy-read version, can be found on the Better Care Together website.

You said 

The questions raised by people at the events covered a range of topics, many of which were pertinent to local geographical areas.  The feedback from the public identified a number of areas where there were concerns and the need for more information to give a better understanding of proposals and processes.  Many comments were supportive of the various plans and particularly the need for investment to modify and improve Leicester’s hospitals.

The questions and feedback were responded to on the night of each event by a panel of NHS managers and clinicians.  Responses have also been made via social media and via other online mechanisms.  In addition, a question and answer log has been created and is available on line on the Better Care Together website.  It is being continually updated as and when new questions arise. You can find the log here

The key emerging themes can be summarised as follows:

  • Processes and procedures of bidding for capital resources and the unknown timeline for being permitted to commence public consultation are confusing for the public, the majority of who have a strong desire for formal consultation to take place at the earliest possible opportunity.
  • In the past Leicester has been in a similar position of wishing to invest in services, but for a variety of measures has not had funds available to implement plans.  There is worry that history may repeat itself.  
  • Broad support that investment is needed into the hospitals in Leicester and agreement that overall the plans are the right ones.  However, many people still want to have a better understanding around the decision to transform Leicester General Hospital into a community hub and the plan to move acute services to Glenfield Hospital and Leicester Royal Infirmary.
  • Need for continued engagement and involvement of the public in the acute and maternity services discussion to ensure that services are person-centred.  Also to ensure that if national approval is given and capital funding bids are successful that we fulfil on our promise to go out to formal consultation ensuring that the LLR public have their voices heard.
  • Need for transparency on what estates are being sold off, why and what will happen to the income from the sale.
  • Assurance that formal consultation on acute and maternity services will be effective and that feedback from the public will influence and impact on the final proposals.
  • Plans should consider the quality improvements to the infrastructure and environment including car parking, access into and around sites, sign-posting and public transport.
  • Assurance, particularly from rural communities that the centralisation of acute services will benefit patients and conversations are ongoing with acute hospital trusts across the LLR borders.
  • Assurance that proposals will respond to and address the current financial issues faced by NHS bodies, and will not contribute to further challenges.
  • Concerns about the proposed closure of the midwifery led birthing unit at St. Mary’s in Melton Mowbray and anxiety that local pre and post pregnancy support services, greatly appreciated by many, may be lost locally.
  • Recognition of national staff shortages, particularly nurses and how the proposals impact on current staff and attracting and recruiting new staff.
  • Importance of the role of primary care including GP federations/GP localities and the voluntary and community sector when redesigning services provided outside of hospital in the community, including in peoples’ homes.
  • Need for better access to primary care and GP appointments.
  • Better use of information technology when integrating health and social care services to ensure systems talk to one another so that patients and their carers do not have to repeat their story including creation of a single patient record.
  • Recognition that local areas are different and there is a migration of LLR residents outside of the counties as well as a migration of residents from other counties into LLR’s acute and community services.
  • Enthusiasm to participate in discussion about community services including community hospitals at the earliest possible opportunity.

We did

All feedback from the events is being distributed across Better Care Together partners and work streams in order that it can influence the decision making processes within each work stream and in specific programmes of work. 

It is being used to refine the Pre-consultation Business Case for the Acute and Maternity Reconfiguration and is also being fed into the current Community Services Redesign work.  It is strongly influencing our communications and engagement plan for the coming months, as people told us that they wanted ongoing involvement in co-producing the proposals.

We are committed to continuous communications and engagement on all aspects of the Better Care Together programme. We are also committed to formal consultation in regard of the acute and maternity reconfiguration. 
This will be at the point when our plans have been approved and capital resources are available. 

In preparation for this we are using the feedback from the 2018 engagement to draw up a consultation plan.  This plan will outline how we will undertake the consultation to ensure that we reach out to all communities in Leicester, Leicestershire and Rutland promoting the opportunity of participating in the consultation process. 

The plan itself will be co-designed so that it is comprehensive and enables effective public involvement and feedback, so that a robust decision on change that is the best interests of local people can be made.

To keep up to date on our plans and opportunities to be involved in influencing them or to find out more about Better Care Together, please visit our partnership website.

If you would like to speak to someone about getting involved in our work, please contact us on 0116 294 4104.

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