Fylde and Wyre 2030 Vision for Health and Care: Engagement Outcomes and Next Steps

1. Fylde and Wyre2030 Vision for Health and Care:Engagement Outcomes and Next Steps Governing Body Meeting 25 March 2014

2. Objectives www.fyldeandwyreccg.nhs.uk • To give stakeholders an opportunity to influence our long-term vision • To ensure our priorities are congruent with our partners • To support the development of the CCG’s communications and engagement strategy and OD plan • To develop the CCG’s ‘public pledges’ • To further develop the Affiliate Scheme • To ensure the CCG is meeting its statutory engagement duties

3. Engagement approach… e.g. www.fyldeandwyreccg.nhs.uk • Face to face engagement with Fylde, Wyre and Lancashire County councils – OSCs and officers • Presentations to Fylde and Wyre Health and Wellbeing Partnership, PPE Group,GP practice managers, staff and Council of Members • Provider workshop – 27 attendees; GP practice event – 97 attendees • Engagement with schools – 110 children (Kirkham) • Community engagement – listening cafes, focus groups – 320 people • Enquiry line responses – 36 responses • Qualitative engagement and feedback from approximately 1,800 people • Quantitative feedback (MORI) – 1,004 people

4. Media engagement

5. Web and social media www.fyldeandwyreccg.nhs.uk • Twitter promotion • Tweets to ‘amplify’ the PR and other messages • 30 Tweets • 3 mentions • 24 retweets • 6 favourited items • Website promotion • Online form for responses • Document to download: • 150 views on the page • 129 unique views – specific ‘traffic’ to the page • Time spent on the page: 1 minute, 37 seconds

6. Findings www.fyldeandwyreccg.nhs.uk General themes Priority-specific themes Feedback regarding the pledges Ipsos MORI You said, we did Next steps

7. General themes www.fyldeandwyreccg.nhs.uk • Broad support for the strategy/vision • Services need to be coordinated and integrated • Needs to be more recognition and support for self care and to promote personal responsibility • Information about services and conditions needs to be readily available • Need to recognise that each locality/community is different with different needs • The strategy is strong on the “what” but not on the “how” • Prevention needs to be given greater prominence • Many partners are relied upon but not referenced • CCG will need to demonstrate that people can influence health decisions

8. General themes - 2 www.fyldeandwyreccg.nhs.uk • Some respondents feel slightly cynical about future promises based on their experiences of the Fylde coast consultation • There is a fear of privatisation and sense that the strategy will open the door to this • Transport provision needs to be a key consideration in all developments • Waiting times need to be improved • Assurance that older/vulnerable people in hospital will be well cared for

9. Priority service areas www.fyldeandwyreccg.nhs.uk Cancer Children and maternity End of life Learning disabilities Long-term conditions Mental health and dementia Planned care Urgent care

10. Cancer – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this should be a priority • Concern around a perceived lack of or limited local/community based cancer treatment and care • Query around quality of services and whether they are meeting needs • Post-cancer care is poor • Prevention and early diagnosis need more prominence • Services need to be more joined-up • Need to reflect the role of all professionals (e.g. pharmacies in medicines reviews)

11. Children & maternity – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this is a priority • Recognition that stopping smoking in pregnancy and improving breast feeding rates are important priorities • Mental health and wellbeing is a key concern for children – and needs to be referenced • Variable experiences around discharge of new mums from hospital • Transition from childhood to adulthood a critical period – services need to be joined-up to support this • Childhood obesity is an issue – not referenced • Self-harming behaviour in children a growing problem – not referenced

12. End of life care – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this is an important priority • Children’s end of life (EoL)/palliative care services not referenced and are often forgotten • There needs to be more choice for EoL and this needs to be explicitly communicated • Lancashire County Council provides bereavement and related support services – this needs to be referenced/promoted • EoL needs to be discussed wider – schools in particular • Counselling is important • Professional awareness and training in , e.g. GPs, care homes • More information/directory of EoL support should be available • Hospices play a key role and not referenced

13. Learning disabilities – key themes www.fyldeandwyreccg.nhs.uk • Recognition that this is an important group • Support for people with learning disabilities across all services is variable, lacking knowledge regarding needs • Concern around the transition between childhood services and adult services as needs change and vary considerably • How do we know that services are appropriate and meeting needs?

14. Long-term conditions – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this is a key priority (“most important issue”) • Need for one-stop shop resource of help/information about conditions and services • Need for better communication between GPs and specialists • Need swifter access to GPs if with a long-term condition • Disease specific themes : • Diabetes/stroke – should be priorities of their own considering scale of problem • Carers – need to have more prominence in the strategy/plan • More information and commissioning of long-term condition-orientated screening services • Epilepsy – NICE comprehensive care plan recommendation – implemented?

15. Mental health & dementia – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this is an important priority • Services are perceived as poor and inconsistent; out of hours mental health services are variable • Services need to be better integrated • There is a lack of respite care facilities • Counselling services – need more and better access • Psychological support – insufficient psychology services/psychologists • More explanation of services/information about mental health and dementia required • Consider technological solutions for supported living • Support for dementia sufferers and carers is perceived as poor • Will the Harbour be adequate given growing dementia population?

16. Planned care – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this is a priority – strong support for care in community settings • GP services considered excellent – but can GPs deliver given their pressures? • Sense that some services have been lost due to larger changes to services – or may be in the future • Coordination of services is vital • We need to evaluate services in the community • Will shifting services to the community de-stabilise the hospital(s)? • Ensure a full range of after-care and support in community when discharged from hospital • Services will need to be integrated, avoid duplication and ensure no overlaps • Waiting times for rehab-type services are too long • Progress needed on the rehab beds in Fleetwood

17. Urgent care – key themes www.fyldeandwyreccg.nhs.uk • Agreement that this is a priority • Perceived as the most important part of the NHS • GP accessibility is variable and is a rationale for using urgent care/A&E • Recognition that the A&E deferral scheme has been successful and needs to continue • Need more information about “what service to use, when and where” • A&E Blackpool – concerns about waiting times, perceived poor service • Feedback that NHS 111 “isn’t working as well as NHS Direct”

18. Pledges www.fyldeandwyreccg.nhs.uk • Broad support for the pledges (“laudable”) • Need pledges to be commitments rather than aspirations, i.e. avoid “should” and say “will” • Integration of services should be an additional pledge • Pledges should be supported by targets • Updated pledges now part of the document

19. Telephone survey www.fyldeandwyreccg.nhs.uk • 1,004 telephone interviews between 3 and 17 Feb 2014 • To inform long-term vision and five-year plan • To inform communications and engagement strategy • To set a benchmark to evaluate implementation of strategies • Benchmark results from other studiesto give context

20. Reputation of the NHS www.fyldeandwyreccg.nhs.uk • 85% – local NHS provides a good service (cf. 77% in Public Perceptions of the NHS) • 78% – national NHS provides a good service (cf. 66% in Social Care Tracker) • Perception of quality directly related to how informed a person is • Good service: ‘No problems’ (35%); Good quality of care (25%); Efficient (20%); Good GP (19%); Good GP access (11%) • Poor service: Poor hospital care (29%); Poor GP access (21%); Wait too long for GP apt (21%); Poor GP service (16%) • 60% have heard of the CCG. BUT only 6% know ‘a great deal’; 17% ‘a fair amount’; 23% ‘just a little’ • 78% heard of health challenges; 42% ‘a fair amount’; 22% have not • Awareness higher from 55-74 year olds and higher social grades

21. Experiences of coordinated care www.fyldeandwyreccg.nhs.uk 21% have a long-term condition (LTC); 15% are unpaid carers 75% with LTC know who to contact about their care; 42% have a specific health professional 54% have a regularly reviewed care plan; 33% do not 43% have to repeat medical history when they see a health professional; 47% do not

22. Providing community-based care www.fyldeandwyreccg.nhs.uk • 83% support practices working together to address NHS challenges – 54% ‘strongly support’ • Support higher where people are more satisfied with NHS services (85% cf. 70%), and where people are younger • High support to move end of life care and rehab to community; more caution for tests. Mirrors national research re moving ‘clinical’ services • High support to move post-hospital care, particularly among parents • Strong agreement to give people tools and freedom to manage their condition, and use of new technologies to do this (86%) • 86% agree practices should coordinate care; 74% support idea of practices providing different services based on needs

23. Communication & engagement www.fyldeandwyreccg.nhs.uk • People with LTC are less satisfied with information provision • 63% likely to speak to a health professional (most trusted = GP; 57% would make an appointment); 45% internet. Very few look at local sources of information, e.g. the media • Older residents more likely to want to talk to a health professional; younger residents more likely to use the internet • High support for using technology for transactional healthcare (e.g. repeat prescriptions), with most support from 16-34 age group • Less support to use technology for more ‘clinical’ services – getting tests online (62%); online consultation (48%) • Over 75s: 28% wouldn’t find any technological applications useful • People with LTC also not as supportive

24. Choice www.fyldeandwyreccg.nhs.uk • Choice of GP surgery – 92% say it’s important; choice of hospital 88% • People with LTC more likely to want choice of hospital consultant compared to those who don’t (75% cf. 67%) • People generally confident to choose a GP surgery and hospital • 81% think choice of treatment is important, but only 67% feel confident making a choice – need to support patients understand options and pros/cons • People likely to speak to GP re choice (52%), then non-NHS websites (20%); friends/family (19%); NHS websites (13% NHS choices; 11% other; 6% local hospital) • Older people – speak to GP; younger people – websites

25. Patient access www.fyldeandwyreccg.nhs.uk • Adults with high temp/sore throat out-of-hours – 30% NHS 111; 19% walk-in centre; 7% A&E • Why? Quick advice (20%); don’t know options (18%); repeat what done before (13%) • Child with high temp/sore throat out-of-hours – 34% walk-in centre; 30% A&E; 29% NHS 111 • Why? Quick advice (23%); don’t know options (16%); staff experienced (10%) • Parents more likely to know about options available out-of-hours

26. You said, we did… www.fyldeandwyreccg.nhs.uk

27. You said, we did… www.fyldeandwyreccg.nhs.uk

28. You said, we did… www.fyldeandwyreccg.nhs.uk

29. You said, we did… www.fyldeandwyreccg.nhs.uk

30. You said, we did… www.fyldeandwyreccg.nhs.uk

31. Next steps www.fyldeandwyreccg.nhs.uk • Publish the revised document. • Communicate outcome to those who responded / attended events, and via mass media channels. • Develop action plans based on research findings, e.g. in commissioning plans and revised communications strategy. • Further develop mechanisms to scale-up and systematise engagement to inform CCG decision making, as well as systematising the feedback loop (‘You said we did’). • Involve people as we develop detailed plans.