Public Consultation Outcomes and Decision Hartfields, Fens and Wynyard Road Karen Hawkins Associate Director of Commissioning & Delivery NHS Hartlepool & Stockton-on-Tees CCG October 2016

Background Time-limited APMS contracts Extended a number of times Legal advice unable to extend further Now expire 31 March 2017 We have a Duty to comply with requirements relating to procurement, patient choice and competition

Pre-Consultation Fens Hartfields Wynyard Rd 40.39% 38.06% 28.96% The CCG has a Duty as to public involvement and Consultation in the development and consideration of proposals for change, therefore undertook engagement in relation to the existing services 2,956 people took part in pre-consultation engagement activity in June 2016 This was an overall response rate of 36.41% Fens Hartfields Wynyard Rd 1,108 910 578 40.39% 38.06% 28.96% Individual Practice Response Rates

Full Consultation Report The full consultation report will be published on the CCG website Printed copies and other formats will be made available on request www.hartlepoolandstocktonccg.nhs.uk

Options www.hartlepoolandstocktonccg.nhs.uk

Consultation Headlines Following engagement the CCG, as part of it’s Duty, then undertook consultation on the options for change The consultation dialogue period ran from 01 August to 23 September 2016 Consultation reach included patients aged 16 years and over registered at the three practices 1,236 people responded to the consultation

TOTAL 1,236 Respondents Fens Hartfields Wynyard Rd Other* 233 128 165 710 TOTAL 1,236 * Other = respondents that did not say which practice they were registered

Activity Overview Communications Activity Communications activity included: A letter sent to patients aged 16 years and over at each practice Press and media releases Stakeholder briefings Social media activity Community and voluntary sector newsletters and networks Posters and flyers in public venues across the three practice areas

Activity Overview Consultation Activity activity included: Consultation questionnaire Public consultation events Targeted engagement of people from groups with protected characteristics Targeted engagement of stakeholders Online and social media activity

Targeted Engagement The CCG commissioned Hartlepool Voluntary Development Agency (HVDA) to conduct targeted engagement with members of groups with protected characteristics. The full protected characteristics report will be published on the CCG website, with the main themes being outlined in the results section of this presentation.

Stakeholder Engagement Relevant stakeholders were identified and engaged through email and stakeholder briefings. Stakeholders were also sent hard copies of the Consultation narrative document, posters and leaflets to distribute to their networks. Following concerns raised at last Audit & Governance Committee a comprehensive overview of activities was provided to the Chair to evidence the CCGs compliance with their Duty to consult

Questionnaire Results Support for options by practice From Option 1 Option 2 Option 3 Fens 151 24 31 Hartfields 15 99 11 Wynyard Road 63 67 57 Other 226 265 147 Totals 455 246 Percentages 36.8% 19.9%

Questionnaire Results Opposition to options by practice From Option 1 Option 2 Option 3 Fens 74 151 161 Hartfields 78 23 93 Wynyard Road 80 75 Other 215 190 367 Totals 447 439 714 Percentages 36.2% 35.5% 57.8%

Formal response - Stakeholders Formal responses were received from: Hartlepool Borough Council Audit and Governance Committee Healthwatch Hartlepool The Rt Hon Iain Wright MP The Joseph Rowntree Foundation Unison The main points raised within formal responses referred to: Process Consultation engagement Consultation options Access to alternative services Procurement options Staff Full responses are contained within the consultation report.

Appraisal of Options 1 and 2 One contract on two sites Criteria Fens & Wynyard Road Hartfields & Wynyard Road Consultation Support 455 [36.8%] Exclusive Support 208 [16.8%] 266 [21.5%] Consultation Opposition 447 [36.2%] 439 [35.5%] Affordability Both schemes financially viable with no significant variance in estimated income/expenditure Premises No scope to extend premises at Fens

Appraisal of Options 1 and 2 One contract on two sites cont …. Criteria Fens & Wynyard Road Hartfields & Wynyard Road Consultation Feedback Accessibility - Concerns about accessibility for patients from Hartfields accessing services at Fens/Wynyard Road Support for current services Resources – concern that decision is financially driven Accessibility Distance from Fens to Hartfields & Wynyard Road approx 4.3 and 0.5 miles respectively Wynyard Road is the closest practice to Fens Three practices within approx 2 miles of Fens Distance from Hartfields to Fens & Wynyard Road approx 4.3 and 3.9 miles respectively Two practices closer to Hartfields

Appraisal of Option 3 One contract on Wynyard Road Site Criteria Consultation Support Least support [19.9% - 246 respondents] Most opposed [57.8% - 714 respondents] Consultation Feedback Greatest loss of service Furthest for patients to travel Least likely to cope with the demand Least fair in terms of impact [particularly on the perceived number of elderly/less mobile patients at Hartfields Affordability Estimated to be most financially viable

Conclusions Options 1 and 2 were equally supported scoring 36.8% each are financially viable both from a CCG and provider perspective and there is no significant variance in either option Ensures accessibility, choice and resilience across the town There was slightly more opposition to Option 1 [Wynyard Road and Fens – 36.2%] than to Option 2 [Wynyard Road and Hartfields – 35.5%] Option 3 was the least popular with respondents Is the most financially viable option both from a CCG and provider perspective Reduces access points Potential to reduce resilience across the town 710 patients did not indicate that they were a patient from either of the three practices 119 [9.6%] respondents supported more than one option 353 [28.6%] respondents opposed more than one option

Additional Stakeholder Request Formal request from stakeholders and groundswell of opinion for the Primary Care Committee (PCC) to consider a 4th Option of One Provider 3 sites: PCC had previously considered this scenario and determined it was not a viable option based on the criteria all original 13 scenarios were assessed upon prior to consulting on the viable options Formal request was considered at PCC and determination; The market through recent mergers/termination of contracts has already indicated that they would not be able to sustain a 3 site option based on the current list size, workforce and national monies available to deliver GMS Any response on this option would pose a significant risk to delivery and continuous patient care as is not affordable to the Provider The CCG has a Duty to commission sustainable, high quality effective and efficient services therefore the PCC did not agree to progress to procurement on the option of 1 Provider 3 sites.

Outcome The PCC met on the 25th October 2016 and following review of all information available determined; Option 2 – one provider on the two sites of Hartfields and Wynyard Road is to be progressed to procurement

Actions Taken Current providers have been notified of decision; Local practices have been notified Decision publicised on CCG website

Next Steps Patients of all practices to be notified Procurement documentation to be completed Procurement process to be undertaken