1. 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

2. 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

3. 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,
40.39% % %
Individual Practice Response Rates

4. 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

5. Options

6. 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

7. TOTAL 1,236 Respondents Fens Hartfields Wynyard Rd Other*
TOTAL 1,236
* Other = respondents that did not say which practice they were registered

8. 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

9. 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

10. 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.

11. Stakeholder Engagement
Relevant stakeholders were identified and engaged
through 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

12. 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%

13. 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%

14. 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.

15. 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

16. 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

17. Appraisal of Option 3 One contract on Wynyard Road Site
Criteria
Consultation Support
Least support [19.9% respondents]
Most opposed [57.8% 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

18. 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

19. 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.

20. 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

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

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