Previous Consultations and Engagement

Since it was formed the CCG has carried out numerous engagement projects. Some of these projects are listed below.

The NHS invited service-users to take part in a survey of the Non-Emergency Patient Transport Service (NEPTS) in Hampshire.

It is reviewing the £11m a year service to see if improvements can be made to ensure it is being run in the most effective and efficient way for all the patients eligible to use it.

All patients are normally expected to make their way to hospital or outpatient clinics for non-emergency appointments.

But the NEPTS service is provided free for the small minority of people registered with a GP practice in Hampshire who can’t travel to appointments independently on grounds of their medical condition only.

The survey was run by NHS Fareham and Gosport Clinical Commissioning Group (CCG) on behalf of the other CCGs in Hampshire.

Hard copies were made available in GP practices and hospital outpatient departments.

Those who used this valued service, or were a carer for someone who used the service, were encouraged to share their views. There were general questions for all users of the service – and specific sections for renal patients only.

We told people that, in the next few years, the local NHS must change.

The NHS across the local area – Portsmouth, Fareham and Gosport, and South Eastern Hampshire – must improve the health and wellbeing of people living here, make services more effective, while keeping finances in balance.

Many of these changes are simply the right thing to do – they will improve care, and make life better and easier for patients and their carers. But change is also essential because demand is growing faster than funding, and some key groups are in short supply.

The overall objectives are clear – stronger community-based services, more ‘seamless’ support, greater use of technology to benefit patients – but the details are not finalised.

So we wanted to hear your views about how health services could and should change, and those views will influence the decisions the local NHS must make.

The initial questions were about the ‘big picture’. So, what are the strengths and weaknesses of the local NHS? How can access to GPs be improved? Which services should be available at weekends? Is it ok to create centres of excellence, if that increases travel times?

The results of Phase 1 can be found here.

“The NHS needs to change” – that is said a lot, and with good reason. People’s need for care is rising faster than the funding available. Key staffing groups such as GPs are in short supply. New technology gives people more convenient options than the traditional pre-booked appointment.

So we asked what that “change” actually looks like.

We focused on four specific areas: long term illnesses; care of frail people; mental health, and same-day care.

This work built upon the feedback we generated during Phase 1 of Your Big Health Conversation.

A brief presentation of Phase 2 findings can be found here. The full report into the findings is here.

NHS111, ambulance services, GP services and community services are working even closer together to provide local people with the right care in the right place at the right time.

Not everybody needs the same help when they call NHS111. One person may want to know where their local pharmacy is, another may need a community nurse and someone else may need to speak to a doctor.

Working together we are developing access to healthcare professionals who will be able to advise on the most appropriate clinical care, including callers with mental health problems, medication requirements and children’s health issues.

To ensure patients receive advice or treatment tailored for their needs our healthcare professionals are starting to review some 999 calls and calls that advise a caller to go to their local Accident and Emergency Department (A&E), so that ambulances are dispatched only to patients who need one and to avoid unnecessary journeys to A&E.

We have also introduced NHS111 online as another way of using the service to make it easier for local people to get the urgent advice and support they need.

 How is the service changing?

We are introducing clinical advisors in some areas who are able to review cases and support the person who takes your call. This means that now patients may be:

• Offered care and advice from a range of healthcare professionals within the service which include mental health nurses, child health clinicians, GPs and pharmacists, and speaking directly to the person they need
• Advised they need to see a healthcare professional urgently, which includes mental health nurses, child health clinicians, GPs and pharmacists, and offered an appointment which the service can book for them
• Advised they need to see a GP in the next few days with, in some areas, the service making an appointment.

A survey was created for the public to share their views, to help as we develop the service in the future.

Plans are currently being developed to improve the mental health rehabilitation offer in the city – focussing on the service currently provided at the Oakdene Unit, which is presently situated on the St James’ Hospital site within The Limes.

To help us to make the right changes, in the right way, we have spent time talking with patients, with Oakdene staff and other frontline staff. We have also studied feedback from other engagement work which referenced mental health care, and held conversations with stakeholders. Alongside this, we have examined data about who uses the 14-bed rehabilitation unit, what support they receive, and how effective that support is.

Much of what we learned has been positive, but there are also some important findings which suggest there is a better way of providing rehabilitation services:

• Patients valued the supportive staff and the care they received on Oakdene Unit, however despite the nice environment, it felt more like a hospital than a home
• People wanted to connect more with the ‘outside world’ but some were nervous – for example, about loneliness, or safety
• The community rehab service would be better, and more effective, if it was outside the hospital setting
• For some people coming into the hospital based service, suitable housing on discharge presented a problem
• It has been demonstrated that rehabilitation services can play a vital role in recovery, but the ward based service is restricted to 14 beds.  A community rehabilitation service will be able to support more people in home based environments.

As a result of the data we have gathered, and the feedback we have received, the following changes are now planned:

• A new community rehabilitation team will support people in a home based environment– both after a hospital stay, or to try to prevent one.
• A new supported living service will be commissioned for people who don’t have their own accommodation but would benefit from rehabilitation.
• The Oakdene building will be repurposed, but will remain part of mental health inpatient provision.

When people living in the Southampton, Hampshire, Isle of Wight or Portsmouth (SHIP) areas seek treatment for infertility, their local Clinical Commissioning Group is responsible for funding fertility services (such as In-Vitro Fertilisation, or IVF) to help women become pregnant.

IVF is a high-cost treatment and so it is important to make sure that the Clinical Commissioning Groups (CCGs) across the area offer IVF in the most effective way for the local population. They must also ensure that they balance the funding for this treatment alongside the other pressures on local NHS funding.

What is happening?

The SHIP-wide ‘Priorities Committee’ has recently reviewed the most recent evidence of clinical and cost effectiveness for IVF and Intra-Cytoplasmic Sperm Injection (ICSI). Please note that for this process the term ‘IVF’ is being used to describe both treatments.

The Committee is now preparing a recommendation about the future commissioning of these services which will be considered by each of the CCGs. The local CCGs are keen to ensure they do this in light of the views of local people.

Why is this happening now?

In February 2013 the National Institute for Health and Care Excellence (NICE) published updated clinical guidelines for fertility services. The non-compulsory guidelines included specific guidance for CCGs regarding IVF.

How does NHS funding work?

Each CCG is allocated an annual budget which it uses to commission (buy) a wide range of health services and treatments for local people. These services include urgent care services, treatment for long-term conditions, community services, planned operations, x-rays and diagnostic tests.

The CCG’s role includes researching and planning which services are needed by the local population, buying those services in at the best possible price, and monitoring those services to ensure they are delivering what was agreed, and what people need.

The NHS budget is limited so funding for any service or treatment must be balanced against the funding requirements for many other necessary local health services and treatments.

What is the current IVF policy?

The following table shows the current SHIP access criteria compared to the 2013 NICE guidelines:

Seeking your views

We undertook a period of engagement to gather the views of local people, their representatives, GPs and interest groups on whether funding for IVF is a priority for the NHS and on the access criteria. Each CCG would then consider the recommendation from the SHIP Priorities Committee in light of this valuable feedback.

The CCGs invited local people to share their views by completing an online survey. Alternatively, the survey could be printed and sent by post.