Annual Report 2004 - 05

Patient Experience

Patient and Public Involvement

Cotswold and Vale PCT is committed to involving patients, carers, local opinion formers and the wider public in developing quality healthcare.

Section 11 of the Health and Social Care Act 2001, which came into effect in January 2003, places a legal duty on NHS Trusts to make arrangements to involve and consult patients and the public. Along with every other health trust, Cotswold and Vale PCT must consult and involve the public:

• not just when a major change is proposed, but in the ongoing planning of services;
• not just in the consideration of a proposal, but in the development of that proposal;
• in decisions about service delivery, not just decisions about major changes.

Throughout 2004-05, we have listened to people’s views on many of the different services we offer, and these views will continue to be sought as we move forward with developing healthcare for the 21st century.

Investing in Excellence

In July 2003, we started an extensive, countywide review of children’s health services. Cotswold and Vale led the project for the county, but relied on close working with neighbouring PCTs, Gloucestershire Hospitals Trust, social services and other partner organisations, including the voluntary community.

For over a year, we spoke to hundreds of parents, young people, MPs and councillors, special interest groups and the wider public. From September to December 2004, we carried out a major public consultation exercise, meeting with people in public venues across the county, as well as visiting them in their own groups to consult more informally.

As the lead commissioner (purchaser) for children’s services in the county, we knew that we could not carry on commissioning services in the same way.

The advent of the European Working Time Directive, and its impact on the number of hours that junior hospital doctors could work, meant that Gloucestershire Hospitals NHS Foundation Trust had to make changes to the way children’s and maternity hospital services were offered in the county.

It became increasingly obvious that it would no longer be possible to offer more specialist services at both Cheltenham and Gloucester hospitals.

As the long period of public involvement came to an end and the formal consultation got underway, the discussion came down to the issue of safety versus local access.

The outcome was an agreement by all three Gloucestershire PCTs, passed by the county’s Overview and Scrutiny Committee, to centre all specialist children’s and maternity services at Gloucestershire Royal.

Lasting well over a year in total, the involvement and consultation on children’s services tought everyone involved a number of lessons: on providing more information around the context and any limiting factors when developing a service; about the need for people to present a compelling argument against service change, not just to argue with sheer weight of numbers; and about being very clear over what ‘public involvement’ and ‘public consultation’ actually mean.

Older people’s mental health

During 2004-05, we have also taken part in the countywide review of older people’s mental health services, led by West Gloucestershire PCT.

At two public meetings held in Stroud and Cirencester, we heard from older people, carers and support organisations about what was important to them in local mental health services.

The debate covered support for carers, reducing numbers of specialist inpatient centres and the best way to provide day services for older people with mental health problems.

Later this year, West Gloucestershire will be launching a three-month public consultation, which Cotswold and Vale PCT will support with events for local residents.

Healthcare in Fairford and Lechlade

In February this year, we launched a review of health services in and around Fairford and Lechlade. Titled Who Cares, the review looks at the future health care needs for a predominantly older population, and how to meet more of these needs at Fairford Hospital.

The Fairford review is a pilot project that comes under the umbrella of Managing Healthcare Change, a much larger review of healthcare development throughout the PCT, particularly around community hospitals and practice-based commissioning.

From late September, we will be going out to public consultation on a range of options around the future of Fairford Hospital.

As well as working closely with local GPs, we have also involved social services and the hospital’s League of Friends from the start of the planning process, back in September 2004. Their input and support has been invaluable, and we will continue working in partnership as services are developed.

Future patient and public involvement

Over the next couple of months, we will be launching a major public involvement exercise. Managing Healthcare Change will look at how we currently provide services through our network of community hospitals; how we commission (purchase) services from providers such as Gloucestershire Hospitals NHS Foundation Trust and the voluntary sector; and how best to meet the changing needs of our 192,000 patients in the early 21st century.

In addition to involving patients and the public in our own planning, the PCT is also part of the wider, national review of NHS structures, led by the Strategic Health Authorities of England and Wales.

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