1.1 The purpose of this paper is to

· Report to Cambridgeshire Health Authority on the outcome of the public consultation exercise on the Greater Peterborough Health Investment Plan,

· Identify the issues raised by the public and how the plan will address them,

· Detail the specific changes made to the plan as a result of the consultation exercise, and

· To seek the Health Authority’s approval for the proposals contained in the Greater Peterborough Health Investment Plan.

 

2.1 At it’s meeting on 28th November 2001 Cambridgeshire Health Authority approved the process for formal public consultation on the Greater Peterborough Health Investment Plan. Specifically, the plan includes:

· Investment in primary care services, including GP, nurse and therapy specialists,

· The development of three new intermediate care centres, one in the centre of Peterborough and one in the environs, for those whose care and treatment can be safely and more effectively provided locally, and

· The transfer of all acute hospital services from the Peterborough District Hospital site to an expanded Edith Cavell Hospital.

2.2 The scheme will cost about £135 million in Capital, at year 2000 costs, and will not only re-provide hospital facilities and three new care centres, but will increase overall bed capacity in the area by 100 beds, ensuring the delivery of NHS Plan targets.

2.3 In February 2001 the Secretary of State for Health approved the Peterborough SOC together with 28 other schemes nationally as part of the biggest ever hospital development and expansion programme in NHS history. The Peterborough scheme was designated as one of 12, which will be allowed to go out to market first.

2.4 The project will be funded under the Private Finance Initiative (PFI) and as such its launch will be controlled by the Private Finance Unit (PFU) of the NHS Executive, which is monitoring the state and capacity of the market to finance and build hospitals.

2.5 The public consultation period ran from 13th December 2001 to 12th March 2002 and was conducted in parallel with the detail development of the health investment plan and outline business case. This has allowed feedback from the consultation process to be used to develop several of the evaluation criteria for the non-financial benefit analysis.

3 PROCESS

3.1 The communication strategy for the consultation process aimed to ensure:

· The process was open and transparent, and provided easy access to information on the Health Investment Plan.

· The public, voluntary groups, health professionals and stakeholders were aware of the consultation process, and had every opportunity to ask questions and make there views known,

· Feedback could be incorporated into the detail development of the Health Investment Plan, including the evaluation criteria used for the non-financial benefit analysis.

3.2 Five public meetings were held during the consultation period covering the whole of the catchment area of the North and South Peterborough PCTs and the southern parts of the Southwest Lincolnshire and Fenland PCTs. (See Appendix A for details of the public and informal consultation meetings and Appendix C for transcripts of the question and answer sessions of each meeting)

3.3 4,600 public consultation documents were issued throughout the area. These included a post-paid questionnaire focusing on three key areas:

· Where should the new local health care centres be located?

· What issues are important when designing healthcare buildings?

· Where does the public want to go to receive healthcare?

4.2 Specific issues raised by the public included:

· Will the planned increase in beds be sufficient to meet future demand?

· Will there be sufficient numbers of operating theatres, clinics and other services, particularly in view of the long time people have to wait now?

· Are the forecasts for population growth high enough?

· Have the plans allowed for housing developments such as the Hamptons or March and Chatteris?

· Will any services be cut?

· Don't we need two hospitals to cope with the increase in demand for healthcare?

· What happens to the current service over the period of the expansion plan?

4.3 The forecasts for future demand are based on the analysis of a wide range of information drawn from local authorities, the health service and nationally published statistics. The main factors considered include:

· Population growth and changes to the health and age profile of the local population.

· Historical patient activity and local trends for changes in the demand for services.

· Changes in medical practice and performance.

· The introduction of new drugs and treatments.

· Planned service developments.

4.4 The plan includes 100 additional inpatient beds.

4.5 The bed forecasts are compliant with National Bed Inquiry requirements.

4.6 Current activity plans will ensure the 2005 waiting times targets are met or exceeded. The phased introduction of the local health care centres from 2005 onwards will provide the interim capacity required up to 2008.

4.7 Access issues related almost entirely to the location of the hospital and focused on public transport services and car parking. The concerns raised include:

· The fact that many people have to make a second bus trip from the city centre to the Edith Cavell Hospital.

· Poor bus services during the evenings and weekends make it difficult for people to visit friends and relatives in hospital.

· The bus stop at the Edith Cavell Hospital is located some distance from the main entrance to the building.

· The very severe lack of car parking spaces at Peterborough District Hospital and parking problems at the Edith Cavell Hospital.

· The long walking distance from the car parks to the buildings.

· The lack of adequate numbers of disabled parking spaces at both hospitals.

4.8 The health investment plan recognises public transport services to the Edith Cavell Hospital are not ideal and transferring all the hospital services to this site will inconvenience people who rely on bus services. Therefore, the plan includes the provision of a shuttle service from the city centre to the Edith Cavell site.

4.9 The car parking capacity planned for the new hospital development will have to be agreed with the local planning authority and will form part of the Travel Plan for the site.

4.10 Making health services more accessible is a key element of the health investment plan. Many services traditionally provided within the hospital will be moved to the new local care centres or into primary care.

4.11 The criteria used to evaluate the relative benefits of the three options for the hospital development will include:

· Which option will provide the best opportunity to design a hospital that is the most effective to run, provides maximum clinical safety for patients and the most appropriate relationships between individual departments? · 

· Which option will provide the fastest access for seriously ill patients that are being transported by emergency ambulance or the air ambulance service?

· Which option will allow easy expansion of services and room for future growth?

· Which option is most accessible for the public?

· Which option will provide a hospital that has the lower whole life costs?

 

4.12 The issues raised cover two areas: staff shortages and NHS funding. Several people commented on the problem of GP recruitment mentioned in the public consultation document. They particularly wanted to know how we will solve the problem as the health investment plan aims to increase the range of services available locally and this would require more staff.

4.13 There was also a concern that the health investment plan would be expensive to implement and the lack of money in the NHS would put it in jeopardy.

4.14 The health investment plan specifically addresses the need to improve staff recruitment and retention. The aspects of the plan that contribute to this are:

· The provision of service capacity based on more realistic utilisation levels thus reducing stress levels amongst staff.

· Streamlining services and increasing the use of information technology to reduce administrative tasks that distract clinical staff from their primary role.

· The development of new roles and expansion of existing roles to meet the new service models and provide new career opportunities.

4.15 The strategic outline case identified the additional revenue cost of the health investment plan as £14 million. The local PCTs have all confirmed their commitment to funding this and have included it in their future plans.

4.16 The specific issues raised by the public are:

· Will the new buildings be better looking and more in keeping with the local area? 

· Why are you planning to have so many single rooms? Most people prefer to be in the company of other patients.

· Hospitals are often difficult to find your way around and very confusing.

· Will there be single sex wards? 

4.17 In many respects these matters are more relevant to the next stage of the health investment plan. However, a commitment has been made to ensure the design of the building takes into account the needs of patients and staff.

4.18 NHS Estates have revised the functional requirements and space standards for key areas of the hospital to take into account the requirements of the NHS plan. These are being included in the planning for the new developments. The NHS design quality guidance will also be adopted as minimum standards.

4.19 During the latter stages of the PFI procurement process we anticipate CABE (Commission for the Built Environment) will wish to assess and comment on the quality of the private sectors proposals.

Peterborough City Council Response

4.20 Councillor M J-C Burton, Cabinet Member for External Affairs, has written to the Project Director and Chief Executive of the Health Authority expressing the Council’s support for the health investment plan. Their only concerns are around the potential problem of staff recruitment and possible budget constrains of the PCTs.

4.21 The proposal to introduce a shuttle service from the Edith Cavell Hospital to the city centre is welcomed as a very good idea and suggest further improvements by ensuring there are good links to other bus services.

4.22 The Council conclude by saying, ‘The City Council will continue to work closely and collaboratively with your services to further develop high quality, convenient and accessible health services for all Peterborough residents’.

 

5.1 As a direct consequence of the public consultation exercise a number of changes and additions will be made to the Health Investment Plan and current service plans.

Woman and Child Unit

5.2 To account for the concerns of those seeking treatment for infertility, specific attention will be paid to the need to be sensitive to the location of these services in relation to the Woman and Child unit.

Multi-faith Rooms

5.3 The number, size and design of the multi-faith rooms will be adjusted to reflect the specific needs of local religious communities.

Space Allowances

5.4 Additional space allowances will be made for quiet rooms to take into account the needs of larger family groups while relatives are suffering from serious illnesses.

Local Care Centres and GP Practices

5.5 A more appropriate balance will be adopted between the need to modernise GP practices and maintain accessibility for the local communities.

Single Rooms

5.6 Current plans for 50% single rooms in accordance with national standards will be reviewed and discussed with NHS Estates to ensure the preferences for most elderly people to be care for in multi-bed bays can be met.

Catering

5.7 Improvements in catering services for those with specific dietary requirements, including religious requirements will be included in the plans for catering services.

Parkinson’s Disease Services

5.8 The need for an open access monthly clinic for people suffering from Parkinson’s Disease will be included in future submissions to the PCTs for service developments.

Memorial Wing

5.9 Further discussions will take place with the city council to ensure there is a secure future for the World War I memorial.

 

7.1 The Health Authority is asked to comment on and to approve this report and the findings on the outcome of the public consultation exercise for the Greater Peterborough Health Investment Plan.

 

 

 

19 March 2002