Below describes the establishment and delivery of a new West Cumbria Community Forum and progress so far by Healthwatch Cumbria in partnership with the Local MP, Cumbria CCG, North Cumbria University Hospitals NHS Trust and a wide range of community representatives.
During the summer and autumn of 2014, Healthwatch Cumbria (HWC) became increasingly aware of the growing strength of feeling and passion that the people of west Cumbria had about their local health services and in particular their local hospital. A Facebook campaign quickly gathered thousands of subscribers and campaign leaders organised a Rally held at the rugby ground in Whitehaven on Monday 29 September 2014.
People were upset, angry and deeply worried that potential changes to services in west Cumbria could mean that they would have to travel further for some services, have second rate services delivered locally, and have worse health and wellbeing outcomes. People were aware of the significant challenges facing the NHS and knew that overarching plans for future service provision had been submitted for approval with detailed discussions about care pathways taking place. So they wanted to be more involved and engaged, rather than feeling powerless to influence thinking or to help shape improvements. The Rally in Whitehaven highlighted the need for HWC to take specific and immediate action and at the same time alerted CCG and the NCUHT to the need for an accelerated programme of communications and engagement.
Further HWC knew that the NHS was working to provide more services closer to where people live and NHS Cumbria Clinical Commissioning Group (CCG) had said that in future there should be less travelling overall for hospital services. Both NHS Cumbria CCG and North Cumbria University Hospitals NHS Trust said that any changes would be to ensure increased safety, sustainability and better outcomes.
It was clear that there were different perspectives and understanding of how all of this was penetrating the community.
HWC decided to develop a proposal in conjunction with NHS colleagues and in line with existing engagement and communication plans to ensure that people’s voices could be better heard at this crucial time and that all opportunities were taken to ensure strong communications would be in place to help people be more informed about why services may need to change.
The proposal was developed from two perspectives. On the one hand, HWC wanted to make sure that the passion and voice of local people could be heard loudly in all the right places as decisions were made moving forward and also that people were properly informed. This had to involve close work with local communities, community representatives, community groups and interested parties.
At the same time, the NHS was clear that it needed to engage more locally and wanted to work with HWC to create more opportunities for the voices of local people to be heard in the shaping of services for the future. It was agreed that HWC was well placed to bring people and decision makers together.
HWC stated that local people had the right to be able to be confident that planned changes would lead to better outcomes for them and their families. They needed to know exactly what will happen in the future. Practically they wanted to know where they would go, for what and why, on an everyday healthcare basis. And it was agreed that the NHS and local health and care leaders needed to demonstrate their understanding of what’s important for people. The recurring dilemma for the NHS was that often detailed discussions about service reconfiguration take place among clinicians and there can be a reluctance to involve people early.
The proposal set out how:
- HWC would facilitate the establishment of a West Cumbria Community Forum to ensure that people’s voices, hopes and concerns could be heard, that informative conversations could take place and that accurate and timely information could be shared;
- HWC would remain independent of the health and social care commissioners and service delivery organisations involved; and
- Would act as a facilitator and enabler to bring key stakeholders together with local people for constructive dialogue and information exchange.
A proposal for a West Cumbria Community Forum was agreed with the following objectives:
- To hear the voice of the people of west Cumbria through a number of different mechanisms that can feed into Forum discussions. These may include analysis of findings from roadshows, surveys, and community conversations, essentially optimising existing channels of communication and engagement
- To welcome key representatives, including those who are involved in the campaign which led to the large public meeting at Whitehaven on 29 September 2014, the Local MPs, all three tiers of elected members, local community representatives, representatives of third sector providers, and representatives from CCG and NCUHT to come together on a regular basis to address issues of concern, discuss ways of ensuring that accurate and timely information is shared and ensure that all opportunities are taken for local engagement.
- To provide an additional mechanisms to
- Ensure that people’s concerns, anxieties, questions, ideas, and experiences, are heard by decision makers;
- Ensure that commissioners and providers have another opportunity to answer questions from the community, listen first-hand to concerns and provide timely and accurate;
- Ensure commissioners and providers have another opportunity to explain the proposed changes and describe how these can improve outcomes;
- Provide regular accurate briefings about strategic and operational developments – setting out what stays, what goes and why as soon as information is available;
- Ensure that the public are clear about which decisions will be subject to formal public consultation and explain exactly how and when this will happen – and that their views are taken into consideration over what processes might be used for consultation;
- Ensure that there are opportunities with community leaders to discuss, test out and demonstrate how real life scenarios will be managed in a west Cumbria setting; and
- To ensure that all opportunities for communicating with the public are used, including the use of short videos demonstrating real life experiences where outcomes have been improved through changed care pathways.
HWC ensured that the Community Forum meetings would be attended by a wide range of people and that all communities were represented. Meetings are held in public but the Forum itself comprises invited representatives. Representatives are required to ensure that they meet regularly with the communities they are representing both before and after meetings of the Forum and that effective two-way communications are maintained.
It should be noted that the Forum is not focused on single issues or lobbying, but rather on debate and discussion about shared issues and concerns that have been brought forward through its representatives and for which there is a demonstrable evidence base.
Where individual experiences, concerns or complaints exist these can be shared directly with the appropriate NHS commissioner or provider organisations through, for example, complaints processes, or directly with HWC, or the NHS Complaints Advocacy service.
Prior to the first meeting HWC considered different possible options for Chair. It was finally decided to invite the Venerable Dr Richard Pratt, Archdeacon of West Cumberland to take on this role. This has proved to be an excellent choice and all members of the Forum have great respect for his chairing skills and ability to bring all the members to together in conversation effectively.
The Forum has now met three times and has sustained high level representation from the two provider Trusts, CCG, local MP, and all community representatives. Meetings typically include an item to encourage the building of trust between partners, skilfully facilitated by the Chair, as well as items on significant issues, including the recent publication of The Maternity Review produced by the Royal College of Obstetricians and Gynaecologists.
Chief Operating Officer – People First Independent Advocacy
8 April 2015