Consultations and public engagement
We want people to get involved and influence local health services. As a CCG, putting patients, carers and service users at the centre of our plan and getting their input is very important. When major plans are being considered to the way services are being delivered we want to hear what you have to say so that these views are integral in helping us make decisions.
In addition to local consultations we will bring to your attention national and regional consultations which might be of interest. For more information on NHS England consultations click here
Current and recent engagements
Urgent care services provided at St Albans City Hospital
The Minor Injuries Unit (MIU) at St Albans City Hospital was temporarily closed in April 2020 when staff were redeployed to support the response to COVID-19. It remains closed to keep the hospital a COVID-19 free site. The temporary closure has provided Herts Valleys CCG with an opportunity to reassess what service to provide at St Albans once urgent care services can restart towards the middle of 2022.
Between June and early August we invited people to give us their views on urgent care services based at St Albans City Hospital to inform a decision on what service to provide there in the future. We did this through a public engagement and brought in The Campaign Company to provide specialist, independent support.
Over 3,200 people took part in the engagement by filling in a survey or by joining discussion groups. People shared information about their use of urgent care services and gave their views on four possible options for future provision St Albans City Hospital as follows:
- Option 1: Not reopen an urgent care service at St Albans City Hospital and ask patients to continue to use other nearby services in the same way as they have been doing in the last 12 months.
- Option 2: Reopen the minor injury unit as it was before the pandemic, as a service that is led and delivered by senior experienced and specially trained nurses. This would not cater for minor illnesses.
- Option 3: Open a new integrated urgent care service that would offer a minor illness and injury service. It would be led and delivered by experienced nurses or medical staff with the support of GPs. It would offer some additional diagnostic services on top of x-rays. Appointments would be through the NHS111 service or GPs. There would be no walk-in patients.
- Option 4: Open a new urgent treatment centre that would provide a comprehensive urgent illness and injury service with a broader range of diagnostic services. It would be led and delivered by GPs with the support of senior and qualified nurses and health care assistants. It would offer both walk-in and booked appointments.
The CCG stated from the outset that the integrated urgent care service was its preferred option because it provided the flexibility to design a minor injury and illness service that would meet local needs without overstretching resources.
What the engagement told us:
Use of services
On average, respondents were likely to access urgent care services once or twice a year.
In the last two years most respondents (74%) accessed urgent care via their GP, followed by NHS 111 (65%) and local pharmacy (62%).
Minor illnesses are the biggest reason for people seeking urgent care. 55% of respondents sought care for that reason, followed by 49% with a ‘sprain, strain, muscle, back or joint pain’ (49%) and 39% having a ‘cut, wound, bite or sting’.
In the last two years people mostly accessed hospital-based services as walk-in patient (49%) followed by NHS111, used by 35% of respondents.
The biggest influence on how and where people seek help for an urgent care is location and convenience (82%). The next most important factors were being able to walk-in (57%), getting diagnosis and treatment for a problem in one go (56%) and having the necessary facilities such as x-rays, tests or prescriptions (54%)
There was a high level of awareness of the NHS111 service. Over half of respondents knew it offered access to expert advice and appointments. Less than 1% of respondents had no knowledge of NHS 111. 13% of respondents said they would always use NHS 111 to access help or support and 25% said that they would ‘rarely or never’ use the service with the remainder falling somewhere in-between.
People who had used the St Albans MIU in the two years before its temporary closure rated it highly. 94% agreed it had met their needs, 96% said it provided good quality care, 91% said the service had been prompt and efficient and 83% said it was open when they had needed it. Negative comments mostly concerned poor continuity of care.
Views on the four options
People were asked to indicate the level of support they would give to each of the options. They were asked to comment on each option individually rather than to rate options in preference to others.
Over half of respondents supported all three options for continued urgent care services at St Albans, showing clear support for keeping services going there. The greater the level of service proposed in each option, the stronger the public support.
- Just 14% of people supported there being no service
- 60% supported the continuation of the Minor Injuries Unit
- 83% supported the option of an Integrated Urgent Treatment Care Hub
- 91% supported a full UTC.
Comments showed that:
- There was strong opposition to option 1. Responded said that St Albans needs an accessible, hospital-based urgent care provision within the city. There were concerns about the impact of having to travel further to access urgent care, the quality of the facilities available elsewhere and impact on other health services if the MIU remained closed.
- Many people who supported option 2 said that this was the minimum level of acceptable service provision rather than their preferred outcome. People said it was important to have local, high-quality service but with some improvements needed if this were to happen. People who opposed this option wanted a more comprehensive service.
- People were largely positive about option 3 because of the increase in services such as treatment for minor illnesses. However, people highlighted concerns about the loss of walk-in appointments, the need to book via NHS 111 and more limited opening times and said they therefore preferred a full Urgent Treatment Centre.
- Option 4 had the most positive comments. Many stated the ability to access walk-in appointments was important, with some stating that option 3 with walk-ins would have otherwise been their preference. Others supported this option because of the longer opening hours. Some respondents raised objections about the strain a UTC would place on local NHS resources.
Read the engagement report from The Campaign Company
Decision-making and next steps
Views from the public engagement were shared with the Herts Valleys CCG board and discussed at a meeting in public on 23 September 2021. The board considered various factors including public feedback and resources and supported a recommendation to further develop plans for an integrated urgent care hub.
More work will now take place with the involvement of patient representatives to draw up the final specification for the integrated urgent care hub and to provide detailed costings. Work to draw up plans for the integrated urgent care hub will also take account of comments made as part of the public engagement.
Subject to further board approval of the outline business case and funding, the CCG will go out to market for a provider to run the new service later this year. The new service is expected to be up and running towards the middle of next year.
We will continue to keep people updated as we develop the new service, including opportunities for people to give further feedback.
The following engagements have now closed.
Hertfordshire CCGs identified they needed to make the best use of the money available, so that as many people can be helped as possible to live healthier, longer lives, avoiding preventable illnesses.
There was simply not enough money to do everything and continue as before – we consulted across Hertfordshire to hear views about some difficult decisions on how to spend the money available to the local NHS.
For more information on the consultation and the decisions click here
West Herts Medical Centre and Urgent Treatment Centre
This consultation which took place between January and March 2018 invited views from patients, potential users, NHS employees and anyone with an interest in the services provided at either the Hemel urgent treatment centre or West Herts Medical Centre. The consultation asked about opening hours for the urgent treatment centre (UTC) and on whether the contract for West Herts Medical Centre should be reviewed.
Following the cosnultation the CCG decided on 8am to 10am opening hours for the UTC and decided not to renew the contract for West Herts Medical Centre and to support patients to re-register with other practices. The West Herts Medical Centre building became an extended access hub so that GP appointments continue to be provided on the site.
To view the full report on the engagement, together with an independent view of the consultation click here
To view the September report to the Herts Valleys board which details recommendations and patient preferences for approval click here.
Consultation for the relocation of Moorfields Eye Hospital from City Road to St Pancras
Proposed Relocation of Moorfields Eye Hospital City Road services: Committees in Common (decision-making) meeting was held on Wednesday 12 February 2020.
The DMBC and associated appendices have been published and are available on: https://www.camdenccg.nhs.uk/aboutus/governing-body-meetings-and-papers.htm and at www.oriel-london.org.uk.
They include a comprehensive summary of the findings from the consultation, the response to the findings and other decision-making information, such as service modelling, financial planning, and the integrated health inequality and equality impact assessment.
Papers from the meeting were as follows:
Moorfields Consultation Committees in Common agenda
Moorfields Consultation Committees in Common report
Decision Making Business Case (DMBC) for the proposed relocation of services from Moorfields’ City Road site to St Pancras.
Decision-Making Business Case: Oriel: creating the centre for advancing eye health
Any questions, feedback and general queries can be submitted outside of formal meetings through the normal communication channels by emailing email@example.com.
North Central London Clinical Commissioning Groups.
Outcome of CiC - Committees in Common (decision-making) meeting:
Proposed move of Moorfields Eye Hospital’s City Road services
The proposal to move Moorfields Eye Hospital, University College London’s Institute of Opthalmology and Moorfield’s Charity to a new site at St. Pancras in London has been approved.
Camden Clinical Commissioning Group on behalf of those CCGs across England that commission services from Moorfields City Road site, in partnership with NHS England/Improvement Specialised Commissioning (London), consulted between 24 May and 16 September 2019 on a proposal to relocate services from Moorfields Eye Hospital’s City Road site to St Pancras. This new-build centre will bring together excellent eye care, ground-breaking research and world-leading education in ophthalmology.
This project will be a partnership between Moorfields Eye Hospital and University College London (UCL) Institute of Ophthalmology (IoO). Moorfields Eye Hospital and UCL will sell the current land at City Road, and all proceeds of the sale will be reinvested in a multi-million pound development on land available at the site of St Pancras Hospital, just north of King’s Cross and St Pancras stations in central London.
During the consultation around 4,600 contributions were received, of which 1,511 were completed consultation surveys. People also gave their feedback in other ways including emails, discussion groups, phone calls, letters and via the virtual assistant on the consultation’s website. You can read the final outcome report at https://oriel-london.org.uk/consultation-documents/ .
To further explore and discuss the findings and their impact upon the proposals, the report and proposals were presented at:
North Central London’s Joint Health Overview and Scrutiny Committee on 31 January 2020. A link to the papers from this meeting can be found https://www.minutes.haringey.gov.uk/ieListDocuments.aspx?CId=697&MId=9242&Ver=4.
NHS England London Region Executive Team on behalf of Specialised Commissioning on 4 February 2020 to make a final decision on the proposal.
A Committees in Common, comprising 14 ‘lead’ CCGs with material contracts defined as greater than £2m per annum at Moorfields’ City Road site, on 12 February 2020 to make a final decision on the proposal. A link to the papers from this meeting can be found https://www.islingtonccg.nhs.uk/jccc-meetings/committees-in-common-moorfields-eye-hospital-relocation/103835?postdiaryentryid=290006&ignore=committees-in-common-moorfields-eye-hospital-relocation&postid=103835.
The Committees in Common has now approved the proposal.
Further engagement and co-production will now be undertaken with staff, the local community and service users to develop and design the new centre. This will include:
Development and implementation of an accessibility plan, which will be co-designed in partnership with sight loss charities, the Oriel Advisory Group, patients, transport providers, local authorities, commissioners and voluntary organisations. The Trust will ensure plans and processes are in place to enable patients to travel to the new centre safely.
Continued involvement of the Oriel Advisory Group and the extensive range of stakeholders that have contributed to the consultation, in the development of the new centre at the St Pancras site.
To realise the potential benefits of new clinical pathways and working at scale, a London Ophthalmology Collaborative will be established to progress system-wide service redesign of eye care services across London.
Development of an organisational development programme to realise the benefits of integrating research, education and innovation with clinical practice.
In addition, Moorfields Eye Hospital will review the feedback received on the patient experience during the consultation and will address areas of improvement before implementation of Oriel where possible. The Trust will also proactively work with partners to ensure that the impacts identified in the Integrated Health Inequalities and Equalities Impact Assessment (IIA) are mitigated as far as possible and the potential positive impacts are harnessed, in a plan to be developed in response to each of the recommendations arising from the IIA.