Agenda item

APPENDIX 1

PUBLIC QUESTIONS

QUESTIONS FROM MRS SUSAN SULIS, SECRETARY, COMMUNITY CARE PROTECTION GROUP

1.  THE IMPACT OF THE  REMOVAL OF THE ‘ADMISSIONS AVOIDANCE SERVICE’ ON THE PROPOSED CUTS IN INTERMEDIATE CARE BEDS FROM 62 TO 42.(Ref. Reports ACS12017 and ACS 10066)

In the 2.11.2010 Report, the reduction in IC Beds was predicated on the creation of a new ‘Admissions Avoidance Service”.

(a)  Why is there no mention or examination of the impact on the IC Service in today’s report?

Reply

Not all patients who are discharged from hospital require an intermediate care bed. Although fewer people going into hospital can mean a reduction in the need for intermediate care beds following discharge, there are other factors which contribute to the reduced requirement for bed based intermediate care, including the introduction of the re-ablement service. The reduction in occupancy of the intermediate care beds predates the introduction of the Admissions Avoidance service.

(b)  Why are the Impact Assessments (p.3.7) not listed as background documents for scrutiny?

Reply

This was an oversight; the impact assessment will be published as part of the minutes of this meeting.

2.  LONDON BOROUGH OF BROMLEY AND BROMLEY NHS INTERMEDIATE CARE CONSULTATION 2^ND FEB – 26 APRIL 2012.

This consultation exercise has not been accessible to the digitally excluded, and has thus discriminated against those most likely to need an Intermediate Care Bed – the elderly and deprived.

(a)  As of 1^st April, how many responses have been received?

(b)  Of these, how many are from (i) Organisations, and (ii) Individuals?

Reply

Response provided by NHS Bromley:

Planning for this engagement work has intentionally targeted those who may be directly affected by any proposals to ensure that their views are understood and hard copy information has been made available to a targeted audience.  The current engagement work with regard to intermediate care services is focussed on those it affects most - an example being making direct contact with prior users of the services. This approach should directly address any potential concerns in regard to digital exclusion or discrimination. 

Engagement about intermediate care services as they interface with the Orpington Health Services Project has been ongoing and widely publicised in local media and using traditional print distribution methods.  This covered the whole of Bromley as the catchment of the Hospital. However, intermediate care engagement has also been treated as an additional separate exercise, as the service is jointly commissioned with the London Borough of Bromley.

In recognition that some users of the service may find it challenging to engage with the process and in order to remedy this NHS Bromley are working in partnership with 'Advocacy For All', an advocacy service that will act on behalf of anyone who wishes to respond.  This has been promoted on all documentation.

Our intention is not to produce large volume responses at this point in time, but to ensure that we engage effectively with the small percentage of the population who have used or may use these services.

The current engagement work that is being undertaken on Bromley’s Intermediate Care service is pre-consultation work which will inform any final proposals. It has recently been determined that the Orpington services including the intermediate care beds will form part of a formal consultation under Section 244 of the NHS Act 2006. When the initial intermediate care consultation documentation was published it was not yet decided if this section would apply. 

Intermediate care will therefore be included within a three month public consultation as part of the Orpington Health Services Project in the summer once authorisation has been given from NHS London. Plans are currently developing for this consultation, which will be subject to an equalities impact assessment.  A draft equalities impact assessment has already been published for the Orpington project and intermediate care services development. It is also intended to engage with the Bromley Compact group to ensure that the consultation is Compact compliant.

The aim of our current engagement work is to develop proposals to the next stage, taking the views of service users, carers and interested stakeholders into account.  To do this, we have taken the view that it is most effective to engage with those directly affected by changes and those who have previously received the service, rather than taking a ‘broadcast’ approach.  We have done this in the following ways:

·  Contacted all members of Bromley LINk, asking them to comment on the proposals in the engagement document

·  Invited voluntary sector groups registered with Community Links Bromley to comment on proposals in the engagement document

·  Met with Bromley Council on Ageing (an umbrella body for voluntary sector groups that represents the interests of older people)

·  The service provider, Bromley Healthcare is contacting previous service users on the commissioner’s behalf to seek direct feedback on their experiences of the current service.

·  Proposals were also discussed at the Older People’s Partnership Group on 11 January 2012

In all cases, hard copies of the proposals were provided, with the offer of additional copies on request.

For the intermediate care engagement in isolation we have received four responses to date, two from organisations and two from individuals.  We have also received verbal feedback from Bromley Council on Ageing.  Preparations for distribution to previous patients mean these have only recently been contacted and we are not expecting to receive their feedback for several weeks. However we will ensure we incorporate all responses when they arrive which would be well in advance of our next consultation phase.