Shaping Healthcare in Northamptonshire. Reviewing the way we support people with neuro-degenerative conditions in Northamptonshire

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1 Shaping Healthcare in Northamptonshire Reviewing the way we support people with neuro-degenerative conditions in Northamptonshire A public consultation 9 May July

2 Foreword Dr Darin Seiger, GP Chair, Nene Clinical Commissioning Group and Dr Peter Wilczynski, GP Chair, Corby Clinical Commissioning Group Welcome to our public consultation about the development of support for people with neuro-degenerative conditions and the future of residential respite care across Northamptonshire. As GP Chairs for Nene Clinical Commissioning Group and Corby Clinical Commissioning Group, we are pleased to introduce our consultation. As you probably know, GPs now have a much greater role in commissioning or buying local health services. Groups of GPs have formed Clinical Commissioning Groups (CCGs) to do this. Nene and Corby CCGs are responsible for commissioning the majority of health services across Northamptonshire on behalf of the local population. Since our formation in April last year, we have looked at local services and how they are provided. Specifically we are aware that services for people with neuro-degenerative conditions are not equally provided for across the county. We want to develop a better approach to the support and management of neuro-degenerative conditions that is the same wherever you live. The main service is currently provided at Favell House in Northampton. It provides two services, one for daytime respite care and one for residential respite care. Daytime services are commissioned by the Northamptonshire County Council (NCC) and residential care is commissioned by Nene Clinical Commissioning Group (jointly for Nene and Corby residents). The service is currently used mainly by people in the Northampton area and this seems like an ideal opportunity to look at whether we can improve the quality of that service as well as increase patient choice, and that is what this consultation is about. We want to ensure that when people need respite care, they can receive it as effectively as possible. We also want to work with the providers of respite care to ensure that services are available to all those that need it across Northamptonshire, that care is appropriate and where possible, bring that care closer to home. 2

3 Please take a few moments to read this document, and then fill in the questionnaire and let us know what you think. If you can, you may also like to attend one of the meetings where we will be discussing our proposals details are on page 9. We look forward to hearing from you. Best wishes, Dr Darin Seiger Nene CCG Chair Dr Peter Wilczynski Corby CCG Chair Introduction This document gives you the background to our public consultation about the improvement of respite services and for people with neuro-degenerative conditions in Northamptonshire. The only provision for Northamptonshire is at Favell House and currently provides respite for residents in Northampton through the provision of 10 beds. We have developed proposals about how people could receive these services in future, and would like to understand what local people think about these proposals. We propose to provide Personal Health Budgets to those needing residential respite care in Northamptonshire which will allow residents to choose where, and from whom, they receive the service. This will provide individuals with choice in making a decision about the most appropriate service to meet their needs. We believe this will produce an enhanced service for the local population who currently use the service as well as for people who may need to use the service in the future. Please take a few moments to read through this document, and then to answer the questions at the end. The information and questionnaire are also available online at or 3

4 Respite services at Favell House, Northampton The following two respite services are currently offered from the Favell House building in Northampton: Residential respite care Currently, short-stay residential care is provided to 57 people who live with neuro-degenerative conditions such as Parkinson s disease, Multiple Sclerosis and those with motor-neurone disease. They receive routine nursing and GP care while also receiving residential care. The respite service is commissioned or purchased by Nene Clinical Commissioning Group from Northamptonshire Healthcare Foundation Trust (NHFT). Daytime care The service also has a daytime centre attached, which is purchased by Northamptonshire County Council (NCC) from NHFT. The day service supports 44 people, some of whom also receive residential respite care. From summer 2013, daytime attendees will be funded through Direct Payments provided by the NCC. The building Favell House was part funded by voluntary donations in circa1995 and is the other half of the Cynthia Spencer Hospice. The two services, however, are not linked. The building is owned by the NHS. Why do we want to change this service? There are a number of reasons why we believe a change in the service could enhance the overall experience of people needing respite care. 1. The residential respite service at Favell House is available to Northampton residents only and not to residents of the wider county. 2. Residents currently have no choice of where they can receive the respite services. 3. The cost of providing the service at Favell House is four times that of other independent sector residential respite services in the county. 4. The service has not been open to new referrals for some time and is therefore not linked to the needs across the county. 4

5 What are we proposing to change? We believe that people would receive a better experience if we could offer: 1. Respite services to those that need it across Northamptonshire regardless of where they live. 2. An assessment of each person that currently attends Favell House with a view to offering them an appropriate personal health budget to facilitate their continued care. 3. A review of the current pathway, the process by which people are diagnosed and treated, for people with neuro-degenerative conditions to support them closer to home and offer services appropriate to their presenting needs. Initial cost appraisal The cost of providing both daytime respite care and residential respite care at Favell House is outlined below in comparison to the average cost across the county. Service Cost at Favell House per resident Average cost across the county per resident Daytime respite care 22 (exclusive of property rental costs) 45 (inclusive of property rental costs) Residential respite care 3,500 per week 800 per week Through the changes we propose to make, we have no doubt that the experience of care would be enhanced by providing people with a broader choice of how they receive respite care and increasing access to these services in Northamptonshire. However, we would like you to consider the cost benefit of the current services as well as the proposed changes. Reducing the cost per resident, while enhancing the quality of the experience, would allow for reinvestment into respite services and specialist nursing in Northamptonshire. What else will be impacted if we make these changes? Aside from the benefits above there will be some other impacts that you will need to consider if we make these changes. Providing personal health budgets to enhance individual choice As with most businesses, if demand for a service at a particular location is low it may impact on the viability of offering services from Favell House in the future. The daytime service, organised by NCC, would also be affected. Reviewing the provision of service at Favell House In order to ensure that we are receiving the best value for money in providing services at Favell House we will need to carry out a competitive review of 5

6 services. This will allow other providers to show us the quality of services they can provide and at what cost. In carrying out this process, it is possible that NHFT would no longer remain the provider of care at Favell House which could have implications for some of their 37 members of staff. There is also an opportunity to consider NHFT using several of their existing buildings to reprovide the service. Reviewing the way neuro-degenerative conditions are diagnosed and managed Change can be unsettling for people and there is a potential that when we review the current process for diagnosing and managing neuro-degenerative conditions, things may change, including how health and social care needs can be better managed through and end-to-end service. Through this process we hope to hear from people that have been through the current system with a view to telling us how we can improve. We are particularly interested in comments about the response they had when asking for support and how healthcare needs are met specifically linked to neuro-degenerative conditions. 6

7 Questionnaire your feedback Option 1 Keep the status quo i.e. leave things as they are STRENGTHS Consistency and familiarity WEAKNESSES No choice for residents wishing to receive respite closer to home Service would be limited to Northampton and not accessible across the county High cost wouldn t allow for investment in personal health budgets The service does not take new referrals as it is not considered a sustainable service in the longterm Option 2 Assess individuals receiving residential care and offer a personal health budget appropriate for their care needs, review the process to diagnose and manage neuro-degenerative conditions STRENGTHS Broaden access to the service for the county Provide choice of where to access the service Review of process to diagnose and manage neurodegenerative conditions to remove unnecessary delays and improve quality of life for individuals Provide a seamless service across health and social care WEAKNESSES Reduction in choice of service at Favell House could mean that it is no longer viable to provide the service at this location This is only made possible by the reduction in cost of existing service Equalities impact assessment Our initial equalities impact assessment has identified that the proposed changes will improve access for all groups of people. We will now do a full impact assessment and we will make sure that the equality implications will be considered at all stages of the consultation process. We will engage with communities and representatives of the different strands of diversity with the support of our equality and diversity colleagues. 7

8 Next steps We would like you to think about these options, and then let us know which one you prefer and provide any other comments you may have. Please complete the questionnaire, and return to us by 4 July You can complete it online at or other options are outlined on page 13. There will be a number of meetings in Northamptonshire where you can meet us and talk to us about our plans. They are listed on page 9. Once the consultation is over, we will gather all the feedback, and use it to help us make our final decision. That decision will be based on the feedback received as part of the consultation and on the other clinical, quality and economic factors we have described in this document. We will continue to involve partners and members of the public in any subsequent implementation and planning phase. The consultation lasts for eight weeks and ends on 4 July Once the consultation is over, we will gather all the feedback, and use it to help us make our final decision. That decision will be based on the feedback received as part of the consultation and on the other clinical, quality and economic factors we have described in this document. We will continue to involve partners and members of the public in any subsequent implementation and planning phase. 8

9 List of meetings where these proposals will be discussed Please note that for an up to date listing and confirmation of dates and times for events, meeting or workshops, please visit or Meetings confirmed for June: Monday 17 June pm Residential Respite Consultation Public Meeting Francis Crick House, Summerhouse Road, Northampton. To book a place involvement.nene@nhs.net or call We will also be engaging with the following groups: MS Society Northamptonshire Arthritis Society Northamptonshire Age UK Northamptonshire Diabetes UK Northamptonshire Deaf Connect Northamptonshire Association for the Blind (NAB) Stroke Association Northamptonshire Carers 9

10 Questionnaire your feedback Section 1 Services Question 1: The options Which option do you prefer? Please tick one. Option 1 Keep the status quo i.e leave things as they are Option 2 Assess individuals receiving residential respite care and offer a personal health budget appropriate for their care needs, review the process to diagnose and manage neuro-degenerative conditions Section 2 Additional questions Question 2: Access to residential respite services I think services should be available to all residents across Northamptonshire I think services should only be available to residents in Northampton Question 3: The consultation Overall, how do you feel about the way you have been consulted and the level of information that you have been provided with? Very satisfied Quite satisfied Neither satisfied nor unsatisfied Quite unsatisfied Very unsatisfied Question 4: Are there any other comments that you wish to feedback in reference to this consultation? Section 3 - About you Please complete as much of the information about yourself as you feel comfortable with, as this will help us understand who is taking part in the consultation. The information you provide will be kept in accordance with the terms of the Data Protection Acts 1998 and 2000 and will be used for monitoring purposes. 10

11 Question 5: If you are filling this in on behalf of an organisation, please state which one: Question 6: Gender Male Female Transgender Question 7: Age group Under to to to to Prefer not to say Question 8: Ethnic group White British Irish Traveller Prefer not to say Any other background, please specify Mixed White and Black Caribbean White and Black African White and Asian Any other Mixed background, please specify Asian or Asian British Indian Pakistani Bangladeshi Any other Asian background, please specify Black or Black British Caribbean African Any other Black background, please specify 11

12 Chinese Chinese Other ethnic group Any other ethnic group, please specify Prefer not to say Question 9: Do you consider yourself to have a disability? Yes No Prefer not to say If yes, please tick all which apply Physical Partial or total loss of vision Learning disability/ difficulty Partial or total loss of hearing Mental health condition or disorder Long standing illness or disease Speech impediment or impairment Other medical condition or impairment, please specify Question 10: Sexual orientation Bisexual Heterosexual Gay Lesbian Other, please specify Prefer not to say Question 11: Religion and belief No religion Bahia Buddhist Christian Hindu Jain Jewish Muslim Sikh Other, please specify Prefer not to say 12

13 Question 11: First four letters/numbers of postcode (we will not be able to identify your address from this but it helps us understand approximately where replies are from) To take part in the consultation, you can: Log on to or to feed in your views online Call to speak to a member of the engagement team Send this questionnaire or write to: Joint Commissioning Team Nene and Corby CCGs Francis Crick House Summerhouse Road Northampton NN3 6BF Please note, the closing date for responses is 4 July Any queries If you have any questions or would like more copies of this document, please contact the communications and engagement team in the first instance on Please contact us if you would like this document in a different format or translated into a different language. Publishing the results The result of this public consultation will be published on Nene and Corby CCGs websites in August The feedback we receive will be used to inform the final decision making on the future of residential respite care in Northamptonshire. 13

14 Cabinet Office Code of Practice on Consultation The key consultation principles outlined in the code of practice are: 1. Departments will follow a range of timescales rather than defaulting to a 12-week period, particularly where extensive engagement has occurred before. 2. Departments will need to give more thought to how they engage with and consult with those who are affected. 3. Consultation should be digital by default, but other forms should be used where these are needed to reach the groups affected by a policy. 4. The principles of the compact between government and the voluntary and community sector will continue to be respected. 5. The new consultation principles will be promoted within Whitehall now, and the public will begin to see the new guidance take effect in early autumn The guidance replaces the Code of Practice on Consultation issued in July

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