Major service change reports
NHS Greater Glasgow and Clyde's consultation on proposals for rehabilitation services for older people in north east Glasgow
This report sets out our assessment of whether NHS Greater Glasgow and Clyde's engagement and consultation process followed Scottish Government guidance, which requires that NHS boards seek, listen to and act on the views of potentially affected people and communities when proposing changes to services.
Based on the evidence outlined in this report, our view is that NHS Greater Glasgow and Clyde has followed the national guidance set out by the Scottish Government.
This process has been led by NHS Greater Glasgow and Clyde. However, it is clear from the questions some people raised that a level of concern remains around the future sustainability of the proposed model. The response to these queries will need input from Health and Social Care Partnerships should the proposals be approved.
The main concerns raised by people related to:
- challenges in public transport and access
- sufficient service capacity to meet people’s needs
- potential adverse impact on quality and continuity of care, especially for people with Parkinson’s Disease, and
- financial matters, with some comments describing proposed changes as 'cost-cutting'.
We recognise NHS Greater Glasgow and Clyde has developed its proposals and approach during engagement and consultation. Examples include:
- Prior to and during engagement the public focus was on perceived cuts to local services. The NHS board has aimed to address some of the concerns raised during engagement, which has allowed the consultation to explore further the proposed service and patient pathways.
- The proposals continued to evolve following the initial proposal presented in the local delivery plan in June 2016. Examples of this are the proposal to provide rehabilitation inpatient beds at Stobhill Hospital rather than Gartnavel General Hospital and for the Movement Disorder Clinic being provided at an acute hospital site rather than a local facility in East Glasgow (Stobhill Hospital scored highest in the option appraisal).
- Experiences from earlier engagement e.g. venues, format of public events and information was taken into account to inform the planning for consultation. Participants also recognised this.
We have made the following recommendations to respond to points raised during the consultation and to inform decision-making, communication of any decision and next steps:
- Public transport across NHS Greater Glasgow and Clyde area can be challenging particularly for some localities. As the NHS board seeks to transform its acute services, it should consider ways in which this challenge can be addressed to support patients and visitors access to services.
- Feedback highlighted that the transport analysis could take additional aspects into account. Further analysis should recognise challenges for people with mobility issues and reflect the catchment area for outpatient services currently provided at Lightburn.
- The outcome of the Public Health Review should be taken into account in the decision-making process.
- Further engagement and promotion is needed to respond to current perceptions around care homes and provide assurance that these are being used to support people in returning to their own homes and communities.
- During the consultation, NHS staff referenced pilots that the current model of care is based on. NHS Greater Glasgow and Clyde should provide evidence on the outcomes and learning of these pilots to provide assurance on the proposed model.
- NHS Greater Glasgow and Clyde should ensure that it addresses points raised and feedback received in submissions to the consultation and where applicable to the individuals providing feedback.