Transforming Ophthalmology Services Consultation
Draft Delivery Plan December 2021 – March 2022
Introduction
This plan describes how we will communicate and engage with the public and our stakeholders during the formal consultation process regarding the proposals to transform ophthalmology (eye) services at East Sussex Hospital Trust (ESHT) which is due to take place between Monday 6th December 2021 and Friday 11th March 2022. The plan has been informed by our pre-consultation engagement work, by the options development and appraisal process and by the Equalities and Health Inequalities Impact Assessment (EHIA).
The plan does
not include any communications and engagement that may be required
with staff.
Background and
context
The CCG is developing proposals for how hospital-based ophthalmology services can best provide high quality treatment, care and support for local people and meet increasing local population need. Acute ophthalmology services for adults in East Sussex are provided by ESHT at Eastbourne District General Hospital, the Conquest Hospital in Hastings and Bexhill Hospital.
Ophthalmology is a branch of medicine and surgery that provides diagnosis, treatment and prevention of conditions that affect the eye and visual system. Medical ophthalmology involves diagnosis and management of disorders affecting a person’s vision, while surgical ophthalmology involves a surgical procedure to correct or improve a person’s vision, for example, cataract surgery. The ways in which ophthalmology specialists work have changed over time, as have the technologies and treatments they use for ophthalmology conditions. For example, it is now possible to provide more services virtually through teleconsultations. While there have been positive advancements, the demand on the service is increasing year-on-year, and this is set to rise further because Sussex has a growing and ageing population.
The CCG’s vision for the future is to provide:
• a clinically excellent ophthalmology service;
• a service that reduces avoidable sight loss and improves the eye health of all our patients;
• the ability to look after a growing and ageing population;
• a service that provides increased support and development for the ophthalmology workforce;
• a service that is clinically, environmentally and financially sustainable now and in the future.
Pre-consultation Engagement
To consider how ophthalmology services could be transformed, the Public Involvement (PI) team undertook pre-consultation engagement which commenced on 4 January 2021 and lasted six weeks (concluding on 14 February 2021).
To reach the local population in East Sussex the PI team co-developed questionnaires with partners and members of the public and these were promoted widely in paper copies and electronically. The team undertook interviews with current and former patients of the service and joined virtual local forums and groups to hear from people about their experiences. The insight gained from this engagement then informed the development and appraisal of options for the future of the service.
Options Development and Appraisal
The CCG commissioned the independent organisation Opinion Research Services (ORS) to lead the options development and appraisal process. Patients, representatives from relevant VCS organisations and Community Ambassadors were invited to attend: five representatives attended for ophthalmology. PI team members and ophthalmologists from ESHT attended to observe, present key information and respond to questions, but did not actively participate in the options appraisal scoring and ranking activities.
Three options development and appraisal workshops (independently chaired and facilitated by ORS researchers) took place in March 2021 to identify and consider a longlist of possible options for the future provision of acute ophthalmology services. Participants were provided with information to enable informed discussion, including summaries of key contextual information (e.g. population health needs, clinical standards, activity demand and capacity, finances, estate footprint, workforce) and summaries of key programme documents (e.g. Equality and Health Inequalities Impact Assessment and Case for Change).
Various potential models of care were developed and discussed at the workshops and participants then ranked and scored the options against the agreed criteria, as a result of which three options were shortlisted for ophthalmology:
1. Ophthalmology services located at two hospital sites, Eastbourne District General Hospital (EDGH) and Bexhill Hospital, supported by one stop clinics at both and a diagnostic eye hub at Bexhill
2. Ophthalmology services located at one hospital site, Bexhill Hospital, supported by one stop clinics and a diagnostic eye hub at Bexhill
3. Ophthalmology services located at one hospital site, Eastbourne District General Hospital, supported by one stop clinics and a diagnostic eye hub at EDGH
These options were then reviewed by ESHT and the CCG and it was decided to proceed to full consultation on Option 1.
Participants at the workshops raised a series of concerns which the PI team will ensure form a focus of the full public consultation currently scheduled to take place in early 2022. These concerns were:
• travel and access: time, distance and cost;
• the ability to cope with increased patient demand;
• concerns about moves to digital appointments.
Clinical Senate Recommendations
In August 2021 the CCG submitted the Pre-Consultation Business Case to the Southeast Clinical Senate for review. The Clinical Senate made the following recommendation regarding Patient and Public Engagement:
In the pre-engagement work do the patient and user views and opinions include those who would normally be seldom heard including those with hearing difficulties, learning disabilities, those who either have no access to or choose not to use IT and those with poor health seeking behaviours? Have you reached those users of the service who will be most affected by the service changes?
In response this Delivery Plan ensures that there is a focus on the groups mentioned in this recommendation.
Equality and Health Inequalities Impact Assessment (EHIA)
The CCG has reviewed the EHIA. This document made a series of recommendations that are given below: responses to each of these recommendations have been included in the Delivery Plan.
|
Protected characteristic |
Engagement activity |
|
Race |
· Ensure links have been made with local faith communities or cultural groups in order to encourage involvement and gain feedback through all stages of patient and public involvement. · Ensure that Friends, Families and Travellers receive information on all involvement activity. · Attendance at Eastbourne Cultural Involvement Group to promote engagement opportunities · Request support from Diversity Resource International to promote engagement opportunities with local ethnically diverse communities |
|
People who have English as a second language |
· Offer telephone interpretation to support those who speak English as a second language and wish to engage · Translate materials into community languages (on request) |
|
Gender reassignment |
· Approach Hastings and Rother Rainbow Alliance Trans Support Group to talk about opportunities to get involved · Approach Bourne Out via Facebook and ask for support with promotion of the questionnaire |
|
Age |
· Work in collaboration with local authority partners to ensure we reach care home residents and staff · Attend East Sussex Senior Association to talk about ophthalmology service transformation and provide opportunities to feedback/ get involved · Attend Age Concern drop in sessions · Engage with RNIB, East Sussex Association for the Blind, Macular Society · Engage with the Public Health Vision Screening Service for Children · Attend PPG forums across East Sussex and offer drop in session if enough interest · Liaise with Age UK East Sussex · Engage with Parent Carer forums |
|
Religion and Belief |
· Ensure that faith communities in East Sussex are engaged in this project. · Invite faith elders to engage, and offer translated versions of materials where required. |
|
Disability |
· Explore opportunities with CVS organisations such as Possibility People to see what forums and networks we can utilise to support engagement · Approach Hastings disability forum to ask for support · Arrange a drop in opportunity for d/Deaf members to come and talk about experiences of ophthalmology services · Make the materials available in Easy Read and British Sign Language on request. · Approach the East Sussex Dementia Adviser Service to support the reach of our engagement · Approach the East Sussex Community Learning Disability Team for support · Take action to identify and engage with charities and organisations that support patients with diabetes · Take action to identify and engage with charities and organisations that support patients with their mental health · Take action to identify and engage with local mental health services · Take action to identify and engage with charities and organisations that support patients with cardiovascular disease |
|
Pregnancy and Maternity |
· Attend East Sussex Maternity Voices Partnership meeting · |
|
Other disadvantaged or inclusion groups |
· Engage with carers throughout the project to seek their views, through one-to-one interviews, liaison with representative groups and questionnaires · Engage with homeless and rough sleepers through pre-existing relationships with supporting organisations such as Rough Sleepers Initiative, Matthew25 and YMCA · Work with the NHS Armed Forces Community lead to ensure we hear from this cohort · Ensure that the Red Cross ‘ Carer Crisis Service‘ and the Care for the Carers ‘intensive support to carers in areas of known high health inequalities’ schemes are included in consultation and are made known to local population |
|
Deprivation and socio-economic disadvantage |
· Utilise foodbanks to share paper copies of questionnaires with freepost address · Ask for support from RVA, HVA and 3VA to target those living in areas of deprivation. |
*This list is not exhaustive but provides examples of the activities planned to reach marginalised groups
Governance
The Ophthalmology Communications and Public Involvement Task and Finish Group will be overseen by the Joint Cardiology and Ophthalmology Steering Group which reports to LMT. An assurance oversight group with membership from Healthwatch, Local Authority and a Community Ambassador will be established to ensure the process is robust and there are no avoidable gaps in engagement.
Key principles
In undertaking communications and engagement around our formal consultation we will adopt a transparent, best practice approach based on a number of key principles:
· Building on our wide range of previous engagement with local people and describing our journey, the purpose of our review and our intent to consult.
· ‘Strength-testing’ all aspects of our thinking, planning and approach.
· Acknowledging the importance our communities place on local services and our interest in all available feedback and insight to further inform our options.
· Incorporating the findings from our Equalities/Health Inequalities Impact Assessment (EHIA) to help us identify the groups and communities we should target for our communications and engagement work.
· Utilising our stakeholder mapping to ensure that we engage with all groups and partners with an interest in our plans including local councillors and MPs.
· Approaching our conversations with transparency in relation to our financial challenge and our need to balance the sustainability of local services whilst offering high quality care, at the right time and place for local people.
· Being transparent about the benefits and risks of our approach and testing our thinking on those.
Supporting information/materials
EngagementHQ
EngagementHQ is an interactive platform that enables people to give their views and feedback on programmes and public consultations. For this public consultation a project page will be created which holds all important documents, promotes all engagement opportunities and encourages the public to share their views through the use of the official survey, quick polls, sharing stories, a live Q and A section and an ideas area.
The CCG’s public website will be updated with the correct documents and promotes the new webpage.
|
Item
|
Location/format |
Details |
Responsible |
|
Consultation document |
Available in print and on CCG website and EngagementHQ website |
Information on the consultation, including all relevant documentation, to be widely shared by email and be made available to download online. There will also be an option for people to call or email to request a hard copy of the consultation document and other relevant documents. |
Communications lead |
|
Easy Read Consultation document |
Available in print and on CCG website and EngagementHQ website |
|
Involvement Lead |
|
Overseas language translated consultation summary |
Top five languages translated |
Will be translated further as required |
Involvement Lead |
|
Survey |
Link on CCG website and EngagementHQ website; paper copies provided at engagement events and on request |
|
Involvement Lead |
|
BSL survey |
BSL translated survey on CCG website and EngagementHQ website |
|
Involvement Lead |
|
Easy Read survey |
Easy Read survey on CCG website and EngagementHQ website |
|
Involvement Lead |
|
EHIA |
On CCG website and EngagementHQ website |
|
Involvement Lead |
|
PCBC |
On CCG website and EngagementHQ website |
|
Project team |
|
Frequently Asked Questions |
On CCG website and EngagementHQ website |
To be updated during consultation |
Comms lead/project lead/involvement lead |
|
Posters |
A4 poster, display in local hospitals, high street opticians, GP practices, libraries, cafes, etc. |
“Have your say” generic message |
Communications lead |
|
Leaflets |
A5 leaflet, available at local hospitals, high street opticians and GP practices, in any other languages identified as a result of the EHIA and our engagement. Also to be sent out with food parcels from foodbanks. |
To include dates and details of key engagement opportunities |
Communications Lead/Involvement Lead |
|
Social media/online assets |
Imagery and suggested copy for social media posts and use on websites, online newsletters, etc. |
To be shared with all relevant partners and stakeholders |
Communications Lead |
Draft consultation activity plan for the period January – April 2022
Note: some activity subject to change and confirmation of dates
|
Communications
|
|
|
Date |
Activity
|
|
October – December 2021 |
Planning Key documents to be revisited including: Pre-consultation Business Case EHIA - reviewed to include any learning from COVID-19 and from the initial stages of the consultation (prior to the pause) Engagement plan – updated engagement delivery plan recognising updated EHIA Consultation document updated, approved and printed Frequently Asked Questions - updated Posters, flyers and leaflets updated, website approved and printed Press release for launch of consultation drafted and approved Stakeholder update for launch of consultation drafted and approved, along with plan to cascade information
|
|
Pre consultation launch 16.11.21 onwards |
Phone calls to identified stakeholders Stakeholder briefing to be issued on day of Joint Committee MP briefing Reactive media statement in place |
|
06.12.21 onwards |
Implementation · Consultation document and associated supporting documents published on East Sussex CCG website with link to complete consultation questions on independent organisation webpage · Leaflets to be distributed via food banks, Community and Voluntary Sector (CVS) organisations and digitally via newsletters · Launch press release issued (including press release in British Sign Language) and added to CCG/ESHT websites · Tailored emails to: Ø Key stakeholders (based on stakeholder mapping) Ø East Sussex Patient Participation Group members Ø East Sussex GP practices Ø Healthwatch East Sussex · Social media posts · Inclusion in GP bulletin · Article in East Sussex Health and Social Care News · Articles in local newsletters - ongoing · Content sharing by key partners (e.g. ESHT, ESCC, Healthwatch, voluntary and community sector etc.) on social media, public websites, intranets, newsletters, etc.) |
|
Between December 2021 and March 2022 |
· Press releases issued to remind people of options to take part before end date · Social media posts continue until end of the consultation · Articles in GP bulletin · Articles in East Sussex Health and Social Care News · Articles in local newsletters - ongoing · Content sharing by key partners (e.g. ESHT, ESCC, Healthwatch, voluntary and community sector etc.) on social media, public websites, intranets, newsletters, etc. · Tailored emails to: Ø Key stakeholders Ø East Sussex PPG members and GP practices |
|
14.03.22 |
· Press release announcing end of consultation and next steps · Social media posts announcing end of consultation and next steps · Article in GP Bulletin announcing end of consultation and next steps · Article in East Sussex Health and Social Care News announcing end of consultation and next steps · Articles in local newsletters announcing end of consultation and next steps · Tailored emails to key stakeholders announcing end of consultation and next steps |
|
Post Consultation and final report |
· Tailored emails to: Ø Key stakeholders Ø Ophthalmology public distribution list Ø East Sussex PPG members and GP practices Ø CVS organisations who supported the public consultation · Article on East Sussex CCG website · Press release which includes highlights from consultation feedback report and a link to the full report · Provide update and copies of the final report at all forums and groups that took part in the consultation |
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Engagement Activities - 06.12.21- 14.03.21
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Membership and provider engagement
|
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Date
|
Activity |
Lead |
|
|
|
Fortnightly
|
Attendance at East Sussex Communications and Engagement Steering Group: distribution of materials including questionnaires, posters, etc. |
Public Involvement team |
|
|
|
January 2022 |
Dedicated webinar for Eastbourne Hailsham and Seaford, Hastings and Rother, High Weald and Lewes and Havens locality members |
Clinical leads |
|
|
|
Patient and public involvement
|
|
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Ongoing throughout consultation |
Provide information on consultation to Sussex Health and Care Partnership, District, Borough and Parish Councils, community and voluntary sector organisations and relevant services and neighbouring CCGs and Acute Trust: include material for distribution, questionnaires, web links etc. and offer attendance if requested:
HVA, RVA, 3VA, Healthwatch, Southdown, Fulfilling Lives, East Sussex County Council Young People’s Services, YMCA, Red Cross, Citizens’ Advice Bureau, East Sussex Chambers of Commerce, Eastbourne and Hampden Park Libraries, Beacon Shopping Centre, Maternity Voices, Action in Rural Sussex, Deaf Cultural Outreach Group (DeafCOG), Diabetes UK (local groups), St John’s Ambulance, Sussex Community Development Association, Sussex U3A groups, Armed Forces Network, Age Concern, Age UK, Amaze SENDIASS East Sussex, Churches Together Sussex, Friends, Families and Travellers, Rough Sleepers’ Initiative, Mathew 25, Salvation Army, Homeless and Rough Sleepers’ Service, East Sussex food banks, Leagues of Friends, Save the DGH, Friends of the Conquest Hospital, Save the NHS, Rainbow Alliance, Bourne Out, Public Health Vision Screening Service for Children, Possability People, MIND East Sussex, Grace Eyre, Amaze, HEART Hastings. |
Communications and Public Involvement team |
|
|
|
06.12.21 onwards |
Attendance at meetings: East Sussex Association of Blind and Partially Sighted Eastbourne Blind Society Hastings and Rother Voluntary Association for the Blind East Sussex Disability Association Care for the Carers – East Sussex Autism Partnership Board LD Partnership Board Hastings HEART East Sussex County Federation of WIs Fellowship of St Nicholas Hub on Rye Hill Community Centre Oasis Community Projects (Ore Valley) Rotherfield St Martin (community hub) Pelham Community Hub (Bexhill) Shinewater North Langney Neighbourhood Partnership (Eastbourne) Blue Van Veterans East Sussex Seniors’ Association Dementia Alliances: Eastbourne, Hastings and St Leonard’s, Bexhill, Wealden, Havens Deaf Cultural Outreach Group (DeafCOG) Eastbourne Cultural Involvement Group Black Butterfly (ethnically diverse communities, asylum seekers, refugees) Seaview Centre St Leonards Hastings and Rother Interfaith Forum (tbc) Eastbourne Faith Forum (tbc) Hastings Older People’s Ethnic Group HOPE-G Hastings Age-friendly Community Coffee Mornings Hellingly Over-60s Coffee Mornings Parent Carer Forums (via ESCC) LGBTQ – contacts being investigated |
Public Involvement team |
|
|
|
06.12.21 onwards |
Individual interviews with service users and carers |
Public Involvement team |
|
|
|
January 2022 |
Stakeholder workshop(s) e.g. Local Optical Committee, Patient Transport Services, Healthwatch |
Public Involvement team |
|
|
|
06.12.21 |
Local Voices Network – invitations to participate in events, links to questionnaires, regular updates on consultation progress |
Public Involvement team |
|
|
|
|
East Sussex Local Strategic Partnership Boards – information prior to and during consultation, updates re: consultation, offer to attend |
Public Involvement team |
|
|
|
30th November 4th December 7th December 21st December 18th January |
High Weald PPG forum Eastbourne Hailsham and Seaford PPG forum Hastings and Rother PPG forum Lewes and Havens PPG forum East Sussex PPG Steering Group |
Public Involvement team |
|
|
|
06.12.21 |
GP practices sent information on consultation including material for distribution, questionnaires, information for electronic screens, posters |
Communications team |
|
|
|
06.12.21 onwards |
Telephone interviews offered to members of the public using dedicated telephone number, with Signlive assigned and interpretation available |
Public Involvement team |
|
|
|
January / February 2022 |
Public meetings: focus on communities identified by EHIA/Clinical Senate recommendations: Hastings/St Leonards: Hollington Four Towers - Rural Rother: Hub on Rye Hill Community Centre - High Weald: Uckfield Civic Centre: one virtual event |
Chief Executive ESHT/CCG and clinicians |
|
|
|
06.12.21 onwards |
Public events – e.g. Eastbourne Open Air Market, Rye Market, Hastings Priory Meadow, Hollington Tesco, Beacon Shopping Centre Eastbourne, Hailsham shopping centre, Crowborough Farmers Market, Seaford Library, Newhaven Country Market, Lewes Farmers’ Market, Newhaven and Peacehaven Community Supermarkets |
Public Involvement team/other CCG teams/Healthwatch volunteers |
|
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This is a live document and dates and opportunities will continue to be added to during the consultation period.