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What we've learned so far

Keep an eye on the Examiner website for more analysis and reaction to the consultation results tomorrow.

In the meantime, here’s what we’ve learned so far

Key question

How old were respondents?

Did more men — or women — respond?

Diane Abbott: 'Bosses could close A&E despite opposition'

And in Westminster, Shadow Health Secretary Diane Abbott waded in to express concern that despite the negative results, local NHS bosses may persist with their plan.

The Labour frontbencher said:

“I am deeply concerned that despite (a) consultation likely to show opposition to the closure of Huddersfield Royal Infirmary there will be a decision to close anyway.

“Labour opposes these continual closures of vital units across the country. I call on (Health Secretary) Jeremy Hunt to heed the outcome of this consultation.”

Diane Abbott MP
Diane Abbott MP

Hands Off HRI: 'Our fight will continue'

Natalie Ratcliffe, of the #HandsOffHRI campaign which has been fighting the proposal, said:

On balance the survey results are just what we expected.

We can only hope that they listen to the views of staff and the community. Our fight will continue.

Campaigner Natalie Ratcliffe says: "Let your voice be heard"
Campaigner Natalie Ratcliffe

Key area 6: The need for change

Despite the concerns there is evidence indicating that many respondents acknowledge that change is needed. Alternative sites, configurations and improvements to services are suggested. Suggestions are also given on how to improve the proposals for example better transport/road links or car parking. There is some recognition that the existing structure of healthcare is unsustainable to meet current and future needs.

Key area 5: Understanding the proposed model

There is evidence in the responses to suggest that the detail of the proposals around the clinical model is not fully understood by respondents. There is not enough information and there is a lack of clarity around how it will work in practice. For example, respondents asked how services could meet the needs of the local population where there is a reduction in the number of hospital beds, staff shortages and increased demands from the populations of both Calderdale and Huddersfield. Respondents believed that emergency care was needed in both Calderdale and Huddersfield due to the size of both towns. There appears also to be a lack of understanding about the terms emergency care and urgent care.

Key area 4: The consultation process

Within this message, respondents raised a number of concerns. There is criticism and suspicion of only consulting on a single option. This led to respondents using terms like ‘done deal’. The language and clarity of the proposals within the consultation documents and the structure of the survey was criticised. Respondents queried how decisions were made, how the final proposal was reached and why the other proposals were not 8 communicated. Respondents want to know more about how the proposals were developed and what the evidence is to support them. Respondents complained at the methods of engagement through the consultation and the extent to which different groups were involved. Staff that did participate mentioned that they would like to be more involved in the formulation and structuring of the plans.

Key area 3: The rationale for change

Respondents question whether the proposals are clinically driven as opposed to financially driven. To what extent, for example, have previous decisions such as the PFI agreement at Calderdale Royal Hospital influenced the proposals? Respondents want to know whether clinical staff, in particular, are supportive of the proposals. And to what extent other services, such as the Ambulance Service. support the proposals.

Calderdale Royal Hospital, Halifax.
Calderdale Royal Hospital, Halifax.

Key area 2: Clinical safety and capacity

As well as concerns that increased travel will have an impact on mortality rates, respondents were sceptical about the quality of care and availability of treatment, and how this could put patients’ lives at risk. Respondents queried whether the proposed model would have the capacity to cope with the population’s needs.

For example, will there be sufficient beds, staff resource and what about the ‘knock-on effects’ for other services and areas (for example, Barnsley)? Is there a good understanding of this? A lack of understanding about the detail of the proposals and how they would work in practice is a key barrier to overcoming concerns.

Respondents want to know how the proposed Urgent Care Centres will link with A&E, for example transferring someone from an Urgent Care Centre if a patient’s condition deteriorates. Respondents ask if the impact on GPs and the Ambulance Service has been fully considered.

Ambulance
Ambulance

Key area 1: Travel and transport

Respondents from Greater Huddersfield are worried about the impact of increased travel times, in particular for access to emergency treatment at Halifax. This was seen as a reason for A&E services to be retained in Huddersfield. Ease of travel between the two towns was also raised by respondents. Congestion 7 on the Elland Bypass, which is the primary route between Huddersfield and Halifax was frequently raised as was access to public transport. Increased travel costs and adequate facilities for car parking at Calderdale Royal Hospital were also mentioned by respondents. Similarly, the additional demand on ambulance services led respondents to believe that there would be a delay in response times and availability to transport those with life threatening conditions.

Traffic snarled up on Sunday afternoon on the Elland bypass
Traffic snarled up on Sunday afternoon on the Elland bypass

Did everyone read the consultation documents?

The largest proportion of respondents had read some of the consultation documents (the main one or the summary version). Only 8.9% of respondents had not read any of the consultation documents. A further 11.6% had attended a consultation event.

Engagement with RCRTRP consultation documents
Engagement with RCRTRP consultation documents

Most of the respondents were from Huddersfield

But there was support for the plan too

“I fully support the proposal to have one emergency care centre/paediatric care centre and one urgent care centre (e.g. minor injuries unit). CHFT services are currently unsustainable and at times unsafe because of the current trust configuration.”

- Member of the public, correspondence log C329

Impact on ambulances

“Ambulance response times are a crucial issue in Calderdale and Greater Huddersfield. A recent report in the local press this month confirmed that the ambulance service is in crisis, with a single emergency centre, average ambulance journey times will increase, as will waiting times to admit patients from ambulances – leaving even fewer ambulances available to respond to calls.”

Response from Hands Off HRI, correspondence log C239

People felt the decision had already been made

Feedback indicated concern with the decision-making process, in particular a sense that the decision had already been made. A number of reasons are given for this, such as only one option for A&E services being consulted on.

Huddersfield Royal Infirmary, Accident & Emergency Dept. Acre Street, Lindley, Huddersfield.
Huddersfield Royal Infirmary, Accident & Emergency Dept. Acre Street, Lindley, Huddersfield.

“I’ve spoken to so many people, friends, neighbours; lots of people in Huddersfield about these proposals and their biggest worry and the thing that causes great upset they say it’s just a done deal.”

- Member of the public at a meeting in Calderdale, 14 April 2016

How were the results put together?

Here’s the science bit:

NHS Midlands and Lancashire Commissioning Support Unit (CSU) was commissioned to provide an independent report of findings based on the feedback from the formal consultation run between 16 March and 21 June 2016, a period of 14 weeks.

In developing this report the CSU undertook the following activity: 

- Analysed 7,582 completed surveys, with approximately 40,000 individual comments to the open questions 

- Reviewed correspondence and feedback received at a range of stakeholder meetings 

- Developed a coding framework based on the responses received, to extract key themes from the consultation 

- Interpreted the findings of this analysis to produce this single report.

'Six key areas' for decision-makers to focus on

They are:

  1. Travel and transport
    Traffic queueing from the Elland bypass towards the Ainley Top roundabout.
  2. Clinical safety and capacity
  3. The rationale for change
  4. The consultation process
    Hospital plans consultation opens at Slaithwaite Town Hall.
  5. Understanding the proposed model
    Hospital shake-up explainer from RCRTRP
  6. The need for change

Plans rejected by Huddersfield

When asked what they like about the proposals 60.8% of respondents from Huddersfield ticked ‘none of these apply’ from the list.

Hands off HRI march
Hands off HRI march

Worries about travel, ambulance service and population size

Some of the key themes that emerged in comments:

  • travel times,
  • impact on other hospitals and the ambulance services
  • meeting the population’s needs.

But - some respondents did highlight the feeling that this model will deliver a high quality of care.

Huddersfield and Calderdale split

From the report:

  • 60% of all respondents stated that they felt they would be negatively impacted by the proposed changes overall
  • There is a significant difference between respondents from Calderdale and Huddersfield.
  • In Calderdale around 33% of respondents believe they would be negatively affected and in Huddersfield it was around 80% of respondents.

Of course it makes sense that Huddersfield respondents were the most concerned — it is thei A&E that could close!

The results are out

The results of the consultation into a hospital shake-up plan that could see Huddersfield’s A&E closed have been released.

Survey responses totaled 7,582 and around 40,000 individual comments on the Right Care Right Time Right Place proposals.

Join us as we dissect the consultation results and reaction from people across Huddersfield and Calderdale