Are you closing my local hospital / MIU?

No decisions have been made and we do not have any preferred options in terms of how services will be provided in the future. We know that people will have very real concerns about the future of their local community hospitals and minor injuries units.

We encourage everyone to share their concerns, ideas and suggestions with us either via our questionnaire, through emails or letters or at our listening events.

We want people to help us shape and improve our future services. This is why we are talking to people about our opportunities and challenges and listening to their views.

Which hospital(s) are you closing? 

No decisions have been made and we do not have any preferred options in terms of how services will be provided in the future.

We are sharing our early thinking about how health and care services in Somerset can work better together and better meet the needs of our population. We have a real opportunity to design a new way of providing care that supports people to live independent, healthier lives.

We are also sharing the reasons why our current services need to change and the challenges that we face in continuing to run them in the way they currently are.

We want people to help us shape and improve our future services. This is why we are talking to people about our opportunities and challenges and listening to their views.

How will you decide which units and hospitals will close and which will stay?

At the moment we are sharing our early thinking and listening to what people are sharing with us. On 12 April 2020 we will collate all the feedback we have received so far and Participate Ltd will undertake an independent analysis of what people have told us. This feedback will be published later this year so everyone can read it.

We will be inviting a wide range of stakeholders to join us in a series of stakeholder workshops which will run over the summer. Stakeholders will include staff, patients, carers, voluntary, community and social enterprise organisations, league of friends associations, patient participation group chairs and other interested parties.

The workshops will be independently facilitated and together the stakeholders discuss and debate the opportunities we have to improve community health and care services and the challenges we face to feed into the development of how future services might work while working together with the Fit for My Future team to help develop solutions for improving services. During this time people will still be able to share their thoughts, ideas and concerns with us and we will feed these into the series of workshops to make sure they are fully considered.

A range of proposals and/or a preferred option (depending on the outcome of the workshops) will then be created which we will bring to formal public consultation. The formal public consultation will run for 12 weeks and all the feedback received will, again, be independently analysed and published. A decision making business case will then be developed and submitted to the Governing Body of Somerset Clinical Commissioning Group for a decision.

What will happen if I need urgent help or support and my MIU is closed?

The ‘talk before you walk’ approach would mean that you would ring NHS111 who would assess your needs and direct you to the more appropriate available support. This may include, for example, putting you in touch with a local community service that can support you or booking an appointment for you with your local GP or booking you an appointment at your nearest Urgent Treatment Centre where, depending on your needs you could have an x-ray, or a blood test or other treatment. Urgent Treatment Centres would be open for a minimum of 12 hours a day and offer a wider range of treatment and care than provided at a Minor Injuries Unit.

I like the idea of ‘talk before you walk’ but I’m concerned that NHS111 won’t have the capacity to take the amount of calls it could receive. How are you going to make sure that people can get through?

‘Talk before you walk’ is not just about calling NHS111. You can also call your GP surgery or, for social care issues, Somerset Direct (Somerset County Council’s service). The choice is yours. By calling any of these services your needs can be assessed and you will be signposted to the right service for your needs.

In terms of NHS 111, we will work closely with our NHS111 provider to make sure that we have the right systems and people in place to support the new approach. We will monitor activity closely and make changes as required to make sure that we have a robust and responsive service in place.

How am I going to get to / travel to X when you move it? 

No decisions have been made and we do not have any preferred options in terms of how services will be provided in the future. Travel will be a key issue which will be considered by our stakeholder workshops.  We will be working closely with colleagues at Somerset County Council and in the voluntary, community and social enterprise sector. We will set up a dedicated travel working group to look at this in detail.

How are you going to make sure that services are accessible to people without their own transport?

Travel will be a key issue which will be considered by our stakeholder workshops.  We will be working closely with colleagues at Somerset County Council and in the voluntary, community and social enterprise sector. We will set up a dedicated travel working group to look at this in detail.

You talk a lot about care closer to home. If you close our community hospital you won’t be providing care closer to home.

We want to provide care as close to home as practical. Our community hospitals beds don’t just serve their local population. A recent review of activity at our community hospitals showed that all our community hospitals are used by people from all over the county and not just their local population.

In addition, some of our hospitals provide specialist countywide services, for example, South Petherton provides a countywide stroke rehabilitation service while Bridgwater provide a countywide short term rehabilitation service. This is about making sure people are able to access the right services for their needs at the right time.

Will this mean staff will lose their jobs?

No. Our aim is to support our dedicated and hardworking staff by providing more opportunities to work flexibly, offering more career opportunities with a greater range of potential roles, and the support and training to thrive in those roles.

We believe that, by working differently and providing a greater range of services, we will remove some of the barriers that frustrate staff, and improve their satisfaction within their roles. This approach will help us to attract staff to Somerset and retain staff within our services against a backdrop of national staff shortages.

When is this going to happen?

We won’t be making any decisions before we have given everyone the opportunity to have their say. At the moment we are sharing our early thinking and listening to what people think about these. We will use this feedback to help shape our thinking further and work with key stakeholders to look at the evidence and data and assess the various options. 

A range of proposals and/or a preferred option (depending on the outcome of the stakeholder workshops) will then be created which we will bring to formal public consultation either later this year or early next year. The formal public consultation will run for 12 weeks and all the feedback received will, again, be independently analysed and published. A decision making business case will then be developed and submitted to the Governing Body of Somerset Clinical Commissioning Group for a decision.

Is this about saving money?

No, this isn’t all about the money.

It is true that services in Somerset are in financial deficit. We know that continuing to provide current services as they are today is both unaffordable and unsustainable in terms of staffing and money.  

In the future we would like to provide fewer community hospital beds, invest money to develop services that support people in their own homes or in a residential or nursing home bed, and ensure that our community bed units are optimally configured so that they are not as susceptible to staffing shortages.

We know that we can do better by caring for people either within or closer to their own homes. Supporting people to stay well, recover well and live well (both for those with and without long term conditions) makes sense for our population as well as for our staff and our finances.

Our population is changing and the support they need from our services is changing – which means that our services must change too. We need to make sure that we are spending the money we get from the Government to run our services in the best way possible to support our population to live well.

What if I don’t want to be cared for at home? 

Wherever possible, we will take your personal preferences into account. We want to care for people as close to home as practical, depending on your care and support needs. Everyone is different and your needs will be individually assessed. There will be a range of options available including short term stays in residential or nursing homes to support people and community hospital beds for those people for whom that is the best place to receive care.

What if I don’t want my family member or friend to be cared for at home? 

Wherever possible, the views of their carers, family and/or friends will be taken into account as well. We want to care for people as close to home as practical, depending on their care and support needs. Everyone is different and each individual’s needs will be assessed and their personal preferences noted. Wherever possible, the views of their carers, family and/or friends will be taken into account as well. There will be a range of options available including short term stays in residential or nursing homes to support people and community hospital beds for those people for whom that is the best place to receive care. The key issue is to make sure that people receive the right support, at the right time, in the place that’s best able to meet their needs.

Will I see the same person / have the same person looking after me? 

In the community, health and care teams will work together to provide the right level of care for your needs, as close to home as practical. You may have a named person who leads on your care (depending on your needs) or you may see the most appropriate person for your needs at the time that you need them.

Teams will include GPs, nurses, pharmacists, physiotherapists, paramedics and social workers as well as partners from the voluntary and community sector such as Somerset Community Connect, Village Agents or Health Connectors, home support from the Red Cross.

Members of the health and care team will have access to your records through a safe and secure digital system so that you don’t have to repeat yourself and they can see at a glance your history, your current medication (if you have any) and what support you receive. This will support continuity of care and information sharing.

What does this mean for the other activities and services based at Community Hospitals? 

Services and activities will continue to be provided in local areas, as close to people’s homes as practical.

Our current thinking is that we will develop community hubs that bring together in one place a range of services including mental health, district nursing, on the day treatment for some conditions, hospital outpatient appointments, and diagnostics tests such as x-rays. Some hubs may be based in current community hospital buildings.

Will this mean people in rural areas don’t get the same level of service?

No, but we live in a rural county. This means that, depending on people’s needs, they may need to travel to receive services. Our aim is to make sure we have services in the right place for people’s needs. Depending on where people choose to live, they currently have to travel up to an hour to access specialist services such as those provided at our two acute hospitals in Somerset. Where we can, we want to bring outpatient services and other specialist advice and guidance closer to home, through our community hubs.

Will this create a postcode lottery? 

No. Everyone in Somerset will be able to access the same services. However, some people will continue to have to travel further than others to access some services depending on where they live.

I can’t get an appointment with my Dr when I have an urgent issue – are you going to fix this? 

We think our ‘talk before you walk’ model will help you get the help and support you need. It will direct you to the most appropriate service for you, first time, and direct you to support as close to home or work as practical and help us to make sure that services are used appropriately and most effectively. It may also save you time and unnecessary travel.

By ringing NHS111, your GP surgery or Somerset Direct (Somerset County Council’s central contact centre) you will speak to a trained professional who will assess your needs and direct you to the most appropriate care option as close to home as practical – and support you wherever possible to access the service.

Options could include:

  • advice on how to care for yourself effectively
  • support from a range of local agencies, for example the Alzheimer’s Society or MIND
  • access to support from social care
  • visit to a local pharmacy or other community resource (such as a dentist or optician)
  • an appointment at a GP surgery with a GP, nurse or other health professional
  • visit to the local Urgent Treatment Centre with an appointment booked for you
  • emergency care via A&E or 999.

I’ve had to wait a while for my knee replacement – how are these changes going to make this better? 

We know from the audit of our hospital beds in 2018 that two thirds of patients could be looked after elsewhere if appropriate community services were available. By making sure we support people to stay at home, or return home sooner after a hospital admission, we will be able to release capacity in our acute hospitals for elective surgery. This has the potential to reduce waiting lists and make sure an acute hospital bed is always available when needed (reducing waits for admission from A&E as well).

Are you privatising the NHS?

No. Absolutely not. We are looking to join up the services already available in communities from the voluntary and social enterprise sector, social care, primary care, community services, and acute Trusts to ensure that people can access the service best able to meet their needs.

What if I agree / disagree with your proposals? 

We want to hear from everyone and welcome all views.

Please share with us your ideas, comments and concerns and let’s work together to shape a health and care system fit for now and the future. 

You can:

  • Fill out our questionnaire which you can find at your doctor’s surgery or online on our website
  • Write to us for free, you don’t need a stamp – write on your envelope FREEPOST SOMERSET COMMUNITY ENGAGEMENT
  • Email us – fitformyfuture@nhs.net
  • Call us – 01935 384119

Or you can come to one of our drop-ins, all the dates and places are on our website www.fitformyfuture.org.uk