Author: Helen Robinson-Gordon,Head of Communications (interim) Date:2 July 2015 Authorised by: Version: final Page | 1 Hospital and Community ServicesEngagement Narrative Toolkit Intended Audience: engagement staff, engagement champions and voluntary sector networks Status: FINAL Circulation date: 2 July 2015 Author: Helen Robinson-Gordon,Head of Communications (interim) Date:2 July 2015 Authorised by: Version: final Page | 2 Aim Thenarrativecirculatedisrequiredtosupportourpre-engagementactivity. Theinformation provided will be used by the facilitators of this engagement (engagement staff and engagement championsorvoluntarysectornetworks)tosetthesceneforthepre-engagement,providean overview of where we are at now and answer any questions.In addition we will use paragraphs to support the development of any questionnaires we may develop to engage people.

Theengagementwillbetargetedtothosegroupswhorepresentaparticularcharacteristicas set out in the equality act, a local area and or a service.This will not be wide scale engagement but the gathering of specific views required that we need to consider or thatwill further inform our thinking. Intermsofconstructingthenarrativeaheadoftheformalpublicconsultationonhospital services in Calderdale and Greater Huddersfield, there are two parts to the sequence. Previous engagement questions In our previous engagement activity it is worth noting that we asked the following questions: What do you think about the ideas described in the leaflet? Do you have any other suggestions for changing Health and Community services? Do you want to tell us anything else about Hospital and Community services in Calderdale and Greater Huddersfield? The narrative and questions we want to ask at pre-engagement stage build on the leaflet called The Future of Hospital and Community Services information but provide more clarity on the areas most subject to change.The questions therefore need to probe these areas further and in more detail. 1. Part one Note to reader First is the importance of the wider message - reminding stakeholders of the context to the need for change and what they can and cannot influence as the more detailed plans take shape.There are a number of key messages which need to be communicated to all stakeholders and stakeholder groups during this phase of pre-consultation engagement and involvement. These are relatively generic, helping to set the scene but they do relate to the clinically led design principles regarding the future of health and social care in Calderdale and Greater Huddersfield: In terms gaining maximum impact, they need to be woven into the introductory briefings provided to stakeholder groups and then reiterated at the end of a session. Author: Helen Robinson-Gordon,Head of Communications (interim) Date:2 July 2015 Authorised by: Version: final Page | 3 The key messages are: We want to remind and reassure audiences that this is not a new round of engagement on a new topic; rather it is further opportunity for you, patients, carers, members of the public, to see we are building on what you have already told us about healthcare services in Calderdale and Greater Huddersfield.Another chance to make known your views and provide suggestions on the proposed developments and improvements. Over the next five years, we want to provide joined-up, holistic, people-centred care, to support people to stay healthy and live independently for longer. But finances within health are in a precarious state and there isnt a large pot of money to pay for everything we may want to do. From the conversations we have already had, we know people want to have services based locally, be cared for closer to home and to receive more support and education to look after themselves better for longer.We are making those changes and although progress is slow, it is there and has the potential to be very successful. We will keep refining the Care Closer to Home programme as it grows. We want to have health care services that are provided by staff that have the right skills, values and behaviours patients and the public expect. They also need to be services we can sustain given that we know there are certain staff and skills shortages at a national level that is also reflected at a local level.

We intend to go out to a formal public consultation we are aiming for the autumn of this year but ahead of that we want to ensure our local communities have had chance to put forward their views and are as well informed as they can be so that the public consultation will have real meaning and be important to local people. Author: Helen Robinson-Gordon,Head of Communications (interim) Date:2 July 2015 Authorised by: Version: final Page | 4 2. Part Two The messages for the detailed narrative We currently have two district general hospitals trying to provide almost all types of hospital services to about half a million people. This doesnt fit with modern health needs and we are not delivering national standards of best practice for a significant number of services. This means patients are not currently getting the quality of care or the safest level of care to which they are entitled Calderdale Royal Hospital is a relatively new building and a fantastic resource for the community. However, it has a long lease on it and will have to be fully utilised for many years to come. The Huddersfield Royal is a bigger site but the buildings are much older and will require a lot of money to bring it to modern standards to make it fit for purpose. These are very practical issues we have to face when considering where we locate services in the future. Note to reader The narrative, or key messages communicated in this part of the process must have resonance going forward in the content of the formal public consultation. There must be continuity of theme, tone and message if we are to keep the confidence of local residents.Continuing with the themes contained with the principles of care and which are already within the introduction, this part of the conversation is crucial but must be entered into only once the wider general messages (outlined above) have been discussed and understood. This is because it is where all involved will be held to account, scrutinised and reminded of the content, possibly to the letter, at every opportunity going forward. It is worth noting that CCGs have a legal duty to ensure that that individuals to whom the services are being provided or may be provided are involved in the: Development and consideration of any change to the commissioning arrangements where these will impact on the manner in which the services are delivered and the range of health services available.1

We need to be mindful of our legal obligations and ensure we dont give cause for any organisation to call into question our processes. Our stakeholders must feel real involvement. Author: Helen Robinson-Gordon,Head of Communications (interim) Date:2 July 2015 Authorised by: Version: final Page | 5 The local and national clinical consensus is to put specialist emergency and acute medical services on a single site as the best option to deliver safe and sustainable emergency care in the future. This is care for life threatening conditions, which all of us may experience once in a lifetime. Putting services which support patients with such conditions on a single site would also enable the hospital to increase the amount of hours emergency care specialists could be available in the department on any given day. This means that we would be able to deliver a safer service and a better quality of care for those needing emergency treatment. It would also mean that planned or routine surgery would have far less interruptions. If this type of surgery was centred on one site, the risk of those operating theatres being used for emergency operations would be much reduced. We believe that by doing this, we will save more lives.

By September of this year, the Trust is required to develop a plan which shows how it can be financially sustainable going forward. It is working with the regulator, Monitor, to do this. So, while its true to say that the Hospital Trust did express a preference for a single site and for that site to be Huddersfield; the Trusts financial position has deteriorated since that plan was published. Now, a range of proposals for change have to be looked at again. No decisions have been made about the future of local hospital services and its important to emphasise that point Any changes to hospital-based services are not being considered in isolation. For more than a year we have been improving the quality and range of health care services we provide closer to peoples homes. By doing this, we are confident that we can reduce the need for people to travel to hospital for routine care. For example, we have introduced new technology which is already reducing the number of routine and outpatient hospital visits for people with certain types of respiratory (breathing) diseases. We have changed the way care is provided in care homes to reduce the number of times older people have to be admitted to hospital as an emergency. For people who do not need to go to the Emergency Department, but who still require urgent care, the model proposes the development of two or more centres providing urgent care services. Best practice indicates that urgent care centres sit alongside existing hospital facilities - an indeed thats already happening in a number of areas of the country. It would seem logical to place these services within the existing hospital estate in Halifax and Huddersfield.A third centre could be developed in order to meet the needs of more geographically remote communitiesThose sorts of details may be something we include in the public consultation as we want to ensure that listen to the needs of local people. Author: Helen Robinson-Gordon,Head of Communications (interim) Date:2 July 2015 Authorised by: Version: final Page | 6 It is obvious that we will need to take account of the widespread belief that decisions have already been made and that the Halifax A&E service is destined to close. It is the view of commissioners that there should be a 24/7 urgent care offer operating out of whichever hospital is not assigned Emergency Care centre status. It is also clear that we will need to ensure that travel times are taken into account and that a reasonable offer is made to all communities served by CHFT making best use of the hospital estate that CHFT has at its disposal. This toolkit will be used to induct the engagement staff and engagement champions or voluntary sector networks.Other materials such as presentation slides, easy read formats and other relevant communication materials will be developed based on the content of this document. Questionnaire The questions are set to gather information on the following service areas: Urgent and Emergency care Planned Care The questionnaire sheets are with this toolkit. Please contact Sharon Morley if you require further copies or advice on alternate formats. Sharon Morley Project Support Officer - Right Care, Right Time, Right Place ProgrammeNHS Calderdale CCG 5th Floor, F Mill Dean Clough, Halifax,HX3 5AX T: 01422 307519E:sharon.morley@calderdaleccg.nhs.uk