Agenda item

Witnesses:

Carol Deans, Director of Communications & Engagement

Ellie Davies, Associate Director of Communications & Engagement

James Clarke, Chief Strategy Officer

Alex White, Programme Director (New Hospital Programme)

Key points raised during the discussion:

1. The Director of Communications & Engagement outlined that the draft Communication and Engagement Strategy incorporated the approach they intended to take and the need to keep things as transparent as possible as well as the ongoing communication throughout the process capturing the feedback to set clear objectives and emphasise the collaboration between the Trust, Integrated Care Board (ICB), system partners, and the community. There was emphasis on stakeholder engagement as well as patients, the public and staff, which included reference to evaluation, ongoing continuous improvement, and crisis management to ensure that they remain agile and able to respond in a crisis scenario.

2. The Associate Director of Communications & Engagement added that critical to the strategy was the approach which concerned creating inclusive and accessible communication to engage in dialogue with all communities across the system to avoid the absence of voices within the decision making process. The use of that insight in the Equality Impact Assessment (EIA) would be a critical part of this work and would enable planning and mitigation of any issues or challenges as the programme progressed.

3. The Director of Communications & Engagement outlined the areas of stakeholders approach, the seldom heard, scrutiny, and communications channels and tools to ensure communication and engagement with all audiences, were appropriate and at the right time, and invited any comments from the committee on the strategy.

4. The Chairman asked what the effects were on the site selection/design process from the various NHS policy changes, with a shift towards prevention rather than intervention as that had serious implications for an acute hospital. The Chairman also noted that he had not realised that the addition to the building was so large in relation to the rest of the site, that hospital design had changed, with more services and space to consider. In relation to how the national policy has impacted the work being undertaken, The Programme Director explained that in response to the Darzi review, which had three pillars: analogue to digital, acute to community, and care to prevention, and which have guided the development of the clinical strategy and associated service transformation plan. There were five key initiatives: maximising the use of virtual hospital; a focus on system-heavy users and improving provision of their care; minimising unnecessary attendance at the ‘front-door’; elective care, ensuring the delivery of care at the right place and right time, particularly with high-volume and low-complexity elective cases; and preventative care. Those were some key aspects of the service transformation and had informed the demand and capacity modelling and the shape of the hospital.

5. The Chief Strategy Officer noted that a lot of the plan was about using existing space in a better way and bringing diagnostic services into the community and closer to home. There were plans to open more diagnostic centres in the community, such as in Slough. FHFT had run a lot of community sites, and was reviewing what services could continue to be promoted and provided.

6. Regarding the additional size of the hospital, the Programme Director explained that technology, such as automated guided vehicles, such as with space required for the use of robots for example, and the impact of the new environmental building regulations means that fans need to be run a lot slower and that ventilation ducts therefore needed to be increased.

7. The Vice-Chairman asked if the extension had the right air change capability. The Chief Strategy Officer confirmed that it had the latest air exchanges and was built to the highest specification available.

8. The Vice-Chairman asked if the extension enabled Frimley Park Hospital to shut down departments. The Chief Strategy Officer explained that as part of the 5-year plan, FHFT would need to reinforce certain wards for RAAC works, and the extension enabled that, with extra capacity.

9. The Vice-Chairman asked if the extension had a sperate entrance. The Chief Strategy Officer confirmed it was linked to the hospital at two separate points, but it did have its own entrance.

10. The Vice-Chairman asked if there would be any elective hubs in the community so that there is a separation of elective from critical emergency. The Chief Transformation, Delivery & Digital Officer noted the government priority to increase their ability to lower waiting times being key and given that Heatherwood Hospital is already in the geography which had no emergency-based services running there at present, provided the opportunity for it to be their hub and to increase the opportunity for the surgical-based work there.

11. A Member asked how issues around hospital discharge were being dealt with as well as what the strategy for that was and referred to spaces in the hospital car park that were screened off and whether that was a RAAC problem, noting the shortage of spaces. The Member also asked for reassurance that no plans had changed for single rooms, given the budget. The Chief Transformation, Delivery & Digital Officer explained that discharge was a core part of the focus, considering the challenges it brings for patients unable to get home to their normal place of residence at the end of their stay, due to issues that either happened inside or outside of hospital. Tremendous progress had been made, with the number of patients who had ‘no criteria to reside’ throughout the Christmas 2024 period were 40 percent lower than two Christmases prior, which had shown a steep downward trend for about two and a half years now. That was impressive internal improvement work at the Trust and partnership working, particularly with the five local authorities with social care in their portfolios, and thanked colleagues in adult social care for all of the hard work that they have been doing. The new hospital would provide great opportunities to improve the discharge processes, such as the use of automated vehicles and with providing medicines to people’s bedside more quickly working in conjunction with Pharmacies.

12. The Chief Strategy Officer explained that patient car parking would be increased by 10 percent at the current site, adding another 44 spaces for patients. This was achieved by closing and relocating a staff car park to another area. The lighting in the patient car park was also being upgraded and the electrician needed to get into certain areas at certain times which was why some areas were closed off. That work would be completed by the end of April 2025, and it was hoped they would have an extra 44 spaces to improve the congestion on the Portsmouth Road. Opportunities for off-site parking such as park and ride, would continue to be looked at.

13. Regarding single beds, the Programme Director confirmed that the wards would be configured to 32 beds, all 100 percent of single rooms as mandated by central government policy and is the intention.

14. A Member asked if the extension was fully staffed. The Chief Strategy Officer explained that it would be fully staffed by the end of April 2025 and there were also around 100 new roles being created.

15. As a result of the new technology the Member asked whether that meant a reduction in staff or whether the staff level remained the same. The Chief Strategy Officer explained there was not a lot less staff as a result of new technology, yet and the single room configuration at points meant more nurses and healthcare assistants would be needed to help with management. Opportunities were being reviewed to increase productivity. This was considered to be a good learning curve for the work force to see how they will operate in a different way.

16. In conjunction with all of the I.T. and what would happen if errors occurred with the Automated Guided Vehicles, the Member asked whether they would be mended on-site. The Programme Director confirmed that they would be and explained that created another space challenge as garage and maintenance shops would be required for them in that event.

17. A Member asked what the process would be to communicate with the seldom heard, who were often the greatest users to ensure that they understood what was happening as they do not communicate through social media. The Associate Director of Communications & Engagement explained that they had undergone an engagement exercise across their communities in response to government changes which had received great response, and work had started to reach out to people in different ways such as work with the voluntary sector and community groups that were often their real access point in. The specifics of this work would be designed and completed over the coming months.

18. A Member suggested that Surrey County Council’s socially engaged officers within the divisions, such as the Community Link Officers and the Chairman offered to provide an email to communicate on that point. The Member also requested that communications with minority groups and in other languages was not missed. The Associate Director of Communications & Engagement confirmed that this was a critical part and that there were five main languages spoken across the system, and as well as translations thought was also considered around making culturally appropriate communications.

19. The Member suggested that the new Sikh Temple in Camberley could be used as a channel of communication.

20. The Chairman stated thatSikh and Nepali communities in Camberley were particularly important to reach out to and perhaps difficult to reach.The Director of Communications & Engagement noted that this community was particularly supportive to the Frimley Park Hospital based staff during Covid, and there were already strong links with that community and that it was about building on this and making use of community leaders as that access point as well.

21. A Member recognised that the business of stakeholder engagement in the risk assessment was in place but asked how the FHFT and the ICB would know when everyone had been consulted with and when that could be stopped, and in particular regarding minority groups. The Director of Communications & Engagement explained that the intention was not to stop with engagement and have ongoing communication and engagement, so when there was a need to ‘deep dive’ into any areas there would be no need to restart relationships as there would always be areas that communities or stakeholders would want to hear about, and it was of importance to keep the information flow constant and continue to hear the feedback as a continued dialogue. 

22. A Member raised the importance of engaging with young people and up and coming adults, noting that the move to a more preventative approach would be a real culture and generational change, and asked for some information on that engagement and how that had been done so that the younger people could enforce that going forwards. The Director of Communications & Engagement explained that there was a new Lead Nurse for the transition of young people into adult services and there had been communication around this regarding how access could be gained to those people, if people do not want to get involved. The Lead Nurse was starting a piece of work, supported by FHFT and the ICB that involved looking at ways to re-energise youth panels to ensure that a range of young people were contributing and to utilise them to access their peers. Work was also being undertaken with Foundation Trust memberships representative of the whole area and those opportunities to get younger people engaged, in which they run sessions for those people and engage them with what is happening to encourage an interest to become members to find out more. Young people were another seldom heard group, and the Associate Director of Communications & Engagement work will cover young groups, with confirmation that young people had become involved in the work mentioned and suggested to the Member that her position as an access point with younger people may offer a helpful opportunity to perhaps work together in relation to facilitating reaching out to young people within Hampshire. The Member responded positively to that.

23. The Chairman raised the importance of utilising every communications channel, noting the recent adults and health select committee report concerning digital exclusion of the elderly and others in a health context, where select committee evidence noted that 20 percent of the population missed out on communications or had difficulty in communicating via that route, and that it is vital to take this consideration into account throughout this process, and consider the appropriate ways to communicate with these people. Regarding scrutiny, the Chairman stated that this committee had a statutory responsibility and statutory powers in relation to health and to be mindful that the boroughs and districts affected have their own process and that it is particularly important in relation to primary care within their areas and given the governments agenda to push prevention which happens more at primary care than it does at secondary care, it is very important that those scrutiny committees provide a session that informs them on what is happening, and communicates with them about what more can be done locally. The Chief Transformation, Delivery & Digital Officer noted that digital exclusion was an important issue, and in addition to the Chairmans point, recognised that it was important to not hold preconceptions on who the digitally excluded were. Good work had been undertaken in that space and considered that they may need to take a view that anyone could be digitally excluded and work back from there. Local data shows that the link between deprivation and digital exclusion is clearly incredibly strong. There was an active digital user group in the elderly space which is very important. People living in deprivation deciles 1 to 4 were 100 percent more likely to be admitted to hospital, and consideration of what route should be taken to ensure that messages on prevention and pro-active care and support to better public services, which keep those people well for longer, comes with all of the different challenges as has been described. A really broad view on digital exclusion should be taken to ensure nothing was being missed. The Chairman referred to the need to include literacy in that and of the issues people have with literacy difficulties, to ensure communication is simple and accessible, through as many channels as possible to get through, and noted the importance of talking to people.

The Vice-Chairman endorsed what the Chairman said on this and noted that at a recent meeting several people had not understood what the NHS had said in relation to a presentation and that Hampshire County Council had asked them to produce an index in relation to the acronyms used. The Vice-Chairman also referred to a recent meeting in which Healthwatch had attended the Hampshire County Council Health and Wellbeing Board, had discussed language for the newer generations and gave an example about the level of language understood by teenagers and above, and suggested that it was critical to tailor the language and have leaflets identified for that age group. The Vice-Chairman also referred to the food hub where they have Nepalese and others who’s native language is not English and noted that in some areas there are over 100 languages being spoken and is  important to go to areas such as food hubs , warm hubs, and libraries and speak to people of different nationalities and those experiencing deprivation where we can send the messaging. Regarding technology, further explanation concerning further explanation may be required concerning the use of Artificial Intelligence (A.I.) which was proving to be successful in administration, reducing workload on staff, but what  needed to be explained to people is what you see A.I. being used for in the future, such as things like the pill box in the rooms, sensors on the floors, pick-ups in each room , which will all help to explain the success and the importance of the individual room as opposed to big wards, and considers that this is a very important communication aspect as well..