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Primary Care Strategy
Consultation Report
HTPCT Primary Care Strategy Consultation Report
Contents
Foreword 3
Executive summary 4
1. Introduction 6
2. Methodology 7
3. Activity 8
3.1 Distribution of documents 8
3.2 Media campaign 8
3.3 Consultation events 8
3.4 Consultation with PCT staff 8
4. Responses 10
4.1 Questionnaires 10
4.2 Written responses 11
4.3 Consultation events 12
5. Summary of responses 13
5.1 Key themes 13
6. Equalities Impact 19
Assessment
7. Limitations 20
8. Summary and next steps 21
Appendices
Appendix A: List of consultation events 22
Appendix B: Summary of questionnaire 28
responses
Appendix C: Summary of formal responses 33
Report finalised 6 December 2007
(updated April 08 to include written response in form of petition omitted in
error and wrongly attributed meeting notes for the Muswell Hill Area
Assemble on 25th October as indicated)
Haringey Teaching Primary Care Trust
St Ann’s Hospital
St Ann’s Road
London N15 3TH
020 8442 6000
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HTPCT Primary Care Strategy Consultation Report
www.haringey.nhs.uk
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HTPCT Primary Care Strategy Consultation Report
Foreword
This report sets out the outcome of the consultation carried out on the
primary care strategy.
Our thanks go to all those who took the time to respond to our consultation,
either through writing to us, completing questionnaires or coming along to the
consultation events. Thanks must also go to colleagues who helped with the
consultation process through giving advice including those from the London
Borough of Haringey, the Public and Patient Involvement Forum, HAVCO and
to local councillors and neighbourhood managers who facilitated our
attendance at the local area assemblies.
Tracey Baldwin, Chief Executive, HTPCT
Richard Sumray, Chair, HTPCT
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HTPCT Primary Care Strategy Consultation Report
Executive summary
The consultation was carried out on the Haringey Teaching PCT
(HTPCT) Primary Care Strategy Developing World Class Primary Care in
Haringey between 28 June and 19 October 2007. The strategy set out
a new model for primary care service provision in the borough.
The consultation was advertised in the local press, 8,500 summary
documents were distributed and 57 consultation events were attended,
including attendance at each of the local area assemblies, reaching an
estimated 1000 people or more. HTPCT staff, public, patients, GPs,
service providers from the NHS and the voluntary and community
sector were all involved. London Borough of Haringey Overview and
Scrutiny Committee engaged fully in the consultation.
Questionnaires were received from 123 individuals, formal responses
were received from 17 local organisations and a range of views was
collected from the consultation events.
An equalities impact assessment was carried out to see what impact
the primary care strategy might have on people who experience
discrimination, disadvantage or are socially excluded in Haringey.
There was general support for the aims of the strategy and some of
the changes proposed within it, in particular the need to tackle
inequalities, improve primary care across the board and ensure better
integration and range of services available locally. 50% of those who
completed the consultation questionnaire felt that the proposed
changes would meet the needs of themselves and their families,
although about half of this group qualified their response with
comments on aspects of the strategy. However, many concerns were
raised about the delivery model itself, particularly in relation to access
and travel to services. Many of these concerns centred around longer
and more difficult journeys to see a GP. These concerns were
particularly strong amongst older people, who were well represented in
terms of attendance at events and contributing their views on the
strategy.
Whilst some people wanted to see no real change to the current
provision of primary care services, others were in favour of a model
that would provide super health centres alongside a number of larger
practices. It was noted that this could make good use of the existing
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modern facilities and would have less of an impact on travelling
distance if they were geographically dispersed across the borough.
The consultation document was explicit that the super health centre
model would involve a trade off between having further to travel to get
to primary care services and a wider range of services in better
premises at more convenient times. There was no clear consensus as
to the benefit of this trade off. Although many concerns were
expressed about the increased travel, others could see the benefits of
the proposed model. Should this model be adopted, further work will
be needed to mitigate the problems identified around travel,
particularly for vulnerable people.
The TPCT fully engaged with Haringey Overview and Scrutiny
Committee (OSC) during the consultation. The formal response from
OSC stated that it was satisfied with the nature and extent of the
consultation and was convinced of the need to develop and extend
primary care services. However, the OSC had some reservations and
wanted to see further details regarding the model and planning,
including financial planning before it could decide whether the
proposed changes were to the benefit of local health services.
The results of this consultation will now be considered by HTPCT and
used to inform the final primary care strategy.
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HTPCT Primary Care Strategy Consultation Report
1. Introduction
Developing World Class Primary Care in Haringey was launched for
consultation on 28 June 2007, the consultation period closed on 19 October
2007. This report describes the consultation process and provides the results
of the consultation. The primary care strategy was launched at the same time
as Your Health, Your Future: Safer, Closer, Better, the Barnet, Enfield and
Haringey clinical strategy that proposed changes in acute services. The
primary care strategy complemented this planning for acute care, but also
highlighted the need for change in primary care notwithstanding
developments in acute care. The primary care strategy was launched the
month before the Healthcare for London Framework for Action, however the
strategy drew on much of the same evidence used to develop the framework
and sets out a similar strategic direction in terms of primary care service
delivery.
The consultation document stated a vision of primary care services in
Haringey: of world class, high quality, responsive primary and community
services for all Haringey residents. By working in partnership with patients,
the public, the local authority, voluntary sector and others, these services
would contribute fully to improving the health of the population, including
reducing inequalities and maximising independence. The strategy also set out
a new model for service delivery, which would involve reducing the number of
primary care premises over time and creating a network of 6 super health
centres in Haringey. The super health centres would provide a wider range of
services with better facilities and longer opening hours than existing primary
care services and bring some services that are currently only available in
hospital closer to people. The super health centres would offer new
opportunities for joint working including co-location with other services
including social care and services provided by the voluntary and community
sector. Please see the full strategy document, or the summary version
produced for the consultation for further details. Both documents are
available online at http://www.haringey.nhs.uk/about_us/consultations/index.shtm or
are available on request by contacting HTPCT.
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2. Methodology
A full consultation strategy was developed (this is also available on the
website as noted above) which included consultation principles and the
methods and mechanisms used to consult with patients, the public and
stakeholders. The main methods used to consult with people were
consultation events, distributing promotional and publicity materials, a media
campaign and direct contact with stakeholders including attending ongoing
meetings.
Some concerns about the scope of the consultation were raised by some
stakeholder groups early on during the consultation period. HTPCT listened to
these concerns and discussed with groups such as Better Health Local
Healthcare, Haringey Association of Voluntary and Community Organisations
(HAVCO) and the HTPCT’s Public and Patient Involvement Forum (PPIF) in an
attempt to reach more people and those from diverse communities with the
consultation. Haringey Council’s Overview and Scrutiny Committee concluded
that the consultation process was appropriate, however, in keeping with the
TPCT’s commitment to involving stakeholders, there will need to be ongoing
work to ensure that the strategy development and implementation
programme continues to be informed by local people and local groups.
The consultation was run by the TPCT, including the complex analysis of the
responses to the consultation. Additional advice and information was provided
by various stakeholders. A small team of PCT staff ran the consultation
process. In addition to staff time, the consultation cost £30,000. Most of this
expenditure was on the production of summary documents with some funds
also used for running meetings and purchasing advertising space in local
newspapers. We feel that we achieved value for money and used our
resources efficiently, in addition to learning a great deal about the views and
concerns of our local residents by engaging our own staff across
commissioning, primary care and governance teams to lead the consultation
events.
An Equalities Impact Assessment (EIA) was also carried out alongside the
consultation process. An EIA is a way of systematically and thoroughly
assessing and consulting on the effects that a strategy is likely to have on
people who experience inequality, discrimination or social exclusion. An EIA
helps to pre-empt the possibility that a policy could disadvantage some
groups on the grounds of race, language, disability, age, gender, sexuality
and faith. Please see section six below for more information about the EIA.
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3. Activity
3.1 Distribution of documents 8,500 summary documents were
distributed, through direct mailing to stakeholder groups, distribution in all GP
surgeries, consultation and publicity events. We also responded to a request
for translation of the document into Greek. The strategy document was
highlighted on the PCT website which was visited by 13, 672 individuals
during the consultation period. Documents were also circulated to dentists,
optometrists, pharmacists and local libraries and council offices. All staff
within the PCT and the Council were also contacted by email with links
through to the strategy on our website.
3.2 Media campaign The primary care strategy consultation was advertised
in the following local publications: Haringey People (which is delivered to all
residents’ homes in Haringey), Haringey Independent, Muswell Hill and
Crouch End Times, Tottenham and Wood Green Independent, Haringey
Advertiser, and Ta Nae (Greek community publication).
3.3 Consultation events PCT staff attended 57 consultation events to
discuss and promote the primary care strategy. This included a range of
different events, such as specific events organised by the PCT to consult with
members of the public, meetings with stakeholder groups, attendance at each
of the local area assemblies in the borough, attendance at the Local
Authority’s Overview and Scrutiny Panel, running stalls in the shopping centre
and discussions with each of the GP collaboratives. It should be noted that
the events took different forms – from public meetings, to meetings with
community/voluntary groups, to focus group style events, which were
designed to elicit meaningful and in-depth discussion. Some of these events
(e.g. area assemblies) were scheduled to take place shortly after the
consultation period formally closed, however responses were collected until
the end of October to ensure that views expressed at these events were
included.
A full list of the events attended can be found at Appendix A.
3.4 Consultation with PCT staff
Following advice from the Joint Staff side Committee (JSC) and the
Operational Management Team around how best to consult with the TPCT
staff about the strategy, the following actions were taken:
Email sent to all staff and attachment to pay slips drawing their
attention to the strategy and inviting them to respond
Email sent to all staff inviting them to the public meeting on the BEH
clinical strategy and Haringey Primary Care Strategy and to the PCT
AGM which focused on the primary care strategy
Messages in core brief and at Senior Managers Group
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Email sent to all line managers to follow up core brief with request to
send any responses to us
Discussion at JSC in July and Sept
Open meeting on 1st October for all staff.
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4. Responses
We gathered three kinds of responses to the consultation: completed
questionnaires, feedback at meetings and written/email responses from
organisations and individuals. Information about the different kinds of
responses follows.
4.1 Questionnaires
123 questionnaires were received (including some that arrived after the
formal consultation period had ended, we included responses received to the
end of November). This provided a response rate of 1.4% of the
questionnaires that were distributed – whilst we would have wanted a higher
response rate this is not out of line with other similar consultations. The
questionnaires included information about the person responding, from this
we know that most of the people responded as individuals (102) although a
small number (12) responded as a representative of an organisation. A large
proportion (68%) identified themselves as local residents and 58% identified
themselves as patients. A small number identified themselves as carers (9 or
7%). More women than men returned the questionnaire, with 70%
responses from women and 26% from men. The people who completed the
questionnaires were from the older age groups, with most responses from the
66-75 age group, followed by the over 75 age group. Graph 1 below shows
the spread by age group.
We also received 8 emails from members of the public and several phone
calls. We received one petition with 40 signatures opposing the strategy. A
summary of the responses to the questionnaires can be found at Appendix B.
Graph 1
Responses by age group
40
Number of responses
35
30
25
20
15
10
5
0
Under 16-25 26-35 36-45 46-55 56-65 66-75 Over 76
16
Age groups
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The largest ethnic group to complete the questionnaires was White British.
Responses by ethnic group are detailed in graph 2 below.
Graph 2
Responses by ethic group
70
Number of responses
60
50
40
30
20
10
0 Pakistani
British
Mixed Other
Other Asian
African
White Other
White and
White
Black
Chinese
Mixed
Ethnic group
4.2 Written responses
Formal responses were submitted by the following 17 organisations or
groups:
Age Concern
Barnet, Enfield and Haringey Mental Health Public and Patient
Involvement Forum
Barnet, Enfield and Haringey Mental Health Trust
Better Local Healthcare Campaign
Haringey Forum for Older People
Haringey Local Medical Committee
Haringey Phoenix Group (voluntary group for blind/partially sighted
people)
Haringey Teaching Primary Care Trust Providerside
Haringey Voluntary and Community Sector Wellbeing Theme Group
Highgate Group Practice
Liberal Democrats
Local Pharmacy Committee
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London Borough Haringey (including response to Barnet, Enfield and
Haringey Clinical Strategy and response from Strategic Sites and
Projects and Policy and Planning Team.)
London Travel Watch
Muswell Hill and Highgate Pensioners Action Group
Overview and Scrutiny Committee
Whittington Hospital NHS Trust.
A summary of these responses can be found at Appendix C. We highlight the
views of Overview and Scrutiny Committee (OSC) in particular. Although it
was satisfied about the nature and extent of our consultation and that we had
made a clear case for developing and improving primary care services it
expressed concerns that:
o Distribution of primary care services needed to be clearly planned
and located where greatest need
o More information on location of super health centres and how the
hub and spoke model would work
o Greater collaboration would need to be developed – and would not
arise from location alone
o More detailed financial plan required
o Clear monitoring and audit process needed.
Until that information was provided the OSC was unable to conclude that the
primary care strategy is in the interests of local health services. These
concerns are specifically picked up in the recommendations formulated as a
result of the consultation process.
We also received a number of other letters, emails and two petitions. The
written feedback received is set out in more detail in Appendix C.
4.3 Consultation events
HTPCT staff attended a total of 57 consultation events, reaching an estimated
total of more than 1000 people at these meetings. These included meetings
with the public, patients, GPs, service providers including NHS organisations
and voluntary and community sector organisations. In addition more than
1000 documents were given out directly to members of the public through
stands at shopping malls (we organised stands on 3 occasions at Wood Green
Shopping City and once on Muswell Hill Broadway). PCT staff also attended
each of the local area assemblies in Haringey to present and discuss the
strategy and engaged fully with the Overview and Scrutiny Committee. The
main points from these events, including formal minutes where available, are
on record and are included in the summary of responses below.
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5. Summary of responses
The consultation resulted in a wealth of written material to be analysed. Some
of the responses could be readily quantified – for example responses to
questionnaires. This is provided where possible in the summary below. More
difficult to quantify has been the range of responses expressed in public
meetings and from written responses. All responses (whether questionnaire,
comments from events or other written feedback) were referenced and
analysed according to themes. These were plotted on a table indicating
interest group and thematic content of response. The table is available on our
website. A detailed summary of the contents of questionnaires is available as
an appendix to this report along with a summary of all other written
responses. In addition a summary of all written responses has also been
provided. What follows is an attempt to provide an overview of key themes
emerging from the consultation from all source material.
There was a significant level of support for the aims of the strategy and many
of the changes proposed within it, however there were also significant and
widespread concerns raised, especially about potential difficulties in travelling
to and accessing services as set out in the strategy. Whilst some people
wanted to see no real change to the current provision of primary care
services, others were in favour of a model which would see super health
centres provided alongside a number of large practices, which could make
good use of the existing modern facilities in the borough and could reduce
travelling distance if they were geographically dispersed across the borough.
There was also a level of cynicism expressed, particularly at public meetings,
about whether HTPCT would be able to deliver the improvements to primary
care services proposed.
5.1 Key themes
Support for/concern with the model proposed
50% of those who completed the consultation questionnaire felt that the
proposed changes would meet the needs of themselves and their families,
although about half of this group qualified their response with suggestions for
implementing the strategy. Around 30% of respondents stated that the
strategy would not meet their needs, with the remainder being unsure or not
answering this question. Other responses, including those from consultation
events and written responses, showed some support for the model, but more
commonly a preference was expressed for a hub and spoke type model,
which would retain some existing GP practices. In addition some called for no
major change to the current system.
It is worth noting that many responses across the range of the consultation
indicated that more detail and evidence was needed about the model and in
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particular which general practices would remain in their current location
before benefits and drawbacks could be assessed.
How changes would affect people
People replying to the questionnaires identified a range of ways in which the
strategy would affect them, with about half of these having a positive impact
and about half having a negative impact. In terms of negative impact, travel
was the biggest single issue identified with fears of not being able to see the
same GP the second most common negative response. However easier access
to services including extended opening hours was welcomed by a number of
people, and some noted that they would have improved access or less
distance to travel by reducing the number of hospital appointments.
Location of super health centres
There were more positive than negative responses to the proposed location of
the super health centres, however two main concerns were expressed:
whether six super health centres would be enough for Haringey and if there
was sufficient coverage for the North East of the borough. There were also
concerns about the fact that two of the super health centres were proposed
to be located at the Whittington and North Middlesex Hospitals either because
these were not in Haringey or because this seemed at odds with the intention
to move services out of the hospital setting. Four of the questionnaires
received asked for a hospital at St Ann’s site, this was also raised at some of
the consultation events.
A number of concerns were expressed in meetings in the West of the borough
about provision being focused on Hornsey Central. Along with general
concerns reflected in the themes summarised here, there were specific issues
relating to the development of Hornsey Central as one of the super health
centres from a number of community groups based in the west of the
borough. The key concern was that Hornsey Central should be developed as
an addition to general practices and other community services in west
Haringey rather than to replace those services.
Facilities and services in super health centres
A long list of services that should be provided in super health centres was
generated from the consultation responses, most popular were foot health
(including chiropody and podiatry), blood testing, dentists, physiotherapy,
opticians/ophthalmology, diagnostics (namely x-ray and scans), preventative
services (e.g. check-ups) alternative therapies, mental health, minor injuries
and urgent care. The need to ensure good access especially for disabled
people was noted, as was the need to provide good facilities such as waiting
areas, parking and health information and ensuring appropriate access for
disabled people in particular. Some concerns were expressed about locating
minor procedures and urgent care in primary care settings rather than in a
hospital setting.
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Travelling to GPs
Questionnaire responses suggested that 46% of those who responded would
have further to travel to see their GP under the changes proposed by the
strategy. Nearly half of these people added that they would also have to use
public transport instead of walking as they do at present, or would have a
more complicated journey e.g. have to take more than one bus.
Approximately 15% said it would not affect their journey and 14% said their
journey would be easier or they would have less travelling to do.
It should also be noted that people commented throughout the consultation,
but particularly during the Equalities Impact Assessment event that they
already experienced travel difficulties in getting to their GP and other health
services, particularly as a result of disability or ill health.
Health inequalities
Comments at some of the consultation events indicated that the strategy was
unclear about exactly how it would tackle health inequalities, and deliver
health equity, in particular there were concerns raised about provision in the
North East of the borough, where super health centres might have less
impact due to their proposed location. There were also concerns that the east
of the borough would bear the brunt of the reduction in number of local GP
practices and local access given their size and condition.
Access
Access to services, including travel, was the most commented on aspect of
the strategy. As already noted above, the greater distance between people’s
homes and the super health centres than between their homes and their
current GP practice, was of concern for a number of people. The impact this
would have particularly on older people, those with mobility problems,
disabled people, mothers/parents of young children and those on lower
incomes was highlighted.
There was significant support for improved access in terms of having
extended opening hours (evening and weekend) and in terms of a wider
range of services available in the one place, but there was no consensus that
the trade off between further to travel and better services was a good one or
not.
It was noted by some that extended opening hours would benefit those in
work more so than those who were available for daytime appointments.
Extended opening hours were also popular with the young people involved in
the focus group.
The equalities impact assessment indicated that the strategy had the potential
to both increase and reduce access to primary care services, and a number of
suggestions are made as to how to ensure access is improved especially for
vulnerable groups in the EIA report itself.
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Continuity of care
Many local residents noted the value of the relationship they have with their
GP and were concerned about losing this by the development of the super
health centres, this was especially the case for people with ongoing, complex
health problems.
Working with GPs
A number of concerns were raised about how GPs would be encouraged to
work within the new model proposed. The Local Medical Committee –
representative body for local GPs - indicated in its response that it was willing
to work with the PCT to develop the strategy further but had a number of key
concerns about the viability of model in particular around:
GP contractual issues alluded to in the strategy
financial viability
ownership of premises
the need to define the service model before identifying buildings
whether current substandard premises could be developed as an
alternative
the need for further exploration of travel and transport issues
the apparent reduction in patient choice.
Workforce skills and development
The need to ensure that all parts of the workforce have the appropriate skills
and training was raised generally and more specifically around providing
appropriate services to children and young people and other vulnerable
groups such as mental health service users. This was reflected in the EIA
particularly in relation to reception staff and equalities competencies. This
would also need to include developing the workforce to deliver the sort of
integrated care model proposed by the strategy. The point was made that co-
locating services and practitioners would not in itself deliver improved services
but that this would need to be underpinned by ongoing development.
Implementation issues
There were many comments and even more queries about the detail of how
the strategy would be implemented, these included comments on the need to
phase in the strategy, concerns about keeping the implementation on budget
and on time, queries about the design of buildings as well as exactly how
services would be organised.
Pharmacy
Concerns about the impact on pharmacists’ business were raised. The Local
Pharmacy Committee – representative body for local pharmacists – raised a
number of concerns about the delivery model, particularly what they saw as
the loss of local access to services, but was keen to work with the PCT to
develop the model and to extend the scope and role of pharmacy within the
new service model.
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Older people
Older people were well represented in the consultation process, as can be
seen by the age profile of those responding to questionnaires and the formal
responses from, and meetings of, representative groups of older people.
Older people were most concerned about the impact of travelling longer
distances and of potentially losing continuity of care their local GPs provided.
These concerns were reiterated and elaborated upon in written responses
from Age Concern, Haringey Older People’s Forum and Muswell Hill and
Highgate Pensioners Action Group.
Mental health
There was clear support for the proposed to shift of care into the community
from hospitals and the focus on early intervention and health promotion. The
opportunities for improving the way that health, social care and other
agencies and voluntary and community services worked together from and
through the super health centres model were acknowledged and welcomed.
Barnet Enfield and Haringey Mental Health Trust’s Patient and Public
Involvement Forum raised a number of concerns in particular:
insufficient detail about number of GPs that would be retained outside the
super health centres
accessibility given that the focus of the shift was likely to have more
impact in the east where more single-handers/poorer premises were
located
concerns about the impact on people with mental health problems where
motivation and cost might impact on access
Although it welcomed a more joined up approach with primary care
around mental health issues more information was needed about how that
would work in reality.
Learning disabilities
It was noted that primary care services must ensure that the needs of people
with learning disabilities are met. The recent review carried out by London
Borough of Haringey Health Scrutiny Committee is available to inform how
this should be done and recommendations from this are available to be
incorporated into the revised strategy.
Other vulnerable people
The specific needs of refugees, asylum-seekers and other mobile/transient
populations need to be considered, as do those of people living in deprived
areas. These issues are developed further in the EIA report and related
recommendations.
Children and young people
Those providing health and other services for children and young people
highlighted the need to ensure that the specific needs of children and young
people were met within the super health centre model and that developments
were aligned with the broader children and young people’s service
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development agenda. The opportunities for using specialist skills more
effectively and developing environments and workforce skills more
appropriate for children and young people were noted and welcomed.
Young people themselves recognised the potential benefits to them of the
super health centre model in developing services around their needs and
availability. Equally there was support for the better facilities, opening hours
and flexibility of services the super health centre model could bring expressed
by parents with young children.
Carers’ issues
Carers highlighted that they themselves often had complex health issues, and
that an increased understanding and acknowledgement of their role and of
how their caring responsibilities affect them is needed by primary care
professionals. Services designed around their needs (including better
information about the support available for them needed, increased support,
and help with transport) were needed.
Current issues in primary care
A number of people took the opportunity during the consultation to raise
concerns about the current provision of primary care, some of the issues
raised included dissatisfaction with eligibility to foot health services and
registration and coverage of GPs.
Voice of those providing services
There was much support for the key principles and aims of the primary care
strategy from local providers, including the voluntary and community sector,
GPs, pharmacists, acute care, mental health services and the local authority.
However there were some questions raised as to the location and coverage of
the super health centres, and some preferences expressed for more of a hub
and spoke model. Providers and contractors stated that they were keen to be
involved in developing the detail of the implementation of the strategy across
the board.
Other comments
Several concerns with the strategy were raised under this heading on the
questionnaires, most commonly:
Potential increase in waiting times at super health centres
Not being able to see the same GP
Concerns about privatisation of health services
Impersonal nature of large centres
Wish to keep things as they are, or to simply upgrade existing GPs
Concerns were also raised about the consultation process itself.
Interest in joining a local patient group
There was a lot of interest in joining local patient groups with 32 people
giving their contact details in order to do so.
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6. Equalities Impact Assessment
An equalities impact assessment (EIA) was carried out to see what impact the
primary care strategy might have on people who are discriminated against,
disadvantaged or socially excluded in Haringey. This entailed following a
structured process, including seeking advice from London Borough Haringey
Equalities and Diversity Team and the Public and Patient Involvement Forum,
to assess the implications of the strategy on access to primary care. The
methods used to assess the strategy were a rapid review of the evidence
carried out by PHAST an independent public health organisation, an equalities
event with local community groups and focus groups.
The results of the EIA showed that the primary care strategy could have a
positive impact on and improve access to primary care for Haringey residents
if implemented with appropriate care and attention to the need of people
experiencing discrimination, disadvantage or social exclusion. The EIA also
showed that the primary care strategy could have a negative impact or
reduce access to primary care if the implementation of the strategy meant
that travelling to health services became more difficult and longer travel times
were experienced. This would have a disproportionate impact on people with
mobility problems including older people, disabled people and those on low
incomes who would suffer more from additional travel costs.
There are a number of issues that need to be considered to ensure
implementation of the primary care strategy improves access, these are
outlined in the mitigating actions and recommendations in the main EIA
report. The issues raised during the EIA process about the different difficulties
experienced by groups in accessing primary care at present further supports
the case for change and improvement to primary care services in Haringey.
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7. Limitations
Considerable efforts on behalf of HTPCT went into conducting the primary
care strategy consultation and in carrying out the equalities impact
assessment. Particular attention was paid to the early concerns raised about
the consultation process by stakeholders and attempts were made to respond
to these concerns. A significant number of people were reached through the
consultation and some valuable discussions were had about the strategy. A
degree of cynicism was encountered as to how much notice the PCT would
take of the issues raised during the consultation process.
The voice of younger people was not present at the EIA event, and there
were few questionnaires returned from younger people, although the vast
majority of questionnaires distributed at Wood Green Shopping City and
Muswell Hill Broadway were to young people. A focus group was organised
with younger people to mitigate against this potential bias, and discussions
were had with relevant partnership groups and a parents group.
The EIA did not include an analysis of issues relating to sexuality, and little
discussion was had about gender. A further focus group will take place
around sexuality that can inform the next stage of the strategy. Issues
relating to gender can also be considered in terms of future service planning,
taking into account the HTPCT Gender Equalities Scheme.
There was little discussion about the specific needs of travellers, although this
group was noted as having specific needs, further consideration might be
given as to how to best meet these.
The primary care strategy noted that better access to and support from
primary care practitioners for people resident in nursing care homes in
Haringey could be provided, although this area did not feature in the
consultation responses, this is still an area that should be included in future
plans for improving primary care.
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HTPCT Primary Care Strategy Consultation Report
8. Summary and next steps
Many of the aims of the primary care strategy were supported by those
responding to the consultation. However there were real concerns expressed
about the development of the super health centre model in isolation from a
network of local GPs. Many of these concerns were from older people and
centred on having to travel further and have more difficult journeys to see a
GP than they did at present.
The super health centre model makes it clear that there is a trade off
between having further to travel to get to primary care services and a wider
range of services in better premises at more convenient times. There was no
clear consensus as to the benefit of this trade off, as although many concerns
were expressed about the increased travel, others could see the benefits of
the proposed model.
Once this report has been finalised and approved, it should be made widely
available so that those who have responded to the strategy receive clear
feedback.
The results of this consultation will now be considered by the PCT and used to
inform the final primary care strategy. In particular a series of
recommendations setting out how HTPCT proposes responding to the
outcome of the consultation process is in development.
GH/SDS
16.11.07
List of Appendices
Appendix A: List of consultation events
Appendix B: Summary of questionnaire responses
Appendix C: Summary of formal responses
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HTPCT Primary Care Strategy Consultation Report
Appendix A: Primary Care Consultation Calendar
From June – October 2007
Date Title Audience Location Presenting/ Notes/output Numbers
Attending PCT s attended
Tuesday 26 LPC/PLDG Pharmacists Stephen Deitch Formal
June response
received
M1
Thursday Joint Staff PCT staff B1 Meeting Clive Martinez Minutes on file 8
29 June Committee Room Gemma Hughes
3.00pm to St Ann’s
5.00pm Hospital
M2
Monday Overview & Local London Gerry Taylor Note on file 20
2 July Scrutiny councillors Borough of (Christina
M3 Committee Haringey Gradowski in
attendance)
Thursday Public Patient Public and The Cypriot Dr Mayur Gor Notes on file 40 people
5 July Involvement patients Community Christina Gradowski
12.00pm to Forum Centre, The Gemma Hughes
5.00pm Main Hall
M4 Earlham
Grove,
Wood Green
London N22
5HJ
Tuesday PPI Forum Members of Rotunda, Christina Gradowski Note on file 5 members
10th July the PPI Factory
2007 Forum and Lane,
M5 CIDA Tottenham
Wednesday Mental Health Patients/ A1 Meeting Gemma Hughes, Note on file 8
18th July Consultation Community Room Christina Gradowski and minutes of
10.00am to Sub-Group of groups St Ann’s meeting
11.30am MH Hospital
M6 Partnership
Board
Thursday Haringey Partners Council Gerry Taylor Note on file 20
19th July at Strategic Chamber Vicky Hobart
7.00pm Partnership Civic Centre
M7 High Road,
Wood Green
N22
Saturday Lordship Public Lordship Richard Sumray Summary 25 members of
21 July Lane Open Lane Health Gemma Hughes documents the public
10.30am to Day Centre David Lammy MP handed out
1.30pm 239 Christina Gradowski only
M8 Lordship Justin Talbot,
Lane Dilo Lalande,
London N17 Sam Clements
6AA
Monday BEH Clinical Public The Cypriot Tracy Baldwin None available 8 people
23 July Strategy Community Dr Mayur Gor (docs made
2.00pm to Centre, The Steve Beeho or available)
4.30pm Main Hall Dilo Lalande
M9 Earlham
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HTPCT Primary Care Strategy Consultation Report
Grove,
Wood Green
London N22
5HJ
Monday Local Area Public Fortismere Gerry Taylor Notes on file Approx 40
23 July Assembly School Dr Mayur Gor people
7.30pm to Muswell Hill North Wing
9.30pm Creighton
M10 Avenue
Muswell Hill,
London N10
1NS
Tuesday BEH Clinical Clinical The Cypriot Richard Sumray, None 0 people
24 July Strategy Community Dr Mayur Gor
6.00pm to Centre, The Sarah D’Souza
8.30pm Main Hall Christina Gradowski
M11 Earlham
Grove,
Wood Green
London N22
5HJ
1st August CYP/Super Clinical A1 meeting Sarah D’Souza Note on file 12 people
10-12.00 health centre room
M12 model
Tuesday OMT Staff B1 Meeting Sarah D’Souza Formal 8
14th August extended Room, Trust response
9.45am to Headquarter received
11.30am s, St Ann’s
M13 Hospital
Tuesday South East Clinicians, Lecture James Slater Minutes on file 15
14th August Practice staff, public Theatre, St Dr J Pandya
at 2.00pm Based Ann’s
M14 Collaborative Hospital
Tuesday North East Clinicians, Laurence Gerry Taylor Note on file 15
21st August Practice staff, public House
at 12.30pm Based Surgery
M15 Collaborative 107 Philip
Lane
Tottenham
N15 4JR
Tuesday EIA Staff and B1 Meeting Sarah D’Souza Note on file 11
21st August Workshop PPI Room, St
at 12.30pm Ann’s
M16 Hospital
Wednesday SMG Staff Lecture Sarah D’Souza, None 25
29th August Theatre, St Gemma Hughes
9.00am to Ann’s
10.3am Hospital
M17
Wednesday Visit to Member of 19 Oak James Slater Written 1
29th August member of Public Avenue, response
at 4.00pm public Tottenham received – on
M18 N17 8JJ file
Monday 3rd Scrutiny Overview Committee James Slater Note on file 35
September Review Panel and Room 3, Christina Gradowski
at 5.30pm Scrutiny Haringey Dr Mayur Gor
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HTPCT Primary Care Strategy Consultation Report
M19 Staff and Civic Centre, Dr Peter Christian
Public High Road
Wood Green
Thursday Shopping Public Wood Green Farah Butt Documents 350 docs given
6th Mall stand Shopping Dilo Lalande and handed out out
September City Faye Booker (Temp) only
at 11am to
3pm
M20
Thursday BEH Clinical Public Wyllyotts Tracey Baldwin No specific
6th Strategy Theatre feedback re
September Public Darkes Lane strategy
At 7.00pm Meeting and Potters Bar
to 8.30pm briefly EN6 2HN
M21 Primary Care
Strategy –
Herts
Friday 7th Joint Staff Staff Blue Room, Clive Martinez Minutes on file 10
September Committee St Ann’s
10am to Hospital
12.30pm (Formal)
M22
Monday BEHMHT MH Nicholson Christina Gradowski Formal 20
10th Board Theatre Sarah D’Souza response
September Chase Farm received
at 2.00pm Hospital site
M23 The
Ridgeway
Enfield
EN2 8JL
Tuesday Tottenham & Public Tottenham Catherine Herman, Note on file 100
11th Wood Green Green (Non Exec Director)
September Pensioners Leisure Christina Gradowski
2pm Forum Centre, Dr John Rohan
M24 Philip Lane
N15
Tuesday Haringey Public Chestnuts Clive Martinez Notes on file 30
11th Patient & Community Gemma Hughes
September Public Centre, St
6.30pm Involvement Ann’s Road
M25 Forum N15
Tuesday Area Public Wood Green Sarah D’Souza Note on file 30
11th Assembly – Library, Dr Alan Schamroth
September Wood Green High Road
at N22
7.30pm
M26
Tuesday Area Public Salvation James Slater Note on file 60
11th Assembly – Army, 2 Dr Nalliah
September St Ann’s & Terront Sivananthan
at Harringay Road N15
7.30pm 3AA
M27
Wednesday BEHMHT Consultant, The Lecture Gerry Taylor Note on file 8
12th Consultant & Clinical staff Theatre, James Slater
September Senior & Senior Block 6, St
at 9.00am Manager Managers Ann’s Hosp
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HTPCT Primary Care Strategy Consultation Report
M28
Friday 14th Muswell Hill Public Muswell Hill Christina Gradowski Note on file 50 docs given
September Broadway Broadway out
1-3pm
Saturday NDC Public The Laurels Christina Gradowski Note on file 70
15th Partnership New Deal Healthy Dr J Pandya
September Meeting for Living
2007 Communitie Centre
11am–2pm s 256 St Ann’s
M30 Road N15
Saturday Shopping Public Wood Green Dilo Lalande Documents 400 docs given
15th Mall stand Shopping Marcin Dabrowski handed out out
September City, Wood only
at 11am to Green N22
3pm
M31
Monday 17 Expert Patients Michele Daniel Note on file 15
September Patient
Reunion
Monday Public event Public Cypriot Christina Gradowski No feedback 1
17th on Centre, Anita Grabarz
September BEH/Primary Earlham
at 6.00pm care Strategy Grove N22
to 8.00pm
M32
Wednesday Public event Public Middle Lane James Slater No feedback 0
19th on Methodist Jackie Langford
September BEH/Primary Church
6.00pm to care Strategy
8.00pm
M33
Saturday Shopping Public Wood Green Marcin Dabrowski, Documents 350 docs given
22nd Mall stand Shopping Farah Butt handed out out
September City only
Friday 28th Joint Staff Staff Blue Room, Clive Martinez No comments 8
September Committee St Ann’s received
10.00am to Hospital
12.30pm (Informal)
M34
Monday 1st Staff HTPCT & Green Clive Martinez Note on file 16
October at Consultation MHT Staff Room, Block Andy Beckingham
1.00pm – Event 6, St Ann’s
2.00pm Hospital
M35
Monday 1st Mental Clinical/ B1 Sarah D’Souza Note on file 5
October at Health/Super Managers
1.00pm – Health Centre
2.00pm Model
M36
Monday 1st Area Public Campsbourn Dave Fazey Minutes on file 30
October at Assembly – e Baptist Dr Siva
7.30pm Crouch End Church, 1-3 Andy Beckingham
M37 The
Campsbourn
e, High
Street,
Hornsey N8
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HTPCT Primary Care Strategy Consultation Report
7PN
Tuesday HTPCT AGM Public, Cypriot Gerry Taylor Notes on file 75
2nd October Staff, Board Centre James Slater
2.30pm – The Main Sarah D’Souza
5.00pm Hall
M38 Earlham
Grove,
Wood Green
N22 5HJ
Tuesday Hornsey Public Middle Lane Christina Gradowski Notes on file 50
2nd October Event Methodist
at 6.30pm Church
M39
Thursday Central Partners & Bounds Gemma Hughes Note on file 15
4th October Practice Staff Green James Slater
at 12.30 Based Health
M40 Collaborative Centre
Friday 5th For Equalities Groups reps Haringey Gerry Taylor Full report of 36
October at Impact of Age, Irish Christina Gradowski event available
12.30 to Assessment Disability, Community Gemma Hughes
4.00pm Race, Cultural Andy Beckingham
M41 Deprivation, Centre, Michele Daniels
mobility, Pretoria Vicky Hobart
Sexuality, Road,
Gender, Tottenham
Belief/ N17 8DX
Religion
Monday 8th Child Young Partners London Gerry Taylor Minutes on file 21
October at People’s Borough of
6.30pm Strategic Haringey
M42 Partnership Civic Centre
Board High Road
Wood Green
N22
Monday 8th Area Public Tottenham Dr Mayur Gor Note on file 60
October at Assembly – Hotspur Christina Gradowski
7.30pm White Hart Football Juliet Jensen
M43 Lane & Club (Oak
Northumberla Room) Bill
nd Park Nicholson,
Tottenham
N17 0AP
Tuesday 9th Scrutiny Staff and Committee Gerry Taylor Note on file 10
October at Review Panel Public Room 3, Christina Gradowski
7.00pm Haringey
M44 Civic Centre,
Wood Green
Wednesday HAVCO Public/ Cypriot Gemma Hughes Formal 20
10th Wellbeing Community Centre Dilo Lalande response
October at Theme Group Groups Earlham received
10.00am to Grove,
1.00pm N22 5HJ
M45
Friday 12th Carers Group Public Haringey Gemma Hughes Notes on file 20
October at Meeting Carers
10am – Centre
2.00pm Winkfield
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HTPCT Primary Care Strategy Consultation Report
M46 Road N22
Friday 12th Wood Green Public/Stake Wood Green Gemma Hughes Note on file 7
October Walking Audit holders
M47
Monday Living Under Healthy Park Lane, Farah Butt Docs
15th One Sun Living Tottenham distributed
October at Community N17
12midday Project
M50
Tuesday Pembury Parents Lansdowne Gerry Taylor Note on file 10
16th House and Public Road,
October at Children’s Tottenham
9.30am Centre, N17
M51
Wednesday Muswell Hill Public (30 The Bowling James Slater Note on file 30
17th and Fortis attendees) club in Kings Dilo Lalande
October at Green Avenue off Dr Siva
8.00pm Association Queens
M52 Avenue
Mr Hajdu
hajdu.clarion
@talk21.com’
–
Thursday Area Public Miller Gerry Taylor Note on file
18th Assembly – Memorial Juliet Jensen
October at West Green Church Hall,
7.30pm & Bruce The Avenue,
M53 Grove Tottenham
N15
Friday 19th LMC Partners & Venue to be James Slater Formal
October at GPs advised response
1pm to received
2pm
M54
Monday Health Well Partners Haringey Vicky Hobart Minutes on file 15
22nd being and Public Civic Centre
October at Partnership Wood Green
5.30pm to Board N22
8.00pm
M55
Thursday Area Public Marcus Christina Gradowski Note on file 60
25th Assembly – Garvey Andy Beckingham
October at Tottenham & Library, 1
6.30pm Seven Sisters Philip Lane
M56 N15
Thursday Area Public British Legion No attendance at
25th Assembly – Hall session – included
October at Muswell Hill Muswell Hill in error in first
7.30pm N10 report
M57
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HTPCT Primary Care Strategy Consultation Report
Appendix B
Summary of questionnaire responses to primary care strategy
consultation
Question 1: Will these changes meet the needs of you and your family?
61 answered yes, although 31 of these were yes, if…
39 said no
23 don’t know/blank
Question 2: How would these changes affect you and your family?
Responses to this question were split roughly in half between positive and negative
comments, with a few neutral comments/queries. Some respondents made both
positive and negative comments. The one issue that caused by far the most
comments (34 comments) was regarding travel and having to travel further to see a
GP. Particular difficulties for elderly and disabled people were noted including
additional cost and needing to use public transport. Loss of continuity/being able to
see the same GP was the second most common negative response (8). However
easier access to services including through extended opening hours was welcomed
by a number of people, and some (6) noted that they would have improved
access/less distance to travel by reducing number of hospital appointments.
Issues in order of number of responses:
Issue Positive (+ve) or negative Number of comments
comments (-ve)
Travel -ve 34
General positive comments +ve 13
General negative comments -ve 13
Easier access/one stop shop +ve 9
Better range of services +ve 9
Extended opening hours +ve 8
Loss of continuity/being able to -ve 8
see same GP
Reduce travel/improve access +ve 6
(less visits to hospital)
Healthy living services +ve 3
A more impersonal service -ve 3
Reduce waiting times +ve 2
Losing local services -ve 1
More crowded/busy waiting -ve 1
rooms
Quicker diagnosis +ve 1
Less crowded waiting rooms +ve 1
Job opportunities +ve 1
More continuity +ve 1
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HTPCT Primary Care Strategy Consultation Report
Question 3: What are your views on where we will locate the 6 super
health centres?
General comments/queries Need to be planned strategically, with consideration
of travel issues, well spaced and where needed by local community
Wood Green or Turnpike Lane?
There were more calls for a centre at Wood Green than at Turnpike Lane, with one
person suggesting a centre between Wood Green, Turnpike Lane and
Northumberland Park.
Generally positive responses to suggestions
There were a number (13) of generally positive responses to the consultation
including specific mention of sites already suggested in strategy (as noted below)
Generally negative responses to suggestions
Nine people made generally negative responses to the suggested location.
Specific locations suggested:
Hornsey Central (6)
Bounds Green (5)
North East (4)
St Ann’s (full functioning hospital) (4)
Tynemouth Road (2)
Gordon Road (2)
Muswell Hill (2)
Highgate (1)
Lansdown Road (1)
Somerset Gardens (1)
Hornsey Road (1)
Tottenham Hale/Ferry Lane (1)
North West (1)
Ensure wealthier areas are well served too (1)
Distance too far
Seven people noted that distance to travel would be too far – also raised under other
questions.
Keep status quo
Nine people wanted to maintain the current large number of smaller
practices/current GP premise.
Will 6 super health centres be enough? 7
Seven people queried if 6 would be enough, and 2 people suggested more centres
should be built in between.
Question 4 Are there any particular services/facilities you would want to
see provided in your local super health centre?
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HTPCT Primary Care Strategy Consultation Report
Most popular services required were foot care including podiatry and chiropody and
and blood tests.
The services suggested are listed below, with the most popular choices at the top of
the list:
Dentists/oral health
Physiotherapy
Opticians/ophthalmology
Diagnostic services e.g. x rays & scans
Preventative e.g. checkups
Women’s health (and men’s health) including smear test, gynaecologist
General practice and good access e.g. named doctor, direct access to GP
Alternative medicines e.g. acupuncture, homeopathy, shiatsu, reflexology
Pharmacy
Counselling
Transport provided (free)
Hospital/out patient treatment
Minor surgery
Pregnant and post-natal mothers/Support groups for parents/post natal
service/Maternity
Mental health care (psychologist, psychiatrist) Council and mental health trust
staff especially talking therapy, drug monitoring and close co-operation
between GPs and mental health workers
Family planning
Paediatric services
More out of hours (12-24 hours) (inc 1 weekend)
A&E for minor accidents/A&E for Haringey/emergency services 24/7
Diabetes treatment (eye checks etc at same place)
Health information
Occupational Therapy
Larger area for retired/elderly
Breast cancer screening
Partnership in action
Dieticians
Vaccinations
Home care/house calls
Walk in centre
Early appointment system
Closer to home
Open Saturdays
No appointments – drop in
Post-stroke services e.g speech-language therapy
Every aspect of medical care/All medical tests done in same place
Outreach and advocacy especially for young mothers
Midwife team
Better health visitor facilities
Children and young people (more info about how they fit into the service)
Dementia clinic
Treatment of melanoma
More access to specialised hospital medication.
Health care linking more to leisure for over 50’s,
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HTPCT Primary Care Strategy Consultation Report
Smoking advice
ENT
Geriatric care with beds
Help for carers
Respite care
Interpreting service
Confidential HIV tests
Gym
Hearing
Community health services
Family health education
Drug abuse prevention
GUM
Facilities/access:
Toilets
Enough seats for waiting patients
Coffee bars
Parking for disabled people and parents with children
Telephone facilities
Access
Health food café
Easy access for disabled users
Better access for people with learning disabilities
Improved access for refugees and asylum-seekers
Question 5 How would these changes affect your journey to your GP?
Too far to travel or other negative change
Would have to go by bus/public transport or take more buses than at present
Won’t affect
Positive change/shorter journeys/better access
Unclear
Okay if at Turnpike Lane
Question 6 Are there any other things you want to tell us about the
proposed changes?
Not in favour/Don’t want to change/want to remain at present health centre
Looking forward to changes/positive view
Why not upgrade existing facilities
Fewer Super health centres and upgrade existing good GPs
Super health centres too large/impersonal/bureaucratic
Too expensive to run super health centre
Better and quicker way of getting appointments needed/No appointments
Concerns re waiting times
Set up special clinics for patients with chronic health problems
Change title of super health centre to integrated health centre – sets up too
much in terms of expectations
Against impersonal places, want current friendly atmosphere
Want in addition to GP not instead of
Want services out of hospital but want GPs where they are now
How can I be sure these centres are not privatised?
Need to be able to see same doctor/Don’t want to have to change doctor
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HTPCT Primary Care Strategy Consultation Report
Concerned they will increase waiting times as will be more difficult to get
Appointments
How big will centres be –long queues?
Against LIFT as PCT would lose land/premises in 25-30 years
Want to see map with bus routes to each centre
Better communication needed between GPs and health centres and better
understanding of role of health centres
Upgrade GPs outside of SHC to carry out minor ops
Staged approach
Ambulance service?
Better facilities for patients
Inconsiderate to needs of elderly, disabled and parents of young children
Will make service worse and increase death rate of seriously ill patients
Concern re impact on local pharmacy
More GPs and community staff
More consultation needed before implementation
Keep local pharmacists
Rebuild St Ann’s
How will you reach young people, refugees and asylum-seekers, cultural and
religious barriers to accessing primary care?
Shouldn’t make people from White Hart Lane move
How would one clinic cope
More details needed
Dental and optical facilities
Can some small GPs remain
Try pilot scheme first
Keep bounds green
Keep public informed
Build new centres to high environmental standards
Learning disabilities review needs to be taken into account
Mental health
Needs of the East and N East of borough must be met
There are not enough doctors
Extended opening hours will benefit working/affluent more than others
Longer journeys
Creeping privatisation?
Use space in Super health centres for other related services
Question 7 Would you be interested in joining a patient focus group to
develop your local super health centre?
Yes (32).
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HTPCT Primary Care Strategy Consultation Report
Appendix C Written Responses
Ref Organisation Key notes Date
R1 Haringey Local No one model fits all approach. Concerns re Oct
Medical viability of super health centre (SHC) model 2007
Committee GP contractual issues clarity needed
financial viability
ownership of premises
need to define service model before
buildings, can current substandard
premises be developed,
further exploration of travel and transport
issues
reduction in patient choice
Will work with HTPCT to develop model/address
these concerns.
R2 Overview and Satisfied re consultation 13.11.07
Scrutiny Need to develop and improve primary care
Committee services demonstrated
Concerns:
Distribution of primary care services needs to
be clearly planned and located where greatest
need.
More information on location of SHCs and hub
and spoke model will work
Greater collaboration will need to be developed
– will not arise from location alone
More detailed financial plan needed.
Clear monitoring and audit process needed
Until info provided unable to conclude that PC
strategy in interests of local health services.
R3 Barnet Enfield Welcome structured planning of PC by which to 24.9.07
and Haringey tackle health inequalities
Mental Health 2 SHCs out of borough
Trust concerns re liaison and access
support move of diagnostics into community,
need to align strategic decisions re use of SAH
site with MHT,
more detail about services in SHCs
R4 Whittington Support for principles 17.10.07
NHS Trust need to be involved in developing model and
care pathways,
Whittington can support in range of ways
infrastructure, clinical and other expertise,
want to be considered as provider,
particular interest in developing urgent
care/out of hours and day treatments,
need more information about financial model
R5 Barnet Enfield Insufficient detail about number of GPs within 12.10.07
and Haringey SHC and number retained outside
Mental Health concerns about accessibility, focus of shift likely
Trust PPIF to have more impact in East where more
single-handers/poorer premises
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HTPCT Primary Care Strategy Consultation Report
concerns about impact on people with limited
mobility or MH where motivation and cost may
impact on access,
would welcome more joined up approach re
MH/PC but document unclear what that would
be.
Supports development of substantial SHC at
SAH.
R6 Liberal Support for need for change, addressing health 18.10.07
Democrats inequalities in east and better services in SHC
model. Concerns
more detail re services in SHC,
look to local NHS providers first,
support hub and spoke model rather than
comprehensive relocation of GP practices,
IT key to effective model,
2 SHCs located out of borough and lack in NE,
parity of budgets per capita east with west,
need for pharmacies to compete on level
playing field
R7 Haringey Location of SHCs and which GPs practices 19.10.07
Phoenix Group relocating crucial to blind/partially sighted –
(voluntary new routes to learn, fears in general re travel,
group for use of dial a ride/computer cabs
blind/partially benefits re SHCs re smaller/friendlier, could
sighted) provide very valuable
services re hearing aid batteries, chiropody,
diabetes, dentists, blood tests and general
information re services/concessions for blind.
Need to ensure signage/lighting/navigating
SHC and systems/written material and staff
training re dealing with blind people
R8 Age Concern Support for objectives 25.10.07
Delivery model concerns-
Distance to GP, continuity, clarity re
registration
Services to include podiatry, physiotherapy,
and clarity re urgent/unplanned care
NE not well served re SHC location
Transport must be addressed
Clarity re MH, care residents and older peoples
needs
Clarity re collaboration with voluntary sector eg
commissioning community development
services
R9 Haringey Need for joined up approach re redevelopment 16.10.07
Council ( part of of SAH site and that health services maintained
response to and improved there.
BEHCS) Proper consultation with patients over
relocation of each GP practice re move to
SHCs,
PCT ensure all patients can reach local health
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HTPCT Primary Care Strategy Consultation Report
services or otherwise seen at home/transport
provided.
R10 Local Pharmacy Concerns re SHC delivery model ?Oct 07
Committee Fit with Healthcare for London (HfL) – reduce
choice, centralise care, reduce integration and
contribution of workforce where pharmacies
out of business, impact on poorest/most
vulnerable re travel/costs
Want PCT to support/nurture and develop
viable network of pharmacies to provide
multifunctional/accessible role in delivery model
R11 HTPCT Support for strategy 6.11.07
Providerside
R12 Haringey 6 SHC help to channel 106 monies more 20.6.07
Council effectively, need to discuss importance of
Strategic Sites smaller premises especially in new
and Projects developments
and Planning welcome co-location opportunities
Policy Team
R17 Muswell Hill & Current uneven performance is due to shortage 18.10.07
Highgate of provision therefore need additional GPs
Pensioners Members don’t want doctors to re-locate
Action Group Do not want HTPCT to use private provider for
diagnostics
Renovated Fortis Green Clinic is preferred
Do not want a large pharmacy at Hornsey
Central
R19 Haringey Forum Transport difficulties – transport should be 18.10.07
for Older People provided
Nothing about provision for older people’s
needs
Online booking
Access at weekends and longer opening hours
required
Fortis Green should be refurbished
More preventative services required
Day care facilities required for people with
mental health problems and learning disabilities
Local GP surgeries should be kept open
The forum wants to have further input into the
strategy
R25 Travelwatch Wishing to start dialogue re planning for transport 27.09.07
R26 Highgate Group Supportive of overall aims 12.10.07
Practice Supportive of plans for Hornsey Central
Not supportive of plans for polyclinic at
Whittington
Want to see LIFT development Highgate Group
Practice/Church Road
R27 Haringey VCS Support for overall aims and vision 28.11.07
wellbeing Potential to offer longer opening hours, better
theme group services, enabling VCS services to enhance
primary care services
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New model intended to be more user-friendly
Need to support positive relationships between
GPs and other services/organisations
Concerns re travelling in terms of distance,
time and access to public transport and parking
and impact on older and disabled people.
Suggest a transport strategy is devised
alongside primary care strategy
Risk assessment re mental health needed
Work needed to target particular communities
around accessibility
Important to engage with VCS in process in
terms of service delivery and advocates for
users
Concerns re variance in ability of residents to
engage in consultation
Need to ensure links between primary care
strategy and wellbeing strategic framework
VCS need to plan how to influence the delivery
of the strategy
R28 Better Local Opposed to the new model proposed in the context
Healthcare of West Haringey and Hornsey Central
Campaign development as super health centre model on the
basis of
Concerns about the long term cost and
principles of PFI
Concerns about the evidence base/outcome
of implementing proposed model
Lack of clarity about the nature of services
to be provided
Particular concerns with shifting minor
procedures and urgent care from hospital
setting/quality of care
A range of access issues including GP
location in HC, reduction in local practices,
travel and continuity/personalised care,
coverage in West Haringey
Lack of information about meeting the
needs of vulnerable people and more
broadly a call for detailed impact
assessment on travel/environment and
pharmacy
Significant concerns about the nature,
scope and accessibility of the consultation
process and the strategy for ongoing public
involvement, particularly vulnerable groups
Page 37 of 38
HTPCT Primary Care Strategy Consultation Report
Other
responses –
public
(anonymised)
R13 email Concerns about travel for vulnerable people and 11.7.07
loss of modern custom built practices
R14 letter Concerns about travel for vulnerable people and 18.10.07
need to retain Bounds Green Group Practice as
part of SHC model in this area.
R15 Petition 40 To keep current system of local GP practices and 16.10.07
names not move to SHC model
R16 PALs calls Alzheimer’s society – needs of dementia Various
patients to inform services available at
SHCs – especially Hornsey Central
Various concerns from older people about
local GP practices closing and transport.
Lack of clarity in consultation
R18 email Concerns re travel to only 6 centres 18.10.07
Lack of continuity of care
Have some polyclinics but also keep good
local GPs
R20 email Are there enough doctors 23.10.07
Should have hospital in Haringey at St Ann’s
R21 email Pleased with outcome of recent issue re choice 14.08.07
R22 email Objecting to plans as current system is accessible 17.10.07
R23 email Draws attention to the report carried out by 15.10.07
Haringey Health Scrutiny Committee: Improving
the health of people with profound and multiple
learning disabilities – need to develop robust
disability access and quality standards for inclusion
in all contracts
R24 email Concerns about the proposals – what will happen 24.10.07
to Lawrence House?
R29 Petition with Concerns from residents of N17 about closure of
@180 names GP practices, distance of travel and nature of
consultation
(Note – original of petition not received by PCT
during consultation period. Copy of petition
received Feb 2008)
Page 38 of 38
Related docs
Other docs by HC120831145656
