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Consultation feedback on proposals to create a

Single Commissioning Organisation for Staffordshire

and Stoke-on-Trent

Report of findings

Monday, 2 September 2019

2 | NHS Midlands & Lancashire Commissioning Support Unit

Table of Contents

1 Executive summary .................................................................................................................. 4 Introduction ............................................................................................................................... 4 Communications and engagement .......................................................................................... 4 Participants and respondents .................................................................................................. 5 Findings ..................................................................................................................................... 5 Comments on the options......................................................................................................... 6 Support for option 1 ......................................................................................................................................................... 6 Support for option 2 ......................................................................................................................................................... 6 Summary of organisational responses ............................................................................................................................ 7

Alternative options .................................................................................................................... 7

2 Introduction ............................................................................................................................... 8 Report authors ........................................................................................................................... 8 Report structure ........................................................................................................................ 8 Background ............................................................................................................................... 8 The proposals ............................................................................................................................ 9 Overview of the consultation .................................................................................................... 9

3 Communications and engagement methodology ................................................................ 10 Communications and collateral .............................................................................................. 10 Consultation document .................................................................................................................................................. 10 Press ............................................................................................................................................................................. 10 Social media .................................................................................................................................................................. 11 Web content .................................................................................................................................................................. 11 Distribution .................................................................................................................................................................... 11

Engagement channels ............................................................................................................. 12 Survey ........................................................................................................................................................................... 12 Public events ................................................................................................................................................................. 12 Consultation meetings ................................................................................................................................................... 14 Correspondence ............................................................................................................................................................ 15

4 Respondent profiling .............................................................................................................. 16 Demographic profile ................................................................................................................ 17 Map of consultation respondents ........................................................................................... 18

5 Findings ................................................................................................................................... 19 Reporting and analysis notes ................................................................................................. 19 Views on option 1 .................................................................................................................... 20 Feedback from the survey ............................................................................................................................................. 20 Feedback from correspondence .................................................................................................................................... 27

Views on option 2 .................................................................................................................... 29 Feedback from the survey ............................................................................................................................................. 29 Feedback from correspondence .................................................................................................................................... 35

Alternative options .................................................................................................................. 36 Feedback from the survey ............................................................................................................................................. 36 Feedback from correspondence .................................................................................................................................... 38

Considerations raised ............................................................................................................. 39 Feedback from correspondence .................................................................................................................................... 39

Other comments ...................................................................................................................... 40 Feedback from public events ......................................................................................................................................... 40 Feedback from other consultation meetings .................................................................................................................. 40

6 Conclusions ............................................................................................................................ 42 Comments on the options....................................................................................................... 42 Support for option 1 ....................................................................................................................................................... 42 Support for option 2 ....................................................................................................................................................... 43

Alternative options .................................................................................................................. 43

Appendix 1: Example social media posts .................................................................................. 44

Appendix 2: Organisations sending correspondence .............................................................. 45

Appendix 3: Queries and feedback from public events ............................................................ 46

Appendix 4: Summary of event demographic profiling questionnaires .................................. 47


References

Figure 1. Map of the six Staffordshire and Stoke-on-Trent CCGs’ areas ....................................................... 8

Figure 2. Front cover and example pages of the consultation document ..................................................... 10

Figure 3. Map of public event locations ....................................................................................................... 13

Figure 4. Map of respondents’ location ........................................................................................................ 18

Table 1. Summary of support for the options ................................................................................................. 5

Table 2. Summary of organisational responses ............................................................................................. 7

Table 3. Press releases and press coverage ............................................................................................... 10

Table 4. Social media analytics ................................................................................................................... 11

Table 5. Emails sent .................................................................................................................................... 11

Table 6. Public events ................................................................................................................................. 12

Table 7. Consultation meetings ................................................................................................................... 14

Table 8. Correspondence received.............................................................................................................. 15

Table 9. Number of respondents and participants ....................................................................................... 16

Table 10. Survey respondent types ............................................................................................................. 16

Table 11. Respondents by CCG area .......................................................................................................... 16

Table 12. Profile of members of the public completing the survey ............................................................... 17

Table 13. Option 1: Keep the current arrangements of six separate CCGs under a single leadership team 20

Table 14. Option 1: What do you agree with? .............................................................................................. 21

Table 15. Option 1: Do you have any concerns or are there any groups or individuals you think may be

negatively impacted by this option? ............................................................................................................. 23

Table 16. Option 1: How could these negative impacts be overcome? ........................................................ 25

Table 17. Feedback from correspondence with positive themes around option 1 / negative themes around

option 2 ....................................................................................................................................................... 27

Table 18. Option 2: Develop a new, single CCG ......................................................................................... 29

Table 19. Option 2: What do you agree with? .............................................................................................. 30

Table 20. Option 2. Do you have any concerns or are there any groups or individuals you think may be

negatively impacted by this option? ............................................................................................................. 31

Table 21. How could these negative impacts be overcome? ....................................................................... 33

Table 22. Feedback from correspondence with positive themes around option 2 / negative themes around

option 1 ....................................................................................................................................................... 35

Table 23. Do you have any other suggested options that we should consider? ........................................... 36

Table 24. Feedback from correspondence with alternative options ............................................................. 38

Table 25. Themes for consideration and comments on consultation process raised in correspondence ..... 39

Table 26. Summary of support for the options ............................................................................................. 42

https://csucloudservices.sharepoint.com/teams/comms/f/INVOLVEMENT/A%20Projects/2019/Staffordshire%20CCGs%20-%20single%20CCG%20consultation/Reporting/SCO%20report%20v4.docx#_Toc17875973

https://csucloudservices.sharepoint.com/teams/comms/f/INVOLVEMENT/A%20Projects/2019/Staffordshire%20CCGs%20-%20single%20CCG%20consultation/Reporting/SCO%20report%20v4.docx#_Toc17875974


1 Executive summary This report of findings presents the feedback from the public consultation which took place across

Staffordshire between Thursday 9 May 2019 and Sunday 30 June 2019. The consultation was exploring

public, patient and wider stakeholder views on two proposals for the future of the six Staffordshire CCGs.

Introduction

Health services in Staffordshire and Stoke-on-Trent are currently split into six geographical areas and led by

six separate local Clinical Commissioning Groups (CCGs):

• Cannock Chase CCG

• East Staffordshire CCG

• North Staffordshire CCG

• Stafford and Surrounds CCG

• South East Staffordshire and Seisdon Peninsula CCG

• Stoke-on-Trent CCG.

The proposals are:

Option 1: Keep the current arrangements of six separate CCGs under a single leadership team

• The six CCGs will stay as separate organisations, each responsible for their own statutory functions

(legal obligations)

• The single leadership team will oversee the delivery of these, supported by meetings held jointly or

‘in common’

• The CCGs will align their priorities and objectives, but each CCG keeps its own constitution, and is

responsible for its own local area.

Option 2: Develop a new, single CCG

• To form a single Strategic Commissioning Organisation (SCO) for the county

• The single leadership team will oversee the delivery of the CCG’s statutory functions (legal

obligations), supported by governance (committee) meetings

• A single Governing Body will work to one set of statutory duties

• This model would free-up money and capacity to create efficiencies, for example across buildings,

processes and IT.

For further information, please view the consultation document.

Communications and engagement

A range of collateral was produced to provide information on the consultation and encourage feedback. This

included:

• A consultation document: ‘Your views on our journey...towards becoming a single Strategic

Commissioning Organisation’ to inform stakeholders of the consultation

• Two press releases: One at the start of the engagement period on 9 May 2019 and the second on

31 May to inform stakeholders of the extended closing date

• Social media posts: The consultation was promoted across the CCGs’ Facebook and Twitter

profiles

• Web content: The consultation was promoted on each of the CCGs’ websites.

Collateral was sent to all GP practices in the area, available at CCG offices, used at public events and

meetings and made available at Together We’re Better (the Staffordshire and Stoke-on-Trent Sustainability

Transformation Partnership) public listening events. Emails were also sent to inform stakeholders of the

https://www.northstaffsccg.nhs.uk/stoke-governance/register-of-procurement-decisions/1601-abag-9348-strategic-commissioning-organisation-brochuresurvey-v12-digital/file


consultation. These stakeholders included voluntary and patient representative groups, staff, GPs and

corporate stakeholders.

Feedback was gathered using the following engagement channels:

• Paper and online survey: This was structured into two main sections – views on the proposals and

demographic profiling questions

• Eight public events: These were held at locations across the consultation area

• Meetings: These were held with a range of stakeholders, including patient district groups, MPs and

scrutiny committees

• Correspondence: Stakeholders could provide feedback via email or letter.

Participants and respondents

Feedback on the consultation proposals came from:

• 76 responses to the consultation survey

• 80 participants at eight public events

• 27 pieces of correspondence

Survey respondents were asked questions to enable a demographic profile of respondents to be

understood. This is summarised below:

• Ethnicity: 42 (88%) respondents were White British and 4 (8%) White Irish

• Age category: 32 (67%) respondents were aged 60 or over

• Religion: 23 (55%) respondents were Christian and 15 (36%) had no religion

• Sex: 25 (51%) respondents were female and 20 (41%) were male

• Gender identity: 35 (81%) respondents had not undergone any gender reassignment

• Sexual orientation: 29 (64%) respondents were heterosexual and 3 (7%) bisexual

• Relationship status: 30 (63%) respondents were married

• Pregnancy: 1 (2%) respondent was currently pregnant

• Health problem or disability: 16 (36%) respondents had a health problem or disability which limited

their day-to-day activities

• Carer: 6 (13%) respondents were carers for a person aged 50 or over

• Armed services: 2 (4%) respondents had served in the armed services.

Findings

In the survey, a slightly greater proportion of respondents expressed support to keep the current

arrangements, with 29 (45%) of respondents supporting option 1, compared to 30 (42%) of respondents

who supported option 2, to create a single CCG.

A greater proportion of respondents were unsupportive of option 2, with 31 (44%) respondents indicating

they were not supportive, compared to 21 (32%) of respondents for option 1.

Table 1. Summary of support for the options

Supportive

(4 or 5) Neutral

(3) Not supportive

(1 or 2) Base


45% 23% 32% 65


42% 14% 44% 71


Comments on the options

Support for option 1

In support of option 1, it was commented that retaining six CCGs would ensure a better understanding of

local issues more tailored to local needs and local representation and involvement.

The need to consider the demographic and geographic differences in the area was a key theme throughout

(e.g. deprivation in Stoke-on-Trent, rural versus city).

There was concern that resources would be focused on Stoke-on-Trent / urban areas if option 2 was

implemented. However, there was also concern in the survey and in correspondence that Stoke-on-Trent

would be negatively affected if option 2 was implemented – for example, with a loss of funding.

Organisational comments: Organisations commenting in opposition to the proposal to create a single

CCG or expressing concerns included Stoke-on-Trent City Council, Cannock Chase Council, Hednesford

Town Council, Healthy Staffordshire Select Committee and Staffordshire Moorlands District Council.

• Stoke-on-Trent City Council expressed disagreement with option 2. The Deputy Leader of the

Council and Lead Member for Health and Social Care commented that Stoke-on-Trent is

demographically and geographically different from Staffordshire, and that a single CCG would lose

local focus and decision-making capability. They commented that funding would move from North to

South and there would be a shift in emphasis away from the population’s need to resolve financial

pressures.

• Stoke-on-Trent City Council Adults and Neighbourhoods Overview and Scrutiny Committee

expressed concern that a single CCG would result in a postcode lottery. They commented that there

would be variations in service provision and facilities in Stoke-on-Trent. They said that the result

would be a ‘one-size-fits-all’ commissioning model, with services not being commissioned according

to need.

• Healthy Staffordshire Select Committee expressed concern that the proposed move was

financially led and that commissioning policies had not been mentioned. They commented the North

and South of the county have differing population needs.

• Cannock Chase Council commented in opposition to the proposed creation of a single

commissioning organisation. They argued that it is a cost-cutting measure – not in the best interests

of patients and carers within Cannock Chase. They commented that a single commissioning

organisation would see resources diverted away from Cannock Chase. They expressed concern that

there would be a loss of influence over local clinical commissioning decisions and worsening of

existing poor engagement with the council.

• Hednesford Town Council commented that CCGs should remain local to ensure local

representation and understanding of local needs.

• Staffordshire Moorlands District Council commented that Staffordshire Moorlands has a large

rural population with different needs to the rest of the county. They expressed concern that localism

would be lost if the CCGs were to merge into one organisation.

• 3 local MPs also raised opposition to the single CCG. Concerns that they raised included a loss of

focus on local needs; effects on funding allocations and impacts on service provision.


In support of option 2, it was commented that six CCGs are an inefficient use of resources and that one

CCG would be more efficient. Other comments were that option 2 would improve consistency across the

area, as having six CCGs results in inconsistencies whereas option 2 would result in economies of scale.

Organisational comments: Organisations expressing broad support for option 2 included NHS Trusts,

Healthwatch Staffordshire and Staffordshire County Council.


• North Staffordshire Combined Healthcare NHS Trust and University Hospitals of North

Midlands NHS Trust commented that the single CCG would support in the management of system-

wide issues.

• Midlands Partnership NHS Foundation Trust commented that a single CCG would support

collaborative working and ICP development; simplify governance arrangements; reduce duplication

and support equitable care across Staffordshire and Stoke-on-Trent.

• Healthwatch Staffordshire commented that the proposal would improve consistency and potentially

result in savings that could be reinvested into services.

• Staffordshire County Council also expressed support for option 2 in correspondence.

Summary of organisational responses

Table 2 provides a summary of the organisational views received via correspondence. These have been

split into broadly supportive of a single CCG and concerns raised or opposition to a single CCG. However,

those that have been categorised as broadly supportive may also have raised some considerations or

concerns and those categorised as concerns raised or opposition to a single CCG may also have made

positive comments.

Table 2. Summary of organisational responses

Broadly supportive of a single CCG Concerns raised or opposition to a single CCG

Healthwatch Staffordshire Adults and Neighbourhoods Overview and Scrutiny Committee, Stoke-on-Trent City Council

Midlands Partnership NHS Foundation Trust Cannock Chase Council

North Staffordshire Combined Healthcare NHS Trust Paul Farrelly MP

Staffordshire County Council Healthwatch Stoke-on-Trent

Tamworth Council Healthy Staffordshire Select Committee, Staffordshire County Council

University Hospitals of North Midlands NHS Trust Hednesford Town Council

Jeremy Lefroy MP*

Reach (part of Asist)

Ruth Smeeth MP

Gareth Snell MP

Staffordshire Moorlands District Council

Stoke-on-Trent City Council *Raised a query over funding

Alternative options

A key theme in both the survey and correspondence was that Stoke-on-Trent should be a standalone CCG.

The need to involve patients and communities in decision-making and to improve partnership working

across CCGs were key themes in the survey.

Organisational comments:

• Healthwatch Stoke-on-Trent queried why a Northern Staffordshire CCG is not an option.

• Stoke-on-Trent City Council (the Deputy Leader of the City Council and Lead Member for Health

and Social Care) commented that Stoke-on-Trent should remain its own CCG or there should be an

amalgamated CCG across Stoke-on-Trent and North Staffordshire on the same geographic

boundaries as the Northern Alliance.

• Similarly, Stoke-on-Trent City Council Adults and Neighbourhoods Overview and Scrutiny

Committee gave two alternative options: One CCG for Stoke-on-Trent and another CCG for the

remainder of Staffordshire, or three CCGs based on the three divisional committees for the North,

South East and South West as outlined within the proposed governance structure in the consultation.


2 Introduction

Report authors

The Staffordshire and Stoke-on-Trent Clinical Commissioning Groups commissioned NHS Midlands and

Lancashire Commissioning Support Unit (MLCSU) Communications and Engagement Service to coordinate

the independent analysis of the feedback from the consultation to produce this report.

Report structure

This report is structured into the following sections:

• Section 1: Executive summary

• Section 2: Introduction

• Section 3: Communications and engagement methodology

• Section 4: Respondent profiling

• Section 5: Findings

• Section 6: Conclusion.

Background

The background information in section 2.3 and 2.4 is taken from the consultation document.

Health services in Staffordshire and Stoke-on-Trent are

currently split into six geographical areas and led by six

separate local CCGs. These are:







The CCGs need to keep ahead of the growing and changing

needs of the 1.1 million people living in Staffordshire and

Stoke-on-Trent. The NHS Long Term Plan, published in

January 2019, looks at working together effectively, with no

barriers.

In recent years, the six CCGs have developed closer working

relationships, and now have a single leadership team and

staffing structure. Governing Body meetings are also held ‘in

common’ so that any strategic decisions affecting the whole

population can be made. The CCGs are now proposing to

formalise these arrangements by creating a Single

Commissioning Organisation (SCO), with responsibility for

the entirety of Staffordshire and Stoke-on-Trent from April

2020.

In December 2018, the CCGs made an application to NHS England confirming their intention to develop and

operate as a single organisation. Consultation has already taken place with the Governing Bodies of the six

CCGs and with more than 150 GP surgeries in the region.

Figure 1. Map of the six Staffordshire and Stoke-on-Trent CCGs’ areas



The proposals

The proposals are:


• The six CCGs will stay as separate organisations, each responsible for their own statutory functions

(legal obligations)

• The single leadership team will oversee the delivery of these, supported by meetings held jointly or

‘in common’

• The CCGs will align their priorities and objectives, but each CCG keeps its own Constitution, and is

responsible for its own local area.


• To form a single Strategic Commissioning Organisation (SCO) for the county

• The single leadership team will oversee the delivery of the CCG’s statutory functions (legal

obligations), supported by governance (committee) meetings

• A single Governing Body will work to one set of statutory duties

• This model would free-up money and capacity to create efficiencies, for example across buildings,

processes and IT.

For further information, please view the consultation document.

Overview of the consultation

The consultation ran from Thursday 9 May 2019 until midnight on Sunday 30 June 2019. NHS Midlands and

Lancashire Commissioning Support Unit have collated all feedback gathered from the consultation and have

produced this report for the CCGs. A decision will be made by the CCGs’ Governing Bodies.



3 Communications and engagement methodology This section details the communication and engagement activities undertaken during the consultation

across the six CCG areas.

Communications and collateral

This section details the range of collateral used to promote the consultation.

Consultation document

A consultation document – ‘Your views on our journey...towards becoming a single Strategic Commissioning

Organisation’ – was produced, informing members of the public and other stakeholders of the proposals and

rationale for becoming a single CCG.

Press

Table 3 details the press releases produced regarding the consultation and the coverage generated.

Table 3. Press releases and press coverage

Date Headline Coverage / publication

Press releases

9 May 2019 Public, patients and partners to participate in

Staffordshire and Stoke-on-Trent NHS Commissioning Consultation

A little bit of Stone

Stoke Sentinel

31 May 2019 Consultation on health organisation extended to

allow more residents to participate No coverage

Press coverage

10 May 2019 Public consultation opens to create new single NHS

Clinical Commissioning Group A little bit of Stone

22 May 2019 CCG merger plan in bid to end ‘postcode lottery’ Stoke Sentinel

22 May 2019 Will this major healthcare shake-up be good to

patients? Stoke Sentinel

One reactive press enquiry was received from the Express and Star on 10 May 2019.

Figure 2. Front cover and example pages of the consultation document



Social media

The consultation was promoted on Facebook and Twitter using organic engagement. Table 4 presents the

social media analytics. See Appendix 1 for examples of social media posts.

Table 4. Social media analytics

Facebook

Number of posts 6

Overall reach 118

Engagements (actions on posts) 21

Twitter

Number of Tweets 10

Total impressions 4,370

Engagements 42

Total likes 5

Web content

The consultation was promoted on each of the CCGs’ websites. Content included links to consultation

material and details of how to get involved – including a link to the online survey and details of the public

events.







Distribution

500 copies of the consultation document were printed and distributed as follows:

• Sent to all GP practices in the area

• Available at CCG offices

• Used at public events and meetings

• Available at Together We’re Better public listening events.

Emails were also sent to inform stakeholders of the consultation. Table 5 summarises the emails sent.

Table 5. Emails sent

Email Date sent

Staff e-bulletin 3 May 2019

Email to corporate stakeholders 9 May 2019

Email to patient groups 9 May 2019

GP bulletin 15 May 2019

Patient newsletter 24 May 2019

Reminder email to corporate stakeholders to promote the consultation 29 May 2019

Email to patient / district groups about extended survey and new Seisdon date 30 May 2019

GP membership update 31 May 2019

Reminder email to corporate stakeholders to promote extended consultation 31 May 2019

GP bulletin 5 June 2019

Update to Healthwatch partners to promote event 12 June 2019

Biddulph Patient Participation Group offer for attendance at meeting (following correspondence)

12 June 2019

Tamworth district group promotion of event 12 June 2019

Tamworth GP members notified of extra event 12 June 2019

Email to corporate stakeholders to remind about consultation closing 27 June 2019

Staff e-bulletin 28 June 2019

https://cannockchaseccg.nhs.uk/get-involved/consultation-and-engagement/previous-consultations-and-engagement/single-strategic-commissioning-organisation

https://eaststaffsccg.nhs.uk/get-involved/consultation-and-engagement/previous-consultations-and-engagement/single-strategic-commissioning-organisation

https://www.northstaffsccg.nhs.uk/get-involved/consultation-engagement/previous-consultations-engagement/single-strategic-commissioning-organisation

https://sesandspccg.nhs.uk/get-involved/consultation-and-engagement/previous-consultations-and-engagement/single-strategic-commissioning-organisation

https://www.staffordsurroundsccg.nhs.uk/get-involved/consultation-and-engagement/previous-consultations-and-engagement/single-strategic-commissioning-organisation

https://www.stokeccg.nhs.uk/stoke-get-involved/consultation-engagement/previous-consultations-engagement/single-strategic-commissioning-organisation


Engagement channels

This section gives an overview of the engagement channels.

Survey

Both paper and online versions of the survey were used to gather feedback. The survey was split into two

sections:

• Your views on our proposals: This was split into views on option 1 and views on option 2

• About you: This section contained demographic profiling questions.

Public events

Eight public events were held to inform stakeholders of the proposals and gather feedback. This ensured

that there was an event held in each CCG area, with additional events held in South East Staffordshire and

Seisdon Peninsula CCG, as the CCG is split across two areas and to ensure there were events in both

Lichfield and Tamworth. Table 6 lists the events and figure 3 shows a map of the public events.

Table 6. Public events

Date CCG area Location Venue Number of

attendees

22 May Stoke-on-Trent CCG Stoke-on-Trent Medical Institute, Hartshill, Stoke-on-Trent ST4 7NY

16

23 May South East Staffordshire and Seisdon Peninsula CCG

Lichfield The George Hotel, Lichfield WS13 6PR 3

28 May North Staffordshire CCG Leek St. Edwards Academy, Leek ST13 8DN 9

29 May Stafford and Surrounds CCG Stafford Entrust, Stafford ST16 3TH 5

4 June Cannock Chase CCG Cannock Aquarius Ballroom, Hednesford, Cannock WS12 1BT

20

5 June East Staffordshire CCG Burton Pirelli Stadium, Burton DE13 0BH 5

7 June South East Staffordshire and Seisdon Peninsula CCG

Codsall Bill Brownhill Room, South Staffordshire District Council, Codsall WV8 1PX

5

20 June South East Staffordshire and Seisdon Peninsula CCG

Tamworth Tamworth Community Fire Station, Marlborough Way, Tamworth B77 2JN

17

Total 80


Figure 3. Map of public event locations


Consultation meetings

In addition to the public events, a range of meetings were attended to inform key stakeholders of the

proposals and gather feedback. These included overview and scrutiny committees (OSCs), MP meetings

and district meetings. Feedback received from meetings has been included in the report. Table 7 lists the

meetings.

Table 7. Consultation meetings

Date Type of event Feedback received

23 April 2019 Stafford County OSC No minutes received

29 April 2019 Stafford Borough OSC Brief meeting, not minuted

2 May 2019 Executive meeting No minutes received

8 May 2019 Patient Council Minutes received, included in section 5.5.2

14 May 2019 Patient Board No minutes received

16 May 2019 East Staffordshire OSC Informal meeting, not minuted

16 May 2019 South Staffordshire OSC No minutes received

16 May 2019 Cannock Chase District Group Minutes received, included in section 5.5.2

17 May 2019 Community Health Voice No minutes received

20 May 2019 Tamworth Scrutiny Committee No minutes received

20 May 2019 Lichfield OSC No minutes received

20 May 2019 South East Staffordshire District Patient Group No minutes received

21 May 2019 Seisdon District Patient Group Minutes received, included in section 5.5.2

22 May 2019 Stafford and Surrounds District Group No minutes received

23 May 2019 Cannock Chase OSC Brief meeting, not minuted

24 May 2019 MP meeting in North No minutes received

28 May 2019 MP meeting with Gareth Snell No minutes received

6 June 2019 Leek Moorlands Overview and Scrutiny

Committee No minutes received

6 June 2019 Staffordshire Health and Wellbeing Board Consultation materials shared for

information

13 June 2019 Stoke OSC No minutes received

18 June 2019 Patient Congress No minutes received

19 June 2019 Staff away day No minutes received

19 June 2019 Newcastle Health, Wellbeing and Partnerships

Scrutiny Committee

Draft minutes published online, included in

section 5.5.2

20 June 2019 Adult and Neighbourhoods OSC Response received as correspondence

25 June 2019 Staffordshire Moorlands District Council: Health

Overview and Scrutiny Panel Meeting

Response / summary of meeting received

as correspondence and minutes received

15 July 2019 Healthy Staffordshire Select Committee Response / summary of meeting received

as correspondence

31 July 2019 Tamworth OSC Brief meeting, not minuted

5 September 2019 Staffordshire Health and Wellbeing Board Briefing was shared virtually with members

during the consultation


Correspondence

In addition to the survey and public events, members of the public and other stakeholders independently

shared their thoughts and views using a range of correspondence methods. These included emails sent to

the consultation mailbox and written correspondence sent to the CCGs.

All correspondence has been analysed as part of the reporting process. Table 8 details the correspondence

received. See Appendix 2 for details of organisations sending correspondence.

Table 8. Correspondence received

Respondent type Email Letter Total

Member of the public 7 1 8

NHS Trust 0 3 3

Local authority / council 7 2 9

Patient representative group 0 2 2

Charity / voluntary organisation 0 1 1

MP / councillor 3 1 4

Total 17 10 27


4 Respondent profiling In this section, the respondents to the consultation are profiled. This section includes a breakdown of the

responses by type of engagement, a breakdown of survey responses by CCG area and response type, as

well as demographic information for those who indicated they were responding as a member of the public in

the survey.

Table 9 shows the numbers of respondents and participants.

Table 9. Number of respondents and participants

Engagement channel Number of respondents and participants

Consultation survey 76 respondents in total

(including paper and online)

Written correspondence 27 pieces of written correspondence received,

including letters and emails

Public events 8 public events held with 80 attendees in total*

*Only two of the 80 participants returned their demographic profiling questionnaire. A demographic profile summary of these

participants can be found in Appendix 3.

Table 10 shows the respondent types completing the survey.

Table 10. Survey respondent types

Survey respondent types Number of respondents %

As a member of the public 54 71%

On behalf of an NHS organisation 5 7%

On behalf of another public sector organisation 1 1%

On behalf of another organisation 2 3%

On behalf of a patient representative organisation 14 18%

On behalf of a voluntary organisation 7 9% Base 76

NB: Some respondents selected more than one option.

Table 11 presents the survey respondents by CCG area. Respondents were asked to provide their postcode, which was used to determine which CCG area they were from.

Table 11. Respondents by CCG area

CCG area Number of respondents %

Cannock Chase CCG 8 11%

East Staffordshire CCG 8 11%

North Staffordshire CCG 16 21%

South East Staffordshire and Seisdon Peninsula CCG 23 30%

Stafford and Surrounds CCG 9 12%

Stoke-on-Trent CCG 8 11%

Unknown 4 5% Base 76


Demographic profile

Table 12 shows a demographic profile of members of the public completing the survey.

Table 12. Profile of members of the public completing the survey

Ethnicity Sexual orientation

White: British 42 88% Heterosexual 29 64%

White: Irish 4 8% Bisexual 3 7%

Mixed: White and Asian 1 2% Prefer not to say 13 29%

Asian/Asian British: Other 1 2% Base 45

Base 48 Relationship status

Age category Married 30 63%

30 - 34 3 6% Single 4 8%

35 - 39 4 8% Divorced 2 4%

40 - 44 2 4% Lives with partner 2 4%

45 - 49 2 4% Widowed 4 8%

50 - 54 2 4% Prefer not to say 6 13%

55 - 59 2 4% Base 48

60 - 64 8 17% Pregnant currently

65 - 69 9 17% Yes 1 2%

70 - 74 9 19% No 38 84%

75 - 79 6 13% Prefer not to say 6 13%

Prefer not to say 2 4% Base 45

Base 48 Recently given birth

Religion Yes - -

No religion 15 36% No 40 89%

Christian 23 55% Prefer not to say 5 11%

Jewish 1 2% Base 45

Muslim 1 2% Health problem or disability

Any other religion 2 5% Yes, limited a lot 4 9%

Base 42 Yes, limited a little 12 27%

Sex No 29 64%

Male 20 41% Base 45

Female 25 51% Disability

Prefer not to say 4 8% Physical disability 5 26%

Base 49 Sensory disability 2 11%

Gender identity Mental health need 2 11%

Yes* 1 2% Learning disability or difficulty 1 5%

No 35 81% Other 1 5%

Prefer not to say 7 16% Prefer not to say 6 32%

Base 43 Base 19

Armed services Carer

Yes 2 4% Yes - young person(s) aged under 24 2 4%

No 39 87% Yes - adult(s) aged 25 to 49 1 2%

Prefer not to say 4 9% Yes - person(s) aged over 50 years 6 13%

Base 45 No 35 76%

Prefer not to say 3 7%

Base 45

*Have you gone through any part of a process or do you intend to (including thoughts and actions) to bring your physical sex

appearance and/or your gender role more in line with your gender identity? (This could include changing your name, your

appearance and the way you dress, taking hormones or having gender confirming surgery)


Map of consultation respondents

Figure 4 shows the locations of respondents completing the survey. Respondents were asked to provide

their postcode, which has been used to plot respondents’ locations on the map. Postcodes were provided by

72 respondents.

Figure 4. Map of respondents’ location


5 Findings This section presents the feedback on the proposals from the consultation survey, events, correspondence

and other channels. This section is structured as follows:

• Reporting and analysis notes

• Views on option 1

• Views on option 2

• Other suggested options.

Reporting and analysis notes

The consultation survey used a combination of ‘open text’ questions, for respondents to make written

comments and ‘closed’ questions where respondents ‘ticked’ their response to a number of pre-set

responses.

For the open questions, a random sample of responses from each question were read and the key themes

(codes) mentioned by respondents were identified. This was undertaken for every open question. Some

codes were replicable across more than one question, while others were specific to one or two questions.

This means that every comment was coded, because the list of themes was not predetermined, but instead

emerged from the responses received.

The section in the survey around views on the options was split into ‘views on option 1’ and ‘views on option

2’. The structure of the findings section mirrors this. However, some respondents chose to give their

feedback on option 2 in the option 1 section of the survey. Therefore, to gain a full picture of respondents’

views on each option, both sections should be read.

For survey responses, results are shown by CCG area. Respondents were asked to provide their postcode,

which was used to identify CCG area. Results are also shown by respondent type. Some respondents to the

survey selected multiple respondent types – those that selected both member of the public and on behalf of

an organisation have been treated as organisational responses.


Views on option 1

This section presents views on option 1: keep the current arrangements of six separate CCGs under a

single leadership team.

Feedback from the survey

Respondents were asked on a scale of 1 to 5 the extent to which they supported option 1, with 5 being very

supportive and 1 not at all supportive. Table 13 shows the feedback.

Overall, 29 (45%) of respondents expressed support for option 1.

Table 13. Option 1: Keep the current arrangements of six separate CCGs under a single leadership team

Level of support

Total

CCG Respondent type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East

Sta

fford

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke-o

n-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r /

oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive

org

an

isation

Supportive (4 or 5)

45% 57% 63% 33% 50% 13% 63% 33% 40% 43% 56%

Neutral (3)

23% 14% 38% 33% 13% 25% 25% - 24% 14% 25%

Not supportive (1 or 2)

32% 29% - 33% 38% 63% 13% 67% 36% 43% 19%

Base 65 7 8 15 16 8 8 3 42 7 16

When comparing feedback by CCG area, support was highest among respondents from East Staffordshire

(5 / 63%) and Stoke-on-Trent (5 / 63%) and lowest in Stafford and Surrounds (1 / 13%).

When comparing feedback by respondent type, support was highest among voluntary / patient

representative organisations (9 / 56%) and lowest among members of the public (17 / 40%).


Table 14 shows the feedback when respondents were asked what they agreed with around option 1.

The key themes raised were:

• Option 1 ensures a better understanding of local issues more tailored to local needs (21)

• Option 1 ensures local representation and involvement (12)

• Local representation is important (9).

Table 14. Option 1: What do you agree with?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East

Sta

fford

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke

-on-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation

Option 1 ensures a better understanding of local issues more tailored to local needs

21 2 3 5 6 1 4 - 13 1 7

Option 1 ensures local representation and involvement

12 3 3 1 2 - 3 - 6 1 5

Local representation is important 9 - 2 3 2 2 - - 5 1 3

Six CCGs is an inefficient use of resources / one CCG is more efficient

8 1 - 2 1 3 - 1 4 2 2

A single leadership team is needed 8 1 1 - 5 1 - - 6 - 2

General comment in agreement with option 1 7 1 - 1 1 - 3 1 4 1 2

The current system works effectively 6 1 2 - 1 1 1 - 3 2 1

Option 2 would improve consistency across the area / six CCGs results in inconsistencies

4 - - 1 - 3 - - 2 1 1

General comment in agreement with option 2 3 1 - 1 1 - - - 2 - 1

General comment in disagreement with option 1 2 - - - 2 - - - 2 - -

General comment in disagreement with option 2 2 1 - - - 1 - - 1 - 1

Re-organisation is costly / unnecessary 1 - - - - 1 - - 1 - -

A separate CCG for Stoke-on-Trent and/or Stoke-on-Trent and Northern Staffordshire

1 1 - - - - - - - - 1

Other 1 - - - - - - 1 - 1 - Base 66 8 8 12 18 9 8 3 42 7 17

Key themes by CCG area:

• Cannock Chase: Option 1 ensures local representation and involvement (3)

• East Staffordshire: Option 1 ensures a better understanding of local issues more tailored to local

needs (3), Option 1 ensures local representation and involvement (3)

• North Staffordshire: Option 1 ensures a better understanding of local issues more tailored to local

needs (5)

• South East Staffordshire and Seisdon Peninsula: Option 1 ensures a better understanding of

local issues more tailored to local needs (6)

• Stafford and Surrounds: Six CCGs is an inefficient use of resources / one CCG is more efficient

(3), Option 2 would improve consistency across the area / six CCGs results in inconsistencies (3)

• Stoke-on-Trent: Option 1 ensures a better understanding of local issues more tailored to local

needs (4).


Key themes by respondent type:

• Member of the public: Option 1 ensures a better understanding of local issues more tailored to

local needs (13)

• NHS / public sector / other organisation: Six CCGs is an inefficient use of resources / one CCG is

more efficient (2), The current system works effectively (2)

• Voluntary / patient representative organisation: Option 1 ensures a better understanding of local

issues more tailored to local needs (7).

Table 15 shows the feedback when respondents were asked if they had any concerns or felt that there were

any groups or individuals they thought may be negatively impacted by this option.


• Consider the demographic / geographic differences across the areas (14)

• Consider the need for equity across different areas (7).


Table 15. Option 1: Do you have any concerns or are there any groups or individuals you think may be negatively impacted by this option?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East

Sta

fford

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke-o

n-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation

Consider the demographic / geographic differences across the areas

14 1 2 3 4 1 2 1 9 2 3

Consider the need for equity across different areas 7 1 1 1 2 1 1 - 4 1 2

Option 2 would focus resources in Stoke-on-Trent / urban areas

4 2 - 1 1 - - - 1 - 3

Option 2 may result in a loss of understanding of local issues / option 1 has a more local focus

4 - 1 1 1 - 1 - 1 1 2

Consider the need to maintain service provision locally

4 - - - 2 1 1 - 4 - -

Consider the need for adequate funding 3 - - - 2 - - 1 2 1 -

Re-organising structures negatively impacts on patients

3 1 - 1 - 1 - - 2 - 1

Consider potential job cuts if option 2 is implemented 3 - - 1 - 2 - - 3 - -

Consider transport issues, parking and non-drivers 3 - - 2 1 - - - 2 - 1


3 - 1 - 1 1 - - 1 - 2

Consider the need for local identity 2 - - - 1 - 1 - - - 2

Consider the need for local involvement (e.g. Patient congress, voluntary groups)

2 - - 2 - - - - - 1 1

Option 2 may reduce involvement of vulnerable and seldom heard groups

2 - 1 - - - 1 - 1 - 1

Consider the need for improved access to services (e.g. appointments)

2 - - - 2 - - - 2 - -

Smaller service providers may be disadvantaged if option 2 is implemented

2 - - 1 - - 1 - 1 - 1

Need to ensure adequate staffing 2 - 1 - - 1 - - 1 1 -

Consider the needs of the elderly 2 - 1 1 - - - - 2 - -

Greater clarity is required on the proposals 1 - - - - - 1 - 1 - -

Consider whether costs can be reduced 1 - - - - - 1 - 1 - -

General comment in agreement with option 1 1 - - - - - 1 - - 1 -

Consider that top-down organisation / top-heavy management could negatively affect patients

1 - - - 1 - - - 1 - -

Stoke-on-Trent may be negatively affected (e.g. loss of funding)

1 - - - - - 1 - - - 1

Consider that option 2 could result in silo working 1 - - - 1 - - - 1 - -

Consider the boundaries of partner organisations 1 - - - - 1 - - - 1 -

No / no concerns / nothing 10 2 1 2 4 1 - - 8 - 2

Other 2 - - - 1 1 - - 2 - - Base 58 5 8 10 17 9 7 2 37 7 14


• Cannock Chase: Option 2 would focus resources in Stoke-on-Trent / urban areas (2)

• East Staffordshire: Consider the demographic / geographic differences across the areas (2)

• North Staffordshire: Consider the demographic / geographic differences across the areas (3)


• South East Staffordshire and Seisdon Peninsula: Consider the demographic / geographic

differences across the areas (4)

• Stafford and Surrounds: Consider potential job cuts if option 2 is implemented (2)

• Stoke-on-Trent: Consider the demographic / geographic differences across the areas (2).


• Member of the public: Consider the demographic / geographic differences across the areas (9)

• NHS / public sector / other organisation: Consider the demographic / geographic differences

across the areas (2)

• Voluntary / patient representative organisation: Consider the demographic / geographic

differences across the areas (3), Option 2 would focus resources in Stoke-on-Trent / urban areas (3).


Table 16 shows the feedback when respondents were asked how these negative impacts could be

overcome.


• Keep option 1 / stay as it is (7)

• Option 2 should be implemented (5).

Table 16. Option 1: How could these negative impacts be overcome?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East

Sta

fford

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke

-on-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation

Keep option 1 / stay as it is 7 2 2 - 1 1 1 - 4 - 3

Option 2 should be implemented 5 - - 1 2 2 - - 2 1 2


4 - - 1 1 - 1 1 1 1 2

Involve patients and communities in decision making 4 - 1 3 - - - - 1 2 1

Ensure adequate local service provision and quality of care

4 - - 2 2 - - - 3 - 1

More funding is required 4 1 1 - 1 1 - - 3 - 1

Ensure suitable staff are employed 3 - 1 - - 2 - - 2 1 -

CCGs should work together without becoming one CCG

2 - - - 2 - - - 2 - -

Ensure that smaller areas retain a voice 2 - - 1 1 - - - - 1 1

Ensure standards are equitable across the CCGs 2 - - - - - 2 - - 1 1


2 - - - 2 - - - 2 - -

Ensure governance is effective 2 - - - - - 2 - - 1 1


2 1 - - - - - 1 1 - 1

CCG membership should be voluntary 1 - - - - - 1 - 1 - -

Greater partnership working across sectors is required

1 - - - - 1 - - - 1 -

Consider reducing CCGs without combining as one 1 - 1 - - - - - 1 - -

Improve Primary Care Networks 1 - - - - 1 - - 1 - -

Ensure fair / equal distribution of funding if option 2 is implemented

1 - - 1 - - - - - 1 -

Ensure decisions are made locally 1 - - - 1 - - - 1 - - Base 48 5 6 8 11 9 7 2 29 7 12


• Cannock Chase: Keep option 1 / stay as it is (2)

• East Staffordshire: Keep option 1 / stay as it is (2)

• North Staffordshire: Involve patients and communities in decision making (3)

• South East Staffordshire and Seisdon Peninsula: Option 2 should be implemented (2), ensure

adequate local service provision and quality of care (2), CCGs should work together without

becoming one CCG (2), consider the need for improved access to services (e.g. appointments) (2)

• Stafford and Surrounds: Option 2 should be implemented (2), ensure suitable staff are employed

(2)


• Stoke-on-Trent: Ensure standards are equitable across the CCGs (2), ensure governance is

effective (2).


• Member of the public: Keep option 1 / stay as it is (4)

• NHS / public sector / other organisation: Involve patients and communities in decision making (2)

• Voluntary / patient representative organisation: Keep option 1 / stay as it is (3).


Feedback from correspondence

Table 17 shows the feedback from correspondence with positive themes around option 1 or negative

themes around option 2. Positive themes around option 2 from correspondence can be found in section

5.3.2.

Table 17. Feedback from correspondence with positive themes around option 1 / negative themes around option 2

Total Public Org.


11 1 10

Stoke-on-Trent may be negatively affected by option 2 (e.g. loss of funding) 6 1 5

General comment in disagreement with option 2 4 1 3

Option 1 ensures local representation and involvement / option 2 will reduce involvement

3 0 3

Proposed savings will not be realised 2 1 1

Re-organisation is costly / unnecessary 2 1 1

Keep option 1 / stay as it is 3 1 2

Re-organising structures negatively impacts on patients 3 0 3

General comment in agreement with option 1 2 0 2

Proposal will adversely affect system management 1 1 0

Staffordshire is a large area for one CCG 1 0 1

Cannock may be negatively affected 1 0 1

Option 2 may reduce involvement of vulnerable and seldom heard groups 1 0 1

Smaller service providers may be disadvantaged if option 2 is implemented 1 0 1 Base (correspondence numbers) 27 8 19

5.2.2.1 Organisational responses

This section presents the feedback from correspondence submitted by organisations or MPs with positive

themes around option 1 or negative themes around option 2. Positive themes around option 2 from

organisational correspondence can be found in section 5.3.2.1.

Stoke-on-Trent City Council (the Deputy Leader of the Council and Lead Member for Health and Social

Care) commented in disagreement with option 2. They reasoned that as Stoke-on-Trent is the 14th most

deprived local authority in the country with significant health inequalities, it is therefore different

demographically and geographically from Staffordshire. They expressed concern that Stoke-on-Trent would

lose local focus and decision-making capability, funding would move from North to South and that there

would be a shift in emphasis away from the population’s need to resolve financial pressures.

Stoke-on-Trent City Council Adults and Neighbourhoods Overview and Scrutiny Committee

responded in support of option 1 (retaining six CCGs) and against option 2 (creating a single CCG). They

expressed concern that a single CCG would result in a postcode lottery with variations in service provision.

They commented that the proposal could reduce facilities in Stoke-on-Trent and lead to residents having to

travel further. They argued that the proposal would result in a ‘one-size-fits-all’ commissioning model with

services not being commissioned according to need.

Paul Farrelly MP commented in opposition to option 2. They suggested that health services are more

responsive to local needs when they are organised locally. Concerned that the CCG will be rooted in

Stafford, they argued that the county is a very diverse area with no natural connection between localities.

Gareth Snell MP also commented in opposition to option 2. They highlighted concerns over the

management and accountability of a single CCG; inadequate CCG ratings and impacts on budgets and cuts

to services. They also commented that smaller service providers may be disadvantaged with worsening

relationships with the community and voluntary sector, which could disadvantage those with specific needs.

Ruth Smeeth MP also raised opposition to option 2. They commented that due to the current ratings of five

of the six CCGs, they felt that the CCGs were not stable enough to become a single CCG without adversely

affecting service provision. They commented that North Staffordshire and Stoke-on-Trent CCGs currently

have a higher funding allocation, which would not be protected in a single CCG. They also highlighted

concerns over governance and that local needs would not be represented as well in a single CCG.


Feedback was received from Reach (part of Asist), following a meeting held with members of the public with

learning difficulties. They highlighted concerns that one CCG would be too big to support the health needs

of the whole of Staffordshire, as the area is too big and would need to ensure that finance and information

was adequate for each locality.

Staffordshire Moorlands District Council commented that Staffordshire Moorlands has a large rural

population with different needs. They expressed concern that localism would be lost if the CCGs were to

merge into one organisation.

Cannock Chase Council commented in opposition to the proposed creation of a single commissioning

organisation. They commented that it is a cost-cutting measure, not in the best interests of patients and

carers within Cannock Chase. They expressed concern that the merger would see resources diverted away

from Cannock Chase, a loss of influence over local clinical commissioning decisions and worsening of

existing poor engagement with the council.

Hednesford Town Council commented that that governance structures of CCGs should remain

autonomous and local to their represented communities. The CCG needs to remain at local level in order to

be in touch with local needs.

A Newcastle-under-Lyme Borough Councillor commented in supported of retaining the current six CCGs.


Views on option 2

This section presents the views on option 2: develop a new, single CCG.


Respondents were asked on a scale of 1 to 5 the extent to which they supported option 2, with 5 being very

supportive and 1 not at all supportive. Table 18 shows the feedback.

Overall, 30 (42%) of respondents expressed support for option 2.

Table 18. Option 2: Develop a new, single CCG

Level of support

Total

CCG Respondent type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East

Sta

fford

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke-o

n-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r /

oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive

org

an

isation

Supportive (4 or 5)

42% 38% 13% 38% 50% 78% 38% - 43% 43% 40%

Neutral (3)

14% - 25% 23% 18% 11% - - 18% 14% -

Not supportive (1 or 2)

44% 63% 63% 38% 32% 11% 63% 100% 39% 43% 60%

Base 71 8 8 13 22 9 8 3 49 7 15

When comparing feedback by CCG area, support was highest among respondents from Stafford and

Surrounds (7 / 78%) and lowest in East Staffordshire (1 / 13%).

When comparing feedback by respondent type, support was at similar levels across all respondent types.


Table 19 shows the feedback when respondents were asked what they agreed with around option 2.


• Six CCGs is an inefficient use of resources / one CCG is more efficient (27)

• General comment in disagreement with option 2 (13).

Table 19. Option 2: What do you agree with?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East S

taff

ord

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke-o

n-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation


27 3 3 3 9 5 4 - 21 3 3

General comment in disagreement with option 2 13 2 2 2 3 - 3 1 7 2 4

Option 2 would improve consistency across the area / six CCGs results in inconsistencies

7 - 1 2 2 2 - - 6 - 1

Option 2 would result in economies of scale 6 - 1 2 1 2 - - 4 - 2

Local representation is important 6 - 3 1 1 1 - - 4 - 2

General comment in agreement with option 2 6 - - 2 2 - 2 - 3 1 2

Option 2 supports the management of system-wide issues

5 - - 1 3 - 1 - 3 1 1

Option 1 ensures a better understanding of local issues more tailored to local needs

3 1 - 2 - - - - 1 - 2

A single leadership team is needed 3 - - 1 2 - - - 2 1 -

Option 2 supports the delivery of the NHS Long Term Plan

2 - 1 - - - 1 - - 1 1

General comment in agreement with option 1 1 - - - - - 1 - - - 1

Other 7 1 - 2 2 1 - 1 1 1 5 Base 65 6 8 14 19 8 8 2 43 7 15


• Cannock Chase: Six CCGs is an inefficient use of resources / one CCG is more efficient (3)

• East Staffordshire: Six CCGs is an inefficient use of resources / one CCG is more efficient (3),

Local representation is important (3)

• North Staffordshire: Six CCGs is an inefficient use of resources / one CCG is more efficient (3)

• South East Staffordshire and Seisdon Peninsula: Six CCGs is an inefficient use of resources /

one CCG is more efficient (9)

• Stafford and Surrounds: Six CCGs is an inefficient use of resources / one CCG is more efficient (5)

• Stoke-on-Trent: Six CCGs is an inefficient use of resources / one CCG is more efficient (4).


• Member of the public: Six CCGs is an inefficient use of resources / one CCG is more efficient (21)

• NHS / public sector / other organisation: Six CCGs is an inefficient use of resources / one CCG is

more efficient (3)

• Voluntary / patient representative organisation: General comment in disagreement with option 2

(4).


Table 20 shows the feedback when respondents were asked if they had any concerns or felt that there were

any groups or individuals they thought may be negatively impacted by this option.


• Consider the demographic / geographic differences across the areas (12)

• Option 2 would focus resources in Stoke-on-Trent / urban areas (10)

• Consider the need for local involvement (e.g. Patient congress, voluntary groups) (9).

Table 20. Option 2. Do you have any concerns or are there any groups or individuals you think may be negatively impacted by this option?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East S

taff

ord

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke-o

n-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation


12 1 2 3 3 1 2 - 6 1 5

Option 2 would focus resources in Stoke-on-Trent / urban areas

10 2 1 2 5 - - - 6 1 3

Consider the need for local involvement (e.g. Patient congress, voluntary groups)

9 1 1 2 3 - 2 - 7 1 1


8 1 - 2 2 2 1 - 7 - 1

Consider the need for equity across different areas 4 1 - 1 2 - - - 3 - 1

Stoke-on-Trent may be negatively affected (e.g. loss of funding)

4 - - 1 - 1 1 1 2 1 1

Option 2 may reduce involvement of vulnerable and seldom heard groups

4 - - - 1 - 3 - 2 - 2

Consider the need to maintain service provision locally

4 - 1 - 2 1 - - 2 1 1

No / no concerns / nothing 4 - 1 - 2 1 - - 4 - -

Consider the need for adequate funding 3 - 2 - - - - 1 1 1 1


3 - - 1 2 - - - 3 - -

Consider potential job cuts if option 2 is implemented 3 - - 1 1 1 - - 3 - -

Re-organising structures negatively impacts on patients

2 - 2 - - - - - 1 1 -

Consider the boundaries of partner organisations 2 - - - - 1 1 - - - 2

Smaller service providers may be disadvantaged if option 2 is implemented

2 - - - - - 2 - - - 2

Need to ensure adequate staffing 2 - - - 2 - - - 2 - -

Consider reducing CCGs without combining as one 2 1 - - - 1 - - 1 - 1

Consider whether costs can be reduced 1 - - 1 - - - - - 1 -

A standardised IT system is required (e.g. appointment booking, medical records)

1 - - - 1 - - - 1 - -

Consider transport issues, parking and non-drivers 1 - - - 1 - - - 1 - -

Consider the needs of the elderly 1 - - - 1 - - - 1 - -

Other 9 - - 4 1 1 1 2 5 1 3 Base 67 5 7 15 20 8 8 4 44 7 16



• Cannock Chase: Option 2 would focus resources in Stoke-on-Trent / urban areas (2)

• East Staffordshire: Consider the demographic / geographic differences across the areas (2),

Consider the need for adequate funding (2), re-organising structures negatively impacts on patients

(2)

• North Staffordshire: Consider the demographic / geographic differences across the areas (3)

• South East Staffordshire and Seisdon Peninsula: Option 2 would focus resources in Stoke-on-

Trent / urban areas (5)

• Stafford and Surrounds: Option 2 may result in a loss of understanding of local issues / option 1

has a more local focus (2)

• Stoke-on-Trent: Option 2 may reduce involvement of vulnerable and seldom heard groups (3).


• Member of the public: Consider the need for local involvement (e.g. Patient congress, voluntary

groups) (7), option 2 may result in a loss of understanding of local issues / option 1 has a more local

focus (7)

• NHS / public sector / other organisation: Limited comments raised

• Voluntary / patient representative organisation: Consider the demographic / geographic

differences across the areas (5).


Table 21 shows the feedback when respondents were asked how these negative impacts could be

overcome.


• Involve patients and communities in decision making (20)

• Keep option 1 / stay as it is (10)

• Consider the demographic / geographic differences across the areas (8).

Table 21. How could these negative impacts be overcome?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East S

taff

ord

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke

-on-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation

Involve patients and communities in decision making 20 - 4 4 8 2 2 - 12 3 5

Keep option 1 / stay as it is 10 2 - 2 2 - 3 1 6 - 4


8 - - 1 3 - 4 - 4 1 3

Ensure governance is effective 5 2 1 - - 1 1 - 2 2 1

Ensure suitable staff are employed 4 - - 1 2 1 - - 4 - -

Ensure adequate local service provision and quality of care

4 - - 1 2 1 - - 2 1 1

Ensure decisions are made locally 4 - - 1 1 1 1 - 1 2 1


2 1 - 1 - - - - 1 - 1

Greater partnership working across sectors is required

2 - 1 - - 1 - - - 1 1

Ensure standards are equitable across the CCGs 2 - - - - 1 1 - 1 1 -


2 - - 2 - - - - 1 - 1

More funding is required 2 1 - - - 1 - - 1 - 1

Ensure fair / equal distribution of funding if option 2 is implemented

2 - 1 - 1 - - - 2 - -

Improve Primary Care Networks 1 - - 1 - - - - - - 1

Involve GPs in decision making 1 - - 1 - - - - 1 - -

Other 16 1 2 3 5 3 - 2 12 2 2 Base 63 5 7 13 19 8 8 3 42 7 14


• Cannock Chase: Keep option 1 / stay as it is (2), ensure governance is effective (2)

• East Staffordshire: Involve patients and communities in decision making (4)

• North Staffordshire: Involve patients and communities in decision making (4)

• South East Staffordshire and Seisdon Peninsula: Involve patients and communities in decision

making (8)

• Stafford and Surrounds: Involve patients and communities in decision making (2)

• Stoke-on-Trent: Consider the demographic / geographic differences across the areas (4).



• Member of the public: Involve patients and communities in decision making (12)

• NHS / public sector / other organisation: Involve patients and communities in decision making (3)

• Voluntary / patient representative organisation: Involve patients and communities in decision

making (5).


A survey respondent indicating they were responding on behalf of Midlands and Lancashire

Commissioning Support Unit commented that they supported option 2, as it would benefit the health

system in Staffordshire in delivering the NHS Long Term Plan and would provide an opportunity to deliver

quality at-scale commissioning solutions. They also commented that the model supports better integration

across commissioners, providers and primary care, and would reduce duplication with a much more

streamlined, less bureaucratic delegations and decision-making processes.



Table 22 shows the feedback from correspondence with positive themes around option 2 or negative

themes around option 1. Positive themes around option 1 from correspondence can be found in section

5.2.2.

Table 22. Feedback from correspondence with positive themes around option 2 / negative themes around option 1

Total Public Org. Option 2 supports the management of system-wide issues 4 1 3

Six CCGs is an inefficient use of resources / one CCG is more efficient 4 1 3

General comment in agreement with option 2 3 0 3

Option 2 would result in economies of scale 2 0 2

Option 2 would improve consistency across the area / six CCGs results in inconsistencies 2 0 2

Local devolution is positive 1 0 1

Option 2 supports integrated care and collaborative working 1 0 1 Base (correspondence numbers) 27 8 19


This section presents the feedback from correspondence from organisations with positive themes around

option 2 or negative themes around option 1. Positive themes around option 1 from organisational

correspondence can be found in section 5.2.2.1.

North Staffordshire Combined Healthcare NHS Trust commented that the proposal would result in

economies of scale through combining back office functions. They suggested that there is the potential to

improve the capacity and capability to effectively manage system-wide issues, such as emergency planning.

Tamworth Council commented that the council has not seen as much engagement with the CCG as other

partners. They added that they anticipated increased involvement with the new locality manager and teams.

University Hospitals of North Midlands NHS Trust commented in support of the proposal to develop a

single CCG as this would reduce duplication, promote a joined-up approach and give a single focus to

creating sustainable services for the whole population.

Staffordshire County Council commented that they were very supportive to the proposal to combine

CCGs. They commented that they are interested in how the role of the CCG will develop within an

integrated care system (ICS), and make a ‘three-part’ offer to the local NHS – strengthening local

involvement in the NHS, provision of strategic commissioning of care homes, home care and other services

on behalf of the CCGs and provision of some commissioning support functions on behalf of the ICS or

individual NHS organisations.

Healthwatch Staffordshire expressed broad support for the proposals to introduce more consistent

services for patients across the county. They commented that there may be economies of scale and savings

which could be reinvested into services.

Midlands Partnership NHS Foundation Trust expressed support for option 2, commenting that a single

CCG would support collaborative working and ICP development; simplify governance arrangements; reduce

duplication and support equitable care across Staffordshire and Stoke-on-Trent. They also comment that the

option provides opportunities for efficiencies across buildings, processes and IT and will provide a more

focused approach to local patients and service users.


Alternative options

This section presents feedback on alternative options.


Table 23 shows the feedback when respondents were asked if they had any other suggested options that

should be considered.


• Stoke-on-Trent should be its own CCG (6)

• Involve patients and communities in decision making (6)

• Improve partnership working across CCGs (5).

Table 23. Do you have any other suggested options that we should consider?

Total

CCG Respondent

type

Cann

ock C

hase

East

Sta

fford

shire

Nort

h S

taff

ord

shire

South

East

Sta

fford

shire

an

d

Seis

don P

enin

su

la

Sta

fford

and S

urr

ou

nds

Sto

ke-o

n-T

rent

Unknow

n

Mem

ber

of

the p

ublic

NH

S / p

ub

lic s

ecto

r / oth

er

org

an

isation

Volu

nta

ry / p

atie

nt

repre

senta

tive o

rgan

isation

Stoke-on-Trent should be its own CCG 6 2 - 1 - - 2 1 3 - 3

Involve patients and communities in decision making 6 1 - 1 2 1 1 - 4 - 2

Improve partnership working across CCGs 5 1 1 - 2 1 - - 1 2 2

Form a Northern Staffordshire CCG and a Southern Staffordshire CCG

4 - - 3 - 1 - - 2 1 1

Change is not necessary 3 1 - - 1 1 - - 2 - 1

Form three CCGs in the area 2 - - 1 - - 1 - 1 1 -

GPs and practice staff should be directly employed by the NHS

1 - - - - - 1 - 1 - -

South East Staffordshire and Seisdon Peninsula CCG should be part of Wolverhampton or Dudley CCG

1 - - - 1 - - - 1 - -

Improve partnership working with other CCGs (e.g. Derbyshire CCGs)

1 - 1 - - - - - - - 1

Reduce office locations 1 - - - 1 - - - 1 - -

Consider greater patient education 1 - - - 1 - - - 1 - -

No / nothing 12 - 2 2 3 3 1 1 8 2 2

Other 13 - 1 - 8 2 1 1 11 - 2 Base 53 4 5 8 17 9 7 3 34 6 13


• Cannock Chase: Stoke-on-Trent should be its own CCG (2)

• East Staffordshire: Limited comments raised

• North Staffordshire: Form a Northern Staffordshire CCG and a Southern Staffordshire CCG (3)

• South East Staffordshire and Seisdon Peninsula: Involve patients and communities in decision

making (2), improve partnership working across CCGs (2)

• Stafford and Surrounds: Limited comments raised

• Stoke-on-Trent: Stoke-on-Trent should be its own CCG (2).



• Member of the public: Involve patients and communities in decision making (4)

• NHS / public sector / other organisation: Improve partnership working across CCGs (2)

• Voluntary / patient representative organisation: Stoke-on-Trent should be its own CCG (3).



Table 24 shows the alternative options outlined in the correspondence received

Table 24. Feedback from correspondence with alternative options Total Public Org.

Stoke-on-Trent should be its own CCG 3 0 3

Consider a Northern Staffordshire CCG (e.g. combining Stoke-on-Trent and North Staffordshire CCGs)

2 0 2

Form three CCGs in the area 1 0 1

CCGs should work together without becoming one CCG 1 0 1 Base (correspondence numbers) 27 8 19


Healthwatch Stoke-on-Trent requested detail on why a Northern Staffordshire CCG is not an option.

Stoke-on-Trent City Council (the Deputy Leader of the City Council and Lead Member for Health and

Social Care) made two alternative suggestions:

• Stoke-on-Trent should remain its own CCG

• There should be an amalgamated CCG across Stoke-on-Trent and North Staffordshire on the same

geographic boundaries as the Northern Alliance.

Stoke-on-Trent City Council Adults and Neighbourhoods Overview and Scrutiny Committee also

made two alternative suggestions:

• One CCG for Stoke-on-Trent and another CCG for the remainder of Staffordshire

• Three CCGs based on the three divisional committees for the North, South East and South West as

outlined within the proposed governance structure in the consultation document.


Considerations raised


Table 25 presents the themes for consideration raised in correspondence, as well as comments on the

consultation process.

Table 25. Themes for consideration and comments on consultation process raised in correspondence

Total Public Org.

For consideration

Consider the demographic / geographic differences across the areas 8 1 7

Consider deprivation in Stoke-on-Trent 7 1 6

Consider the need to maintain service provision locally 5 0 5

Consider the impact on wider stakeholders (e.g. Together We're Better) 5 2 3

Patient care is more important than NHS structures 4 2 2

Involve patients and communities in decision making 4 1 3

Consider the need for equity across different areas 3 1 2

Consider implications on funding 2 0 2

Consider the need for improved access to services (e.g. appointments) 2 0 2

Consider potential job cuts if option 2 is implemented 2 0 2

Consider the financial position of CCGs 2 1 1

Consider local service provision 2 1 1

Consider the need for adequate funding 1 1 0

Ensure fair / equal distribution of funding if option 2 is implemented 1 0 1

Consider how the impact of changes will be measured 1 0 1

Involve GPs in decision making 1 0 1

Ensure decisions are made locally 1 0 1

Consider the role of a single CCG in an integrated care system 1 0 1

Consider impacts on access to services 1 0 1

Consider quality of care by commissioned providers 1 1 0

Consider the need for cultural change 1 0 1

Comments on

consultation process

Consider the need for engagement across the consultation area 4 3 1

Consider the need for greater public awareness of the proposals 3 0 3

Greater clarity is required on the proposals 3 1 2

Consultation should not be necessary for these proposals (e.g. waste of money / no public interest)

1 1 0

Base (correspondence numbers) 27 8 19

5.5.1.1 Organisational responses Healthy Staffordshire Select Committee expressed concern that the proposed move was financially led,

and that commissioning policies had not been mentioned. They commented that the North and South of the

county have differing population needs. They expressed concern that commissioning policies would be

changed to the detriment of the public. They felt that cultural change was needed more than changing the

structures.

Jeremy Lefroy MP queried how funding would be managed, given that CCGs currently receive different

levels of funding.


Other comments

Feedback from public events

This section summarises the feedback from the public events. See Appendix 3 for coded queries and

feedback from public events.

Cannock Chase CCG

At the Cannock public event, considerations were raised over the need for improved access to services (e.g.

appointments) and transport issues, parking and non-drivers. Queries were also raised regarding the

consultation process and the impacts on service provision.

East Staffordshire CCG

At the Burton public event, queries were raised around decision making processes – impacts on boards and

committees, as well as budgets and funding allocation.

North Staffordshire CCG

At the Leek public event, comments included the need to involve patients and communities in decision

making – greater partnership working across sectors is required, local representation is important and option

1 ensures a better understanding of local issues as it is more tailored to local needs. Queries were raised

regarding the consultation process rationale for the single CCG.

South East Staffordshire and Seisdon Peninsula CCG

At the Lichfield public event, comments in support of option 2 were raised, including: six CCGs is an

inefficient use of resources / one CCG is more efficient, and option 2 supports the delivery of the NHS Long

Term Plan. Considerations were also raised, including: the importance of local representation, requirements

for a standardised IT system (e.g. appointment booking, medical records) and the need to consider the

demographic / geographic differences across the areas.

At the Tamworth public event, comments included that option 2 would support the management of system-

wide issues. Queries were also raised, including: the impact on boards and committees, and access to

records.

At the Codsall public event, comments included the need to maintain service provision locally. Queries were

also raised around guidelines / NHS England procedures.

Stafford and Surrounds CCG

At the Stafford public event, comments included greater clarity being required on the proposals – local

representation being important and the need for improved access to services. Queries were raised around

GP numbers and the impacts of option 2.

Stoke-on-Trent CCG

At the Stoke-on-Trent public event, considerations were raised over the impact on committees and boards

and the need for adequate funding. Other comments included the need for adequate staffing and to involve

patients and communities in decision making. Queries were raised around re-organisation, including the

cost of reorganisation, boundaries / structures of reorganisation and decision-making processes.

Feedback from other consultation meetings

This section presents feedback from other consultation meetings that were minuted.

Cannock Patient District Group

It was queried what would happen if three CCGs agreed to move towards one single strategic organisation

and three did not.

Seisdon Patient District Group


Members commented that the title of the new CCG should not include Stoke-on-Trent and wanted

assurance that local considerations would be considered. It was queried whether GPs were in favour of the

merger.

Patient Council Meeting

It was acknowledged that Stoke-on-Trent is a deprived area, but there are also deprived areas in

Staffordshire Moorlands and Cannock Chase that need funding. It was queried whether the single CCG

would change the health postcode lottery; for example, in hearing aid provision. It was also queried whether

some of this alignment work could take place now as there is a single leadership team in place and whether

there would be the same funding per patient across the CCG area. It was commented that members need to

be involved and give feedback and that some services would be better commissioned across a single

footprint, such as child and adolescent mental health commissioned beds.

Staffordshire Moorlands District Council: Health Overview and Scrutiny Panel Meeting

It was commented that the CCGs should recognise the difference in needs of patients and the providers of

care for the North and South of the county, and that Staffordshire Moorlands has different needs to other

areas due to its rural population. Members highlighted concern that as the CCGs had different policies, and

that services provided to patients would be levelled down to the lowest common denominator. Members

were not convinced that a single strategic commissioning organisation would improve the level of service

and patient care provided.

According to this group, the main services the public wish to see improvements to are GP appointments, out

of hours service and an increased number of nursing staff.

It was commented that structural changes had been seen since the 1980s and it seemed that there was a

constant churn of change for little practical result. Members felt that the main driver for change was to

reduce costs and that there was no clear evidence to support changes to social policies. Some members

thought that GPs should be able to influence decision making without a merger of the CCGs. It was also

commented that localism would be lost if the CCGs were to merge into one organisation.

Some members agreed with reduced management within the proposed new structure but had concerns on

how this would fit in with other organisational structures and the voluntary sector.

It was commented that feedback should be gathered more regularly and from a wider group of people. It

was also suggested that there should be a method to measure the impact of the proposed changes.

Newcastle-under-Lyme Health, Wellbeing and Partnerships Scrutiny Committee

Members of the committee engaged in discussions with CCG representatives in attendance. Members felt

uncertain that the requirement for services in respect to elderly people was adequately met. Specific

questions from members included the safeguarding of services and managed care pathways and the

consolidation of maternity services. Concern were raised around the loss of jobs on combining sites and

availability of appointments to patients locally.

Members asked for assurance on the co-existence of urban and rural models and whether the savings

made would be used to purchase extra integrated care packages. Members also asked about the

organisational / geographical barriers to change and the alternative views.


6 Conclusions In the survey, a slightly greater proportion of respondents expressed support to keep the current

arrangements, with 29 (45%) of respondents supporting option 1, compared to 30 (42%) of respondents

who supported option 2, to create a single CCG.

A greater proportion of respondents were unsupportive of option 2, with 31 (44%) respondents indicating

they were not supportive, compared to 21 (32%) of respondents for option 1.

Table 26. Summary of support for the options

Supportive

(4 or 5) Neutral

(3) Not supportive

(1 or 2) Base


45% 23% 32% 65


42% 14% 44% 71

Comments on the options


In support of option 1, it was commented that retaining six CCGs would ensure a better understanding of

local issues more tailored to local needs and local representation and involvement.

The need to consider the demographic and geographic differences in the area was a key theme throughout

the survey and correspondence (e.g. deprivation in Stoke-on-Trent, rural versus urban).

There was concern that resources would be focused on Stoke-on-Trent / urban areas if option 2 was

implemented. However, there was also concern in the survey and in correspondence that Stoke-on-Trent

would be negatively affected if option 2 was implemented – for example, with a loss of funding.

Organisations commenting in opposition to the proposal to create a single CCG or expressing concerns

included Stoke-on-Trent City Council, Cannock Chase Council, Healthy Staffordshire Select Committee and

Staffordshire Moorlands District Council.

Stoke-on-Trent City Council expressed disagreement with option 2. The Deputy Leader of the Council and

Lead Member for Health and Social Care commented that Stoke-on-Trent is demographically and

geographically different from Staffordshire, and that a single CCG would lose local focus and decision-

making capability. They expressed concern that funding would move from North to South and there would

be a shift in emphasis away from the population’s need to resolve financial pressures. Stoke-on-Trent City

Council Adults and Neighbourhoods Overview and Scrutiny Committee expressed concern that a single

CCG would result in a postcode lottery. They commented that there would be variations in service provision

and facilities in Stoke-on-Trent. They said that the result would be a ‘one-size-fits-all’ commissioning model,

with services not being commissioned according to need.

Healthy Staffordshire Select Committee expressed concern that the proposed move was financially led and

that commissioning policies had not been mentioned. They commented the North and South of the county

have differing population needs.

Cannock Chase Council commented in opposition to the proposed creation of a single commissioning

organisation. They argued that it is a cost-cutting measure – not in the best interests of patients and carers

within Cannock Chase. They commented that a single commissioning organisation would see resources

diverted away from Cannock Chase. They expressed concern that there would be a loss of influence over

local clinical commissioning decisions and worsening of existing poor engagement with the council.

Hednesford Town Council also commented that CCGs should remain local to ensure local representation

and understanding of local needs.



In support of option 2, it was commented that six CCGs are an inefficient use of resources and that one

CCG would be more efficient. Other comments were that option 2 would improve consistency across the

area, as having six CCGs results in inconsistencies whereas option 2 would result in economies of scale.

Organisations expressing broad support for option 2 included NHS Trusts, Staffordshire County Council and

Healthwatch Staffordshire. Both North Staffordshire Combined Healthcare NHS Trust and University

Hospitals of North Midlands NHS Trust commented that the single CCG would support in the management

of system-wide issues. Midlands Partnership NHS Foundation Trust commented that a single CCG would

support collaborative working and ICP development; simplify governance arrangements; reduce duplication

and support equitable care across Staffordshire and Stoke-on-Trent. Healthwatch Staffordshire commented

that the proposal would result in savings that could be reinvested into services.

Alternative options

A key theme in both the survey and correspondence was that Stoke-on-Trent should be a standalone CCG.

This was also highlighted by Stoke-on-Trent City Council (the Deputy Leader of the City Council and Lead

Member for Health and Social Care), who also suggested an amalgamated CCG across Stoke-on-Trent and

North Staffordshire on the same geographic boundaries as the Northern Alliance. Similarly, Stoke-on-Trent

City Council Adults and Neighbourhoods Overview and Scrutiny Committee made two alternative

suggestions: A CCG for Stoke-on-Trent and another CCG for the remainder of Staffordshire or three CCGs

based on the three divisional committees for the North, South East and South West as outlined within the

proposed governance structure in the consultation document.

The need to involve patients and communities in decision-making was another key theme in the survey.

Healthwatch Stoke-on-Trent requested detail on why a Northern Staffordshire CCG is not an option.


Appendix 1: Example social media posts


Appendix 2: Organisations sending correspondence

Respondent type Organisations and MPs with representatives sending correspondence

Charity / voluntary organisations Reach (part of Asist)

Local authorities

Adults and Neighbourhoods Overview and Scrutiny Committee, Stoke-on-

Trent City Council

Cannock Chase Council

Healthy Staffordshire Select Committee, Staffordshire County Council

Hednesford Town Council

Newcastle-under-Lyme Borough Council

Staffordshire County Council

Staffordshire Moorlands District Council

Stoke-on-Trent City Council

Tamworth Council

MPs

Paul Farrelly MP

Jeremy Lefroy MP

Ruth Smeeth MP

Gareth Snell MP

NHS Trusts

Midlands Partnership NHS Foundation Trust

North Staffordshire Combined Healthcare NHS Trust

University Hospitals North Midlands NHS Trust

Patient representative groups Healthwatch Staffordshire

Healthwatch Stoke-on-Trent


Appendix 3: Queries and feedback from public events

Query Total

Event

Bu

rto

n

Ca

nn

oc

k

Le

ek

Se

isd

on

Sta

ffo

rd

Sto

ke

Ta

mw

ort

h

Query regarding consultation process 14 2 4 4 1 1 1 1

Query regarding budgets and funding allocation 8 3 1 1 1 0 1 1

Query regarding decision making processes 8 6 0 0 0 0 2 0

Query regarding guidelines / NHS England procedures 6 0 1 2 2 0 0 1

Query regarding access to records 6 0 0 2 1 0 1 2

Query regarding boundaries / structures of reorganisation 6 0 1 2 1 0 2 0

Query regarding impact on contracting 5 0 0 2 1 0 1 1

Query regarding impact on boards and committees 5 3 0 0 0 0 0 2

Query regarding GP numbers 5 1 0 0 0 2 1 1

Query regarding impacts on service provision 5 1 3 0 0 0 1 0

Query regarding rationale for the single CCG 4 0 0 3 0 1 0 0

Query regarding access to services for patients 4 1 1 1 0 1 0 0

Query regarding office / base locations 4 0 1 1 0 1 1 0

Query regarding implementation of single CCG 3 0 1 1 0 1 0 0

Query regarding cost of re-organisation 3 0 0 1 0 0 2 0

Query regarding impact on staffing 1 0 1 0 0 0 0 0

Query regarding impact on stakeholder relationships 1 1 0 0 0 0 0 0

Feedback Total

Event

Bu

rto

n

Can

no

ck

Le

ek

Lic

hfi

eld

Se

isd

on

Sta

ffo

rd

Sto

ke

Ta

mw

ort

h

Involve patients and communities in decision making 7 1 0 4 0 0 0 2 0

Local representation is important 6 0 0 2 2 0 2 0 0

Consider the need for improved access to services (e.g. appointments) 6 0 3 0 1 0 2 0 0

Consider the need to maintain service provision locally 6 0 1 1 1 2 0 0 1

Six CCGs is an inefficient use of resources / one CCG is more efficient 5 0 1 1 3 0 0 0 0

Greater clarity is required on the proposals 4 0 0 0 0 0 3 1 0

Consider the demographic / geographic differences across the areas 4 0 0 1 2 0 1 0 0

Consider transport issues, parking and non-drivers 4 0 2 0 0 0 2 0 0

Greater partnership working across sectors is required 4 1 0 2 0 0 0 1 0

Consider the need for adequate funding 3 1 0 0 0 0 0 2 0

Option 2 would focus resources in Stoke-on-Trent / urban areas / North of county 3 1 0 0 0 1 0 0 1

Consider the impact on committees and boards 3 0 0 0 0 0 0 3 0

Option 1 ensures a better understanding of local issues more tailored to local needs 2 0 0 2 0 0 0 0 0

Option 2 would improve consistency across the area / six CCGs results in inconsistencies 2 0 1 0 1 0 0 0 0

Option 2 supports the delivery of the NHS Long Term Plan 2 0 0 0 2 0 0 0 0

A standardised IT system is required (e.g. appointment booking, medical records) 2 0 0 0 2 0 0 0 0

Consider the need for equity across different areas 2 1 0 0 1 0 0 0 0

Need to ensure adequate staffing 2 0 0 0 0 0 0 2 0

Stoke-on-Trent should be its own CCG 2 0 0 0 0 1 1 0 0

Consider the impact on wider stakeholders (e.g. Together We're Better) 2 0 0 0 1 0 0 1 0

General comment supporting option 2 2 0 0 0 0 1 0 1 0

Option 2 supports the management of system-wide issues 1 0 0 0 0 0 0 0 1

Consider whether costs can be reduced 1 0 0 1 0 0 0 0 0

Consider that top-down organisation / top-heavy management could negatively affect patients 1 0 0 0 1 0 0 0 0

Stoke-on-Trent may be negatively affected (e.g. loss of funding) 1 1 0 0 0 0 0 0 0

Consider the need for local involvement (e.g. Patient congress, voluntary groups) 1 0 0 0 1 0 0 0 0

Smaller service providers may be disadvantaged if option 2 is implemented 1 0 0 0 0 0 0 1 0

Consider a separate CCG for Stoke-on-Trent and/or Stoke-on-Trent and Northern Staffordshire 1 0 0 0 0 1 0 0 0

Ensure suitable staff are employed 1 0 0 1 0 0 0 0 0

Consider implications on funding 1 0 0 0 0 0 0 1 0

Consider the need for greater public awareness of the proposals 1 0 0 0 0 0 0 1 0

Proposal will lead to benefits in managing system-wide issues 1 0 0 0 0 0 0 0 1

Ensure decisions are made locally 1 0 0 0 1 0 0 0 0

Other 17 3 0 6 4 0 0 4 0


Appendix 4: Summary of event demographic profiling

questionnaires The profile of the two event participants submitting their demographic profiling questionnaire is:

• Religion: Both respondents had no religion

• Sex: Both respondents were male

• Gender identity: Both respondents had not undergone any gender reassignment

• Sexual orientation: Both respondents were heterosexual

• Relationship status: One respondent was married; one was single.

No further questions were answered.

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