The head of Derbyshire’s independent health and social care watchdog has warned that meaningful public and patient input into the future of local health services is in danger of being side-lined following recent developments in the county.
Derbyshire’s Clinical Commissioning Groups (the NHS bodies responsible for the planning and commissioning of health care services in the county) have announced that action will need to be taken to address an £80m financial gap in the services they fund against the budget they receive.
This financial challenge has led to the development of a financial recovery plan that will see extensive cuts to services over the coming year and one of the first casualties has been the announcement that an engagement group focusing on mental health will soon be disbanded.
Karen Ritchie is Chief Executive of Healthwatch Derbyshire – the organisation which ensures that patients, service users and members of the public have a say in the design and delivery of services.
She explained that listening to patients, carers and the wider public’s own experiences of and views on services was a vital part in planning and shaping future health provision in the County. However, during times of financial hardship, she is concerned that it becomes much more difficult for patients and members of the public to influence decisions that are being made about the services they rely on.
Furthermore, as part of the £80 million financial recovery plan, Derbyshire’s Clinical Commissioning Groups have announced the decommissioning of Mental Health Together, a new service focused on giving people with first-hand experience of mental health conditions a greater say in how services are delivered. The service will end in the autumn of 2018.
Mental Health Together was launched in July 2017, and is already engaging extensively with Mental Health Service Receivers and carers to hear their views on access to services, care and treatment whilst receiving services, and support they received to maintain their recovery.
Ms Ritchie said that the service was extremely important given that the recent Care Quality Commission Inpatient report showed that patients with a pre-existing mental health condition persistently reported a poorer experience of care across most areas of the NHS.
This was in terms of patient experience, i.e. information sharing, respect and dignity, coordination of care, confidence and trust, respect for patient centred needs and values, and perceptions of overall experience of care.
Ms Ritchie said:
This is highlighted time and time again in their survey and would indicate that priority should be given to this issue if it is to be resolved. However, the CCG is decommissioning the very service put in place to help improve outcomes for Mental Health Service Receivers by putting them at the centre of decisions made about them.
With this news Healthwatch Derbyshire have very real fears that the wider views and experiences of patients and members of the public will not be taken into account during the implementation of the financial recovery plan, over the course of this year.
Ms Ritchie continued that the recent Gosport Hospital Inquiry highlighted the importance of listening to patients, service users and the wider public and warned that public engagement and consultation should not be side-lined simply because of financial constraints.
Gosport was an extreme case of authorities not listening to concerns and experiences but it brings into sharp focus the importance of the patient and public voice.
There is no question that health and social care services are facing big challenges and that changes need to happen. However, the whole point of engagement and consultation is to create a safe space for legitimate debate over difficult issues, which is even more important when decisions are being made with financial restraint in mind.
Important decisions which are driven by financial pressures need to take into account the views of patients and members of the public and fully explore the impact that changes might have on patient experience. This is precisely the role of Healthwatch Derbyshire, and in turn that of Mental Health Together.
We ensure that patients and members of the public have the opportunity to input their own experiences and views of service provision into the process by advocating for honest and genuine engagement.
I therefore appeal to the commissioners and providers of health and social care services in Derbyshire to reconsider how they implement their financial recovery plan over the coming months to ensure that it gives patients and members of the public the genuine opportunity to influence decisions that will impact on them.