TCI Member Case Study – Forest of Dean Community Hospital Services: Engagement and Citizens’ Jury
Background and engagement
Since September 2015 a range of engagement activity has been undertaken by NHS Gloucestershire Clinical Commissioning Group (GCCG) and Gloucestershire Care Services NHS Trust (GCS) to gather feedback from residents in the Forest of Dean, Gloucestershire regarding their health and care needs now and into the future. This feedback has informed the development of options for community hospital services in the Forest of Dean, leading to a period of consultation on a preferred model for the future. As a result of the Consultation in 2017, the decision was made in January 2018 to build a single new community hospital for the Forest of Dean to replace the Dilke Memorial and Lydney and District Community Hospitals.
In response to consultation feedback and the recommendations endorsed at their meetings in January 2018, GCCG and GCS jointly appointed Citizens Juries Community Interest Company (CIC) to run an independent citizens’ jury. The Jury was asked to consider information and make a recommendation regarding the location of the new hospital for consideration by the CCG Governing Body and the Board of GCS. Citizen’s Juries CIC is a social enterprise dedicated to designing and running citizens’ juries, supported by the University of Manchester. It works in partnership with the Jefferson Centre, the US-based charity which developed the citizens’ jury method.
Six weeks of public engagement on the location of a new community hospital in the Forest of Dean was held to contribute evidence to the Citizens’ Jury process and to support decision making. The purpose of the engagement was to obtain public, staff and community partners views of certain statements regarding the three potential locations for the new hospital. It was not to poll votes to determine the location of the new hospital.
Three themes in particular emerged during this period of engagement:
- the relationship between where survey respondents state they live and where they think the new hospital should be located;
- concerns and comments in relation to public transport and access; and
- a range of views relating to a ‘central’ location in the Forest of Dean.
A full Outcome of Engagement Report is available at www.fodhealth.nhs.uk
The Jury met for four and half days at the end of July 2018 to consider the best location for the new community hospital in the Forest of Dean. The Jury was made up of 18 local residents who were recruited, by Citizens Juries CIC, to ensure a balance in terms demographics such as age, gender, educational attainment and geography. The make-up of the Jury reflected the demographic of the Forest of Dean community.
The information and evidence presented to the Citizens’ Jury was reviewed by an independent Oversight Group, selected by Citizens Juries CIC. The three members of the Oversight Group represented Healthwatch Gloucestershire, Forest of Dean District Council and the Voluntary and Community Sector Alliance.
An independent equality impact analysis on the potential locations of a community hospital in the Forest of Dean was commissioned and presented to Jury (and subsequently to GCS Board and the Governing Body of GCCG).
Part of the Jurors Report was a ‘statement to our neighbours’, below are a few extracts:
We were asked to complete a difficult task, with the understanding that some people are disappointed at the closure of two community hospitals.
It was a rare and beautiful opportunity to work with an impressively diverse, fair representation of people from across the Forest of Dean. We have enjoyed every minute contributing to our joint thoughts and feelings for the best hospital location.
Witnesses, who were not to advocate for any particular location, remained un-biased, forcing us to deliberate about how their presentations would inform our choice of hospital location. We assessed and re-assessed the options for each location repeatedly with great dedication.
The citizen’s jury is a worthwhile exercise irrespective of what is done with our recommendation by NHS bodies and enabled us to create a fair representation of our views. The process was enlightening and gave us an interest in getting more involved in local interest issues in future.
In addition to the recommendation regarding the location of the new hospital, the Citizens’ Jury made some supplementary recommendations:
- Improving transport accessibility options for communities throughout the region and ensuring accessibility for drop-offs, transfers, and other transport needs
- Considering how to incorporate on-site amenities (such as a cafe or a chemist) to maximise the benefits of the new hospital
- Ensuring that a full range of necessary and suitable services are provided and that the new hospital is adequately staffed
- Planning for future use and needs of the entire Forest of Dean in the design and size of the building.
The recommendation of the jury was presented to the Governing Body meeting in August 2018. Governing Body members were impressed by the conscientious approach taken by the Jury and, having reviewed all of the evidence, endorsed their recommendation to build the new hospital in, or near, Cinderford.
The CCG Governing Body and Board of GCS also committed to ensuring the additional recommendations are given full consideration as the programme to develop the new hospital progresses.
The involvement of local people through the Citizens’ Jury was supported by Healthwatch Gloucestershire, Health and Care Overview & Scrutiny members, Hands off Dilke & Lydney (local lobbying group) and the wider community. The process attracted the attention of local media and has been the subject of much review. The CCG consider the process to be a robust mechanism, which empowers members of the local community and gives them a voice at the very highest level of decision-making. All information relating to the Forest of Dean Citizens’ Jury, including how the jurors were selected and the Jurors’ Report can be found at: https://citizensjuries.org/citizens-juries-2/forest-of-dean-citizens-jury/
Becky Parish, Associate Director, Engagement and Experience and Caroline Smith, Senior Manager Engagement and Inclusion at NHS Gloucestershire CCG.
If you have experience running a Citizens’ Jury or are interested in how they could be useful in your change management scenario, get in touch with us.