North East and North Cumbria Integrated Care Board (ICB) has responded in detail to reports by Healthwatch South Tyneside and Healthwatch Sunderland which set out the views and concerns of service users.
Healthwatch was asked by ICB to survey NHS podiatry patients about the proposal to move to a single provider and to reduce the number of clinic locations from 30 to a minimum of 18.
Staff and volunteers attended eight sessions at clinics in South Tyneside, speaking to 89 patients. Concerns raised included the potential impact on travel, continuity of care (including change of staff), waiting times and quality.
ICB has sent Healthwatch a detailed response to our reports and said it has amended the service specification which defines what standards of care are expected from a provider.
On travel, it said: “During the procurement process, the feasibility of two clinics per Primary Care Network will be fully tested, including making sure any potential providers can deliver what is needed in relation to activity and demand. This includes identifying clinic locations.
“This will be set out in the procurement and evaluation strategy. The procurement will include detailed testing around transport and travel infrastructure, i.e. a transport impact assessment to take into account distance, public transport links, parking, disabled parking, costs, and an understanding of the change from what is in place currently to what is to be.”
It continued: “Continuity of care was already included within the proposed model but has now been strengthened. This means the service specification and outcomes have been updated to reflect continuity of care as far as clinically possible. This is highlighted most for those at high risk and states every effort must be made to ensure the same clinician provides continuity of care.
“In response to concerns over waiting times, the proposed new model has been designed to free up appointments for those most in need. It is expected to have a positive impact on waiting times.”
A further area of concern raised by patients was decision making around who remains in the service and who self-cares. ICB said: “Part of the procurement process will be to ensure the decision making in relation to deciding who will be eligible for clinical treatment and who will be encouraged and educated to self-care will be done in clinically sound way.
“As part of the bidding process, providers will be evaluated on how they can meet the requirements of the contract including the criteria they will use to determine eligibility, what self-care will involve, how it will be monitored to ensure it is clinically safe, what and how education will be provided, including methods, content, assessing success, provision of equipment/materials.
“The proposed changes to the podiatry service will not impact on patients with existing physical and mental disabilities. Reasonable adjustments will be made to ensure there is equity of access for these service users.”
The full Healthwatch South Tyneside report, including the detailed response from ICB, can be found here.
