Results of Questions 1-5

Questions 1-4 and Question 5

The first four questions of the survey were designed to establish the relative importance to local residents of the two main hospitals run by the North Bristol NHS Trust – Frenchay and Southmead. The questions sought to establish the overall importance to residents of the two sites, to see if residents regarded a casualty department as an essential feature of a major hospital, and to see how far residents’ views were swayed if the justifications for change were advanced on medical, rather than financial, grounds.

The results of the questions were as follows:

Q1. If North Bristol NHS Trust proposed to concentrate its services on one main site to tackle its financial problems, would you support it? [NB – underlining as appeared on the survey form]

73%: NO, keep Frenchay and Southmead  
14%: YES, but only if it’s at Frenchay 
  2%: YES, but only if it’s at Southmead
12%: YES, whatever site they choose

Q2. If health professionals at North Bristol NHS Trust thought they could provide a better standard of care by concentrating its services on one main site, would you support them?

64%: NO, keep Frenchay and Southmead 
17%: YES, but only if it’s at Frenchay 
  3%: YES, but only if it’s at Southmead
17%: YES, whatever site they choose

Q3. If health professionals at North Bristol NHS Trust thought they could provide better Accident & Emergency cover by closing one A&E, would you support them?

69%: NO, keep both A&Es
15%: YES, if the A&E is at Frenchay
  2%: YES, if the A&E is at Southmead
13%: YES, whatever site they choose


Q4. If health professionals at North Bristol NHS Trust thought they could provide better A&E cover by closing one A&E and providing new “minor injury” provision in the community, would you support them?

60%: NO, keep both A&Es
19%: YES, if the A&E is at Frenchay
3%: YES, if the A&E is at Southmead
18%: YES, whatever site they choose

Q5. If there were to be a number of new “minor injury” centres around the area, where would you like to see one?

56%: Yate/Chipping Sodbury 
24%: Thornbury 
19%: All other sites (including, in decreasing order of popularity: Winterbourne/Frampton Cotterell; Bradley Stoke; Frenchay);

 

Comments on replies to questions 1-5

The answer to question one shows the depth of resistance to financially driven change. Roughly three quarters of those who responded to the survey rejected outright any change based on the Trust’s financial problems. Only one in eight was prepared to accept a finance-driven closure and trust to the judgment of the Trust as to which site should close.

Among those willing to countenance a consolidation on one site, the overwhelming preference among those who expressed a preference was for Frenchay over Southmead. To some extent this reflects the population balance of the Northavon constituency, but this does not wholly explain the strong preference for Frenchay. Contributory factors are also likely to be Frenchay’s location close to the motorway network, and also the fact that existing casualty facilities are much better resourced at Frenchay than at Southmead.

Question two was designed to probe whether the attitude of local residents would be different if the Trust’s medical staff presented a clinical justification for the concentration of services on one main site. The results showed that about one in ten residents was prepared to accept change if they thought that this was based on clinical grounds. But, strikingly, nearly two thirds of respondents would not be convinced even if health professionals made the case for change.

Perhaps the most likely reason for this deep-seated scepticism about clinically-based justifications for site re-configuration is that residents do not believe that this is the real reason for change. With the North Bristol Trust having run up a deficit of £44 million in the last financial year, it is widely known that the Trust is under severe financial pressure. It will be very hard for the Trust now to convince residents that major service reconfigurations are driven by clinical best practice rather than financial necessity.

Question three looked at attitudes to the retention of Accident & Emergency units at both Frenchay and Southmead, if there was a clinical case made for consolidation on a single site. Interestingly, the replies to this question are marginally more hostile than to question two which also asked for a response to a clinical argument for re-configuration. In simple terms, residents were deeply dubious that closing one A&E would leave them with better cover, even if doctors said that it would.

Question four probed attitudes to a model of A&E cover that has been mooted – a single main casualty unit and one or more “minor injury” units at local centres. An additional one respondent in ten would be prepared to accept the closure of a major A&E department if it meant more local provision, but roughly three in five would still be opposed outright.

Looking further at the option of “minor injury” centres, respondents were asked in question five, where in the community would be their priority for such a centre. By far the most popular suggestion was somewhere in the Yate/Chipping Sodbury area, with just over half of all respondents mentioning this part of the constituency. It is clear that there is a very strong demand for community health facilities in this area.

Just under a quarter mentioned Thornbury, which is a surprisingly high figure given that Thornbury residents only around 15% of the sample. This is perhaps indicative of the extent to which many of the surrounding villages look to Thornbury as their natural centre. No other location was mentioned by more than five per cent of respondents.