Views from patients and the public
At each stage of developing our proposal, we have invited people to give their views.
How we involved people in our proposal
During 2013 we undertook a range of engagement activities with patients, the public and staff groups. The key findings from these preliminary activities were used to shape the options for a future eye care centre.
In late 2013, there was a 12-week consultation which asked patients, public and staff for their views on a proposed move of services from the City Road site to a new eye centre to be built in a preferred location in the King’s Cross/Euston area. People were also asked to rank and comment on a list of decision-making criteria.
There is a growing list of people who have let us know they want to stay informed and involved in the project. A core group of patient and public representatives – the Oriel Advisory Group – has been established to help us with this work.
We also assembled a group of patients and members of the public to take part in the most recent options review in April 2019.
Building on many ideas about improving patient experience, this group agreed that what matters to patients, carers and their families are:
- clinical expertise above all else, even if this means travelling further to receive the highest quality specialist care
- a smooth clinical pathway through the whole system from getting the first appointment to follow-up care and support
- getting to the hospital, including in an emergency
- an efficient and caring experience at the hospital
- good communications and information
- person-to-person support when needed.
The group also highlighted as important:
- proximity to public transport hubs
- a manageable and obstacle-free journey from the transport hub to the hospital
- interior design to support wayfinding for people with sight loss
- access by ambulance and motor vehicles.
Main themes from feedback
Support in principle for a new centre
Most people who participated in discussions indicated strong support in principle for a new purpose-built centre of excellence for eye care, with the
potential benefits of combining research and education with frontline eye care.
People who responded to an online survey were less positive about our proposal than those who attended a discussion, their main concern being disruption caused by change.
Critical to success
Most people in discussions expressed the following views:
- The level of current hospital services should continue, with an expectation of improvements in both clinical care and patient experience.
- Any change should be managed with minimal disruption, smooth transition and continuity of service.
- Accessibility was a high priority, both getting to and around the hospital.
Improving patient experience
People expressed a great deal of confidence in Moorfields’ clinical care but not in the patient experience at City Road.
Most people expected that the proposed move to a new centre could and should improve the physical aspects, as well as the whole culture of eye care – people saw a real opportunity to achieve world class standards in all aspects of care for patients.
Physical design – improvements needed were:
- a more logical layout of facilities to ensure a smooth flow of patients through the various stages of their appointment
- good signage and information
- comfortable access to toilets, water and food – particularly important for people who might have to wait for some time and have had to travel a substantial distance from home
- a comfortable environment that is socially and emotionally supportive to patients and carers.
Personal interactions – improvements needed were:
- efficient reception, able to communicate clearly and help people to access the service in the best possible way
- efficient check-in, accessible for people with sight loss
- friendly staff, trained in supporting people with visual impairment and other disabilities, such as hearing loss and dementia
- people available to help with wayfinding, not necessarily employed staff.
Opportunities for information and support
People offered ideas on using space in a new centre to help people access wider support, including counselling services, possibly in collaboration with the voluntary sector.
Access to research
People were appreciative of the potential benefits of integrated eye care, research and education. They were keen to see faster translation from discovery and innovation to frontline care and for more patients to have access to clinical trials.
Support for staff
People showed a keen interest in how staff felt about the proposed move and how the proposal could support recruitment and retention.
Wider strategic view
Some people raised the need to embrace new technology and treatments with a potential shift towards more care for people at home and in primary care.
Community-based optometrists, social care and voluntary sector professionals who participated in discussions highlighted the benefits of closer relationships to ensure more “joined-up” care for patients.
People were also interested in what might happen to the City Road site if it were sold.
We will continue to offer the opportunity in the future for people to give us their thoughts on these and other aspects, should the proposal be approved to proceed to the next stage. Visit the get involved section of the website to find out how you can give your views.
Impact on equalities
We understand from listening to people that they are apprehensive about how any change would be managed with minimal disruption, smooth transition and continuity of service.
To make sure that we address these concerns we have considered how issues of equality affect service users in the proposed changes and are analysing these through an equality impact assessment (EIA).
The EIA process is designed to ensure that a project, policy or scheme does not discriminate against any disadvantaged or minority groups. As well as helping us to improve services, EIAs also help to ensure that we meet our responsibilities under the Equality Act and fulfil our public sector equality duty.
The EIA for the proposals to move Moorfields from its site on City Road to the St Pancras hospital site is being conducted in two parts, with the initial (desktop research) phase completed for the pre-consultation business case (PCBC), and the second stage to be conducted during this consultation.
Recommendations to address the impact on equality will be included in the Decision-Making Business Case.
The initial phase EIA, conducted in January 2019, focused on:
- How the services might impact on people with protected characteristics under the Equality Act 2010
- How the CCGs and providers should ensure equality and fairness in terms of access to these services, and appropriate provision for all patients based
on their clinical, personal, cultural and religious needs.
- How the CCGs would work together with local providers and patients and carers to ensure a high quality of services that all patients can experience.
Read our initial assessment and give us your views on which equality impacts you feel we should be considering and how we can minimise any impacts.
As part of the April 2019 options appraisal, and using existing data sets, we re-examined which sections of the population might be most affected by the proposed changes. We focused on the CCG areas which are the closest to Moorfields and whose populations receive 45% of the care provided by Moorfields at City Road.
This analysis found that:
- the relocation of Moorfields from City Road to the St Pancras Hospital site could result in more patients attending Moorfields from some areas such as Enfield and Newham
- north east London CCGs had a high number of people with long-term limiting illness or disability that significantly hindered their ability to carry out normal daily activities, so had the potential to be disproportionately impacted by any change
- north east London had a high prevalence of Black, Asian and minority ethnic (BAME) people for whom the impact of the co-morbidities on eye health could be higher, and therefore could have the potential to be disproportionately impacted by any change
- in the Moorfields catchment area, Tower Hamlets was in the top 10% most income-deprived in England and five other north east London boroughs were
in the top 20% most income-deprived. It was therefore likely that patients with conditions related to low incomes who attended Moorfields would most likely arise from these areas.
We will ensure that the people living in the areas we think will be most affected understand the implications of the proposed move. This will build on engagement activity already undertaken with people in particular groups and in north east London.