An amendment was laid by the Policy & Resources Committee to the policy letter brought by the Committee for Education, Sport & Culture on moving forward the development of a community hub. This has been an area of intense frustration as various sites suggested have not been able to be progressed. Three years ago it was thought the site of the KEVII Hospital may be used, then Les Ozouets Campus and, as set out in the policy letter, Delancey. The latter is a compromise, which will enable new ways of working, but will only be an interim solution.
Sir, It has been known for years that many of HSC’s child and adult social services are scattered across the Island in ageing and unsuitable properties. For years, successive Committees and successive Assemblies have agreed that these services should be consolidated onto a single site, allowing for greater collaboration between teams, easier access for service users and opportunities for efficiencies combining common service. This would improve experiences for staff and service users and also enable the release of current sites.
And when I say years, I mean years spanning 3 electoral terms and at least 5 Health Boards or Committees.
The 2020 vision in 2011 made reference to a number of buildings in HSSD’s property portfolio being ill suited to the delivery of modern health and social care services or are expensive to maintain. Specific proposals were included in the Capital Portfolio at the beginning of this term to co-locate peripatetic services and a further commitment was made through the Partnership of Purpose. It is safe to say that no further commitment is needed- just action.
The States of Guernsey has an Estates Plan. It establishes a number of Property Objectives for Estates Optimisation. First and foremost is better working locations, providing the right buildings in the right place and condition to meet current and future service delivery needs. Current community provision would fall short of this standard and it is right that action is taken to address this.
In the context of the Partnership of Purpose, the relocation of community services is vital. Not only are some current work environments fundamentally unsuitable, they are creating a very real barrier to realising the values of the Partnership of Purpose and the adoption of new ways of working.
The Partnership of Purpose is about achieving the physical, virtual and financial transformation of the health and care system. It is based on an ever closer integration of care which places the user at its centre and provides a greater focus on prevention and support and care in the community. The current property portfolio prevents this. Staff are forced to work in physical silos, service users are unable to access multiple services in a single visit and it is challenging to trial new ways of working. Multi-disciplinary working is happening, but it is having to overcome the fundamental challenges posed by the infrastructure.
And I have to say it has not been for the want of trying but I until now it has felt like we were banging our heads against a brick wall. A well built one at that. I won’t bother members with our own frustrations here but suffice it to say we had lost confidence that any solution would be found. Everything seemed to be wrong, nothing seemed to be right. However, hopefully the stars are now aligned and I was pleased to hear the P&R Presidents commitment to the co-location of a number of services at Delancey. This provides a real opportunity to improve working environments and pilot new ways of working across current team boundaries. It is considered that there would be opportunity to co-locate staff from the Children & Family Community Services, the Youth Justice Team, the Youth Commission, and other services. It has the potential to enable the vacation of Lukis House and Swissville and other sites.
And I would aks members to consider this. Under the survey undertaken by Peter Marsh Consulting and set out in Section 3.1 of the policy letter, none of the buildings at Delancey were rated as good.
But, it is a sad indictment of our current property processes that they are a considerable improvement on those currently occupied by community services. Indeed, all the work undertaken to date has indicated that it would fully meet the needs of community services.
The development of Delancey for health and care purposes is considered a vital albeit interim milestone in the Partnership of Purpose as we work towards a long term Communtity Hub. It will in the short term improve working environments, enable a number of States’ buildings to be vacated and enable new ways of working to be piloted.
That is why we want members to support proposition 6a). however, that is only an interim solution.
It is a good next step that will help transformation and free up States property and will enable us to start to make real changes. However, it is not a long term solution.
- Because, whilst the proximity to service users is beneficial, the site is not centrally located on the Island;
- Accessibility to the site is less than perfect with no bus route, minimal parking and being on top of a hill not the easiest for those with mobility issues.
- Delancey will host a range of services to pilot collaborative working between statuary and charitable sectors however the site size limits the number of services that can be located there and the ability to incorporate private providers
- The extent and scope of the long term ambition will require a larger and more flexible space, to host a community café and other facilities which Delancey will not be able to accommodate
- As opposed to just housing Children & Family services, the long term Community Hub will accommodate a range of services throughout the life course of our people which will need a range of in-reach and out-reach providers
- The long term Community Hub will strengthen our approach to meeting the needs of all our service users (supporting the disability & inclusion strategy)
In short, the site is temporarily sustainable for services relocating there, represents a better quality environment for our staff and will act as a test bed for transformational changes, but not for the longer term aspiration of a Principal Community Hub.
I think I need to go into more detail about what we mean here.
A key aspect of the new model of health and care is the physical co-location of services through a number of easily accessible sites called Community Hubs. Through these Hubs, individuals will be able to access a range of face-to face and virtual services provided by public, private and third sector organisations. By consolidating services which are currently scattered across the Islands, the Community Hubs will seek to improve access to care and enable islanders to deal with multiple health and care needs in a single visit. This approach will be of particular value to those individuals with long term conditions and will facilitate direct access to services which currently require a referral.
While it is envisaged that there will be a network of Community Hubs throughout the Island- some of which may be developed around existing GP practices or community centres, and is something we are currently in discussion with various interested parties, it is considered that it will be necessary to develop a Principal Community Hub. What makes this different is, in addition to supporting public-facing services, it would also provide a base for shared back-office support for the public and third sectors.
The Principal Community Hub needs to incorporate a wide range of service provisions, from across HSC, ESC, ESS and the private and charitable sectors. By combining a wide range of community services, and areas available for hire by other community groups, the site will be a valuable resource to all members of the community.
To achieve these ambitions, a number of site requirements have been identified, which indicates that there are few available which would readily allow the envisaged co-location of the full breadth of services. The vacation of schools through the Transforming Education Programme is likely to be one of the few opportunities available to the States to the re-purpose an existing building as a Principal Community Hub, thereby avoiding the significant capital costs associated with a build.
The Committee’s officers have undertaken extensive work to scope current provision and opportunities for the future but we’ve had to pause the progression of a Business Case based on growing uncertainty in respect of site availability.
Without the progression of this work and the associated development of the infrastructure underpinning community care, the Committee’s ability to realise the Partnership of Purpose is stymied. Without shared spaces, the ability to adopt new ways of working is limited, the development of working practices across organisational boundaries is restricted and we cannot improve convenience for service users.
I’m not especially happy we can’t pin down where the new Hub will be and I understand the process we have signed up to but have yet to be convinced that all parties are quite aware of the roles that they are there to undertake. Inaction appears to have been the order of the day. Decisions do need to be made. That’s why I am pleased there is a deadline state, although I would hope matters can now be resolved in a more timely manner given the work that has already been done by HSC staff.
This has been going on too long. The will is there politically I believe, but process has got in the way. It needs this Assembly to make things happen and I ask members to support this amendment.