Consultations in East Sussex

We consulted between September and October 2021 with both registered and non-registered users of the East Sussex Health Promotion Resources Service on stopping the provision of hard copy health promotion resources. A total of 15 people took part in the consultation, with the majority having a mixed or negative view on the proposal. The main concerns centred on future access to only downloadable resources, and  we have been working since the consultation closed to explore the impact of our proposal in more detail through the completion of an Equality Impact Assessment (EqIA). This was discussed at the Inclusion Advisory Group and shared with the Senior Management Team. They made the decision to go ahead with our plan, due to the resource implications of continuing to provide hard copy resources that are infrequently ordered and have limited use. 

What we were proposing

Before 1 April 2022, registered users of the East Sussex Health Promotion Resource Service (HPRS) have been able to order free hard copy health promotion resources across a range of subject areas for delivery.

Our proposal was that, from that date, we stop offering hard copy health promotion resources to registered users, and instead only offer resources in online access or download formats – with exceptions for hard copies of locally produced fuel poverty resources, as these continue to be ordered in large numbers. 

These proposals were based on:

• changes in how society accesses information and resources since the HPRS was introduced in 2014;
• increased use by health promotion professionals of signposting to online information, downloadable resources, and social media;
• a consistent decrease, since 2018/19, in the number of registered users placing orders and the number of hard copy resources they have ordered; and
• the ongoing challenge of hosting a hard copy health promotion catalogue whose resources are kept up-to-date as national guidance and evidence changes.

A public consultation on the proposed changes was conducted in September 2021. Of the 15 responses received, most (12) were submitted by registered Health Promotion Access Catalogue (HPAC) users.

Although the number of respondents was small, it was clear that people’s preferences were varied. Asked how they typically shared health promotion information and resources with the people they worked with, the most common method selected by respondents was to ‘give or post them hard copy resources’. However, ‘signposting by email to online/downloadable resources’ was the respondents’ preferred method of sharing health promotion information with people.

Things were similarly mixed when people were asked about the proposal itself. Of 15 who answered, 3 were positive, 5 had mixed views, 6 viewed it negatively, and 1 was neutral. In addition, opinion was split evenly between those who felt their health promotion work would be affected either negatively by the proposal, and those who had mixed views or felt neutral.

Concerns from current service users centred on how easy it would be to share resources with clients or patients who may have limited or no digital access, including older people and those with disabilities. Positive comments reflected how some services had already changed the way they share health promotion information by not giving out hard copy leaflets, working in a much more ‘online-focused’ way. Should they need to, these services could download and print off downloadable material for specific individuals.

The consultation findings were shared in December 2021 with the Inclusion Advisory Group (IAG). In doing so, it was noted that 12 HPAC users took part (out of a total of 225 individually registered who were invited). The IAG summary report also noted a consistent decrease in the number of registered users placing orders, and in the number of hard copy resources being ordered (other than for locally produced fuel poverty resources). Mitigating actions were included in relation to the potential impact on older people, those with a disability, those whose first language is not English, and those who may have limited or no digital access.  IAG did not raise any direct concerns and endorsed the proposal.

Following the IAG meeting a paper was presented to the Senior Management Team and the decision made to move ahead with the proposed service changes, including the mitigating actions   

Since 1 April 2022, ordering of hard copy resources has stopped for registered HPAC users., with the exception of locally produced fuel poverty resources, and a small selection of leaflets aimed at older people which are still available to order via the HPAC website.

The HPRS catalogue has been reviewed and appropriate validated downloadable resources have been added as alternatives to replace the removed hard copy resources. The catalogue will continue to list a collection of high quality, validated, health promotion resources in download or web access format to support health promotion work.

To address the concerns raised in the consultation, our Equality Impact Assessment recommended that we:

• Encourage HPACT users to continue placing orders for hard copy health promotion resources up until 31 March 2022. Subject to availability, additional orders could be placed during this period.
• Ensure HPAC catalogue listings will include (where available from validated sources) current, evidence-based resources suitable for people with disabilities, including British Sign Language, links to audio books, videos, podcasts, and easy read downloads. 
• Provide descriptions of downloadable or web accessible resources on HPAC to indicate whether the information is available in other accessible formats or languages.
• Retain a small selection of the top 3 resources listed and ordered from HPAC which particularly focus on topics/issues specific to older people. Monitor the orders (by organisation and volume) over a period of 3 months to determine the level of demand for these resources and whether there is a viable business case to continue their provision.

East Sussex County Council worked with a range of health, care and voluntary sector partners, to conduct a joint strategic needs assessment (JSNA) for our lesbian, gay, bisexual, trans, queer and other sexual and gender identity minorities (LGBTQ+). We wanted to understand LGBTQ+ local people’s experiences of health, accessing local services and about how COVID-19 has impacted them.

The findings from the survey that formed part of the needs assessment will help us improve services locally.

The report can be viewed on our JSNA website.

The JSNA made a wide range of recommendations. These included further engagement with LGBTQ+ communities, to increase the knowledge and uptake of a range of services and to collect further insight on how these communities experience these services. A number of recommendations are also outlined, aimed at increasing inclusion and awareness of LGBTQ+ people and their needs in a wide range of health and care services. The report also made five specific recommendations on Trans healthcare. Finally, recommendations were made in relation to increasing the monitoring and data collection of LGBTQ+ people in services.

Over the summer we consulted on our plans for sexual health services in East Sussex ready for the new contract in October 2022.

The aim was to make sure that the proposed service model would provide easy access to services that meet people’s needs. It was important to hear people’s views as the service model has changed significantly in the last few years due to digital innovation and COVID-19.

People were concerned that some groups of people may find it more difficult to access the service. 

In response to the consultation feedback, the service specification has been adapted to allow two drop-in triage clinics for all ages at each clinic site in Hastings and in Eastbourne. This is in recognition of people who are digitally excluded, do not have phones, or rely on limited phone credit or are genuinely unable to access their GP.