The NHS commissioned a Citizens Jury that would give Forest of Dean District residents the chance to evaluate prospective new hospital locations, and recommend a preferred location that would be best suited to meet the needs of the Forest of Dean now and for years to come.
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Problems and Purpose
In 2018, the Gloucestershire Care Services National Health Trust announced plans to close two area hospitals, to be replaced with an updated facility to serve the entire region. These closures were a sensitive topic for many and public officials needed a way to listen to residents and learn more about the benefits and tradeoffs of potential hospital locations from their view.
The NHS bodies commissioned a Citizens Jury that would give District residents the chance to evaluate prospective hospital locations, and recommend the potential location that would be best suited to meet the needs of the Forest of Dean now and for years to come. At the Citizens Jury in July, 2018, 18 residents from across the Forest of Dean District embarked on a close study about the benefits and tradeoffs of a new hospital location in Lydney, Cinderford, or Coleford.
Background History and Context
In the Forest of Dean district, United Kingdom, the local hospitals are closely intertwined with the community: they were founded and financed by community members themselves, and have served residents for decades. They’re seen by many as not only a testament to the rich history of the Forest, but also to the collective spirit of the region.
Organizing, Supporting, and Funding Entities
The Jefferson Center and their UK partner, Citizens Juries c.i.c., were commissioned by Gloucestershire Care Services NHS Trust and NHS Gloucestershire Clinical Commissioning Group to conduct the Citizens Jury.
Participant Recruitment and Selection
The opportunity to participate in the Citizens Jury was advertised in local papers, job websites, and over the radio. By the end of recruitment, over 200 people applied to be members of the jury. From this pool, 18 jurors were selected to represent the demographics of the Forest of Dean district.
Methods and Tools Used
The Jefferson Center and Citizens Juries c.i.c. used a Citizens Jury approach: over the course of 5 days, the 18 Forest of Dean District representatives considered benefits and tradeoffs for building the new hospital in Lydney, Coleford, or Cinderford. The Jury members learned about the demographics of the area, current and projected population growth, and transportation options from outside experts. The jurors discussed which factors were most important to consider when choosing the new location, then compared each city by these factors. They voted on a final decision, which was shared with the public.
What Went On: Process, Interaction, and Participation
After participating in a simulation exercise to introduce jurors used to the Citizens Jury process, participants listened to a National Health Service Representative speak about the history of community hospitals in the region. Next up, jurors listened to presentations from town representatives from Lydney, Coleford, and Cinderford, who each made a case for building the hospital in their community. Participants also learned about demographics of current hospital users, travel times to the hospitals across the region, the community effects on local planning, economics, and traffic that would follow the decision, and an overview of recent public engagement efforts by the NHS.
The jury then spent time assessing the three locations as it related to the information they learned about NHS services, town locations, FOD populations, community transport, and travel times. With deliberations at a close, participants voted on their final recommendations for a new hospital location. Participants were given up to three votes to rank the factors they considered to be most important in their choice of location. Voting and vote counting took place in front of public observers, and the recommendation of the jury was then announced to the public by two jurors (including BBC TV and local press representatives).
After hearing evidence from witnesses for over four days, eight members of the jury voted to recommend Cinderford as the best location, while Lydney and Coleford each received five votes.
Some of the reasons the jurors chose Cinderford include:
- Its proximity to the entire Forest of Dean District, key for both staff and patients access
- Its location near primary roads
- Cinderford’s proportion of residents over 65
Influence, Outcomes, and Effects
The Gloucestershire Clinical Commissioning Group and Gloucestershire Care Services NHS Trust unanimously decided to back the jury’s recommendation, and the hospital is expected to be built within 3-4 years.
Analysis and Lessons Learned
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News coverage: the NHS boards accept the Jury's recommendation