Overall, feedback received indicated that the majority of people had understood the reasons for change, how the proposal had been developed, felt listened to, and that there had been sufficient opportunity to take part in the consultation. Where people have requested further meetings or information NHS Highland has been responsive.

Areas of good practice we identified

• Steering group members were encouraged to share information and get feedback from local groups and networks during the option appraisal process.
• There was a mail drop of the summary consultation paper to every household and local business which aimed to ensure all local people affected by the proposed change received direct information about the consultation.
• There was ongoing review of the approach taken during the process and in particular the mid-way review allowed for a responsive and proactive approach to influence the remainder of the consultation.
• The walkabouts undertaken in local communities allowed for more targeted engagement and awareness raising in 4 community settings.
• NHS Highland responded to requests for meetings or further information during the consultation and demonstrated an active consultation process.
• An additional mail drop of the consultation questionnaire took place in August in response to public feedback.
• Information about the consultation was shared through social media on Facebook and Twitter (including the hash tag #skyechat) as part of the engagement and consultation process.
• The option development and appraisal process began with a 'blank sheet', and the previous discussions over the last 10 to 15 years which had attracted local concern did not influence the generation of models for the option appraisal.

Learning points

In order to learn from the experience of this process for future service change, NHS Highland should:

• consider where to display posters and leaflets in communities for future consultations
• consider using an 'at a glance' table to clarify current service provision against future provision of services, earlier in on the consultation document
• ensure consistent language is used in the meetings and consultation materials when referring to the outcome of the option appraisal
• consider including more detailed information in the summary consultation document about the option appraisal process (for example, who was involved, criteria used and discounted options)
• consider including the consultation questionnaire in the consultation document to encourage participation
• consider using Youtube, as with the recent consultation in Badenoch and Strathspey, to inform the wider community of the review and steering group membership

NHS Highland plans to discuss the proposed recommendation at the December 2014 Board meeting. If the preferred option is supported by the Board it will then go to the Cabinet Secretary for Health and Wellbeing for approval.