Devon STP: there is ‘no rush’ to make decisions on community hospital buildings. What’s more, it hasn’t agreed what a ‘health hub’ is or how many there should be

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Speaking for the Devon NHS Sustainability and Transformation Partnership (STP), Dr Sonja Manton told a meeting of county councillors this morning that there was ‘no rush’ to decide the future of community hospital buildings.

Contrary to Dr Simon Kerr’s suggestion in April that decisions would be made in July, Dr Manton was clear that the end of July is a deadline for the Devon Clinical Commissioning Groups (CCGs) to bid for capital funding from NHS England, but not for decisions about the local estate. If these two were previously linked, they are not any more.

She also confirmed what she said to me some months ago, that no decisions will be made about buildings until after the conclusion of the ‘community conversations’ such as Seaton Area Health Matters and Honiton Health Matters, launched earlier this year, and that discussions are still going on about the distribution of local services.

Dr Manton, who was launching the STP’s two-year report, also stated that there was no agreement yet on what a ‘health hub‘ is, or how many of them there should be.

There is no room at all for complacency, however, since the report states:

We know a large amount of space in our community hospital buildings is underused. The revenue cost of our community hospital estates is in the order of £20 million; money the NHS could use to improve other services. Working with other public sector partners, as part of the One Public Estate initiative, we will review the space that is required to deliver care, and plan to consolidate the number of sites to free up estate and generate money, which can be re-invested in technology and infrastructure.

It also appeared from the meeting that midwife-led maternity services are unlikely to be restored in Honiton or Okehampton any time soon. References were made to staffing difficulties and also safety issues in case of difficulties during birth.

Local refugee support group backs County Council’s request for help in finding accommodation for refugees

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Ottery Refugee Response have sent me Devon County Council’s appeal for help in finding accommodation:

Devon is playing its part in meeting the UK government’s pledge to bring 20,000 of the most vulnerable Syrian refugees to the UK by 2020. We are also part of the government’s national programme to look after unaccompanied asylum-seeking children.

Resettling Syrian families

A life away from war. Landlords - how you can help

Local councils working together across Devon have pledged to house over 40 Syrian families. Since June 2016, families have arrived in Devon at the rate of just over one each month on average. Families continue to arrive when housing is ready for them. To meet our pledges, we need landlords who will rent properties to councils to house refugee families. The UK government’s resettlement programme provides funding to Councils for housing and other resettlement costs such as English classes, interpreting, cultural orientation and help into work.

Looking after unaccompanied children

In summer 2016, the government set up a ‘national transfer scheme’ so that councils across the country could share the responsibility for looking after unaccompanied asylum-seeking children. These children may arrive in the UK independently or under government programmes. Devon joined the national transfer scheme from the start. We are already looking after children placed with us under that scheme and we have indicated to the government that we are prepared to receive children over the next few years in line with that commitment.

In autumn 2016, Devon hosted a temporary Home Office centre to look after children brought into the UK to be reunited with family members when the Calais ‘Jungle’ was closed.

Sign up to keep in touch with what Devon is doing and how you can help >

Contact email address: refugeesupport@devon.gov.uk

County Council asks Highways England to bring forward and implement proposals for the A35 at Wilmington ‘as soon as practicable’

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IMG_0755​I addressed Devon County Council’s Cabinet yesterday, and they gave their support to Wilmington’s campaign ​for crossings and traffic calming measures on the A35 through the village.
The Leader, Cllr John Hart, was very supportive and said that the Council had already written to HE, but not received a reply, and they would now write again.
The resolution was ‘that the County Council engages as a consultee with Highways England on their proposals for the A35 route corridor, and requests that the proposals are brought forward and implemented as soon as practicable.’
 
You can watch the webcast  (Wilmington discussion starts at 1.51).

Beds, beds, beds – Devon’s NHS couldn’t or wouldn’t give me their overall occupancy figure for the recent winter: but they were forced to buy in more capacity and there were ’12-hour trolley breaches’

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Devon NHS’s Sustainability and Transformation Partnership (STP) admitted in a report to Health Scrutiny yesterday that they had been desperately short of beds during the recent winter. They had to buy in extra beds to keep up with more patients staying longer, because of complex conditions. There were ’12-hour trolley breaches’, where patients had to wait more than 12 hours to be seen.

Despite my asking them directly, they did not give a figure for overall occupancy levels, although they did not deny my suggestion that they had been as bad as or worse than the   nationally reported level of 95 per cent. (The nationally recommended safe level is 85 per cent.)

Jo Tearle, Deputy Chief Operating Officer for the Devon CCGs, rebutted my suggestion that cutting community beds had contributed to this crisis, saying that these were not the kind of beds they had needed, and that there had been capacity in community hospitals most of the time. However this suggests that there was no capacity some of the time. It is difficult not to believe that extra community beds wouldn’t have given them more leeway.

Meanwhile, Kerry Storey of Devon County Council indicated the strains that the ‘new model of care’ at home had been under. She said that maintaining personal care at home during the winter had been ‘a real challenge’, requiring ‘creativity and innovation’ – you don’t need much imagination to see that it will have been a real crisis time with frail people at home in isolated areas, care workers and nurses struggling to get through the snow, and staff themselves suffering higher levels of illness.

I and others predicted that because of the closure of community beds, there would be severe pressure on beds in a bad winter or a flu epidemic (and actually, this was not overall a bad winter and the snow episodes were late and short; despite higher levels of flu, there was no epidemic this winter).

Shock revelation at Health Scrutiny suggests the ‘new model of care’ is more about switching intermediate care from community hospitals to ‘block bookings’ in private nursing homes – saving costs and freeing up assets. How long will it last?

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There was a staggering revelation yesterday at Health Scrutiny from Liz Davenport, Chief Executive of South Devon and Torbay NHS Foundation Trust, that they had made ‘block bookings of intermediate care beds in nursing homes’ when they introduced the ‘new model of care’. South Devon has closed community hospitals in Ashburton, Bovey Tracey, Paignton and Dartmouth and is currently consulting on the closure of Teignmouth – where I spoke at a rally last Saturday.

The ‘new model of care’ is supposed to mean more patients treated in their own homes, and there does seem to have been an increase in the numbers of patients sent straight home from the main hospitals.

But the idea that all patients can be transferred directly from acute hospitals to home is untrue. There is still a need for the stepping-down ‘intermediate care’ traditionally provided by community hospitals – the only difference is that now it’s being provided in private nursing homes instead.

It’s likely to be cheaper to use private homes, because staff don’t get NHS conditions, and crucially it frees up space in the hospitals so that the CCGs can declare buildings ‘surplus to requirements’ and claim the Government’s ‘double your money’ bonus for asset sales. It seems NEW Devon CCG has also made extensive use of nursing home beds, but we don’t yet know if there were ‘block bookings’.

However the private nursing home solution may not last – DCC’s chief social care officer, Tim Golby, reported that nursing homes are finding it difficult to keep the registered nurses they need to operate, and some are considering reversion to residential care homes.

This may be where the South Devon trust’s long term solution comes in – it had already been reported that it is looking to partner with a private company in a potential £100m deal which will include creating community hubs that contain inpatient beds.

The new model of care is also about privatisation.

I tell Health Scrutiny why Seaton and Honiton need to keep services in our hospitals – Exmouth Tory tells me I’m ‘abusing the procedure’

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When Claire Wright put ‘community hospitals’ as an item on the Devon Health Scrutiny Committee today, I went along and argued why Seaton and Honiton hospitals need to stay open with all the services and clinics currently provided – and more. Then Conservative Councillor Richard Scott from Exmouth – where the hospital is safe because it’s kept its beds – accused me of ‘abusing the procedure’. Claire and deputy chair Nick Way (Lib Dem) both defended me. The Tories then block-voted against Claire’s attempt to get the Committee to protect ALL community hospitals.