NHS
Shouldn’t we be looking again at community hospital beds, to support care-at-home model? Devon Conservatives squash recommendations of review chaired by Claire Wright
Claire Wright writes: A recommendation urging no further community hospital bed closures in Devon has been voted down by Conservative councillors on Devon County Council’s Health and Adult Care Scrutiny Committee.
The recommendation, which was debated on Thursday (22 November) was part of a set of measures set out in a scrutiny spotlight review aimed at supporting the care at home service (or rapid response) to be more effective.
Highlighted in particular as a challenging area were services for end of life care, which have been put under considerable pressure, especially since the loss of community hospital beds. … read on at Claire’s blog
Report of Seaton meeting with RD&E published
Agreed notes from the meeting of Seaton Area Health Matters with the RD&E Trust are now on the Health Matters website.
A patient tells me of waiting 11 months for hip replacements in @RDEhospitals – and it’s going to get worse this winter. The RD&E boasted of cutting ‘elective admissions’ by 5 per cent last year, but this is a shameful failing of the Trust and @NEWDevonCCG.
From a constituent: ‘I am writing to you with another example of the impact and stupidity of reducing beds in local community hospitals. I am presently on the waiting list for hip replacement surgery at the RD&E. This waiting list is currently 11 months, compared with the Government guidelines of 18 weeks.
‘During a follow-up phone call with the RD&E last week, I was told that winter health problems were already causing a shortage of beds and the knock-on effect will be further delays for people on waiting lists for serious surgery. Clearly, beds in community hospitals could have been used to help with winter health emergencies.’
Hip replacements are called ‘elective surgery’ and the RD&E Trust boasted earlier this year that it had reduced the number of these admissions by 5 per cent. As I pointed out to the Health Scrutiny Committee at the time, this might be something to be pleased about if lifestyle changes, etc., meant that people didn’t need so many operations – but the evidence is to the contrary. It has been achieved by lengthening waiting lists for patients who suffer pain and discomfort for months or even years on end.
The lack of priority for ‘elective’ admissions is one of the most shameful failings of the NHS in Devon, alongside the mounting delays in treatment for cancer. Both these problems are repeatedly brushed under the carpet by local NHS leaders.
Seaton Health Matters has constructive meeting with RD&E about health services in the area, and we look forward to working together for the best solutions
Jack Rowland, Geoff Pook, Dr Mark Welland and I, representing Seaton Area Health Matters, met Professor Em Wilkinson Bryce and Adel Jones of the RD&E at Seaton Hospital yesterday to discuss the future of health provision in the area. All agreed it was a constructive meeting, and we look forward to working closely with the RD&E on plans for health, wellbeing and community activities centred on the Hospital.
One of our next steps will be to have a detailed discussion with colleagues in Axminster, who also met the RD&E recently, to formulate an Axe Valley approach. Notes of the Seaton meeting are being prepared, and once I have these I will make more details available.
Seaton Health Matters website live
The Seaton Area Health Matters group is pleased to announce that their website is now live and can be accessed:
You can keep up to date with what we are trying to achieve to tackle the top 10 priorities identified earlier this year facing our area in the provision of health, care and wellbeing services. We will also post news that we receive as the result of discussions we are having with the Royal Devon & Exeter Trust and the Clinical Commissioning Group as well as news that emanates from Council meetings at Town, District and County level.
Broadly the challenges involve trying to establish a health hub to extend the number of clinics and services available at the Seaton Community Hospital site and co-ordinating the information to show the range of voluntary groups involved in providing health and wellbeing support in the area.
We welcome input on these important issues and the website enables this to happen.
It seems likely CCG strategy director DID say that there would be no closures of East Devon community hospitals – but in a private meeting for councillors. Over to you again, @NEWDevonCCG: we need a definitive, detailed public statement
Conservative councillor Phil Twiss has commented on East Devon Watch about my post yesterday. He says:
Happy to clarify that a discussion about provision of services in our local hospitals was raised at the Health Scrutiny Masterclass to improve knowledge (other Scrutiny committees hold similar cross party meetings as required), held on the 4th of October, which is open to all members of DCC. This particular one was attended by a broad cross party selection of Councillors, but not Martin Shaw or colleague Claire Wright who chose not take up the opportunity to hear from a variety of healthcare professionals at the Masterclass. My apologies to your reader for any confusion with the committee held on the same day.
I am delighted that local charity FORCE are now providing some chemotherapy treatments in Honiton, making it easier than travelling in to Exeter, with hopefully other services coming down the track; there is a clear ambition for healthcare hubs here and in the Axe Valley, where there is cross party work taking place to this end.
My reply on the same site:
Since Phil Twiss has clarified where Sonja Manton was speaking, but doesn’t comment on what she said, we must assume that he stands by his statement in the open Council meeting that she had confirmed there would be no closures of community hospitals in East Devon. If so, this is obviously very welcome, but the devil could be in the detail, and it is not good enough for such vital public information to be leaked to councillors in informal meetings. We need a public statement from the CCG, assuring us of the future of Axminster, Honiton, Ottery St. Mary and Seaton hospitals (as well as Okehampton which is part of the wider Eastern Locality).
Twiss’s comment that Claire Wright and I “chose not to take the opportunity” to attend the masterclass barely deserves a reply. However I have been dealing with a very difficult family situation over the last two months and this was one meeting which I had to pass up. I am not, in any case, a member of the Health Scrutiny committee, but since I was elected I have attended almost all its meetings, chiefly to support Claire in fighting for the community hospitals.
If the CCG now accept that the hospitals must stay, this will be a great victory for the campaigns in all the towns over the last few years, and for Claire, the Independent councillors at EDDC, and myself, who have supported local communities while the Conservatives have constantly left the door open for the CCGs to close them “where appropriate”, in the words of their most recent motion at the County Council.’
@philtwiss’claim that @SonjaManton said ‘there are no plans to close any community hospitals in our area’, not backed up by @NEWDevonCCG. What’s the explanation, Phil?
Conservative County Councillor for Honiton, Phil Twiss (right), told Devon County Council on 4th October that ‘Sonja Manton [Director of Strategy for the Devon Clinical Commissioning Groups] said at the Health and Adult Care Scrutiny Committee the other week that there no plans to close any community hospitals in our area. We were talking about Seaton, Honiton and Axminster at the time.’
I was surprised that he should give us this good news in passing, and that the CCG had made no announcement of something so obviously important. So eventually I watched the webcast of the Health Scrutiny meeting on September 20th. Although Sonja Manton spoke several times, I couldn’t find her saying anything like what Phil said – indeed anything about community hospitals at all.
So I emailed Sonja and she confirms she didn’t speak about the hospitals. As for the issue, all she would say was, ‘I can assure you that our continued focus remains on planning and commissioning services and support to meet the needs of the Devon population in the best possible way. We recognise how strongly communities feel about community hospital buildings and will continue to work with communities and stakeholders to modernise and evolve the way our services are delivered and where they are based to make sure we make best use of all our resources and public estate.‘
So was Sonja more forthcoming at another, presumably private, meeting, Phil? Or was what you said wishful thinking?
EDDC fails to protect our community hospitals, offering specious justifications for failing to list Seaton Hospital as a ‘Community Asset’
On Wednesday, Cllr Jack Rowland (right), Chair of Seaton Area Health Matters, questioned EDDC’s refusal to list Seaton Hospital as a Community Asset – which would have given Seaton Town Council, which made the request, additional grounds and time to object to any proposal for closure.
He was given the answer below. I think the reasons are specious. The guide to the Localism Act which is quoted does not claim to list all the types of buildings that can be covered, but merely gives examples. As the fact that two other Devon councils have listed hospitals shows, this is a question of interpretation. EDDC have chosen to interpret Community Assets narrowly, and then explain away the other councils’ decisions by the fact the hospitals concerned may be in relatively deprived areas, the reason North Devon gives for listing Ilfracombe – although this reason is not mentioned in the guide to the Localism Act, either!
Clearly community hospitals do, as the guide says, ‘play a vital role in local life. … Local life would not be the same without them, and if they are closed or sold into private use, it can be a real loss to the community.” This is true regardless of how deprived the area is. Jack Rowland’s challenge has shown that once again, EDDC has defaulted to failing to protect our community hospitals.
EDDC’s ‘recorded reason’:
The main use of the property is the ‘care element’ which may be considered as furthering the social wellbeing or social interest of the community, however, this does not come within the scope of the Localism Act.
A plain English guide to the Localism Act, states:
“Every town, village or neighbourhood is home to buildings or amenities that play a vital role in local life. They might include community centres, libraries, swimming pools, village shops, markets or pubs. Local life would not be the same without them, and if they are closed or sold into private use, it can be a real loss to the community.”
In this case the nominated asset does not fall into the category of a Community Asset under s88 of the Localism Act and therefore should not be listed.
The Council believes that this interpretation of the law is correct as there is no evidence to suggest that community hospitals were in the mind of the legislator when the law was enacted. This is reinforced by the definition of ‘social interests’ in Section 88(6) of the Localism Act 2011 which states that it is, in particular, cultural, recreational or sporting interests. In addition there certainly appears to be no reference to community hospitals for example on any relevant websites. Had it been the intent of the legislator to include health care then one would have expected it to be listed in the relevant definition. It has also been confirmed that religious observance in a building does not fall within ‘social well-being’ and our view is that this is analogous to circumstances surrounding health care provision.
In the Case of North Devon Council they have helpfully published their reasoning for deciding that Ilfracombe hospital was an appropriate site to be registered under the community right to bid: https://www.northdevon.gov.uk/media/378607/decision-notice-tyrrel-hospital.pdf
In particular, considerable emphasis is put on the fact that Ilfracombe is an area of high deprivation and low car ownership in a rural locality. This justification has been used to justify a departure from the original legislative intention.
Teignbridge Council have not published any of their decisions but looking at the location of the relevant properties it would appear that the assets are similarly located in areas which experience the worst levels of deprivation in Devon: http://www.devonhealthandwellbeing.org.uk/jsna/overview/archive/socio-economic-deprivation/indices-of-deprivation-2015/
The same cannot be said to be the case in either Axminster, Honiton, Ottery St Mary or Seaton. In the circumstances therefore there is no justification for departing from the correct legal interpretation and any consequential risks’.
Who’s ‘weaponising’ community hospitals, @HugoSwire? Two years ago you were happy to sell out Seaton Hospital to save your parliamentary career
Dear Hugo Swire,
In a recent Exmouth Journal article you said: “Regrettably, Ottery Hospital has been weaponised by an anti-Tory coalition for nigh on ten years with them telling a naturally alarmed local community that it will be sold off or closed. I have spent 10 years trying to counter this scaremongering. …”
It’s hardly scaremongering when the hospital has lost its beds and this July’s Devon NHS Sustainability and Transformation Partnership report said, ‘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’s also rich for you to talk about ‘weaponising’ community hospitals. In Seaton we remember all too well when the Clinical Commissioning Group launched its consultation on the future of community hospital beds in 2016, with its preferred option being Option A which would keep the beds in Tiverton, Exmouth and Seaton. You said in Parliament that ‘option B, which sees the beds retained in Tiverton, and also in Sidmouth and Exmouth, is the option worthy of support. Sidmouth has an extremely high proportion of over-85s, with people increasingly living longer, and of people with dementia. Exmouth is the biggest town in Devon with more than 35,000 people.’
Four months later the CCG followed your recommendation, changed its preference, and closed Seaton’s beds. The reasons given for preferring Sidmouth to Seaton were specious – Seaton has an almost identical proportion of elderly. In short, Hugo Swire, you sold Seaton down the river because it was no longer in your constituency (having been removed due to boundary changes in 2010) and you needed to save beds in Sidmouth as well as Exmouth to fend off the challenge from Claire Wright, who even so ran you close in the 2017 General Election.
Today Seaton Hospital, like Ottery, Honiton and Axminster, faces an uncertain future. If it closes, it will be a knock-on effect of the beds decision, and it will be partly on your head.
Martin Shaw, County Councillor for Seaton and Colyton
Seaton & Colyton MATTERS 