NHS

NHS Support worker jobs available now in Sidmouth, Seaton and Axminster

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Richard Anderson, the Health and Social Care Community Services Manager for Sidmouth, Axminster and Seaton, has asked me to publicise the fact that NHS Support Worker jobs are available now in the three towns.

Good rates of pay, pension etc.  Please ring Julia Blake on 07592 579919.

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.

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.

‘A wake-up call for East Devon … the threat is even more serious than the loss of beds last year’ – my letter in The Paper for Honiton on the fallout from Dr Kerr’s statement that Seaton and Honiton hospitals are ‘at risk’

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Published in this week’s issue:
The Paper for Honiton (17 May) was right to highlight the statement of Dr Simon Kerr of NEW Devon Clinical Commissioning Group (CCG) that Honiton and Seaton hospitals are ‘at risk’ of closure, which he has not denied making. This should be a wake-up call to everyone in East Devon that any of our community hospitals, including also Axminster, Ottery St Mary and Whipton, which have lost their beds could be closed after the CCG’s Local Estates Strategy is published around July. The CCG remains focused on cutting its deficit, mainly the result of the NHS being badly underfunded, and the Government has given it a ‘double your money’ incentive to sell off ‘surplus’ buildings.
This threat is even more serious than the loss of beds last year. In the face of it, I call on all East Devon county councillors and the leader of East Devon District Council to join me in pressing the CCG to continue funding a wide range of outpatient services in all our hospitals, keeping them as health and wellbeing hubs (in line with the policies supported by all parties in last year’s county elections), and turning the CCG’s idea of ‘place-based care’ into reality. We have an enviable system of community hospitals supported by local people over many decades. Let this remain the centre of our local health provision in every town – without exception.

Seaton & Area Health Matters holds successful second meeting – steering group set up and agreement on Axe Valley approach

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On Thursday, the follow-up took place to the inaugural meeting of Seaton & Area Health Matters. After an informative presentation by Richard Anderson, manager of the community team for Seaton, Exmouth and Sidmouth based at Seaton Hospital, the meeting broke into workshops, and when we reconvened agreed on an approach which envisages an Axe Valley health hub centred on Seaton and Axminster hospitals. Axminster is having a similar process of discussions and we will liaise with them down the line. The Seaton steering group will meet shortly – members (I haven’t got the full list) include Cllr Jack Rowland, Dr Mark Welland and myself.

CCG chair says Seaton and Honiton hospitals ‘at risk’ of closure in Local Estates Strategy

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It has been revealed that Dr Simon Kerr, Chair of NEW Devon CCG’s Eastern Locality, told a meeting with representatives of 38 Degrees on 5th April that Seaton and Honiton hospitals were ‘at risk’ in the CCG’s Local Estates Strategy due in July. His remarks were taken down by the 38 Degrees member who produced draft notes of the meeting, and have been confirmed by other participants, but have not yet been confirmed by the CCG.

Although the hospitals both lost their inpatient beds last summer, Seaton Hospital currently hosts over 50 outpatient services (and there are probably at least as many in Honiton). Both are vital community health resources, created with decades of financial and practical support from people all around the Seaton and Honiton areas.

As part of a move to promote ‘place-based care’, the CCG and RD&E are currently taking part in two ‘community health conversations’, Honiton’s Health Matters and Seaton and Area’s Health Matters, which local voluntary groups, town and parish councils etc. are involved in. However if place-based care means anything, it should mean that communities should keep their local hospitals as health hubs, with more rather than fewer services.

Together with Cllr Jack Rowland, who stood down as mayor of Seaton last week but remains the town council’s representative on the Health Matters organising group, have written to Dr Tim Burke, Chair of the CCG, to ask for an unequivocal assurance that the hospitals will remain open.

I am hoping to shortly announce a meeting of the hospital campaign group.

I have written to @CllrIanThomas, incoming EDDC leader, for assurances on health services and hospitals, after Conservative amendment leaves East Devon community hospitals vulnerable to closure

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In a debate at EDDC on Wednesday Independent East Devon Alliance councillor, Marianne Rixson, proposed a motion ‘requesting the NHS organisations to observe the following principles:
1.  All community hospitals which have lost beds should be maintained as health hubs.
2.  Wherever possible, services and clinics should be moved out of Exeter to local community hospitals.
3.  More outpatient services should be provided in each community hospital, with no overall cuts to the level of services in any town in order to minimise complex journeys between towns.’
image1I was disappointed to hear that this motion was completely replaced by an ‘amendment’ (left) proposed by Conservative Councillor Mike Allen, which was then carried.
I have written the letter below to express my concerns to incoming Council leader, Ian Thomas, the member for Trinity ward, to ask him to join me in pressing for each of our hospitals to be kept as a hub for outpatient services.
LETTER TO IAN THOMAS
Dear Ian, 
 
Belated congratulations on your nomination to lead EDDC, which I assume will be agreed at the Annual Meeting in a fortnight’s time. I am writing following last week’s Council resolution on health, to ask for your clear support for keeping all community hospitals in East Devon as health hubs. As this is a matter of great public interest, I shall make this letter public.
 
Since I could not be present at the meeting, I will not comment on the procedure adopted, except to inform you that members of the public have complained to me about the way Cllr Rixson’s motion was ‘amended’ by Cllr Allen. My concern is rather that the resolution potentially increases the vulnerability of some of our community hospitals to closure when the CCG announces its Local Estates Strategy.
 
I welcome the resolution’s call for the CCG to provide ‘evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet’, and the reference to ‘consultation with local communities’ about community hospitals, as well as the review of service changes (bed-based to home/community-based care). You will need to press hard on the latter, as Claire Wright has been asking for it repeatedly without success at DCC.
 
My worry is that the resolution removes the benchmark assurances that Cllr Rixson’s motion sought. While the resolution says that all efforts should be made, in consultation with local communities, to ensure the existing estate of community hospitals is retained for health care purposes, it only recommends that, Where appropriate, the potential development of “Health Hubs” be investigated. 
 
Unfortunately this can clearly be read as implying that hubs will not necessarily be appropriate in every hospital – and that EDDC might therefore accept the closure of those hospitals which are not developed as hubs
 
I remind you that when the Conservatives fought the County elections last year, you said you wanted ‘bed-less hospital buildings adapted to accommodate new health-related services and boost community health provision‘. There was no suggestion of any exceptions then.
 
I would like you to give an explicit assurance that you will join me in pressing for
 
(1) each of the hospitals which has lost its beds (Axminster, Honiton, Ottery and Seaton), as well as Exmouth and Sidmouth, to be kept open;
(2) achievement in each hospital of the ‘boost’ in health provision which your 2017 policy rightly asked for – and any in any case no overall cut in services in any of them; and
(3) a formal public consultation in the affected town and surrounding area should a closure of any community hospital, involving substantial relocation of outpatient services, be proposed.
 
Kind regards,
 
Martin

My message of support to the legal team who are fighting the dismantling of the NHS in a crucial case in Leeds Crown Court tomorrow #Justice4NHS

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Tomorrow, the crowdfunded legal case brought by 999 Call for the NHS to stop US-style ‘Accountable Care Organisation’ (ACO) contracts being introduced into the NHS will be heard in Leeds Crown Court. Supporters from all over the country are gathering in Leeds and I’ve sent them this message:
‘On behalf of the councillors and activists who are campaigning against the Integrated Care System in Devon, I send best wishes to our legal team and everyone who is campaigning to keep a universal, comprehensive and fully public National Health Service.
‘Following our opposition, the Devon STP has given up the idea of Accountable Care Organisations for the time being. We believe that this legal case has already played a key role in slowing down the moves by the Conservative Government and NHS England to place our health service in the ACO straightjacket. We now look forward to a legal victory which will turn the tide against the dismantling and privatisation of the NHS.’