Devon community hospitals
Health Scrutiny hears there will be no precipitate decisions on community hospitals – local conversations with CCG and RD&E offer chance to shape ‘place-based health systems’ around towns
In my third and final report from yesterday’s Health Scrutiny, I come to the report on the future of the hospitals by NEW Devon CCG and NHS Property Services, in response to the Committee’s request for clarification. (This arose from my presentations at the September and November meetings). While NHS PS stressed that in principle they will eventually have to charge market rents, Claire Wright elicited the useful information that currently NHS England are still paying for the buildings, and the company said they are ‘always happy to work with local communities to consider local services’. Scrutiny’s resolution requested that NHS PS ‘uphold this undertaking’ and keeps the Committee informed on the timeline for changes in the status of the hospitals.
The CCG’s Sonja Manton confirmed that the community conversations the CCG and RD&E are now promoting to develop ‘place-based systems‘ around ‘market towns’ – which have already begun in Honiton and Okehampton – can certainly include the services people want to have delivered locally in the hospitals. While there are cost constraints and not everything which people want will necessarily be delivered, local communities can certainly discuss these services with the NHS organisations, as well as how voluntary organisations can help the NHS and adult social care. Okehampton’s Conservative county councillor, Kevin Ball (below front left, with Non-Aligned Group leader Frank Biederman behind), stressed the progress his community had made in the recent meeting in the town. He and Okehampton’s mayor, Jan Goffey, mentioned that FORCE Chemotherapy will soon be opening a service in the hospital.
In my speech (1:34:20) I welcomed the new ‘place-based’ focus and stressed the importance for towns like Seaton – which is 45 minutes to an hour from acute hospitals – of using the free space in the community hospital to deliver routine treatments and operations for which people currently have to go to Exeter. I pointed out that constituents complain to me all the time about the stress, strain and cost of repeated travelling, often when unwell, without parking, park-and-ride space or bus services – while Exeter complains of congestion!
I mentioned the request of the RD&E’s Em Wilkinson-Bryce, in Honiton last week, for the community to trust the NHS organisations, and said that a serious conversation about local services – in which the NHS takes on board what people want – would be the best way to create this. We wanted to keep the beds, but now they are gone proper ‘place-based’ strategies for each of our towns offer the prospect of working together with the NHS. Preparations are underway for a meeting similar to ‘Honiton’s Health Matters’ in Seaton in March, and I will give more information as soon as the date is fixed.
I’m making a new proposal to safeguard community stakes in community hospitals, tomorrow at Health Scrutiny
Community hospitals in Devon have always been built and maintained with a high degree of community involvement and support. In many cases, local communities took the initiative to build the hospitals and raised substantial part of the original funding, or even the entire funding of additional wings and facilities, as well as contributing to staff and other running costs, the introduction of new specialist services, etc.
Unlike Private Finance Initiatives undertaken in partnership with private companies, these ‘community finance initiatives’ – which sought no profit from their investments other than the improvement of the facilities and services they enabled – appear not to have secured their interests in the hospitals they helped to build. The Leagues of Friends and others who raised funds for hospitals trusted that their investments would continue to be used for the benefit of place-based health services in their local area.
Since the 2012 Health and Social Care Act, however, the organisation of the NHS has changed and the ownership of NHS buildings is in the process of being transferred to a new company, NHS Property Services, wholly owned by the Secretary of State and charged with managing the NHS estate in line with national priorities. NHS Property Services is enabled to sell off parts of the estate and to charge NHS organisations market rents for their use of NHS buildings.
This change creates dilemmas for local communities which have invested in Devon community hospitals. Clearly Leagues of Friends and other local bodies, including town and parish councils as representatives of communities which have raised large amounts of funding, can be considered ‘stakeholders’ in community hospitals. However these community stakeholders appear not to possess formal rights in the ownership and governance of the hospitals.
The proposal is that the Health and Adult Care Scrutiny undertake an investigation into
1. The changing ownership and governance of community hospitals in Devon and its implications.
2. The historic and ongoing contributions of local communities and Leagues of Friends to funding the hospitals.
The purpose of this investigation would be to address the question of
3. How community stakeholders’ interests should be secured in the future governance of community hospitals.
It is envisaged that in the course of this investigation, the Committee would both collect evidence and invite expressions of views from all stakeholders, including both local community organisations and NHS bodies, including NHS Property Services.
A planning inspector has ruled against Clinton Devon Estates’ attempt to build houses on half of the Budleigh Salterton hospital garden (the hospital is one that has already lost its beds): https://eastdevonwatch.org/2017/09/07/clinton-devon-estates-and-budleigh-hospital-garden-a-pr-nightmare-for-today-and-tomorrow/
The Royal College of Surgeons vice-president, consultant urological surgeon Ian Eardley, says that figures showing continuing over-occupancy of NHS hospital beds in England ‘suggest bed reductions have now gone too far in the absence of sufficient social care or community care alternatives.’
Exactly what we are all saying to NEW Devon CCG! Time to SUSPEND THE CONSULTATION AND GET ON WITH IMPROVING THE COMMUNITY CARE ALTERNATIVES.
The RCS leader added “We are now seeing increasing numbers of frail older patients in hospital because they have nowhere else to go. The lack of additional money in the autumn statement for social care and the NHS is only going to make this even harder.”
Neil Parish MP said he would press for additional resources – what will he do now that his Government has let him down?
Local community hospitals, including Seaton, will have to pay £3.1m a year in rent to NHS Property Services, in new fallout from the Conservatives’ disastrous reorganisation of the NHS. Seaton’s share of these supposed ‘market rents’ is not yet clear.
Thanks to Independent County Councillor Claire Wright for once again exposing this dangerous situation, which will surely threaten the closure of some hospitals in due course.
Whatever relief we feel at the news that the number of general medical beds in Seaton Hospital will increase must surely be tempered by the fact that the clumsily named NEW (Northern, Eastern and Western) Devon Clinical Commissioning Group, doesn’t even get the idea of community hospitals.
A NEW Devon spokesman, writing in this week’s View From, says that they have to take account of the ‘whole population’ of the area, not just specific ‘communities’. Community opinion in Axminster (and Ottery St. Mary, which will also lose its beds) has simply been set aside.
EDDC’s Scrutiny Committee, chaired for the first time in years by a non-Conservative (Independent, Roger Giles), has asked both MPs to request the Secretary of State for Health, Jeremy Hunt, to overrule the decision to remove the beds from the two hospitals. Our MP, Neil Parish has already said he will do this for Axminster. I wish him well with this but I’m not holding my breath.
Parish says that ‘Our Government’s NHS legislation puts much store on local people being consulted and listened to’. However the Lansley reorganisation was universally criticised for creating a fiendishly complex structure which would make it more difficult for people to influence. And so it has proved.
Seaton Hospital – beds safe for now. But for how long?