Minutes:
(Councillors Ball attended in accordance with Standing Order 25(2) and spoke to this item and Councillor Parsons attended under Standing Order 25 (1) and spoke at the invitation of the Committee questioning the rationale for the decisions and impact on their respective communities of the proposed closure of community beds at Okehampton and temporary closure of beds at Holsworthy Community Hospitals).
Ms J Fitzgerald (Chief Officer, NEW Devon Clinical Commissioning Group CCG), M L Nicholas (Director of Strategy / STP Programme Director, NEW Devon CCG), Mr R Sainsbury (Chief Operating Officer, NEW Devon Clinical Group) and Dr S Kerr (Vice-Chair Eastern Locality, NEW Devon CCG) attended and spoke to this item at the invitation of the Committee.
The Committee considered the Report of NEW Devon CCG on the ‘Your Future Care’ on the outcome of public consultation which had commenced on 7th October 2016 and the subsequent decisions of the CCG Board on 2 March 2017.
The CCG Representatives reported that its Board at its meeting on Thursday 2 March 2017 had determined:
· a reduction of community hospital beds from 143 to 72 in the Eastern locality
· Tiverton & District Hospital to be a fixed point providing an inpatient unit with 32 beds
· Exmouth Community Hospital as a 16-bedded hospital
· Sidmouth Community Hospital as a 24-bedded hospital
· in light of the rurality and associated factors, to commission further work to assess more extensively the services needed in the Okehampton area.
The decisions meant that community inpatients beds at Sidmouth, Exmouth and Tiverton community hospitals would remain, while those at Seaton, Exeter (Whipton), Okehampton and Honiton would close.
The Clinical Commissioning Group’s representative responded to Members’ questions and/or commented that:
· detailed planning for implementation of the changes would start as soon as possible and led by the community services provider, the Royal Devon & Exeter NHS Foundation Trust;
· the robust implementation assurance process which would be in place and inpatient beds would only close when the assurance process had been completed and this would be phased to ensure the new community services were in place and patient care could continue to be provided safely;
· an assurance panel including consultant geriatricians, GPs and Healthwatch with social and primary care input, would be established and community representatives would be included from the areas affected by the changes;
· a consultation response unit (CRU) had been set up to answer questions and could be contacted via d-ccg.yourfuturecare@nhs.net
· approximate cost savings arising from the planned changes and that the detailed plans relating to staffing and resources arising from the proposals had not, as yet, been drawn up;
· relevant Performance Indicators in regard to current and future outcomes would be provided.
The Chairman undertook to seek a breakdown of the cost of the STP process in Devon reported at £2.6 million over the last 6 months.
The Scrutiny Officer outlined the timetable for any referral to the Secretary of State which would necessarily be preceded by a formal request to the CCG which should respond within 28 days to the concerns raised and emphasis on dialogue with a view to local resolution.
It was MOVED by Councillor Wright, SECONDED by Councillor Chugg and
RESOLVED
(a) that this Committee object to the decision by NEW Devon CCG to reduce the number of community hospital beds in Eastern Devon from 143 to 72 and regardless of cost no bed closures be made until it is clear there was sufficient community care provision;
(b) that, if adequate assurances are not given to the above and the issues set out below, the CCG’s decision be referred to the Secretary of State for Health on the grounds that it was not in the in the interests of the health service in the area and the consultation was flawed:
:
• there is no clear explanation of what care at home will look like or work and this model has frequently been mixed up with Hospital at Home which is entirely different;
• there may not be adequate care available in people's homes, given the staffing shortages in the NHS, and the significant difficulties in adult social care;
• Hospiscare reported in its consultation response to the bed closure proposals that during 2015 managers 58 incidents reported to the CCG where the breakdown of social care packages for people at end of life had caused distress. All of these people had wanted to be cared for at home;
• there are no clear answers on how many more staff are required to make the new model of care work and that there are shortages in many health professional disciplines
• despite a significant budget deficit, there is no clear financial saving to be made. In fact once the new model of care is in place the savings may be extremely small;
• there is no clear plan on the future of hospital buildings that have lost their beds and are now in the ownership of NHS Property Services;
• the new Government direction that will come into effect next month which mean health trusts will need to prove that there is sufficient alternative provision before any beds close;
• closure of many care homes;
• Okehampton and Honiton hospitals were excluded from the consultation process;
• the temporary closure of Holsworthy Hospital which is where the patients were to be referred;
• the ongoing and significant pressure on RD & E hospital beds and difficulty with discharge;
• possible doubt over the data relating to the decision to retain Sidmouth hospital beds over Seaton’s hospital beds;
• staff appear to be opposed to the plans.
(c) that a review of community hospital bed closures be made across Devon since 2014 to establish the effectiveness of the replacement home care, including examining the role of social care.