At the latest OSC meeting on Friday (6 September), of which I am a member, there was a bumper agenda, with 14 items listed, including:

– information on how £1m cuts to the maternity budget in north Devon, may affect frontline care

– a north Devon community hospital that is planning a public consultation after suddenly closing all its beds

– plans to shut all the beds at Budleigh Salterton community hospital, including an eight bedded stroke unit serving East Devon, to make way for day care services

– the progress of plans for a major change in the way community services are delivered, called “transforming community services.”  This document, once published in consultation form in the next few months, will set in train plans to significantly change the way in which Devon community hospitals are used.

Around 600 people attended the “health summit” events, which ran across Devon in many towns over the summer.

I asked what the feedback was from these events in terms of what services people had said they wanted to keep. The answer,which was along the lines of high quality clinically led care etc, was a bit vague, in my view.

I asked that the raw data in terms of typed up notes from these events, be given to the committee for the next meeting.  It is vital that scrutiny councillors are aware of what people said what health services are most important to them.

Changes to the way in which community hospitals are used
I don’t yet know the detail of these proposals, suffice to say I think we can look to what is taking place at hospitals in Torrington and Budleigh Salterton and Ashburton (which announced similar plans last year) to get a flavour of what may be around the corner.

To those of us who are familiar with what is happening at the major hospitals – the RD&E, for example, is under significant pressure with major staffing cuts and the numbers of people being admitted – it is hard to believe that community hospital beds, often used for recuperation, simply aren’t needed. 

Yet the message given at Friday’s meeting by several NHS staff, was that community hospital beds in question were lying empty and therefore, surplus to requirements.

The forthcoming changes are set amid a push to care for more people in their own homes and this was a position frequently articulated on Friday.

The coalition claims that NHS budgets are ringfenced, however, in March this year it announced that the NHS must make £20bn of “efficiency savings” by 2015, accompanied by the following nonsense statement:  “So there are more funds available for treating patients and to allow the NHS to respond to changing demands and new technologies.” – see policy document here – https://www.gov.uk/government/policies/making-the-nhs-more-efficient-and-less-bureaucratic
So NHS budgets are already being crippled – and that’s before any ring-fence is removed.

Staffing
One of the issues of concern that came out of Friday’s OSC meeting, was that Northern Devon Healthcare Trust (NDHT), which runs community hospitals across Devon, seem to often have staffing difficulties, and services are affected as a result.

Managers insisted on Friday that NDHT’s staffing issues were no worse than anywhere else, however, Cllr Polly Colthorpe raised concerns about a minor injuries service at Tiverton Hospital, which has been reduced to just one day a week. As a result barely anyone uses it, she said.

Staffing difficulties appear to have also played a part in the sudden removal of all the beds at Torrington Hospital, which has infuriated the community there. Although, the message from the NHS staff was that they simply were not needed.

This struck a chord with me because at Ottery community hospital at least, beds have been gradually closed.  This link states that Ottery Hospital has 24 beds – http://www.northdevonhealth.nhs.uk/services/community/ottery/ 

Not any more. Over the past year or two, Ottery hospital’s beds have been closed bit by bit so that there are now around only 12 beds in use, I believe.  The general answer when enquiries are made, is that the beds aren’t needed and are lying empty for much of the time.

In July, Ottery Hospital’s minor injuries unit closed for three months because of staffing issues, and instead is now operating out of Coleridge Medical Centre. 

When I worked for the NHS, Ottery Hospital’s minor injuries unit was operating from something like 8am-8pm, then the hours were reduced to 9-5pm and now the unit is open during the mornings only. 

The knock-on effect is that people turn up and are turned away and then gradually fewer people use the service ….

Chairman, Cllr Richard Westlake, requested details of all staffing vacancies across Devon community hospitals, for the next meeting.

Stroke care in East Devon
Going back to what’s happening at Budleigh Salterton Hospital, the eight bed stroke unit is a service for all East Devon patients and its proposed loss will affect people across East Devon who need help with recovering from strokes, after being discharged from the RD&E.

Scrutiny councillors were informed by health service staff that feedback had revealed that Budleigh Salterton Hospital was tricky to get to for stroke patients and their visitors.

However, the same member of staff also indicated that recovery for patients staying at Budleigh Salterton Hospital’s stroke unit, was “fantastic.”

Presumably, the argument about being tricky to reach could apply to most community hospitals in East Devon.

The continual unsettling messages of forthcoming significant change, the effect of budget cuts, hints at staffing problems, and the difficulties getting clear answers, prompted councillors to request more scrutiny meetings, to look into issues more closely.

The Francis report
One of the agenda items was a resume of the Francis report – related to the appalling series of unnecessary deaths at Mid Staffordshire Hospital. Here, it was clear that the health scrutiny function had failed and many reports to the committee had simply been “noted.”

This prompted me to outline concerns at the number of verbal reports that NHS staff were giving during Friday’s meeting, without any supporting paperwork. Previously, I have objected to tabled reports, which are equally frustrating and not good practice.

Proper scrutiny can only be effectively carried out if adequate information is received by councillors in advance of the meeting, so I proposed that this happened in the future. Other councillors agreed.

Officers confirmed that they had repeatedly and unsuccessfully asked for such information.  Hopefully things will now change.

Health and wellbeing OSC chair, Cllr Richard Westlake will now write to DCC leader, Cllr John Hart, to formally request that the number of health and wellbeing scrutiny committee meetings are increased.

The webcast, with index points relating to agenda items and speakers, can be viewed here:  http://www.devoncc.public-i.tv/core/portal/webcast_interactive/93464

Photograph:  The excellent Ottery St Mary Hospital.