Monday, 18 June 2012

Intensive Community Support and Ward Closures: An Update

Last month I reported on the plans of Leicestershire Partnerships Trust to divert 48 hospital beds in west Leicestershire to ‘Intensive Community Support’. In very simple terms providing nursing care at home for frail and elderly patients who have historically required stays in community hospitals.

Whilst it is undoubtedly true that given the choice many patients would prefer to recover from illness in their own home I warned that ICS should not simply be seen as an opportunity to cut costs.

Last week LPT revealed to staff and stakeholders more details of their plans and the proposals are at the very least worrying.

A very simplified summary is that ward 3 at Coalville Community Hospital and Grace Dieu ward at Loughborough Hospital will face closure as a result of the initiative.

However, in a ‘question and answer’ sheet given to staff management reveal that:

‘We will be reallocating resource into community-based services but we do expect to make cost savings…’

This is deeply concerning as the Government’s own report on pilots to integrate health and social care make it clear that there is no money to be saved by improving care in this way. (National Evaluation of the Department of Health’s Integrated Care Pilot: RAND Corporation)

Indeed this must raise concerns that ‘expecting to make cost savings’ may well lead to the initiative not being implemented in a thorough manner for the benefit of patients.

But this is not the end of the concerns. The question and answer sheet goes on to cover the issue on whether hospitals will face closure. The answer is somewhat ambiguous:

‘We are not introducing this model to close community hospitals. Community hospital wards will remain a vital part of the pathway of care for frail older people but with these patients being treated in the community they will not be occupying a community hospital bed.’

It must be noted that there is absolutely no commitment to keep any hospital open.

One logical conclusion is that a closure of a ward in Coalville could well lead to a relocation and closure of Ashby and District Hospital. Indeed this is an outcome that many staff do fear.

The proposals of LPT, whilst laudable in principle, at this point are entirely unsatisfactory.

Management MUST make clear where they expect cost savings to come from whilst at least maintaining care standards given contrary evidence from the governments own pilots.

Similarly management must be more transparent about their plans for retention of our highly valued community hospitals.

Without clarity staff, stakeholders and local people will continue to be deeply concerned that local hospitals face a very uncertain future.

I am in the process of contact the Locality Service Manager to ask for answers to these two vitally important questions.

4 comments:

  1. My God!! Once again it is the elderly in the community who will be suffering. My Aunt has been under the care of Gracedieu Ward at Loughborough hospital. The care is second to none. Without this ward she would have been sent home from the Royal after a major op without the strength or the ability to stay at home on her own. The eldery will be bounced back to hospital without due care and support. All elderly people would want to return their own homes wherever possible but not until they are fully fit and able. AN ACCIDENT WAIITNG TO HAPPEN !!

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  2. Thanks for your comment.

    I too share your concerns about the potential closure to wards.

    Whilst it is undoubtedly better if elderly patients can be cared for at home the necessary safeguards must be in place to ensure both their safety and that nursing care of the highest standard is provided.

    Such an initiative can't be delivered on the cheap and concerns must be raised that if it is care will suffer.

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  3. I visited Loughborough Hospital last week on an outpatient basis. A gentleman (who was recovering from an amputation) mentioned to me that his ward was closing. It was the first I had heard of it, and your blog is the only reference I can find to it. I, too, feel horrified, not just for the immediate problems it will cause but also because of concerns that the entire hospital may close at some time in the future. I don't know the age of the gentleman I spoke to but he was by no means a geriatric and I wonder which banner of 'care' he will fall into. There is precious little to go around now - how on earth can the 'community' cope with any more ill and infirm people in it? The idea is wonderful but at the moment the thought scares me beyond belief. Unfortunately, my District Council is Charnwood so I am perhaps not even supposed to be joining in on this site - thanks for listening any way.

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    1. Thank you for your comment, whether you live in North West Leicestershire or not please feel free to air your views.

      I very much share your concerns and in particular the way that the LPT has handled this issue.

      I would urge you to contact the LPT with your views. You can contact them by e-mailing: feedback@leicspart.nhs.uk

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