Hospital Services in West Cornwall

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A County-Wide Committee has been formed specifically to press for a full review of the medical services throughout Cornwall.  The Mayors' Parlour Group endorses the new committee and is committed to supporting the review.  Until such time as a review is complete we are all committed to maintaining the services at the West Cornwall Hospital to the highest level possible, including A&E and 24-hour anaesthetic coverage.

I strongly support the independent review, which I am confident will show we need more beds and services in West Cornwall.  If a new-build hospital is shown to be necessary, I hope that the site at Tolroy will be given consideration (along with a junction on the A30) as it will provide easy access to people from West Cornwall as well as a quick route to Treliske. 

Here is the agenda item put forward by Penwith District Council (it is 4 pages long, use the scroll bars to see the whole document:

What was the result?  The committee voted to defer the decision until the MFF (Market Forces Factor) study has been completed.  Here is an email from Sheena Cox to the outgoing Chairman of the Health and Adult Social Care Overview and Scrutiny Committee reacting to the decision:

25 May 2006

Dear Sally

I am sorry you lost your post as Chair of the HASCOSC today; you were just getting into your stride!

If the chairing of future HASCOSC meetings is mirrored by today’s then I fear neither the electorate nor democracy will be fairly represented.

It was interesting that with a County Council as large and busy as Cornwall’s that the leader who publicly in the past has come down heavily on the side of the NHS at the expense of the electorate should be present in the meeting for well over an hour listening to the election of chair and the debate on the Penwith District Council agenda item.

It was extremely disappointing, that not one member of a scrutiny committee seriously challenged the RCHT representative on her announcement “with a heavy heart I have to say that the debt is far greater than originally thought”; particularly when she was unable to state just by how much worse the debt was.

These are people as are councillors who are responsible for spending public money, delivering services that should be what the public want and need. It is shocking at this stage that the RCHT is unable to give an accurate account of its deficit but it is even more shocking that they were unaware of how badly they had managed so far.

If the review on MFF decides Cornwall deserves more (approximately £44 million), I am greatly concerned that this extra money will be placed in the hands of management that have very clearly mismanaged to date and are it would appear totally unaware of how badly they have done so.

The MFF is but a fraction of monies that Cornwall if treated as other rural areas in the country are would receive (approximately £88 million). I heard no mention of fighting for this.  My worry though should Cornwall be allocated extra funding for MFF and Rurality is that there would be the same mismanagement of funding as highlighted in previous paragraph.

Listening to the NHS and Councillors today have made the electorate more determined than ever to fight for what should be a patient (public) led service, for equitable funding, access and provision within Cornwall that others take for granted.

I would now like to highlight another comment regarding an “Independent Review” at North Devon Hospital in Barnstaple that Sue Wolstenholme made in relation to the public statement by Professor Round at the start of the meeting.  She stated that this independent review had recommended that the hospital be closed and a smaller less acute hospital be built in its place. She went on to intimate that this could happen here if a “very expensive independent review took place”.

I have included below information regarding what appears to be an independent review. The company Durrow Consultancy is the same outfit that was leading the Joint Stakeholders Steering Group (JSSG) in West Cornwall for over 2 years at the cost of over £280,000, £35,000 of which Penwith District Council funded, the remainder was paid for by the DoH, so I would hardly call it a true “Independent Review”. Their conclusion for Barnstaple so far appears to be exactly the same conclusion they drew for West Cornwall!!!!

The NHS (SWPSHA, RCHT and WoCPCT) side of the JSSG unilaterally disbanded the group when they could not persuade the public to go along with their agenda.

The local NHS are now pulling together a group of “hand picked” volunteers to run a similar exercise looking at a new build in the west. It was publicly stated by NHS representatives at a meeting called by the MP for St. Ives and IOS last year that this new build would not have A & E and would probably house patients cared for in the local community hospitals. This is not what the public want. It is yet another blatant waste of public money.

Below is the information regarding Barnstaple that is so far available please read it carefully and compare it to the results of the West Cornwall JSSG and draw your own conclusion as to whether the NHS is participating in costly mindless reviews until they get the results they want or whether they are genuinely trying to provide a service that the public want and need.

I would appreciate as would all the groups, of which I am a member, if you could find out exactly what independent review took place at Barnstaple that resulted in the RCHT representative’s statement today. As patients from Cornwall attend that hospital, I assume you have a copy of the report. If you have is it possible to send me a copy of it, if you do not have a copy is it possible for you to obtain one and send me a copy?

ACHIEVING A SUSTAINABLE FUTURE FOR ACUTE SERVICES IN NORTH DEVON

Northern Devon Healthcare Trust (NDHT) and North Devon Primary Care Trust (PCT) are pleased to announce the appointment of an external team of advisors to work with us over the next 6-8 months. The advisors, from Durrow Consultancy, will provide an expert opinion of what a sustainable acute service should look like in North Devon.

The main body of work will be looking at the balance which needs to be struck between the healthcare needs of the local population, the pot of cash available and sustaining high levels of clinical safety and quality.

Durrow is an experienced and highly respected advisory team of consultants who work exclusively in the health sector, both public and private. They have a sound understanding of key current NHS policy influences and the local environment. They bring with them a reputation for being both challenging and innovative in their thinking and will therefore give local managers the support they need to examine future options, fully aware of the financial and service constraints facing NDHT at the present time.

The PCT and NDHT are keen for staff and partner organisations to be aware this work is about to start and also that they will be informed and consulted on every step of the way as options and themes emerge.

North Devon District Hospital is a core component of the local health community, which also consists of GP practices, community hospitals and teams. All depend on each other to provide a network of services to the local population. The purpose of this review is to establish what needs to change to ensure we can support continued access to a critical mass of specialist expertise and inpatient/outpatient and emergency services.

In making this appointment and progressing the work over the next few months, the PCT and NDHT recognise the importance of wider stakeholder engagement with the public and users of the services. It was for this reason that representatives from the two District Councils and the PPI Forum were on the selection process and will continue to help steer the process over the coming months.

Jono Broad, Chair of the North Devon PPI Forum said, "The appointment of Durrow is an extremely positive step. We welcome the arrival of an outside pair of eyes to look at how we can secure health services for the people of North Devon long into the future. It will be of great interest to everyone to have independent advice on how we can sustain services whilst looking to work in new and innovative ways, to grow and to protect our NHS services both at North Devon District Hospital and throughout the community where services are so needed."

Brian Aird and Jac Kelly said, "We cannot underestimate the importance of this exercise to securing workable and affordable acute service provision for the future that gets us beyond the current difficulties facing the Hospital Trust."

For further information, please contact either the North Devon Primary Care Trust public relations department on 01769 575 157 / katherine.smith@ndevon.swest.nhs.uk or the Northern Devon Healthcare Trust's communications department on 01271 311 575.

10 March 2006

ACUTE SERVICES REVIEW

BACKGROUND TO PROJECT

YOUR NHS IN NORTH DEVON - PLANNING FOR THE FUTURE OF ACUTE SERVICES

WHAT DOES ACUTE MEAN?

In NHS terms, ‘Acute’ refers to an injury or illness which immediately requires the attention of a specialist and needs the diagnostic tests and equipment only available in a district general hospital.

INTRODUCTION:

• Durrow business consultants are working with the North Devon Primary Care Trust and the Northern Devon Healthcare Trust to provide innovative solutions that will ensure the continuation of 24/7 acute (mainly hospital-based) services for North Devon.
• These stakeholder events launch the public engagement in the development of new ideas and different approaches.
• They are not part of a formal consultation process and no decisions regarding future acute service provision have been made yet.
• Durrow will be sharing their own early ideas and your views and comments will be taken into account as they develop their thinking over the next few weeks.

THE CURRENT SITUATION:

• Northern Devon Healthcare Trust ended the 2005/6 financial year with a deficit of £7.9 million. To take account of public sector funding rules and to enable the Hospital to continue providing services, additional funding support for 2006/7 of almost £18.9 million has now been agreed with the Strategic Health Authority. The Trust has a total turnover of almost £80 million. The Department of Health has decreed that all hospitals must get out of the red by 2008.
• North Devon District Hospital (NDDH) was built in 1978 and has a maintenance backlog of £4.5million.
• NDDH has sometimes experienced difficulties recruiting consultants and other senior doctors because it is a small hospital, with limited scope for service development.
• The small size of the local population (which obviously affects the number of people needing treatment) also means that, in some specialist areas, doctors find it difficult to maintain the highest levels of clinical skills.
• To help overcome this, NDDH has built strong clinical links with other hospitals to ensure that North Devon patients get the best treatment and it is likely that this will have to continue and be expanded in the future.
• The Government’s recent White Paper ‘Our Health, Our Care, Our Say: A new direction for Community Services’ says that more services should be provided in the community.
• An innovative plan is required to ensure that hospital based services can continue to be provided safely and to high quality standards in a way which both meets the needs of local people and which avoids regular financial crises.
• The aim is to ensure that excellent 24/7 emergency assessment (equivalent to the best teaching hospitals) and high quality chronic disease management is achieved for the North Devon population.

FACTS AND FIGURES:

• The North Devon and Torridge population is 160,000
• 20% of the population is over 65,
• NDDH has 280 beds for seriously ill patients. Other hospitals in the South West are considerably bigger: RD&E has 740 beds, Derriford has 980, Royal Cornwall has 870 and Torbay has 450.

WHAT HAPPENS NEXT?

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