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Monday 7 May 2018

District Council "strongly opposes closure and removal of community hospital beds and hospital-based services throughout East Devon"

Over a month ago, demonstrations outside the Council Council were pushing for the system for integrating hospital and care treatments to be reconsidered:
Futures Forum: Demonstration at Devon County Council - against NHS Integrated Care System >>> Thursday 22nd March 




Councillors put the brakes on health care changes in Devon - Devon Live

County Councillors preferred not to listen, however:

Futures Forum: County Council approves NHS Integrated Care System - despite its own scrutiny committee and the public showing overwhelming opposition

At District Council level, there was more concern, as reported last week: 

Closure and removal of hospital beds should be opposed, council says

A motion called for the community hospitals which have lost beds to be maintained as health hubs


Daniel Clark Local Democracy Reporter
3 MAY 2018

Councillors in East Devon have welcomed proposals from Devon CCG’s to develop placed-based health care but strongly opposed the closure and removal of community hospital beds and hospital-based services throughout the district.

A motion calling for the community hospitals which have lost beds to be maintained as health hubs, that services and clinics should be moved out of Exeter to local community hospitals and that more outpatient services should be provided in each community hospital was discussed by East Devon District Council at their meeting last week.



Campaigners against bed closures at four Devon hospitals

Proposing the motion, Cllr Marianne Rixson said that health hubs in local areas need to be supported by the Council. She added that the need for less travelling and difficult local bus services needed to be taken into consideration and that if place-based care was to be effective then the level of out-patient services need to be increased overall or at least maintained in every town.

She was supported by Cllr Val Ranger, who added that those people discharged early from hospital, children and elderly living with long-term health conditions should be able to access out-patient services locally in every community.



Seaton Hospital

Councillors voted for an amendment, proposed by Cllr Mike Allen, that said that this Council resolves to welcome the proposal of the Devon CCG’s to develop placed-based health care where strong evidence suggested that it would deliver high-quality patient care and sustainable services.

It added: “However, due to lack of supporting clinical evidence and clear future planning, the Council has strongly opposed closure and removal of community hospital beds and hospital-based services throughout East Devon.

“All efforts are made, in consultation with local communities, to ensure the existing estate of community hospitals was retained for health care purposes, where appropriate, the potential development of ‘Health Hubs’ was investigated, and council members received from the Clinical Commissioning Group a review of service changes (bed-based to home/communitybased care) made during 2017/2018 in East Devon, to include clinical evidence highlighting levels of patient safety and outcomes achieved and an evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet.”

Cllr 


Martin Shaw

After the meeting, Cllr Martin Shaw, said that he has written to Cllr Ian Thomas, who is due to become the new leader of the council on May 16, asking for assurances that each of the hospitals which has lost its beds (Axminster, Honiton, Ottery and Seaton), as well as Exmouth and Sidmouth, to be kept open and that a formal public consultation in the affected town and surrounding area should a closure of any community hospital, involving substantial relocation of outpatient services, be proposed.


Closure and removal of hospital beds should be opposed, council says - Devon Live
Vision Group for Sidmouth - District Council opposes closure and removal of community hospital beds

Here is the full set of minutes from that meeting:

EAST DEVON DISTRICT COUNCIL 
Minutes of the Meeting of the Council held at Knowle, Sidmouth, 
on Wednesday, 25 April 2018

*74 Motion – Proposal of the Devon Clinical Commissioning Groups (CCGs) 

The following motion was proposed by Councillor Marianne Rixson seconded by Councillor Val Ranger and supported by Councillor Susie Bond, Councillor Megan Armstrong, Councillor Dawn Manley and Councillor Matt Coppell. 

““That this Council resolves to welcome the proposal of the Devon CCGs to develop place-based health care, the RD&E's launch of community health conversations in Eastern Locality towns, and the aim of community involvement in supporting statutory services. Noting also the CCGs' intention to announce their Estates Strategy following these conversations, this Council requests the NHS organisations to observe the following principles:
1. All community hospitals which have lost beds should be maintained as health hubs. 
2. Wherever possible, services and clinics should be moved out of Exeter to local community hospitals. 
3. More outpatient services should be provided in each community hospital, with no overall cuts to the level of services in any town in order to minimise complex journeys between towns.”." 

The proposer of the motion, Councillor Marianne Rixson, informed the Council that there had been important policy development in Devon with the CCG working with South Devon and Torbay and had introduced an integrated care system (ICS) for health and social care including DCC social care. Part of the ICS would be a local care partnership for each locality with funding being on an equal per capita basis for each locality. With CCG claiming they wished to save £30M this year this increased the risk to the area’s community hospitals. ICS key principal is place-based care which was welcome providing it led to people be care for and treated in their own communities. Health hubs in local areas need to be supported by the Council. The need for less travelling and difficult local bus services needed to be taken into consideration. If place-based care was to be effective then the level of out-patient services need to be increased overall or at least maintained in every town. 

The seconder of the motion, Councillor Val Ranger reported that early discharge from hospital, children and elderly living with long-term health conditions should be able to access out-patient services locally in every community. There was an assumption that everyone had access to a car, if councillors gave up their cars for a week and had to rely on public transport they would see first-hand the difficulties and expense experienced by people needing to rely on these services. Ring and ride services could not necessarily guarantee a ride. 

The following issues were raised by Councillors during consideration of the motion: 
 The need to look into the finances of all hospitals in the South West 
 The League of Friends were a main investor to many local hospitals 
 People wanted to be independent and close to home for longer 
 The need to work closely with DCC and CCG 
 There was a long history of EDDC opposing the closure of local hospital beds 
 Health hubs were not one size fits all – evidence of community needs was required. 

Councillor Mike Allen proposed an amendment that read as follows: 

“That this Council resolves to welcome the proposal of the Devon CCG’s to develop placed-based health care where strong evidence suggested that it would deliver high-quality patient care and sustainable services. 

That this Council further; 
- Notes the emerging Devon Sustainability and Transformation Plan (STP) process and supports the principal of NHS organisation coupled with local authorities, voluntary and charitable organisations, and local communities working more closely together, to provide better integrated health and social care services. 
- Supports the use of digital and emerging technologies, to improve the patient experience, enable healthcare provision to be better directed towards the needs of the communities they serve, and enhance the ability of residents in rural areas to access the services they need. 

However, due to lack of supporting clinical evidence and clear future planning, the Council had strongly opposed closure and removal of community hospital beds and hospital-based services throughout East Devon. 

This Council requests that; 
1. All effort was made, in consultation with local communities, to ensure the existing estate of community hospitals was retained for health care purposes. 
2. Where appropriate, the potential development of ‘Health Hubs’ was investigated. 
3. Council Members received from the Clinical Commissioning Group (CCG); 
a. A review of service changes (bed-based to home/community-based care) made during 2017/2018 in East Devon, to include clinical evidence highlighting levels of patient safety and outcomes achieved. 
b. An evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet.” 

Councillor Alan Dent seconded the amendment. 
The Chairman put the amendment to the vote and by a show of hands it was carried with 33 in favour, 6 against and 8 abstentions. 
The Chairman put the substantive motion to the vote and by a show of hands the motion was carried. 

RESOLVED 
1. That this Council welcomes the proposal of the Devon CCG’s to develop placed-based health care where strong evidence suggested that it would deliver high-quality patient care and sustainable services 
That this Council further; 
- Notes the emerging Devon Sustainability and Transformation Plan (STP) process and supports the principal of NHS organisation coupled with local authorities, voluntary and charitable organisations, and local communities working more closely together, to provide better integrated health and social care services. 
- Supports the use of digital and emerging technologies, to improve the patient experience, enable healthcare provision to be better directed towards the needs of the communities they serve, and enhance the ability of residents in rural areas to access the services they need. 
However, due to lack of supporting clinical evidence and clear future planning, the Council has strongly opposed closure and removal of community hospital beds and hospital-based services throughout East Devon. 

2. That this Council requests; 
1. all effort was made, in consultation with local communities, to ensure the existing estate of community hospitals was retained for health care purposes,  
2. where appropriate, the potential development of ‘Health Hubs’ was investigated, and 
3. Council Members received from the Clinical Commissioning Group (CCG); 
a. a review of service changes (bed-based to home/communitybased care) made during 2017/2018 in East Devon, to include clinical evidence highlighting levels of patient safety and outcomes achieved, 
b. an evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet.

EAST DEVON DISTRICT COUNCILMinutes of the Meeting of the Council held at Knowle, Sidmouth, onWednesday, 25 April 2018

There was a lot of politicking going on, unfortunately: 

EDDC INDEPENDENTS LEAD CALL FOR ACTION ON LOCAL HEALTH PROVISION

3 MAY 2018


Owl can’t quite see why Tory Councillor Allen felt the need to table his amendment – perhaps he felt Independent councillors were rather too Independent and therefore needed a dash of Tory policy! Now we just have to hope that new Leader Thomas doesn’t go and do exactly the opposite of what was resolved when he attends to DCC health scrutiny meetings – as Diviani notoriously did last year.

EDDC Independents lead call for action on local health provision | East Devon Watch

The Independent County Councillor for Seaton and Colyton had approached the new District Council Leader earlier: 


I have written to @CllrIanThomas, incoming EDDC leader, for assurances on health services and hospitals, after Conservative amendment leaves East Devon community hospitals vulnerable to closure


POSTED ON  UPDATED ON 
In a debate at EDDC on Wednesday Independent East Devon Alliance councillor, Marianne Rixson, proposed a motion ‘requesting the NHS organisations to observe the following principles:
1.  All community hospitals which have lost beds should be maintained as health hubs.
2.  Wherever possible, services and clinics should be moved out of Exeter to local community hospitals.
3.  More outpatient services should be provided in each community hospital, with no overall cuts to the level of services in any town in order to minimise complex journeys between towns.’
image1I was disappointed to hear that this motion was completely replaced by an ‘amendment’ (left) proposed by Conservative Councillor Mike Allen, which was then carried.
I have written the letter below to express my concerns to incoming Council leader, Ian Thomas, the member for Trinity ward, to ask him to join me in pressing for each of our hospitals to be kept as a hub for outpatient services.

LETTER TO IAN THOMAS

Dear Ian, 
Belated congratulations on your nomination to lead EDDC, which I assume will be agreed at the Annual Meeting in a fortnight’s time. I am writing following last week’s Council resolution on health, to ask for your clear support for keeping all community hospitals in East Devon as health hubs. As this is a matter of great public interest, I shall make this letter public.
Since I could not be present at the meeting, I will not comment on the procedure adopted, except to inform you that members of the public have complained to me about the way Cllr Rixson’s motion was ‘amended’ by Cllr Allen. My concern is rather that the resolution potentially increases the vulnerability of some of our community hospitals to closure when the CCG announces its Local Estates Strategy.
I welcome the resolution’s call for the CCG to provide ‘evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet’, and the reference to ‘consultation with local communities’ about community hospitals, as well as the review of service changes (bed-based to home/community-based care). You will need to press hard on the latter, as Claire Wright has been asking for it repeatedly without success at DCC.
My worry is that the resolution removes the benchmark assurances that Cllr Rixson’s motion sought. While the resolution says that all efforts should be made, in consultation with local communities, to ensure the existing estate of community hospitals is retained for health care purposes, it only recommends that, Where appropriate, the potential development of “Health Hubs” be investigated. 
Unfortunately this can clearly be read as implying that hubs will not necessarily be appropriate in every hospital – and that EDDC might therefore accept the closure of those hospitals which are not developed as hubs. 
I remind you that when the Conservatives fought the County elections last year, you said you wanted ‘bed-less hospital buildings adapted to accommodate new health-related services and boost community health provision‘. There was no suggestion of any exceptions then.
I would like you to give an explicit assurance that you will join me in pressing for
(1) each of the hospitals which has lost its beds (Axminster, Honiton, Ottery and Seaton), as well as Exmouth and Sidmouth, to be kept open;
(2) achievement in each hospital of the ‘boost’ in health provision which your 2017 policy rightly asked for – and any in any case no overall cut in services in any of them; and
(3) a formal public consultation in the affected town and surrounding area should a closure of any community hospital, involving substantial relocation of outpatient services, be proposed.
Kind regards,
Martin

I have written to @CllrIanThomas, incoming EDDC leader, for assurances on health services and hospitals, after Conservative amendment leaves East Devon community hospitals vulnerable to closure « SEATON & COLYTON matters
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