is this the real reason our community hospitals are being cut?

Not because it makes good sense now or in the future but as a knee-jerk reaction to poor spending management in the past. That would explain why current reorganisation plans don’t have any numbers in them – the numbers are too shocking:

http://www.exeterexpressandecho.co.uk/Devon-NHS-body-takes-urgent-measures-finances/story-23567672-detail/story.html

and here

http://www.bbc.co.uk/news/uk-england-devon-29783163

One thought on “is this the real reason our community hospitals are being cut?

  1. To me it seems to make sense to find opportunities to be more efficient and to implement changes to make these happen.

    And clearly with a £14m+ deficit last year and a bigger one this year, then (leaving aside the accumulated deficit) one of three things needs to happen:

    a. Increase the local budget by £15m+ per year in order to continue giving the level of services required by the local population;

    b. Make straight forward cuts in services to save £15m+ in order to balance the budget in the future – which implies lower levels and quality of services, longer waiting times, no treatment for less serious conditions etc. etc.

    c. Find ways to eliminate wastage and improve efficiencies in order to make savings whilst maintaining or improving the level of services, waiting times etc.

    And of course, to address the accumulated deficit they may have to have a one-off injection of money or make further cuts to claw it back.

    So NEW Devon CCG seems to be trying to do the right thing, but apparently in the wrong way as they are creating a lot of high emotion and objections, perhaps because:

    1. They have left it too late – if it became apparent in 1Q 2013 that the costs of services were (say) £3.5m PER QUARTER above budget, then they should have started to identify ways to reduce wastage and improve efficiency in 2Q 2013 not in 4Q 2014.

    2. They are keeping the reasoning secret – I think that we all understand that there is not enough money to do everything at tip-top quality, and compromises need to be made. If the CCG want buy-in from both local government and the local population, then they need to explain their reasoning. Of course, they won’t please all of the people all of the time – indeed are likely to please none of the people none of the time – but that is often the consequence of compromise, that the difficulties are spread evenly. But if you keep the reasoning secret, people then wonder what the real motives are and whether the CCG is being honest and open.

    3. They leave it to the last minute – the CCG reports have been produced at the last minute (fact) and the appearance (supposition) is that this is to limit the degree of scrutiny and get the changes bulldozed through. However, the NHS is one of the issues closest to most of our hearts (because we all worry that the NHS services need to be there for us if / when we need them), and this seems always likely to back-fire, creating more uncertainty about motives.

    4. The solution is disjointed from the objectives – it seems to me that the objectives (e.g. how close should beds be to where the patients live) is not well documented, and so the design of services can be seen as somewhat arbitrary because the requirements are unclear. Of course there will be tradeoffs, but to e.g. centralise all beds without understanding any distance objectives leads inevitably to questions about whether the proposed changes are fit for purpose.

    5. Disjointedness – we are told that OSM Hospital will lose all its beds, and that the future is very uncertain – then we are told that it will have a new specialised use. The planning for the NHS needs to be more joined up if we are to have confidence that it is being well run.

    Like

Comments are closed.