“What will happen to acute services at North Devon District Hospital? “I don’t know,” says Northern Devon Healthcare NHS Trust’s chief executive.
Alison Diamond gave a presentation at North Devon Council’s executive meeting on Monday, March 6, under special request from the committee.
The meeting took place at Cedars Inn to allow member of the public to attend and more than 100 people turned up to hear the update and ask their questions.
When asked what was going to happen to the Barnstaple hospital and the proposed cuts to its acute services, which includes stroke, A&E, maternity, paediatric and neonatal support, Dr Diamond did not know the answer.
She said: “I am here on behalf of the Sustainability and Transformation Plan (STP), which aims to provide a Five Year Forward View, to give an update. I do not have any answers today and I do not know what the model of care will look like because no decisions have been made yet.
“Our vision is to have people managing their own care and for that we need responsive care services and fair access to services. Our services are under review because the demand is going up, they were designed for the needs of people from a long time ago, we do not have enough staff, and the standards we have to comply with are always changing.
“Urgent and emergency care, stroke, maternity, paediatric, and neonatal are currently under review but others will follow.”
The emergency services review, led by Adrian Harris, medical director at the Royal Devon and Exeter, states there is a national requirement to meet seven day services, particularly with critical need patients.
It states staffing shortages, especially consultants and nurses, are becoming critical in some of our hospitals and people need to be seen in a timely way but we don’t meet the four hour target in some places in Devon.
The maternity service review, led by Rob Dyer, medical director at Torbay and South Devon NHS Foundation Trust, has found staff shortages in all three services, resulting in a high use of agency staff.
It has said it is more difficult to provide a service 24/7 and there are not enough choice for births, for example, if someone would like to give birth at home. It was noted to have a home birth the mother must live a maximum of 20 minutes from a hospital.
Dozens of members of the public, who were not required to give their names, stood up to put their questions to Dr Diamond and voiced many concerns about the proposed cuts.
The main points were:
Travelling times from the rural North Devon areas to hospitals in Exeter and Plymouth
Social care and appointments needed looking at to improve care
New housing developments would lead to an increase in the population needing care
Staff would not want to come to work at a hospital about to be downgraded
Rob Sainsbury, the trust’s director of operations, said Okehampton patients would be accommodated at Holsworthy hospital, just a day before their cuts were announced
What would the impact be on the hospitals in Exeter and Plymouth and the ambulance service?
Why can planned operations not be moved to more distant hospitals, rather than emergency care?
Is this a move towards privatisation?
One man stated: “The STP is butchering the NHS. Stop these cuts and give the taxpayers back their service.”
A woman added: “Everyone here has reason to be grateful to NDDH, we want it to stay and be improved if anything. We are asking you to help us. We want a hospital that is fit for purpose.”
And finally, a man said: “If someone dies on the road to the hospital, that will be on your conscience.”
Councillor Des Brailey, leader of the council, proposed the following statement of principles: “The council will not support any proposals to change preventative services, clinical care or social care, which it considers would disadvantaged the wellbeing of individuals or communities in North Devon.
“People should have ease and timely access to health services to achieve the best outcomes. The structural and service characteristics of any newly commissioned service must have regard to the population characteristics and the local geography of North Devon.”
The proposal was passed by the committee unanimously after it was amended to include equity, aspirational and affordability, as Councillor Frank Biederman stated: “I don’t want to see people having to choose between feeding their children and taking them to hospital.”
The next step is for the STP team to get feedback and create a model of care. Throughout March, clinical workshops and public engagement will continue. In spring, this feedback will be incorporated and in the summer, the options for change will be published, followed by public consultation on these options, led by the Northern Eastern and Western Devon Clinical Commissioning Group.
Challenges were raised in the Case for Change document created by the Success Regime:
One in three people live with one or more long term conditions
Two in three people would prefer to die at home and only one in four are able to
15 years life expectancy difference in some areas
Deficit of more than £550 million by 2020/21 if nothing changes
600 people in hospital do not need to be there
Care home sector is struggling
Stroke, maternity, A&E and children’s services are unsustainable in patches across Devon.
Less money is spent on health and social care in most deprived areas
95,000 people with a long term condition have a mental illness
One in 4 GPs to leave NHS in next few years.”