East Devon Conservatives are deeply worried about proposals from the NEW* Devon Clinical Commissioning Group to restructure hospital care in the North, East and West of the county in a bid to plug a £400 million budget shortfall over the next three years.

They believe the hospital bed closures proposed by the Devon health provider as the cure for a funding crisis may be the wrong treatment – and could have harmful side-effects for patients.

So the 37 Conservative members of East Devon District Council are sending a collective response to the CCG’s current consultation in the hope of persuading the NHS commissioning group to change its approach to tackling the immediate £100m funding gap, expected to rise to £400m by 2020.

The Conservative councillors are advising the CCG that it would be dangerous to move from a system of mostly inpatient treatment to care at home until a robust structure is in place to provide the alternative cover. Taking this step without the necessary resources in place and with no vital transition budget to call upon, could put patients at risk, they say.

Dangerous

Having studied the CCG’s report, Conservative group members were unimpressed with the strength of the argument in favour of bed closures and home care, especially because the CCG has not been able to provide accurate and meaningful financial detail or convincing trial evidence to back up its proposed Community Care Package.

They also wonder if the massive funding gap could not be closed by greater attention to efficiency savings.

And they are counselling the commissioning group not to adopt a “one-size-fits-all” approach to tackling the area’s financial ills, bearing in mind the differing demographics and age profiles of each local authority area in Devon, especially remote rural communities. Patient vulnerability and loneliness must also be addressed.

The CCG appears to favour a new model of care that has been subject to limited testing, with little hard evidence that it improves the service to patients.

The Conservative group are not convinced by the scant evidence provided after their requests for more detail and are nervous of the CCG’s reliance on a notional target of county hospital beds, regardless of variations in proven need.

Blunt instrument

They want to know more about the 80 clinicians the CCG claims to be in support of the new model. And they are sceptical of a ‘blunt instrument’ approach to treatment, especially when many elderly patients have dementia in addition to multiple clinical problems.

Finally, the Conservative members contest that many areas in East Devon appear to have a reducing stock of nursing and residential home beds. This only aggravates the situation, because these beds are often required in the short or long-term for patients stuck in hospital.

Phil Twiss, Conservative Group Secretary, said: “Some people want to boycott this consultation process – but that won’t help anyone. We believe constructive feedback is the best way.

“We all agree that bed-blocking is a serious issue and we also accept that the clinical commissioning group need to save money. The question is how should they go about it so as to deliver results without making the situation worse.

“We feel that they have the solution the wrong way round. They want to move to a care-in-the-home model at a time when the resources just aren’t there to support that model. It might be the right approach in theory, but it will only work in practice if the social care infrastructure is robust enough to take the strain – and it is not.

Panic measures

“We’re not convinced that the new model has delivered the right standard of success in trial areas and we don’t believe it can be rolled out across other parts of the county until the necessary support structure is in place. And we should not be moving to a new model as a panic measure to solve a funding shortfall that could be tackled by other means.

“For example, a lot of money can be wasted on high-cost agency staff who appear to be a short-term emergency man-power fix but all too often are relied upon as part of the workforce establishment.

“We don’t know whether the budget shortfall was perhaps caused by wasteful practices that are still in place, and so we don’t know whether the CCG could find alternative ways to save money. What we do know is that their current proposals are unconvincing and ill-advised”.