• No answer (yet) to public health stated assumption that care at home costs the same as care in big hospitals

My proposal at yesterday’s health and wellbeing scrutiny committee meeting to suspend the consultation which proposes to halve the remaining community hospital beds in Eastern Devon, fell by two votes.

There was a packed public gallery. Several members of the public, including Di Fuller, chair of Sidmouth’s patient and public involvement group and Cathy Gardner, EDDC Independent councillor for Sidmouth spoke powerfully, expressing deep concerns about the bed losses.

Di Fuller said the consultation should be rejected as “invalid.”

Cathy Gardner called on the committee to demand more funding from central government.

Councillors, Kevin Ball and James McInnes from Okehampton made strong representations on behalf of the town relating to the hospital being excluded from the consultation.

(I am part of a sub-committee of health scrutiny that meets tomorrow to scope an investigation into the funding formula for Devon’s health services, which many people, including me believe is unfair, despite the government’s claims that Devon receives more funding than its fair share).

Staff from the NEW Devon Clinical Commissioning Group presented to the committee. They were Rob Sainsbury, Jenny McNeill and GPs – Joe Andrews and Simon Kerr.

We were shown a video of patients happy with the hospital at home scheme which operates in Exmouth and Budleigh Salterton only, as evidence that care in people’s homes work.

This to me didn’t seem to be adequate evidence given that hospital at home is limited to Exmouth and Budleigh Salterton, is consultant led and mirrors the kind of care one might expect in a hospital. It is a good service but expensive to run.

This is not what is being proposed for the remainder of Eastern Devon.

The four presenters tried their best to sell us their new model of care. Some of us weren’t convinced.

Cllr Andy Boyd was critical of the plans and other members asked questions about housing and various NHS procedures.

I asked how many more staff they would need to operate their new system. We heard they needed more “therapy staff” and other disciplines, but not how many more of each. We were told that a staff analysis was currently being carried out.

I said I was surprised that this information was not known, halfway through the consultation, with an expected figure of savings at around £5-£6m. How can the CCG be confident that the new system will save money when basic information is not known, such as how many staff are required?

Under the previous agenda item I had turned to page three of the October 2015 public health acuity audit – a document used by the CCG to back up its case for shutting beds, where it states as an assumption: “Caring for a patient in an acute care setting is either more expensive than, or at least as expensive as, caring for a patient in alternative setting, including at home.”

I asked for a reaction to this statement. Angela Pedder, Success Regime chief, said she would get back to me about it.

It is surprising that in a document the CCG is using to back up its case, where they say caring for people at home will save money, it states that this care costs the same as acute care (such as the care provided at the RD&E for example).

I raised the issue of Devon County Council’s adult social care budget being £5m overspent and how this overspend will need to be brought back to zero by April 2017. This will surely have a potentially significant impact on any NHS care that is provided in people’s homes.

But Rob Sainsbury said that social care packages could be organised in a different way to support care in people’s homes.

I said that earlier NHS (incorrect) statements about a third of community hospital beds not being used has now morphed into third of bed space not being used. If this is the case surely it is due to previous community hospital bed cuts over the years!

And the other CCG claim relating to Eastern Devon having far more beds than other parts of the county is surely because they have been cut in other parts of the county!

According to a public health audit from last year, there are 94 per cent bed occupancy levels in Eastern Devon. They are far from being half empty.

Finally, I raised the issue of a government watchdog – the Independent Reconfiguration Panel – that examined the Torrington Hospital case for bed losses. It stated in its response that communities must feel they have a genuine opportunity to influence the outcome of a consultation.

I proposed that the consultation be suspended while the CCG included both Honiton and Okehampton in the options to retain beds.

The proposal was seconded by Brian Greenslade but unfortunately was lost 5-7.

Instead, chair, Richard Westlake asked for urgent talks between the CCG and Honiton and Okehampton communities.

In other news, two motions calling for more funding to Devon’s NHS and for the Success Regime to be paused, were agreed by the committee and will go before full council in December.

To view the webcast see – https://devoncc.public-i.tv/core/portal/webcast_interactive/244717