Honiton fighting back on bed cuts

Since this article was written, it has been announced that all Honiton Hospital’s community beds will close on 28 Augusy 2017:

“A BAND of angry residents calling itself Honiton Patients Action Group says it plans to keep hospital beds in Honiton by taking direct action to stop the removal of ward beds and equipment.

The group, consisting of several local patients and their families, say they have become increasingly frustrated at the ‘failure of NEW Devon CCG to listen to the voice of local people and their representatives’.

They claim some end of life patients have already been informed by local GPs that Honiton Hospital will not be available after September and, if they need a local hospital bed, they must be prepared for an out of area transfer to Tiverton, Exmouth or Sidmouth.

A spokesperson for the action group said: “It is quite clear that NEW Devon CCG have never been prepared to fully engage in a sincere dialogue.

“There has been a failure to listen to the voice of local people and our representatives. We believe they decided in advance they would close these beds despite the fullest and proper representations that have been made by locals and their representatives, including MPs, district and town councils. We have tried sitting down and discussing it with them. We have tried large public meetings, marches, deputations and lobbying including the county council. Now we intend to sit down to stop the closure.

“We feel we have been disgracefully let down by the Health Secretary Jeremy Hunt, by Devon County Council and their local representative Cllr Sarah Randall Johnson, and by Cllr Paul Diviani who seems to be representing no one except himself.

“While they prevaricate, the rundown of the wards has begun and it may well be more serious than they are letting on.

“With the closure of the maternity unit and privatisation of the site Honiton Hospital could be scrapped in the near future – this has happened at 45 other hospital sites.

“Meanwhile there is not a scrap of evidence the promised alternative care system is ready or will be effective.

“As patients we will not meekly accept this and at a time of our choosing we plan to take direct action to prevent the removal of beds and equipment and the stripping of wards.

“This will be a peaceful, non-violent, direct action to prevent contractors gaining access to remove the beds and equipment using whatever peaceful methods we can.

“We are also contacting health trade unions to set up a picket line. We shall invite nurses, doctors and local health groups to join in solidarity, along with Neil Parish MP who claimed he would ‘hold feet to the fire’ to stop the closure. Our MP has become very quiet but this is his last chance to show solidarity.

“When we have finalised our plans we hope that local people and families, all of whom could potentially require these beds in future, will join us to keep up the action as long as we can. We need help and support to organise and publicise this if we are to be effective.

“It is the last real chance for Honiton Hospital and our community and we appeal to everyone to search their conscience.

“While we have life and the will to fight ‘They Shall Not Pass’.”


East Devon community bed closures to be speeded up – Seaton to close next week, Honiton the week after

From the blog of Claire Wright – did Diviani and Randall-Johnson know this? Do they care?

“I have seen this SO many times.

A threat to hospital beds. Hospital beds close temporarily due to staffing shortages (because understandably staff leave) and then the permanent closures are brought forward.

What I am not reassured on here is how the loss of the existing beds will morph into the new care at home service and the message on staff redeployment is as vague as ever. Last autumn, I was told by the CCG chair, Tim Burke that around double the number of staff will be appointed… the CCG now talks in terms of ‘redeployment’ and ‘recruitment’ of 50 staff, which is difficult to get to the bottom of, given what we have already been told.

What we also still don’t know (because the CCG won’t tell us) is what happens to those hospitals that lose their beds…

Devon County Council’s health scrutiny committee needs to keep a very close eye indeed, on this issue.

The letter below has been sent to Health Scrutiny committee members:

Your Future Care

I am writing to let you know that we are ready to proceed with the changes to improve care for people across Eastern Devon as part ‘Your Future Care’.

These changes are intended to shift the focus of health and care services to keep more people well and independent at home. Part of this shift will be the redeployment and recruitment of over 50 nursing, therapy and support worker roles to enhance the existing community services in each local area. This will enable the reduction in the number of community inpatient beds across the Eastern locality of Devon.

In order to achieve this safely, we will take a phased approach – working closely with staff and partners – to implement the changes as per the following timetable:

• Seaton Community Hospital week commencing 21 August 2017
• Okehampton Community Hospital week commencing 21 August 2017
• Honiton Community Hospital week commencing 28 August 2017
• Exeter Community Hospital week commencing 4 September 2017 (this is the original closure timetable).

The provision of inpatient services at these locations will cease from these dates. All other services at these hospitals will continue as normal. Patients in these areas in medical need of a community inpatient bed will be accommodated at either Tiverton, Sidmouth or Exmouth hospitals, depending on where they live.

It has become apparent over the last couple of weeks that the schedule for the closure of the in-patient beds at Seaton, Okehampton and Honiton would need to be brought forward by a number of weeks due to the increasing pressures on safely staffing the current configuration of seven community inpatient units.

We have been preparing the comprehensive plans for each area since March 2017 and are confident that moving to the new model swiftly is in the best interests for our patients and our staff. For example, our new Community Connect out-of-hospital service, introduced this Spring, has already led to a reduction in demand for community inpatient beds.

Gateway Assurance Process

As you may be aware, part of the implementation process included a clinical assurance panel reviewing the implementation plans against a series of 30 gateway questions. These were developed to provide assurance of the RD&E’s and the wider system’s readiness to switch to the Your Future Care model.

The Gateway Assurance Panel has given its recommendation to proceed. The workforce HR consultation has been completed and staff have been informed of their new roles and working environments. We have also received the approval of the Equality and Quality Impact Assessments, which took place on the 4th August. We can now commence the redeployment of staff into our enhanced community teams and into the remaining community hospital sites. This change will provide extra capacity and resilience to meet the needs of our local population.

Your Future Care is just the beginning of the work needed to move fully to a model of care which proactively averts health crises and promotes independence and wellbeing for our population.

There is still much more to be done and we at the RD&E look forward to continuing this in partnership with you and our local communities.

Yours sincerely,

Adel Jones
Integration Director”

“Conduct of health committee members investigated by Devon council” – Diviani and Randall-Johnson heavily criticised for behaviour

“Devon County Council has confirmed it is looking into the conduct of members of one of its committees following a debate and vote not to refer a decision to close 72 community hospital beds in Devon to the secretary of state for health.

The matter was debated by the health and adult care scrutiny committee meeting at Exeter’s County Hall on July 25.

Among those who have expressed their concerns is Val Ranger, East Devon District Council ward councillor for Newton Poppleford and Harpford.

She says that at a meeting of East Devon District full council meeting on July 26, Cllr Paul Diviani, who sits on the committee as a representative of district councils, admitted he had not asked the opinion of other district councils about whether they wished to refer the decision to close local hospital beds to the secretary of state, and could offer no evidence on that basis that he was representing their views.

At the meeting Cllr Diviani was among those who voted not to refer the decision to the secretary of state.

Cllr Ranger said: “He said he voted not to because it was unlikely that the secretary of state would overturn the decision.

This seems duplicitous on two count. The first for failing to adequately represent the views of the district councils.

“Secondly for assuming the role of the secretary of state by stating there was no point in referring the matter to him as he was unlikely to overturn the decision.

“At the EDDC scrutiny committee on June 22, EDDC’s views and recommendations were very clear; Northern, Eastern and Western (NEW) Devon Clinical Commissioning Group (CCG) has failed to provide the evidence needed to support their plans.

“However, Cllr Diviani failed to represent those views or the views of other district councils as he did not seek them. He has admitted he voted independently of both EDDC and other district councils, rendering his vote as entirely without integrity in his role at the DCC meeting.

“The vote is an entirely unsafe and undemocratic way of conducting business and brings both EDDC and DCC into disrepute.”

A spokesman for Devon County Council said: “We have received a number of comments, representations and complaints about the health and adult care scrutiny committee held last week and about the conduct of members at that meeting.

“We will be looking at all the points raised by Cllr Ranger and others under our normal procedures to see if there are any issues to be addressed.”

However, Cllr Diviani is confident the investigation by DCC will conclude there has been no wrong doing.

He said: “I take this predictable and entirely politically motivated complaint against me by people who contribute little or nothing positive to the debate at face value, and feel sure that DCC will dismiss the allegations as unfounded.

“I have neither seen or heard anything from Ms Ranger on how her party would address the huge challenges facing the NEW Devon CCG and the NHS.

“As the web cam at County Hall malfunctioned and didn’t record properly, the gist of what I said is as below. I did also explain that my position on that scrutiny committee is by virtue of my being elected by the other leaders of all the Devon districts to represent the county-wide views of the district councils, not just East Devon, and is a function I perform regularly both locally and in London through the District Councils Network where I represent the South West.

“There is a tendency to assume that everything is fine as it is, when it quite clearly is not, and that the government will keep throwing money at the NHS as they always have in the past.

“What that underestimates are the social care costs which are massive, but if tackled correctly will reduce the acute care costs, as evidenced by the Kings Fund report. We will still need our hospital buildings which in Honiton are already being used differently, for example, for kidney or chemotherapy treatments. Staffing is still a problem but that is not building dependent.

“Many of us have made a positive decision to live and indeed work in the countryside and a direct result of that decision is a diminution of accessible services we can reasonably expect the state to provide. When able, it is a price we gladly pay for the quality of life afforded.

“In straightened times, we need to cut the cloth accordingly. As is well documented, the largely under funded cost of adult social care is a significant factor in the problems besetting the NHS where the acute care service is the treatment of last resort, and very good it is too, but with the budget sliced off to the top tier local authority.

“As the truly excellent Kings Fund Report from 2016 made exceedingly clear, sorting adult social care comes first and if we tackle that with the help of the district councils the benefits will flow. The NHS cost pressures will diminish and the money can best be spent where most needed.

“In East Devon we have enormous and justifiable pride in our local hospitals and all our existing towns were well endowed. Costs are, however, never static and will always rise without innovation.

“But here we are talking service industry which is always people dependent and where low wages do not necessarily translate into low cost. Simply put, if one person falls, it will take two people to rectify the situation, and if not rectified speedily, the condition and costs multiply exponentially.

“And speedily must mean access to care, quickly. Our travel times are well known and until they are resolved, we will always need staging posts to either stop people occupying the acute provision when unnecessary or to maintain them in a degree of comfort until they can reach the comfort and safety of their own living space.

“The major flaw appears to me to be the ever present ‘one size fits all’. Flexibility is key and our response should be the start.

“Attempting to browbeat the secretary of state with a demand to overturn his own policies is counter intuitive. I prefer to ask him to rural proof our rural situation before allowing any further reductions in service which we on the ground can see will be detrimental, but our transformers would discount. But that is a local decision which should be made locally.”

Also among those who have raised concerns over the debate and vote at the scrutiny meeting is Claire Wright, Devon County Councillor for Otter Valley Ward.

She has said how she was “disappointed” by the behaviour of scrutiny committee chair Sara Randall Johnson who “appeared to do her utmost” to prevent any referral.

She said: “I am also disappointed with the attitude of the majority of the Conservative group who used a variety of ill-informed views and remarks to justify their determination not to refer, refusing to hear or see any member of the public’s distress, frustration and disbelief at the proceedings.

“The chair’s attitude made me angry and led to a protracted row where I repeatedly asked her why she had allowed a proposal to be made and seconded at the very start of the meeting by her conservative colleague, Rufus Gilbert, not to refer to the secretary of state for health, when I already had a proposal that I had lodged with her and the two officers, before the meeting.”

She added: “When they did what they did at the health scrutiny meeting, the Conservatives betrayed thousands of local people.”

The close vote whether to refer the decision was six votes to seven, with two abstentions. All those who voted with Cllr Gilbert’s motion were Conservative’s.

Cllr Wright, who is seeking advice on what happened at the meeting, concluded: “I am quite certain that with a different approach by the chair the outcome would have been different, and local peoples views would have been respected and acted upon.”


Clinton Devon Estates to take over work of Jurassic Coast Trust

Oh dear sweet Lord – clifftop holiday homes and Disneyland here we come – and definitely no National Park!

An East Devon landowner is set to play a significant part in the future of the Jurassic Coast World Heritage Site.

Clinton Devon Estates, which owns and manages 25,000 acres of land across Devon, has pledged its support to the Jurassic Coast Trust which is taking over the management of the 95-mile stretch of world heritage coastline, from Devon and Dorset county councils this July.

The landowner is joining the Trust as one of four Lead Business Partners, currently the only partner in Devon alongside three based in Dorset, and will pledge £3,000 per year to the charity, helping to safeguard its future.

The Trust’s link with businesses and landowners is essential in ensuring it can carry out its work looking after the world class coastline, which stretches between Exmouth in Devon and Studland Bay in Dorset, on behalf of UNESCO for the “benefit of the whole of mankind”.

A large part of the Estate’s East Devon acreage is made up of the Pebblebed Heaths, which are named after the Budleigh Salterton pebblebeds and are a designated conservation area.

The Trust is poised to support the landowner’s existing educational outreach, which focuses on the ecology and management of the heaths by the Pebblebed Heaths Conservation Trust.

Kate Ponting, countryside learning officer at Clinton Devon Estates, said: “We have had an informal, mutually supportive relationship for a long time as our paths have crossed over the years.

“The Estate owns land very close to, or on the Jurassic Coast, and the Trust is keen to extend its work in East Devon, so the partnership should afford more opportunities for collaborative working.

“We have a lot in common with the Trust whose work is based on geology; the geological story of the Pebblebed Heaths is part of our shared heritage which we’re passionate about.

“We hope to celebrate this heritage further, through extended community engagement and we’re hoping the Trust’s expertise will enhance what we already do.”

The Trust also plans to provide downloadable audio guides about East Devon’s geology for the Clinton Devon Estates’ website.

Guy Kerr, Programme Manager for the Jurassic Coast Trust, said: “We are delighted to have Clinton Devon Estates on board as one of our Lead Business Partners. The East Devon pebblebeds are a crucial part of the Jurassic Coast World Heritage Site and we look forward to working closely with Clinton Devon Estates to preserve this landscape and enthuse people with its incredible stories.”


Shortage of care home beds in Devon – except for the rich, of course

Too ill to be cared for at home or in community-bedless Devon? Tough.

But no worries for the rich in their luxurious “assisted living” apartments in places like Pegasus in Sidmouth and Millbrook Village in Exeter!

And even there no use having beds if there are no carers to take care of people post-Brexit.

“Devon and the South West is heading for a major shortfall in care home beds, a leading property expert has warned.

The region will need to create 1,350 beds a year to offset closures and pressures from an ageing population.

Anthony Oldfield, director at property consultancy JLL, which has an office in Exeter, said: “Even before we take into account the impact of bed closures, the care home sector needs to double the delivery of new beds. Demand for private pay stock set to increase across all regions of the UK, not just the wealthy prime markets, as a result of historic house price growth and no change in the threshold for publicly funded care since 2010.

“The election showed what an emotive subject social care and how it is going to be funded can be. But it is essential that the government reaches a sustainable solution as to how social care is to be funded in a way that doesn’t pass the burden to a shrinking working age population.”

JLL estimates that there will be a shortfall of nearly 3,000 care home beds in 2018 based on the current development pipeline and anticipated increase in demand due to growing demographics in the UK.

Just within the South West, the forecasts suggest a need for an extra 15,100 beds by 2026, or roughly 151 beds per year. With just over 1,200 beds lost in the market in 2016, the regional build rate could actually be closer to 1,350 new beds per year in order to offset home closures.

At the same time that demand is rising, the pipeline of planned developments in the South West suggests that just 700 beds will be built during 2018.

With about 77% of all care home beds built before modern quality standards were adopted in 2002, there is an urgent need for new development to meet demand and improve living standards for future care home residents.

Mr Oldfield said that priority should be given to care home provision in planning policy.

“A change of mindset is required that sees the development of care homes as an imperative for society and ensures that applications are resolved in a timely manner and without the frustrations that many operators report. “Attendant to reforms contained in the green paper should perhaps be protection or classification of land allocated to retirement living developments to ensure that the right type of housing is being built in the right locations. This would enable people to extend the period of independent living.”


Budleigh “health hub” advertises for (paying) tenants

“The Budleigh Salterton Community Hospital Health and Wellbeing Hub (Budleigh Salterton Hub) will bring together local residents, the NHS, the voluntary, statutory and business sectors under a common purpose – to improve the quality of health and wellbeing for approx 48,500 people in the Woodbury, Exmouth and Budleigh (WEB) areas, including all the local villages and hamlets.

As a provider of health and wellbeing support, whether it be through fitness, social activities and groups, holistic therapies, mental health guidance, weight management, physiotherapy, healthy eating and lifestyle choices, art therapies, NHS outpatient services, catering, or childcare provision, this is your opportunity to get involved in this new and exciting project, supporting babies and children from early years through to older people.”


Here is the “information pack”:


Rooms ( including the kitchen) are from (not at) £15-25 per hour (NHS or private) and it seems from reading the brochure that, as yet, it has no tenants.

The (ir)responsibility of politicians

This long article is about the crisis in prisons. But the last four paragraphs quoted here could be about anything that is the responsibility of politicians:

“Who allowed this systematic irresponsibility? Civil servants could no doubt have been more robust in their advice. But the truth is that Grayling and Gove [and here add names of other ministers] at least did not broach any challenge. Any senior officials that they felt were obstructing their plans or raising awkward questions were edged out. It’s tough to push back when your job is at stake.

No doubt some governors and prison officers could have done more to raise problems and find solutions – but most of them had crises to manage.

The only conclusion I can really draw is that the blame lies with the politicians. They cut prison budgets without having a good understanding of the likely impact, then carried on cutting long after those consequences were clear. They focused on pet projects rather than getting the basics right.

They were supported in doing so from the very top. Cameron and Osborne [and now May and Hammond] made the call that people didn’t much care about the condition of our prisons [hospitals/schools/environment], and if budgets were to be cut this was a place to cut particularly deeply. They ignored signs that the system was creaking, and forgot that changing your justice secretary [or any minister except Hunt where no-one wanted his job] every 18 months is a sure-fire way to create problems. Most important, they forgot that there is no better symbol that government is out of control than riots [bed shortages/failing schools/concrete jungles] within the facilities they are meant to run.”