Health leaders are in the ‘Hotseat’ over community hospitals

Leaders from the organisation who run Community hospitals in Cumbria took part in a live interview on the current proposals for the inpatient beds in the county’s community hospitals.

The Chief Executive and the Director of Service Improvement from Cumbria Partnership NHS Foundation Trust; Claire Molloy and Dr John Howarth took questions alongside Dr Niall McGreevy from NHS Cumbria Clinical Commissioning Group from BBC Radio Cumbria presenter Mike Zeller.

In all of the options that have been proposed by the Success Regime the beds in Alston, Maryport and Wigton will close.

Mike asked them to respond to concerns he has been sent from an Alston resident who explained that Alston is largely used as an end of life and palliative care unit. She said:

“As such it is top notch, it is exemplary….. it fulfils all the quality of life indicators for a good death and it seems destructive to get rid of it.”

She went on to explain a possible scenario if the beds were to close at the community hospital:

“We have to wait ages for the ambulance anyway, Alston has a difficult ambulance situation, then there would be that awful journey, then there would be the difficulty to access for other people, then you would be admitted to an acute care ward not a palliative care ward, dealt with by people you don’t know. That in its self could lead to dying away from where you want to die, lack of choice. That could have consequences in the health and metal health in the people who you leave behind. That would be a bad death as it is called. Deaths in Alston are what are known as good deaths.”

Dr John Howarth saying he understood the unique nature of Alston’s situation and is working to help find a better alternative:

“We have been trying to actually work with the community and others to find alternative proposals in Alston, Maryport and Wigton to try and find alternative solutions.

“We are trying to look at better way forwards really quite sustainable and exciting futures on the Alston Moor by looking at the community hospital beds with the extra residential care home beds  and home care and trying to find out how we can have a much more integrated facility that still has beds for things like palliative care and end of life we are more likely to find a long term sustainable future. “

Claire Molloy added:

“What we want to do is create an alternative service that does support people at the end of life in their own home or in some sort of bed in that local community. Now that may not be exactly that community hospital bed that we have got at the moment but as John said we are working with the local community and local stakeholders to see if there is any alternative that we could do.

Kate Whitmarsh from Maryport Alliance explained why her community were very concerned about losing the beds in Maryport Hospital. She explained that as with Alston the hospital mainly looks after people who are end of life or who need extra support before going home after a stay in the main hospital.

“If the beds close, those people will most likely need to be looked after in Cockermouth so the main issue for people is transport. Maryport hospital is on the Ewanrigg estate in Maryport and 42% of households don’t have any access to transport and if you want to get to Cockermouth hospital from Maryport at visiting times its  a 4 hour round trip because you have to go via Workington.”

Dr John Howarth who is working on an alternative plan with the local community said:

“Transport is an issue in Maryport and in the work that we are doing together this is one of the issues we need to tackle. So to put it into context the community hospital had 252 admissions last year and we looked at how people move for care out of Maryport and last year there were 29572 journeys out of the town for care – most going to the local acute Trust so one of the big problems we have a  massive movement for care. So the solutions we come up with need to address these.”

Claire Molloy explained that changing to new ways of working and providing services would not happen overnight but would be part of a transition.

“I think there is something about building the confidence of the local community in these alternatives because I think people really value their community hospitals and in particular they get a fantastic service and our staff provide really good care in our community hospital and so whatever we develop we have to make sure that it is as good a standard as what people are getting at the moment.”

The interview also talked about Integrated Care Communities - a term that is not well understood, Dr Niall McGreevy explained what they were:

“The basis is closer working of those in health and social care and the third sector. We often work in the same community but don’t work together very well, talk to each other and we frequently  duplicate jobs and there are gaps that none of us look after. In ICCs we will be one team we will do things together and it will make things a lot more simple for patients. So it’s a smarter way of working using the resources we have but using them in a different way.

Claire Molloy added that although people may not understand what they are they are actually working in Cumbria right now and we need to improve and expand them:

“I think that difference in what we need to do now is to really scale it up and to do it in a consistent way across all patches.”

The full hour interview is on the iPlayer here or choose the first hour of the Kevin Fernihough link for 23rd November.