Dear Mrs Pedder

Your Future Care Consultation – Response from Honiton Hospital League of Friends

Nothing unites us like our human vulnerabilities and the need for each other’s care.

Every one of us at some point in our lives will be patients and will want in our time of need to rely on a health care system that not only offers excellent and appropriate care but that is based on compassion and trust.

We understand that with advances in modern medicine, an ageing population and finite resources that the task of providing a fit for purpose health care system is a challenging one and we also acknowledge the issues you have with trying to address the huge financial deficit in Devon

Over the past few months many of us in Honiton have worked on engaging in the consultation process with New Devon CCG.

We have attended your meetings and have read the Your Future Care consultation document trying to make sense of the radical changes being proposed to our medical healthcare provision and attempting to understand why Honiton was excluded from the document prior to going out to consultation.

To have a voice in your consultation you require us to complete a response document where options A to D do not include Honiton. We have been bemused as to how we can be invited to contribute to a “genuine consultation” when such a radical decision has been taken prior to the document being released.  I hope you can understand how by dismissing Honiton Hospital from the Your Future Care document leads us to question the integrity of the process and leaves us feeling disenfranchised and silenced as a community.

A hastily added 5th option requires at item 4 on the form to present – to all intents and purposes – pretty much a fully worked up alternative proposal. This is something we do not have the luxury of a consultancy agency to help us with.

We have also tried to look closely at what alternative health care system you are proposing once this care has been withdrawn from the community hospital.  Through reading your document and asking questions at meetings we have no clear vision of an alternative model of care to work towards and have grave concerns about the overburdening of our social care provision that is already woefully over stretched.

Whilst being cared for in one’s own home when we are ill is something many of us would hope for, we are however extremely worried for the most sick, vulnerable and often elderly members of our community. There are many examples where the physical home environment may not be suitable, carers are already on their knees with 24-hour care responsibilities and the complexity of care required leads us to question how safe and appropriate or indeed humane it would be to leave someone alone for what inevitably will be long periods without nursing and medical care.

The care of people at the very end of life and for those who are medically unwell but also have dementia or challenging behaviours require sensitive and expert intervention from appropriately trained nurses and medical practitioners. It may well be that you have new and innovative models of care to offer these most vulnerable of people in our community but meanwhile we believe they are best cared for within the medical ward of our community hospital, close to their families, friends and in the relative comfort and security of familiar surroundings.

The “step up” and “step down” care provided by our community hospitals not only takes the pressure from much needed acute beds but helps accelerate rehab thus promoting independent living and reducing dependency on health care.

We remain unconvinced that eroding our community hospital medical beds will result in better care and financial savings. In the absence of detailed costings of the alternative options you are proposing we have seen no credible evidence of a viable and safe home care based alternative and in fact would advocate the nurturing of community hospitals as the way forward.

In an evidence based world of health care you quote research studies that support your arguments for closing community hospital beds. To take a fair and balanced account of appropriate research we would urge you to halt the “Your Future Care” process at this stage to look at evidence that addresses outcomes of care provided from Community Hospitals.

For instance, Small et al. 2007 in their RCT conclude “this study confirms that the community hospital meets the requirements of evidence-based care and cost-effectiveness. It also achieves patient approval.  We identify a model of community hospital care that incorporates technical aspects of rehabilitation within a human approach that is welcomed by patients”

Honiton is one of the community hospitals involved in a major research programme led by Professor Jon Glasby at the University of Birmingham due to report on findings next year.

Detailed information and resources can be found on the Community Hospital Association website

We believe that we have engaged in your consultation to the best of our abilities and alongside this we have taken expert advice from and worked closely with Dr Helen Tucker of the Community Hospitals Association to facilitate her document – “Community Hospitals Association Response to the NEW Devon CCG Consultation Document Your Future Care January 2017”

Following all that we have read and discussions at meetings we have attended we would like you to seriously consider the following as an additional option:

Tiverton 24 beds
Honiton 16 beds
Seaton/Sidmouth 16 beds
Exmouth 16 beds
Total 72 beds

We are confident that Dr Tucker has the experience and expertise we lack in giving close scrutiny to the process and content of NEW Devon CCG’s “Your Future Care” document and proposals.

We therefore fully support and endorse Dr Tucker’s detailed analysis and response to the Your Future Care Document and would also urge you to pause this process so that:

  1. Principals, options, criteria and option appraisal can be re-visited with improved accuracy of data including access and finance
  2. Honiton is included and taken seriously as a viable option [see above]
  3. Recent research evidence about the value of Community Hospitals can be included and allowed to inform discussions
  4. A clear vision of an alternative model can be offered for appraisal

Your sincerely

Heather Penwarden
Honiton Hospital League of Friends
Honiton Dementia Action Alliance

Community Hospitals Association response to the NEW Devon Clinical Commissioning Group Consultation Document

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