Wednesday, 26 September 2018

Don’t come here to die

PATIENTS who are terminally ill will not be allowed to go to the new Townlands Hospital to die.

PATIENTS who are terminally ill will not be allowed to go to the new Townlands Hospital to die.

The hospital’s new rapid access care unit will be able to refer patients to one of up to 14 NHS beds at the neighbouring care home but refuse those who require end of life care.

These patients will have to stay at home, be admitted to a hospice such as the Sue Ryder home in Nettlebed or travel to hospital beds in Wallingford or Abingdon. The Oxfordshire Clinical Commissioning Group has agreed to install eight beds at the Orders of St John care home, with another six “on demand”, alongside the care unit in the hospital building.

However, the agreement includes 12 “exclusion criteria” where patients may be refused treatment by the care unit. One of these is where a patient “requires intervention to support end of life care in the last stages of life”.

Former Henley GP Peter Ashby, who worked at the Bell Surgery, said preventing terminally ill patients from dying in their local hospital was a “tragedy”.



He said: “In the old Townlands people could be admitted for whatever reason and if that was for end of life care then that’s what we’d give them.

“Sue Ryder doubled up on that but beds at the hospice aren’t always available, even though they cope with it very well.

“I think it’s a tragedy. People want to be on familiar ground with people they know, including local nursing staff. Family and friends who visit overnight will find it much more difficult in Abingdon or Wallingford than Henley.

“There’s a sadness in that and I think it’s a great shame.”

Dr Ashby said he was especially worried as a deal had not yet been agreed to provide the beds in the care home, which will not open until next summer, six months after the new  hospital.

He said: “There is no definite nod from social services that they can provide those beds in the nursing home — they say they are still negotiating. One of the problems with those beds is that to make the care home pay for itself the beds have to be full.

“If the commissioning group says it wants six beds one week and eight the next then they will be paying for beds to be kept empty.”

Henley Mayor Lorraine Hillier said: “It’s shocking that people might have to leave the town to die. The whole point of having the beds is that people could be in their own town if it got to that stage. It’s a very poor move.”

The move was also criticised by the daughter of 96-year-old Elsie Dunmore, who died at Townlands Hospital last month.

Yvonne Gillespie, 69, of Coldharbour Close, Henley, said: “Townlands is so precious, my dad died there too in 2003.

“At the end of your life you want to be pain-free, with your loved ones, in privacy and with people around you who are compassionate and caring.

“I’m disgusted that dying people can’t go there. It’s a wonderful new facility we’ve got and anybody who is sick deserves to be looked after locally. Why should they be shipped off to a hospital miles away where relatives will find it hard to visit and stay?

“We have a good local hospital — why can’t we use it and why should dying be different?”

Mrs Dunmore had been suffering from various illnesses including pneumonia and was moved to Townlands from Abingdon Community Hospital the week before she died.

Mrs Gillespie said: “She had been becoming more and more ill but mentally she was as sharp as a razor. Because of her illnesses she couldn’t walk or get out of bed and the doctor told me she needed to go to hospital.

“I’d recently had an operation and couldn’t drive so I asked if she could go to Townlands but they couldn’t take her and so she had to go to Abingdon.

“She was put in a big ward which was very busy and impersonal and for me it was a nightmare. I couldn’t get there without begging and pleading for lifts.

“In the end, after a lot of arguments and persuasion, they moved her to Townlands. The staff, knowing she was coming, sent someone out to buy her gluten-free food, which she needs. I was so impressed.

“For me the best thing was the level of compassion and care given to my mum. I could be there and if I needed to go home to change my clothes or have something to eat it was less than a mile.

“The care she had in Townlands was amazing, they looked after her beautifully. The ward was always spotless and at the end they moved her to a side room to give her more privacy. They did everything they could to make her last 24 hours comfortable.

“We were able to sit with her and hold her hand. It made the last few hours wonderful and for that I’m incredibly grateful. I wouldn’t have liked to have tried to do that at Abingdon or Wallingford.”

Town councillor Ian Reissmann, who chairs the Townlands Steering Group, said the current Peppard Ward at Townlands did not usually admit terminally ill patients but said there were “genuine concerns” about the new arrangements.

He said: “The situation is that palliative care patients aren’t treated at Townlands because when you reach that stage you need a specialist care provider like Sue Ryder.

“That situation won’t change. That’s the principle of how the current Peppard Ward is run but it all depends on how it’s done in practice.

“Sue Ryder is now offering more care at home and that’s one of the reasons they didn’t move into the top floor.

“I know there are genuine concerns and there are two questions to ask: what will change in the new hospital and what choices do people have for palliative care locally?

“I have asked the commissioning group these questions and I’m pressing them on both points.”

Dr Philip Unwin, a GP at the Hart Surgery, said: “It’s a big change but one that we are hopeful that social services provision and services in the community will be able to manage.

“People may have to go to Wallingford or Abingdon but we won’t know that until we get there. They will always have Sue Ryder too, which is fairly unbeatable.

“Not many people go to Townlands to die. Most people die at home and are cared for by district nurses or Macmillan nurses who provide great services. Most people want to die at home.

“I can’t remember the last time Sue Ryder refused a patient so I’m hopeful this change won’t be too impactful.”

Henley MP John Howell said that in the original plans for the new hospital Sue Ryder was going have beds on the top floor but then pulled out of the scheme.

“You can’t die in Townlands now — they don’t provide end of life care,” he said. “There may be an exception where people move to the hospital and end up dying there but end of life care is an incredibly specialist activity.

“I take my hat off to Sue Ryder and others for providing that and the more they can provide, the better it will be.

“I think residents would like to be cared for properly in the last hours of their life, I know I would be. If that means I have to travel then I’m prepared to do that.”

A spokeswoman for the commissioning group said: “There is a distinction to be made between palliative and end of life care.

“A patient may be receiving palliative care for years and depending on their clinical need maybe accepted by the rapid access care unit where appropriate.

“However the care unit is not a service suitable for end of life care and there are existing patient pathways and services in place to support end of life patients.

“The current inpatient service at the Peppard Ward does not provide an end of life service and this does not change under the new model to be implemented.”



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