Friday, 26 April 2019

Hospice beds cut by half

Hospice beds cut by half

THE number of beds at the Sue Ryder hospice in Nettlebed has been reduced by half.

The charity closed six of its 12 beds at Joyce Grove on Monday, saying they were no longer needed because of a drop in demand for inpatient care.

At the same time, the number of patients being cared for at home has soared.

Sue Ryder says the move doesn’t represent a cut in services because the beds have been out of use for some time and have only now been removed because it wanted to ensure the trend was not temporary.

Over the past six months the bed occupancy rate has been between 50 and 60 per cent at most and on several weeks it dropped to 40 per cent or less and there were occasions when as few as four people were on the ward.

The charity made the decision to reduce the number following talks with the Oxfordshire Clinical Commissioning Group, which is responsible for health services across the county.

Staff were informed in an internal memo last week. No nursing staff are expected to lose their jobs but some will be offered new roles with the hospice’s community care service, which will be one year old next week.

Holly Spiers, Sue Ryder’s director of hospices and fund-raising, says more people are using its outpatient hub, which is based at the hospice and has a phone line to nurses who provide specialist advice or rapid response care.

If a patient being cared for at home wants to spend their final day or two at the hospice, transport can be arranged.

When the hub opened as a pilot scheme, the charity said it would better meet patients’ needs as demand for inpatient stays had fallen by 12 per cent since 2014 while demand for nurses to visit patients at home had almost trebled in that time.

Since then, nurses have made 7,709 visits within the community compared with 1,742 in the previous year. Mrs Spiers said: “The decision was taken following several occasions where occupancy fell to within the 40 per cent bracket and there were times we had only four people on the ward. It makes sense from a business point of view because the demand isn’t there.

“Low occupancy has been a constant over the past three to five years so it isn’t a fluctuation and this decision is supported by our clinical team. It was only taken after analysing our data over a significant period and won’t affect anyone needing a bed or patient care generally.

“This is an ongoing trend and isn’t anything new — we’ve just decided to proactively manage it by closing beds that haven’t been used for some time. To put it in context, our other hospices run at occupancy rates of between 70 and 90 per cent and with more beds.

“Across the country and across all health services, more people want the opportunity to be looked after at home. It doesn’t only affect end-of-life care but home is the preferred place of death for many so we’ve created a much broader and more holistic service offering a wider choice.

“The take-up for the community service has been fantastic, especially considering that it doesn’t serve a large population, while feedback from patients and their families has been overwhelmingly positive.

“I have no doubt that this is right direction to take and I’m proud of what the team has achieved.

“We hope to keep all our staff as we move through this journey and will be offering people the chance to move into community roles so our nursing establishment will remain the same.”

Sue Ryder, which has run the Nettlebed hospice for more than 35 years, intends to sell the building and move both the community hub and the remaining beds to another location in South Oxfordshire.

It says the Grade II listed building, which was erected in 1908 and also has 27 acres of grounds, is expensive to maintain and difficult to reach in bad weather.

It does not expect to leave before next year and says it will take over an empty space at an existing site rather than building its own premises.

In 2014, the hospice was due to move into a new purpose-built 12-bed facility on the second floor of Townlands Memorial Hospital in Henley to form part of a £16 million “health campus.”

However, the charity pulled out of the agreement with the NHS because it would have needed more space elsewhere and didn’t want to be spread across more than one site.

In August, Mrs Spiers announced that up to four beds could be cut after the sale but said the charity would not seek to have fewer than eight. However, this followed a period when the occupancy rate had been nearer to 70 per cent.

The news drew criticism from some patients who said they did not wish to die at home and claimed most people in their situation felt the same way.

Relatives of patients claimed their loved ones were only being cared for at home because they had been refused beds as there was no room at the hospice.

Mrs Spiers said: “We still have beds at Nettlebed and still plan to have them at another location for patients who either want them or for whom complex symptoms or social situations make it impossible to be cared for at home.

“We don’t anticipate a huge spike in demand for beds in future because if that was going to happen we’d have seen it by now.

“Having looked at the data and considered multiple scenarios, our clinicians do not believe it is possible and have confirmed that the current number of six is right.

“We’re now exploring options using the data generated from the pilot to determine what shape our future will take.

“It’s very much our intention to relocate all our services together but at this stage we have nothing more to share about the locations.

“I understand that people are very keen to know where we’re moving to and I wish I could share that or give a timeframe for further announcements but I can’t as it all depends on discussions with third parties.

“However, it is progressing and we’re trying to move as quickly as we can within those constraints.

“We are extremely keen to get across that beds are not going to be lost and that none has been ‘lost’ this time because they’ve been void for many months.”

In the memo to staff, hospice director Maria Turnbull said: “Offering more patients the opportunity to be cared for at home has already demonstrated a number of advantages, including reducing the number of unnecessary admissions to local hospitals and our inpatient unit.

“We will, of course, continue to closely monitor occupancy levels and demand. It is our absolute intention for every one of our current staff to have the opportunity to remain with us as we develop our service.

“May I take this opportunity to thank you all very much for your continued hard work and support, enabling us to be there when it matters for more and more people across South Oxfordshire.”

Ian Reissmann, chairman of the Townlands Steering Group, said: “When we met with Sue Ryder last August we made the case for retaining a central bedded institution alongside the at-home service as there was clear support for this.

“We’re concerned that this reduction could make the hospice unviable by losing the economy of scale. While they are seeking new premises, we’re worried that it may have to close before a suitable venue is found if, for example, it loses staff and can’t replace them.

“Keeping vacant beds open is not a good thing but demand does rise and fall and when it rises above six then local people may have to look elsewhere. The last number they told us they needed was eight.

“The hospice is a well-loved community institution and we are seeking reassurances that it will continue to be available.”

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