Beds axed due to 'market factors'

HEALTH chiefs have been accused of prioritising cost savings over patient care in axing seven hospital beds in Henley.

Campaigners claim the decision to withdraw funding for the short stay beds at the Chilterns Court care centre, next to Townlands Memorial Hospital, was not based on clinical need.

One bed has already closed and the other six will go at the end of the year.

The beds are mainly used by patients recovering from problems such as hip or shoulder operations who had been living independently previously.

But the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board and Oxfordshire County Council have decided to stop funding them to focus on care at home instead.

They say Oxfordshire needs to meet a national requirement of 95 per cent of people being discharged from acute hospital beds going home to live independently or with
support.

The number of short stay beds across the county will fall from 94 to 63 this winter and to between 40 and 45 from April, with none in Henley.

The 63 beds will be based at the following care homes: Chacombe Park in Banbury; Henry Cornish Care Centre in Chipping Norton; Albany in Headington, Oxford; Isis in Oxford; The Close near Abingdon.

A meeting of the reformed Townlands Steering Group on Wednesday last week heard that this was based on “market factors”.

Town and county councillor Stefan Gawrysiak claimed that care homes were invited to quote for providing the remaining beds and the council chose the least expensive option.

He said: “They are saying that with these 63 beds they cannot look at the geography. They are done on, I quote, ‘market factors’, in other words the cheapest price.

“I don’t know what Chilterns Court bid but if a bed can be provided for £1,000 a week in Banbury whereas in Henley it might be £2,000, they are going to go for the cheaper option.

“That is not based on need and services that are near the people — that is the nub of it. It should not be based purely on market factors.

“Money does matter but it should also be based on patient need and the closest to home.

“I don’t mind where the beds are as long as southern Oxfordshire gets provision but there is none.”

Cllr Gawrysiak said that GPs at Henley’s Bell and Hart surgeries, which provide medical supervision for the beds at Chilterns Court on a rota basis, say the beds have 100 per cent occupancy and want them to remain.

“We know of two patients who couldn’t go into the beds because they are full. One of them has been put in Didcot and the other in Farringdon.”

He said it was unfair on a frail elderly person to be so far from home and for their relatives to have to travel to Farringdon, especially by bus.

“You are really pushing back the recovery of that patient,” he added.

Cllr Gawrysiak said that there were about 140,000 residents in South Oxfordshire who would not be able to access the remaining beds easily.

He said: “I know someone who broke her hip and was in the Royal Berkshire Hospital and needed care at home because she hasn’t got any family around — she is 95.

“Instead of popping her into Chilterns Court, she was put in a home in Farringdon and her son, who is also her carer, can’t go and see her. That is wrong.”

Town councillor Ian Reissman, who chaired the meeting, accused the county council and care board of failing to justify closing the beds because they were focused on meeting their target.

He said: “They gave us some figures on the number of patients that had been discharged from the Royal Berks.

“They said that out of 54, four were assessed as not being able to go straight home. Well, that’s seven per cent for a start, so their own figures don’t stack up.

“The phrase ‘market factors’ let the cat out of the bag rather.

“They are following policy but what they haven’t done is have a clear paper which says, ‘This is the plan for short stay hub beds’ and gives reasons, allowing themselves to be scrutinised.”

Town councillor Gill Dodds said that when her late husband, Malcolm, was discharged from hospital it took an “enormous effort” to make their home suitable for him.

She said: “We had visits from occupational health who had to see that the care was okay, that the equipment was okay. That took a whole week.

“Then the ambulancemen had to work out how to carry him up the stairs and that took some more days.

“I’m really nervous because I don’t think care at home is going to be anywhere near adequate. If anyone falls in the night or tumbles out of bed then they will have to lie there until their carer comes in the morning, calls an ambulance and then they are back in hospital.

“I just think it is unsatisfactory. It would be nice to know what sort of care package they have in mind.”

Cllr Reissmann: “You are exactly right. One of the key pieces of information we need is: do adult social care services have the capacity to deliver home care packages quickly and to a level and quality that is acceptable?

“When we have asked them to explain the provision for short stay hub care, they have refused to provide it.”

Mayor Kellie Hinton said: “The current care packages from Oxfordshire County Council are inconsistent.

“Someone can live in one house and have the same carers every day at regular times but the person next door might have irregular times, 8am one day and 10am the next, and different carers each time.

“They should be demonstrating that they can provide care and can be consistent so that everybody gets fair care.”

Retired GP Peter Ashby, from Nettlebed, said: “The idea of these care packages is you have them set up before you go home. This assumption that 95 per cent of people can be turfed out willy nilly is outrageous. I am not a great believer in targets because they are not human.”

Veronica Treacher, from Peppard, said: “A proportion of homes in the town and villages around here are small, have small doorways and difficult staircases — you cannot get a clinical bed in some of these places and that is nothing to do with how rich or poor you are.”

A letter by Deputy Mayor Rory Hunt was read out at the meeting criticising the closure of the Henley beds.

He wrote: “There has been no consultation on either the funding or with the GP surgeries about these beds and there is clear concern about the provision of these beds being removed.

“We have had no good reason for the decision, nor have we had any explanation about how it would improve the standard of care for residents of Henley and the surrounding area.

“Now it appears the nearest beds will be in Abingdon, more 20 miles away.”

Cllr Reissmann said that when campaigners asked for figures about current patient care, he was told that releasing it would breach data protection law.

He added: “It’s an insult to intelligence really.”

Cllr Reissmann said that prior to April last year, when the integrated care board was introduced, campaigners had been able to raise any concerns.

“This much larger entity is much more remote, much less connected, much less inclined to engage and much less inclined to produce good quality strategic documents,” he said.

“I am not surprised. I have been deeply unimpressed by the documents from the integrated care board in the 18 months of its existence. It is clear that the quality of management is disappointingly low.”

Ms Treacher said that previously NHS England had said it was crucial to engage with the public and there used to be regular meetings to discuss issues.

Cllr Reissmann replied: “There is a disappointing reluctance to carry out any form of engagement, never mind consultation.”

He said that when he and Cllr Gawrysiak had met Dan Leveson, executive director of the board, and Karen Fuller, the county council’s interim corporate director for adult social care, they admitted they had not “engaged well and wanted to correct that”.

“But as soon as it came down to actually engaging and answering questions to get information, which I think the community deserves, we had a less positive feeling,” said Cllr Reissmann.

“They should have been here tonight. It would have been the perfect opportunity for them to talk, reassure and listen to what our concerns are.

“I don’t want to say necessarily that these plans are disastrous because we don’t really know but they could tell us and that’s all we are really asking for.

“At the moment we are asking, ‘Give us the information, reassure us that patients will have their needs met’. That’s the important thing they need to do but they haven’t tried.”

Dr Ashby said: “If they carry out these plans to make savings at county council level it is the poor old NHS of Reading and Oxfordshire that picks up the tab for readmissions.”

Cllr Reissmann said: “I just feel that they are not interested and don’t care about talking to the
community.

“That may be harsh but they have used excuses which are feeble and bogus to refuse to give information.

“While I accept they have a lot of work to do and they are busy people, it is our health service; we pay for it through our taxes and these people are answerable to us.

“On their own admission. there has been no geographical criteria use, only market factors. That says it all and I’m surprised we got to see that.

“We’re here to say this isn’t good enough, we expect better, come and work with us.”

The group agreed to write to the county council and care board, inviting officials to attend a meeting in December on a date of their choice.