Monday, 15 October 2018

Call for beds rejected but decision delayed

A DECISION on the future of Townlands Hospital in Henley has been delayed.

A DECISION on the future of Townlands Hospital in Henley has been delayed.

Health chiefs voted to defer a decision on which model should be used at the new hospital, pending “further engagement with stakeholders”.

The Oxfordshire Clinical Commissioning Group wants to install a next-day rapid access care unit which would offer services including antibiotic treatment and transfusions as well as five to eight beds in the neighbouring Orders of St John care home.

But campaigners say there should be 18 beds at the hospital, as promised in the original plans.

At a meeting in Banbury on Thursday last week, the commissioning group’s board endorsed the proposed model but asked for more information on transition plans, staffing, clinical engagement and provision of beds.



Henley Mayor Lorraine Hillier and town councillor David Nimmo Smith both spoke at the meeting but no questions were allowed from the public gallery.

Instead, questions which were emailed to the board ahead of the meeting will be answered within 20 working days.

Cllr Nimmo Smith, who is vice- chairman of the Townlands Steering Group, said: “The community’s concerns have been voluminously expressed in the meetings I’ve attended but pushed aside in this report.

“There is much good in the facilities provided and the model of care proposed may be the best direction of travel but the Henley community has not bought into it.”

Cllr Hillier added: “The rapid access care unit is welcomed but with serious reservations as it’s not yet proven. When Peppard ward closes there will be months with no beds yet space in the hospital to accommodate 18.

“To suggest opening the care unit alone when it’s not yet proven puts lives at risk.”

The board was meeting to consider the results of a public consultation on the plans and was asked to consider three options:

• To go ahead with the proposed model.

• To reject the model and revert to the original plans.

• To ensorse the model but delay a final decision on the future of the hospital for at least two months.

Cllr Nimmo Smith proposed a fourth option: to install 18 beds which would remain until the rapid access care unit had been running successfully for two years without the beds being fully occupied.

Members of the board said the proposed model was a “new direction” and that home-based care would be better for patients than staying in  hospital.

David Smith, chief executive of the commissioning group, said it was having to “deal with the consequences” of decisions taken by its predecessor, the Oxfordshire Primary Care Trust, which was abolished in 2013.

He said: “The build was locked in without any contracts put in place for the services, which included the Royal Berkshire Hospital, Oxfordshire Health and, at that time, Sue Ryder.

“We embarked on a review of the services which included discussions with members of the Townlands Steering Group and culminated in us going into consultation.

“There’s opposition to the model but instead of putting in 18 beds we should use a different model of care. It’s incorrect for people to say there are no beds, we have an absolute commitment to provide beds on the same site.

“It’s also important to recognise that following the consultation we have amended the proposals due to working with the steering group and the Henley MP.

“The old bed-based model of care needs to change. Our job is to take decisions that are in the best interest of the population of Oxfordshire.”

Dr Andrew Burnett, a Sonning Common GP and board member, said: “It’s vital we move to a modern model of care for the hospital and I believe failure to do so will result in a poor service and threaten the viability of Townlands Hospital. One of the beauties of this proposal is that the number of beds will be flexible â?? there will be more or less depending on the need.”

Members of the board expressed support for the model but raised concerns over transitional plans and the quality of nursing that would be provided by the beds being in the care home.

Julie Anderson, south-west locality clinical director, said: “My experience of nursing homes is that they are very different to community hospitals. Things like IV fluid can’t be done in nursing homes.”

David Chapman, Oxford city clinical director, added: “Beds may be required for people but there is a difference between medical beds and assisted living.” Miles Carter, West Oxfordshire locality clinical director, said: “Oxfordshire Health is to provide nursing staff for the care unit and presumably when patients are admitted for 24 or 48 hours the care is provided by staff at the care home.

“I’m not suggesting the nursing quality is of a lower standard but they are expected to do different things and might not be of the skill level to provide care for hospital patients.”

Dr Burnett said inreach services would be provided by the care unit for patients in beds in the care home, including procedures like IV fluid infusions.

The board said the model was backed by research which suggested prolonged hospital stays can cause disability and illness. Even so, it would need to be carefully implemented and the concerns from the community addressed.

Jonathan McWilliam, director of public health at Oxfordshire County Council, said: “In terms of what is the right answer, no one can tell because we are in new territory. Population change means a change of services and we need to look at new models of care.”

The commissioning group promised to come back to the next meeting with a detailed plan for the time between when the new hospital is built and the old one is demolished as well as full financial details.

It rejected the steering group’s proposal, saying running the care unit with 18 beds could cost up to twice as much.

Mr Smith said: “There’s an annual lease cost just shy of £1million, an increased cost which we are going to have to fund out of our own sources.

“If we went with the steering group’s recommendation we would be funding all the services and 18 beds.”

All but one of the board members voted to defer the decision. Dr Anderson abstained.



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