STRUCTURE: Somerset Clinical Commissioning Group is planning a major overhaul of its community services which will see a significant reduction in hospital beds and the potential procurement of an integrated service for patients with long term conditions.

Under plans approved by the CCG’s governing body last week, it is envisaged that up to 100 community hospital beds will be permanently closed over the next five years.

Beds are expected to be closed entirely at a “small number” of the county’s 13 community hospitals, which are currently run by Somerset Partnership Foundation Trust. The remainder will host either step up or step down beds.

A recent audit of bed use in Somerset’s community hospitals concluded the county needed about 210 beds of which around a third should be step up with full medical care and two thirds step down which could be nurse led.

The county currently has 312 beds, although 57 have been temporarily closed already.

Hospitals that lose their beds will be developed as health and wellbeing centres with enhanced outpatient services, ambulatory care and other services, such as support for carers and memory cafes for people with dementia.

The document stressed the model would not be implemented until alternative community services had been developed for people living in their own homes.

Board papers also reveal it is “highly probable the CCG will seek to re-procure services which currently support those with long-term conditions”.

These plans will be worked up over the coming months but are likely to include services provided in primary, community, secondary and social care.

The governing body also approved plans to press ahead with the development of a health and wellbeing campus at Shepton Mallet Community Hospital.

The vision is that this will have integrated primary and community healthcare services as well as some hospital services.

However, due to delays in obtaining information from NHS Property Services, which own the buildings, the CCG has decided to spend another six months working up the plans.

CCG chair Dr Matthew Dolman said: “Whilst a significant percentage of patients currently using community hospital beds in Somerset could be better supported in their own home or community, the right services need to be in place for this to happen. 

“That is why this community service review is clear that a general strengthening of community based health care needs to be implemented in parallel with any new model of community hospitals.”