FINANCE: Northern Devon Healthcare Trust will close beds at two of its community hospitals despite ‘serious concerns’ raised by some of its clinicians.
The trust board took a unanimous decision this week to close medical beds at its Ilfracombe and Bideford hospitals, while retaining beds at its sites in Holsworthy and South Molton.
Northern Devon made the decision after a six week consultation. It said the changes were needed to achieve efficiency savings demanded by Northern, Eastern and Western Devon Clinical Commissioning Group and the NHS Trust Development Authority, and as part of a push to deliver more care in people’s homes.
However, Mervyn Dent, senior elderly care consultant at Northern Devon, wrote a letter to the trust warning of clinicians’ “serious concerns”.
In the letter, Dr Dent claimed the consultation had been “poorly managed”, with staff first hearing about the proposals “through the local media”.
He said the “precipitate time scale [had] precluded any serious consideration of the risks”. There were no plans for dealing with patients with complex social issues, and North Devon District Hospital had at least 30 too few medical beds to manage the winter surge.
“Safety and the achievement of important cancer waiting time targets are likely to be severely compromised,” he warned.
He said there would probably be “considerable negative impact” on income generation and “a need to reopen capacity with agency staffing”, which could “dwarf any savings achieved by the bed closures”.
Dr Dent said that at a meeting of senior clinicians to discuss the plans, the majority present abstained because they felt the case for change had not been adequately made. The leads for the emergency department, medicine, surgery and elderly care did not feel able to support any of the trust’s proposed options.
“If the board decides to go ahead with bed closures… they do so against the unambiguous and forcefully expressed advice of their own lead clinicians and must take responsibility for any consequential service failure or adverse clinical outcomes this winter,” he wrote.
NEW Devon CCG has also come out against the plans. It said it was “concerned at the singular emphasis on finances and the timing of the consultation, together with the possible impact on system resilience and patient safety”.
Roger French, Northern Devon’s chair, said: “After careful consideration of the consultation feedback and our own quality and clinical risk factors, we viewed that the best decision was to leave the beds in Holsworthy and South Molton as they served large, rural and dispersed populations. They also have the most modern buildings and do not struggle to fill staff vacancies.”
The trust said it had made its decision with “caveats”. It would not contradict future outcomes of the Devon success regime, and would develop “quality metrics” to make sure North Devon District Hospital had sufficient capacity ahead of winter.
The third was that the decision was reversible, “if the CCG… or the success regime wanted to put forward a different configuration of services to bring Devon’s finances back into budget”.
Press statements and letter