Agenda item

The Committee considered the following documents which had been submitted in relation to these matters:-

 

·                A report, marked “Agenda Item 9” from WLCCG and LPT which summarised the process which led to the decision to close Ashby and District Community Hospital and updated the Committee with regard to the plans for its implementation.

·                A report, marked “Agenda item 10” from the Ashby Civic Society which presented representations made to the Committee with regard to the closure of Ashby District Hospital.

·                A supplementary agenda pack which included further representations received from the local members and members of the Ashby Civic Society.

·                A Power Point presentation from Dr Barbara Kneale summarising the concerns of the Ashby Civic Society.

 

A copy of the documents listed above is filed with these minutes.

 

The Chairman advised that this matter had been included on the agenda at the request of Ashby Civic Society who had raised concerns about the proposed closure of Ashby District Hospital and the consultation process leading to the decision to close. Ashby Civic Society was requesting the Committee to consider a referral of this matter to the Secretary of State for Health.

 

The Committee was advised that the legal grounds for referral to the Secretary of State were as follows:-

 

(a)       If the consultation had been inadequate in relation to the content or the amount of time allowed;

 

(b)       If the proposal was not in the interests of the health service in its area.

 

The Chairman welcomed to the meeting the following people who were attending to speak on this item:-

 

Toby Sanders Managing Director, West Leicestershire CCG; Caroline Trevithick Chief Nurse and Quality Lead, West Leicestershire CCG; Dr. Nick Wilmott Urgent Care Lead, West Leicestershire CCG; Jude Smith, Head of Nursing LPT and Dr. Barbara Kneale representing Ashby Civic Society.

 

In introducing the report from West Leicestershire CCG and LPT, Toby Sanders emphasised:-

 

·                The clear need for health and care services to change, so that integrated community services were available and patients could, where possible, be supported in their own home.

 

·                A need for accessible and appropriate services for inpatients. Although both WLCCG and LPT took seriously the feedback that they received, there was also a need to consider the best outcomes for patients, particularly those vulnerable, frail and elderly, future needs and available resources.

 

·                The closure of Ashby District Community Hospital was in line with the vision set out in the Better Care Together Programme. Alternative Services were put in place before the inpatient ward closed and the outpatient services would continue to be provided at the hospital until alternative provision was secured.

 

Dr. Barbara Kneale outlined the key concerns of the Ashby Civic Society which were as follows:-

 

·                The proposal was not evidence based, proper consultation and engagement had not been carried out, the hospital was fit for purpose, there was no long-term planning and patient care and safety would be put at risk;

 

·                The proposal was discriminatory given the geographical locations of alternative provision and would have a particular impact on frail, elderly patients;

 

·                The ability of LPT and WLCCG to manage the situation.

 

In the ensuing discussion the following points were made:-

 

The Interests of the Health Service in the Area

 

(i).     The role of the CCG Boards was to satisfy itself that services were safe and where services were decommissioned, that alternatives were in place.  The Board had considered all available data in coming to a decision.

 

(ii).    With regards to the closure of the inpatient ward, it was confirmed that the alternative services, the intensive community support service, the virtual ward and the night nursing service all had capacity. Since the ward had closed there had not been evidence of patients not receiving care. Indeed the pattern of where patients were accessing services was the same now as before the ward was closed.

 

(iii).   The quality of alternative services provided in place of the inpatient service at Ashby District Hospital was tested through patient and carers feedback. Based on the level of incidents, such as pressure ulcers and falls, and the number of complaints, the CCG officers confirmed they were satisfied with the quality of services.

 

(iv).   Prior to closure, Ashby District Hospital had only had a single inpatient ward, which did not allow for flexibility in the staffing arrangements, for example if a patient deteriorated.

 

(v).    With regard to the concern that patients from Ashby now had to travel further if they required inpatient services, the Committee was assured that the aim of the discharge process was to get people back in their own home and where this was not possible, to place them as close to home as possible in order to mitigate issues relating to distance.

The Committee was also advised that prior to closure of inpatient services at Ashby District Hospital, Ashby patients discharged from acute hospitals tended to go to Coalville Community Hospital. A discharge of quarterly data including delayed transfers of care was compiled for the LE65 post code. Over the last two quarters this had shown a reduction in delayed transfers of care.

 

(vi).   It was acknowledged that public transport from Ashby to the nearest community hospitals in Coalville and Loughborough was not ideal but felt that access to the right treatment in a safe setting was more important than having a local hospital.

 

Consultation

 

(vii).  It was noted that, although the consultation on the future of the Ashby District Hospital had only included two formal meetings, many other meetings had also taken place with interested groups. The CCG and LPT had found multiple ways of going out to talk to the public, such as at local supermarkets or on one-to-one basis. The aim had been to go out to people rather than make them come to public meetings.

 

(viii).             Although the consultation had closed in April 2014, the CCG was still listening to the views of people in the Ashby area. This had included considering a petition against the closure of the hospital at a public board meeting where the CCG had noted the strength of feeling but agreed that the decision to close the hospital was the right one.

 

(ix).   Concern was expressed that the CCG had been invited to attend a meeting by the Ashby Civic Society in early 2015 but had not done so. The CCG made the decision not to attend as they had been working with the Ashby Civic Society on a market-place event that was open to the public for them to review all health services available in Ashby. Based on the joint working that had taken place to develop the outcomes for this event, the CCG decided not to attend the separate meeting.

 

(x).    With regard to the view of the Ashby Civic Society, that the consultation was insufficient, the Committee was assured that the CCG’s view was that the consultation was adequate. The CCG had used expertise from the Greater East Midland Commissioning Support Unit and learnt from previous consultation process such as moving the Loughborough walk-in centre. It was acknowledged that improvements could have been made to the process and that lessons would be learn before public consultation was carried out on the future of community health services in Hinckley. However, the consultation was felt by the CCG to be sufficient to identify the range of views in the area and allowed an informed decision to be taken. Subsequent feedback had not identified any issues that had not been raised during the consultation.

 

The Chairman then invited Rick Moore, Chairman of Healthwatch Leicestershire to state the position of Healthwatch on the matter. Mr. Moore advised that Healthwatch had been invited to support the Ashby Civic Society’s campaign. However, Healthwatch had decided that it was not appropriate to take sides. It did however scrutinise the consultation process and was satisfied that whilst improvements could be made, it had been appropriate.

 

It was moved by the Chairman and seconded:-

 

(a)       That this Committee notes:-

 

(i)         The information now provided by the West Leicestershire Clinical Commissioning Group concerning the consultation it has undertaken in relation to Ashby Hospital and plans to meet the needs of patients in that locality;

 

(ii)        The concerns now expressed by the Ashby Civic Society and others at the proposed closure of Ashby Hospital including their request that the matter be referred to the Secretary of State for Health;

 

(b)       That this Committee having considered the information now provided concludes that a referral to the Secretary of State is not appropriate and in all probability unlikely to succeed;

 

(c)        That this Committee requests the West Leicestershire Clinical Commissioning Group to have regard to the concerns raised during the debate and seek to ensure that as part of this and the Better Care Together implementation plan community based services are provided for patients as close to home as safely possible.

 

The motion was put and carried eight members voting for the motion and none against.