Agenda item

The Committee considered a report of West Leicestershire Clinical Commissioning Group (WLCCG) which responded to concerns raised by Ashby de la Zouch Civic Society regarding Community Services in Ashby. The Committee was also in receipt of representations from the Leicestershire County Council Labour Group, Ashby de la Zouch Town Council and the local member Mr. J. Coxon CC. A copy of the report from WLCCG, marked ‘Agenda item 8’, the documents outlining the concerns from the Civic Society, and the other representations are filed with these minutes.

The Committee welcomed Caroline Trevithick, Chief Nurse and Quality Lead, Deputy MD, and Tamsin Hooton, Director of Service Improvement/CSR both from West Leicestershire CCG, along with Rachel Bilsborough, Director, Leicestershire Partnership NHS Trust, to the meeting for this item. The Committee also welcomed Dr Barbara Kneale, Ken Ward, and Christine Baker from Ashby de la Zouch Civic Society.

Arising from discussions the following points were noted:

(i)          The site of the former Ashby Hospital had been sold to a property developer and been developed. There were strict guidelines on what the proceeds of the sale could be spent on and the majority of the funding had been spent on measures to create an agile workforce such as providing nurses with laptops.

(ii)         When patients were transferred from an acute hospital into a community hospital transport was provided. Therefore the availability of public transport was only an issue for the patients’ visitors rather than for the patients themselves.

(iii)       The model of care for Ashby residents was largely consistent with the model in the rest of the WLCCG area, with patients discharged to home wherever possible.  The model had led to a significant increase in discharge to assess and reablement beds. Two care homes in Coalville provided these beds and it was hoped that a care home in Ashby would also come forward.  It was recognised that long stays in acute hospitals were not good for patients’ outcomes, meaning that some patients who were not able to be discharged to their home would be discharged to community hospitals instead.  However, this number was relatively small, with only 2000 patients a year admitted to Community Hospitals. Between November 2014 and October 2018 only 233 patients from the LE65 postcode had been admitted to Community Hospitals. For Leicester, Leicestershire and Rutland 46% of patients were admitted to their nearest community hospital; this was the same as the figure for Ashby residents and reflected patient choice, the desire to be in a hospital near to relatives and specific clinical issues such as the need for a specialist bed which could mean that the nearest Community Hospital was not suitable. Conversations were ongoing with University Hospitals of Derby and Burton NHS Foundation Trust regarding a shared discharge pathway.

(iv)       Ashby de la Zouch Civic Society expressed disappointment that the promised new community services were still under review, given that the hospital had closed over four years ago and two GP surgeries in Ashby had also subsequently closed.  In response, the CCG acknowledged that it had received some negative feedback and was working closely with the Castle Medical Group to consolidate the local offer, including diagnostic services.  However, there was a national issue with GP recruitment and retention. The Community Services Model had also changed over time; the initial focus had been to improve nurse led services, whereas the intention now was to integrate health and social care services.  It was recognised that there could be delays with social care packages however work was ongoing to increase capacity and the health service was also funding additional reablement packages. Evaluation of the impact of integrated care was taking place and Key Performance Indicators were in place.  Healthwatch had been asked to undertake a survey of patients’ experience of the integrated system.

(v)        With regard to concerns that funding received from developers under Section 106 of the Town and Country Planning Act 1990 had not been used efficiently it was explained that a business case had been drafted by WLCCG to use Section 106 monies to expand the GP Surgery in Ashby and this work was ongoing.

(vi)       In response to concerns raised by Ashby Civic Society that they would not be kept informed of developments, WLCCG offered to give consideration to whether Ashby residents could be invited to the Citizens’ Panel which was considering work across LLR in relation to the Sustainability and Transformation Partnership, and it was noted that CCG Board papers were published online enabling residents to keep up with developments. With regards to scrutiny of the future developments it was clarified that due to the various workstreams that were being developed it would not be possible to bring one overarching report to the Committee but instead a number of reports would be submitted for consideration over the coming months.

RESOLVED:

(a)        That this Committee notes:

(i)              The Concerns raised by Ashby de la Zouch Civic Society regarding the impact of the closure of Ashby & District Community Hospital;

(ii)             The response to Ashby de la Zouch Civic Society’s concerns produced by West Leicestershire CCG.

(b)        That this Committee requests West Leicestershire CCG to have regard to the concerns now raised during its review of the impact of home based community care on the use of community inpatient beds and short term reablement beds;

(c)        That this Committee requests West Leicestershire CCG to provide an update on progress with the review referred to in (b) above in 6 months time;

(d)        That this Committee receives the business case for phase 2 of the Community Services Review for consideration;

(e)        That the CCG be requested to prioritise the work with North West Leicestershire District Council regarding S106 funding and report back to the Committee in due course regarding the business case for S106 and CCG capital funding in the locality.