Townlands Hospital Tour March 2016

Market Factors Reason for Closure of Step Down Hospital Beds

Despite representatives from the Berks/Bucks/Oxon Integrated Care Board (BOB ICB) agreeing to engage with the community on the decision to close the step down beds at Chiltern Court Care home at the end of year they did not attend the recent Townlands Steering Group (TSG) committee meeting.  The reason now given by BOB ICB for the closure is based on ‘Market Factors.’

In the course of the rebuild of Townlands Hospital in 2015, the original intention to re-provide the Peppard Ward beds was dropped. In response to concerns from the public, the CCG agreed to lease 7 step down beds, 4 Rapid Access Care Unit (RACU) beds and 1 respite bed from Chiltern Court Care Home in a contract with the Order of St John. The Henley GPs provided care for these beds. In 2019 the contract for the 4 RACU beds in Chiltern Court was terminated and the NHS funds freed up were used to provide 3 End of Life/Palliative care beds in Wallingford.

In October BOB ICB announced the closure without any consultation with stakeholders or the public.  At a meeting with Town Councillors Gawrysiak and Reissmann and Dan Leverson (Place Director ICB) and Karen Fuller (OCC Director Adult Social Services), it was conceded that the public engagement “was less than ideal”, and expressed a wish to correct this. A briefing paper was promised to the TSG, which arrived 10 days later, however the paper raised many questions as well as providing further information.

At the TSG meeting, it was confirmed that the 7 step down beds appear to be funded by OCC, whereas in 2016 the beds were funded and operated by the Oxford University Health Trust, commissioned by the CCG. i.e. originally the beds were NHS community beds. At some point this changed. This is important as a change (closure) to NHS beds requires a consultation, whereas closing OCC funded beds may not. (The fate of the original respite care bed is not known).

Councillor Gawrysiak explained his concerns at the proposal which would reduce the short stay hub beds in Oxfordshire from 94 to 63 this winter, and then to 40 in April. The locations of these beds would be in Banbury, Chipping Norton, Oxford and Abingdon would leave the whole of South Oxfordshire with a population of 140,000 without any of these beds.  The meeting was clearly concerned at the implication that the proposals were cost driven rather than focused on patient need.

The GPs, who provide care for those in the beds, report that the beds are fully used which raises the question about how these patients will receive care in the future.

Councillor Gill Dodds reported her experiences when her husband was discharged from hospital and the enormous effort to make their home suitable for him. This raises the issue of the capacity of OCC Adult Social Care to provide the right home care packages in a timely way. OCC have claimed the system has improved, and the additional hours of care are now available, but no evidence has been provided to substantiate this.

Retired GP and long standing campaigner on Health and Social care Dr Peter Ashby spoke about his scepticism on the target that 95% of patients in hospital must be discharged straight home. This disregarded assessing the needs of each patient as an individual and demonstrated his distrust of targets.

Veronica Treacher commented that homes were not always suitable for home care, giving the example of small doorways and staircases that prevented a clinical bed being installed upstairs.

Councillor Reissmann pointed out that in the past predecessor bodies such as the Oxfordshire PCT and CCG had engaged with the community with positive results. The original position of Dan Leveson and Karen Fuller that they would engage had been lost, and it was regrettable they had felt unable to attend.

It was agreed that TSG recognised that health and social care provisions needed review and were prepared to listen to proposals, supporting information and evidence however they were concerned about the current proposals which would see the reduction in bed numbers across Oxfordshire without being supported by evidence, the locations of beds had not been determined using patient care criteria, but “Market Factors”, the capacity of Adult Social Care services and Community
Nursing to replace the beds with care at home had not been demonstrated.

The TSG would now write to the ICB/OCC to request further meetings and engagement in order to work with the ICB/OCC to listen to community concerns and provide information to address those concerns.  They would attend meeting of the ICB board, HOSC, Health and WellBeing, OCC cabinet to express its concerns.  They would request deferral of the proposals to reduce the provision of beds in South Oxfordshire pending satisfactory engagement and ask for evidence to reassure the community that the proposed plans would see patient’s needs being met.


Leave a Comment

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *