Concern over health service changes

Ms Jayne Carroll

Strategic Commissioning Business Support Manager

NHS Devon

Commissioning Headquarters – County Hall

Topsham Road

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Dear Ms Carroll

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I write as Portfolio Holder for Communities following a debate at our Communities Overview & Scrutiny Committee last Wednesday. This debate on the future of local health included input from local GPs and NHS Devon.

We were alarmed to hear that there is currently some consultation happening about transferring ownership and management of our community hospitals. I understand this is now legally required by the government and that there is an extremely tight timescale to achieve this.

This Council has not been made aware of this change and yet, as locally elected representatives of the communities affected, this would seem both reasonable and in line with the new government expectations of localism. Furthermore, for many of these community hospitals, although the asset may currently be owned by the PCT, many parts of them have been built through local charitable fund raising. In East Devon this has equated to several millions of pounds over the seven Community Hospitals.

It seems likely that, as a result of government pressures for transfer of these assets and their operation, there will not only now be insufficient time for local debate and consideration, but also there will be insufficient time for a proper evaluation of the options by a health economist, and no proper time for a due diligence exercise.

The ownership and management of community hospitals is a matter of passionate interest for local communities in this rural area and would, no doubt, feature highly in the run up to next year’s local elections. Not only is this a community and democratic matter, but one of great concern to GP’s who are expected to be commissioning most health services in the future. They will require a community hospital structure and operation that meets local health needs well into the future. This will need long term planning as, in some cases, a new community hospital may be required to meet future needs and challenges with the demographics, the need for rehabilitation to enable people to return home after a stay in the acute hospital with the need to be close to relatives/carers. East Devon already has a high number of people over the age of 60 years.

Our concern is that, should the community hospitals be owned and operated by an organisation that is either remote to local pressures, or who is driven by other economic enterprising or legal pressures, their future decisions will not be driven by local needs.

Not only does this District Council wish to be party to any decision on the future of community hospitals, but it would seem entirely in line with government thinking that other local representative bodies be given reasonable time to also engage meaningfully.

In this respect, we are also concerned about the government proposal that commissioning and health needs strategy are substantially passed to consortia of GP’s. Quite apart from the preparedness and capacity issues for GP’s, there is a concern that the creation of (indicatively 500) consortia will not recognise natural geographic communities.

Our past experience was that the previous East Devon PCT was able to function economically, effectively and efficiently and, yet, also be locally responsive. This would suggest that, for a large dispersed rural area such as East Devon, planning and commissioning is best operated over an area of this size. This would equate to a GP consortium approximately the size of two current consortia, with joint working over a Devon-wide area where necessary.

I should be obliged for your views on these matters please

Councillor Miss J Elson

Portfolio Holder – Communities

Sent to Hugo Swire MP

Neil Parish MP

Mel Stride MP

Ann James Chief Executive NHS Devon

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