NEW Devon Clinical Commissioning Group >>> >>> >>> "grave concerns over patient safety regarding the forthcoming plans to close community beds"

The North, East and West Devon Clinical Commissioning Group looks after primary health care in most of the county:
NHS NEW Devon CCG – Northern, Eastern and Western Devon Clinical Commissioning Group

The NEW Devon CCG have been to Sidmouth:
Vision Group for Sidmouth - The Future for Health in Sidmouth: report

They have consulted widely across the county about their proposal for health provision:
Futures Forum: The NHS in East Devon >>> CCG's "Transforming Community Services" consultation extended to 24th February

However, whilst the NEW Devon CCG has been cleared of acting improperly over the tendering of health contracts
Monitor: Devon CCG did not breach procurement rules | Supply Management
£100m Devon procurement did not break rules, Monitor confirms | News | Local Government Chronicle
community services: Tiverton Hospital RD&E Northern Devon Healthcare Trust | Tiverton Mid Devon Gazette
Plymouth region health chiefs cleared after watchdog probe into contract | Plymouth Herald

... questions have arisen about the competence of the Group by the very organisations it wishes to abolish or downsize:
Futures Forum: NEW Devon Clinical Commissioning Group >>> 'not fit for purpose'

Now a committee has been set up by the County Council to look into the NEW Devon CCG's proposals:

Task group will investigate decision to close East Devon hospital beds

By Exeter Express and Echo | Posted: September 15, 2015

By Anita Merritt


protestors outside County Hall

A task group is being set up to investigate a decision by health chiefs to axe hospital beds in three Devon towns.

At a meeting of Devon County Council Health and Wellbeing Scrutiny Committee on Monday at County Hall, members voted whether to look further into the decision made by the NHS Northern, Eastern and Western (NEW) Clinical Commissioning Group (CCG), to close 11 hospital beds in Crediton, Axminster and Ottery St Mary, sparking widespread anger.

Members voted five in favour and five against setting up an investigative task group, with chairman Richard Westlake making the casting vote in favour of the proposal.

The proposal for the formation of a task group was made by county councillor Claire Wright.

It was based on her view the NEW Devon CCG’s decision does not meet four required NHS tests: Clear clinical evidence base; Strong patient and public involvement; Impact on current and prospective patient choice; and Support of GP commissioners.

Claire said: “I already sit on one other task group investigation into the decision by the CCG to shut beds at Torrington Hospital, so this new task group will run alongside this one. A set of CCG minutes from May revealed obvious and clear concerns by a Sidmouth GP commissioner, Dr Mike Slot about the decision. Dr Slot expressed his unhappiness in a paper submitted at that May meeting. These minutes were the focus of most of my questions, which took place earlier in the meeting.” She added: “It is not clear whether the CCG will wait for the task group to conclude or plough on with implementing its decision as soon as possible.”

During the meeting, a presentation was given by Rebecca Harriott, chief officer of NEW Devon CCG, who gave a brief overview of the two year Transforming Community Services process, and the three options it debated.

She clarified the final decision made was to close 11 beds in the Eastern locality – less than a 10 per cent reduction from 174 beds.

Reasons given were the intention for flexibility of inpatient units with planned increases to meet demand, and a saving of £560,000 each year which will be reinvested in patient care in the community.

Rebecca assured recommendations from the Wakley Stakeholder Reference Group, which NEW Devon CCG helped to set up, “had been very thoroughly considered by the CCG in arriving at the decision”. She added the model adopted was “clinically and financially sustainable, including with sustainable staffing”.

Assurance was also given to the committee that NEW Devon CCG’s intention was to “enhance” community services and not diminish them, and they would be happy to report to the committee on the impact and progress of the changes.

“It has been a complex piece of work in what was a flexible process,” said Rebecca. “We will spend time on really developing together the future of community hospitals which we see as fundamentally important in the service provision going forward.” She added: “I firmly believe our consolidated model is in the best interest of the population.”

The decision to set up a task group has been welcomed by campaigners who staged a demonstration outside County Hall before the meeting.

James Goddard, chairman chairman of the Save Our Ottery Hospital group, said: “We owe great thanks to councillor Claire Wright who proposed the setting up of a task group to look further into the CCG's proposals, which any sane person will see are totally unworkable and will only lead to pain and misery for a great many people in East Devon.

“Personally, I found the Health and Well Being Scrutiny Committee meeting rather disappointing. The CCG delivered a mumbled presentation relating to their future plans which will leave vast swathes of East Devon without proper medical care. The CCG's evasion of questions was equalled only by their continued refusal to provide any details or costings of their proposed alternative to inpatient beds.”

NEW Devon has said it will continue to implement its decision while the task group conducts its investigation.

Task group will investigate decision to close East Devon hospital beds | Exeter Express and Echo

Over the past week, Cllr Claire Wright, who proposed the setting up of the task force, has posted several entries on her blog:

North Devon GPs “grave concerns” on patient safety over hospital bed closures

Monday, 21 September 2015 by Claire

Powerful letter below from North Devon GPs over plans to close around half of the area’s hospital beds.



Dear Dr Diamond,

‘Safe and effective care within the budget’ consultation

We, the undersigned GPs, would like to register our grave concerns over patient safety regarding the forthcoming plans of Northern Devon Healthcare NHS Trust (NDHT) to close community beds, either in totality or part of the locality, in an unprecedented move before this coming winter as proposed in your current consultation paper.

The current consultation process for “safe and effective care within the budget” has been experienced as a hasty cost improvement process given the far-reaching safety implications of the proposed changes. Whilst we recognise the current context of austerity, we are concerned that the untried, untested closures of so many community hospital beds in this area could prove dangerous for a significant population of patients who might need to rely on community beds to bridge the gap between acute hospital care and their homes when they become severely ill this winter.

The population in North Devon is 166,093 with 1555 people living in residential care homes. There are 4 community hospitals in Holsworthy, Bideford, South Molton and Ilfracombe which has 10 community beds but is temporarily closed. The current 64 beds in 3 community hospitals are fully occupied. East of the Water near Bideford and Ilfracombe are among the most deprived areas in the country with complex health and social needs. Patients in our rural areas will have more difficulties in getting transport to North Devon District Hospital (NDDH) in Barnstaple should all the community hospital beds be closed. Patients in Holsworthy areas will have to travel 35 miles to NDDH should Holsworthy community hospital be closed.

We have particular concerns over the safety of these proposals that are being made in the absence of concrete plans for bolstering and investing in safe staffing levels of the existing very stretched community nursing service. Vulnerable patients this winter could find themselves with inadequate community nursing, physiotherapy and other ancillary services, as well as an over-stretched primary care GP services which will be forced into taking clinical responsibility in an inadequate and under- resourced system. The current time-frame does not suggest any contingency or risk and impact assessment to account for laying down sufficient and timely investment in community services and staff to prevent this.

It must be recognised that North Devon District Hospital (NDDH) currently faces frequent bed shortages, resulting with patients at times having to be placed temporarily in the day surgery unit overnight in bed state emergencies with inadequate facilities as in a normal ward and delayed admissions. Closing community hospitals beds will further compound this situation and may also affect the safe running of NDDH itself.

NEW Devon CCG’s suggested strategic direction is for a timely process of reduction in the numbers of community beds shared over a number of community hospital sites, with money saved by reduction of community beds reinvested in community staffing. This is a very different proposal.

If staff cannot be attracted to work at the community hospitals, it is unlikely they will be recruited in a timely manner to provide sufficient community nursing cover to the local population, resulting in unsafe levels of staff to cover patients discharged from NDDH in the community, often very early in the course of their illness with multiple needs, both medical and social.

Similarly, we are not convinced by the proposal of a community bed unit based at NDDH to be established in time for the winter prior to the closure of all community hospital beds, nor the proposal that a “Frailty Consultant” will be recruited in time to provide clinical guidance and leadership to those proposed beds at NDDH reserved for community patients. NDHT has had severe difficulties and is unable despite multiple advertisements in replacing recently resigned Care of Older People Consultants. North Devon population will end up with no community hospital beds, no consultant with the appropriate skills to provide clinical skills and direction and an over-stretched community service in addition to an acute hospital with bed shortages over the winter.

It has been suggested that the closure of Torrington Community hospital was a success. The truth of the matter is that these patients were often placed in other community hospitals which are still open and evidence shows these community beds are needed.

We agree that patient safety is paramount and as such we do not support the current “safe effective care within budget” plans and their time-frame. We propose NDHT engage all stakeholders including the CCG and staff for a timely and proper consultation to find the best and safe solution for our population.

Yours sincerely

Dr Glenys Knight, Senior Partner, Bideford Medical Centre
Dr Mark Clayton, GP Partner, Bideford Medical Centre
Dr Geoff Spencer, GP Partner, Bideford Medical Centre
Dr Duncan Bardner, GP Partner, Bideford Medical Centre
Dr Alison Stapley, Executive & GP Partner, Bideford Medical Centre
Dr Yuk Chan, GP Partner, Bideford Medical Centre
Dr Ed Bond, GP Partner, Bideford Medical Centre
Dr Ruth Down, GP Partner, Bideford Medical Centre
Dr Richard Davies, GP Partner, Bideford Medical Centre
Dr Andrew Clarke, GP Partner, Bideford Medical Centre
Dr Sarah Ansell, Salaried GP, Bideford Medical Centre
Dr Nicky Relph, Salaried GP, Bideford Medical Centre
Dr Steffan James, ST4, Bideford Medical Centre
Dr Fiona Duncan, ST3, Bideford Medical Centre
Dr Alan Howlett, Senior Partner, Black Torrington Health Centre
Dr David Hillebrandt, semi-retired Holsworthy GP, Sessional and OOH GP
Dr Birgit Hole, Sessional GP
Dr Caroline Flynn, Session GP
Dr Chris Gibb, Senior Partner, South Molton Health Centre
Dr Justin Bowyer, GP Partner, South Molton Health Centre
Dr Rebecca Geary, GP Partner, South Molton Health Centre
Dr Wayne Sturley, GP Partner, South Molton Health Centre

Photograph: A group of us protesting at the decision by NEW Devon Clinical Commissioning Group to close all beds at Ottery, Axminster and Crediton Hospitals and move them elsewhere.

North Devon GPs “grave concerns” on patient safety over hospital bed closures - Claire Wright

Local NHS confirms no decision over minor injuries units

Thursday, 17 September 2015by Claire

NEW Devon CCG has confirmed that it has not made any decisions to shut minor injuries units in Eastern Devon.

Despite the decision coming to the governing body meeting on 16 July, along with the decision to shut hospital beds at Axminster, Ottery and Crediton, it appears that the decision on minor injuries units was deferred indefinitely.  See CCG statement below…...

Work is still to be done before decisions are finalised for the future of minor injuries services in Devon.  A further national report from Sir Bruce Keogh is expected to provide greater guidance and locally there is a great deal of information to take into account as to whether the service model is urgent care centres as originally proposed by Eastern Locality or a combination of urgent care centres and primary care. 

Consultation feedback and alternative proposals will be considered alongside the Eastern Locality’s original commissioning intentions relating to minor injury units, during the procurement exercise for urgent care services in Devon. However this process is currently on hold as the CCG awaits national guidance.

The only decision made at the Governing Body meeting on 16 July 2015 relating to MIUs was that the GB agreed that decision-making on the initial proposals by the Eastern Locality for the future of Minor Injury Units will go to the urgent care board.  This includes consideration of an alternative proposal by the Wakley Stakeholder Reference Group, which recommends greater emphasis on GP-led minor injury provision.

Local NHS confirms no decision over minor injuries units - Claire Wright

Scrutiny taskforce to investigate East Devon hospital bed and minor injuries unit closures

Monday, 14 September 2015by Claire

Devon County Council’s Health and wellbeing scrutiny committee will launch a task group investigation into NEW Devon CCG’s decision to close all beds at Ottery, Axminster and Crediton hospitals - and most minor injuries services in Eastern Devon.

I made the proposal (see 01.25.14) at this afternoon’s meeting based my view that the CCG’s decision does not meet four required NHS tests:

-Clear clinical evidence base
-Strong patient and public involvement
-Impact on current and prospective patient choice 
-Support of GP commissioners.

My proposal squeaked through narrowly on the chairman’s casting vote, with five votes in favour and five against. There were two abstentions, I believe.

I already sit on one other task group investigation into the decision by the CCG to shut beds at Torrington Hospital so this new task group will run alongside this one.

A set of CCG minutes from May revealed obvious and clear concerns by a Sidmouth GP commissioner, Dr Mike Slot about the decision. Dr Slot expressed his unhappiness in a paper submitted at that May meeting. These minutes were the focus of most of my questions, which took place earlier in the meeting.

For other agenda items there does seem to be a pull down menu of speakers names, I believe staff are looking at fixing the first few agenda items so speakers easily identified all the way through the webcast.

It is not clear whether NEW Devon CCG will wait for the task group to conclude or plough on with implementing its decision as soon as possible.

Here’s a link to the webcast -  http://www.devoncc.public-i.tv/core/portal/webcast_interactive/153194

Scrutiny taskforce to investigate East Devon hospital bed and minor injuries unit closures - Claire Wright.
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