Sunday, 24 April 2016

An uncertain future for hospitals in East Devon

There is a lot of uncertainty around the future status of hospitals.

One area of concern is the transfer of the ownership of hospitals - and the charging of a 'market rent'
New clarity for better premises | NHS Property Services Ltd
Lease regularisation | NHS Property Services Ltd

As reported earlier in the month in the Financial Times:
GPs and hospitals face £60m rent rise - FT.com

And as commented on this week in the EDW blog:
Community Hospitals: the more you raise to improve them, the more rent the NHS will charge … | East Devon Watch

These changes are already being felt in East Devon.

In Sidmouth:

Ownership change ‘does not bode well’ for future of Sidmouth Victoria Hospital

19:03 07 March 2016 Eleanor Pipe

Sidmouth Victoria Hospital

Trustees to tackle ‘big problem’ amid concerns

Negotiations are under way to safeguard the £5million community investment in Sidmouth Victoria Hospital and keep a share of its ownership within the town. The talks stem from concern over the future of the site, which is set to be handed over to NHS Property Services – a company that would seek to drive efficiency and generate a commercial rent from the building. The change in ownership is due this spring when the hospital’s current service provider, the North Devon Healthcare Trust (NDHT), will hand over the reins to the Royal Devon and Exeter NHS Foundation Trust.

Chairman of the hospital’s comforts fund, Graham Vincent, said trustees are working to tackle the ‘big problem’ of future ownership and have been consulting with the NHS Northern, Eastern and Western Devon Clinical Commissioning Group (CCG) - a body responsible for commissioning healthcare services.

Mr Vincent said: “There is much concern over the ownership of community hospitals and hubs. Over the last 25 years, Sidmouth hospital has been rebuilt internally whilst retaining the Victorian exterior. The amount of money to rebuild and constantly upgrade equipment totals around £5million - which has come from the local community.”

He revealed the CCG is trying to pursue a joint ownership option, which would enable communities to own a share in the buildings and gain greater control over their use and development in the future. Another solution would be to create a Devon-wide community interest company, which would own a joint share and work on behalf of communities and the CCG.

The town’s minor injuries unit (MIU) - which was recently refurbished as part of a £1.2million community-funded investment - remains shut after it was temporarily closed in November to rein in ‘spiralling costs’.

Mr Vincent stressed that people in the town need to be able to influence services they receive – something that he said has been challenged recently – and he said the ownership needs to be aligned to the needs of the community.

Chairman of the Sid Valley’s patient participation group, Di Fuller, said: “We have the same concerns as the comforts fund. It’s not a good move for the patients – it would be much better if it was owned by the people who provide the services.” She referenced the dilapidated state of Blackmore Drive doctors’ surgery – a building that is owned by NHS Property Services – and said the company’s failure to renovate that important site ‘does not bode well for the future of community hospitals’.

Dr Alex Degan, a GP and CCG board member, said: “This is very much work in progress, but we are working very closely with community representatives, local people and the voluntary sector on the future development of community services (as well as hospitals) in eastern Devon, including Ottery St Mary and Sidmouth.” He said there is a ‘compelling narrative’ for the role of community services in meeting the needs of people as close to home as possible.

NHS Property Services is responsible for 4,000 NHS buildings worth an estimated £3billion. Its remit is to manage assets and modernise or sell buildings according to needs, as well as provide management support services, A spokesman for the company said: “Our role is to work with commissioners to meet their healthcare estates requirements.”

Ownership change ‘does not bode well’ for future of Sidmouth Victoria Hospital - News - Sidmouth Herald

And in Ottery:

New fears raised over future of community hospitals in Devon following rent hikes

By Exeter Express and Echo | Posted: April 13, 2016 By Anita Merritt

Ottery St Mary hospital

Financially challenged health services in Devon are now under even more pressure because of changes announced by an NHS property company to charge market rates for the first time. Among those affected are community hospitals in Exeter and East Devon, and also some doctor surgeries.

NHS Property Services (NHS PS), set up three years ago and owned by the Department of Health, holds about 10 per cent of the NHS estate. NHS service providers in buildings that are owned freehold by NHS PS previously paid an amount that covered the basic costs of running their building. However, as of the beginning of this month, they will be required to pay a professionally-assessed market rent, plus a service charge and a separate charge for facilities management services. Leasehold property costs will remain the same.

Community hospitals that will transfer ownership to NHS PS in June include Axminster, Budleigh Salterton, Crediton, Exeter Community Hospital (Whipton), Exmouth, Honiton, Moretonhampstead, Okehampton, Ottery St Mary, Seaton, Sidmouth and Tiverton. Apart from Tiverton hospital, they are all freehold properties so will be affected by the rent changes.

Dr Alex Degan, a GP and board member of the Eastern locality of NHS Northern, Eastern and Western Devon Clinical Commissioning Group, said: “It is anticipated that there will be a change of provider for community services in Eastern Devon later this year, including at community hospitals in the Eastern Devon area. The Department of Health has made a decision that from June 1, ownership of the community hospital buildings in Eastern Devon will transfer to NHS PS. We expect that financial arrangements for the community hospitals are likely to change following the transfer to NHS PS. The local NHS is working with NHS PS and the respective local communities to find a solution that is in the best interests of the patients we serve.”

It is thought health services in England will face £60m a year additional rent bills as a result of the changes. Properties owned on a freehold basis will switch immediately from a “cost recovery” to a market-rent basis.

The property costs of some NHS service providers are expected to rise as a result of the introduction of market rents. The Department of Health has already committed to meeting increased property costs in the 2016/17 financial year. Arrangements in relation to funding adjustments for 2017/18 and beyond will be considered by the Department of Health in conjunction with NHS England and NHS Improvement.

David Holdcroft, a member of independent campaign group 38 Degrees, said: “The immediate concern is that it might well stop exciting experiments supported by local communities going ahead, for example Budleigh Salterton Hospital. Also, they helped pay for the hospitals in the first place.”

Local MP Hugo Swire says he remains determined to see Budleigh hospital transformed into a health and wellbeing hub, but is concerned over the new rent charges. He said: “I am acutely aware that this ownership issue is not unique to Budleigh and I will be pursuing this matter to ensure that all of the community hospitals in my constituency are protected and improved.”

Concerns have also been raised about the implication to Ottery St Mary Hopsital.

Claire Wright, East Devon district councillor and Devon county councillor for Ottery St Mary, said: “NEW Devon CCG intends to set up a health hub once the remainder of the beds are removed later this year, but the latest news means that if commercial rents are charged, which is very likely, it may be unaffordable to continue to use the building, after which NHS Property Services may well sell it off. I am sure people will be familiar with the financial position of NEW Devon CCG which is some £80m in deficit.”

She added: “Given the body blow that has already been served to Ottery St Mary by way of losing all its beds, the thought of the building being potentially sold off is completely beyond the pale, and horribly unfair to the community which worked incredibly hard to fund-raise large amounts of money for it to be built in the 1990s.”

The rent changes will be discussed at Devon County Council’s health and wellbeing scrutiny committee meeting in June.

NHS PS is a not-for-profit private company which will use the revenue raised through rents for reinvestment in the estate. It does not sell any property unless it is declared surplus to requirement by local health care commissioners.

John Westwood, director of asset management at NHS PS, said: “As Lord Carter found in his report on acute trusts, there are massive savings to be made in the better management of NHS property. In the primary care estate, commissioners have been subsidising underused space and poorly located services. This change removes that subsidy between different parts of the NHS. It will undoubtedly free up resources for the NHS and, in many cases, will raise tens of millions for reinvestment.”

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