Monday, 7 January 2019

The value of community hospitals

The arguments locally over community hospitals have been going on for some time:
Futures Forum: Health and politics in East Devon
Futures Forum: The future of community hospitals in East Devon
Futures Forum: County Council rejects Devon Health Scrutiny report >>> "The care at home (Rapid Response) service is very stretched, especially since community hospital beds were closed."

And they continue:
EDDC says community hospitals do not contribute to social well-being | East Devon Watch
Ottery Community Hospital – a campaigner speaks on council in-fighting | East Devon Watch
Just three Ottery Town Councillors back a working group to protect Ottery Hospital ... - Claire WrightWhy has EDDC refused to list Seaton and other community hospitals as ‘assets of community value’, when other Devon districts have done so? Jack Rowland will ask at the EDDC on Wednesday « SEATON & COLYTON matters

Beyond these 'political points', there are still general points to be made about 'community hospitals':

The value of ‘cottage’ hospitals has been debated from the Victorian period to the present day. Aneurin Bevan, who presided over the birth of the NHS, said: ‘Although I am not a devotee of bigness for bigness’s sake, I would rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of warm sympathy in a small one.’

Counterintuitively there is contemporary evidence to suggest that mortality after surgery is proportionate to the size of the hospital. This may reflect reduced rates of infection. Although difficult to quantify, the ‘homely’ feeling, the quiet environment and the ease with which relatives and friends can visit must all contribute to a patient’s well- being.

Futures Forum: A history of Sidmouth's cottage hospitals

The government has just published its plans for the NHS - and there is not much to be said about the 'cottage hospital': 

Medical professionals left ‘staggered’ as new NHS plan reveals focus on ‘prevention’ over hospital care
7 January 2019 12:00 pm

A new, 10-year plan for the future of the NHS has today been unveiled, revealing that the focus will be on 'preventing' medical conditions. According to the BBC, the areas which will see the biggest funding increases will be mental health, community care, and GPs, in order to help save ‘500,000 lives’, including everyone from babies, to those in old age.

These areas will be receiving a third of the extra £20billion that will be given to the NHS in upcoming years, with NHS England chief executive Simon Stevens claiming it is a “practical route map” for the next decade of care. However, it means that hospitals and urgent care will not be receiving as much money, despite the fact that they currently use up about half of the £114 billion budget.

The aim of the new plan is to reduce the reliance on hospitals and emergency departments. Currently, these areas are some of the most over-stretched and under-resourced of the entire NHS. There is currently a huge staffing crisis within the health service. And in fact, many trusts across the country are consistently missing their targets for timely care – e.g, patients receiving cancer care within 62 days – due to the issues.

Medical professionals have voiced concerns that the lack of funding could be even more harmful to hospital care in the NHS, particularly during the difficult winter. Dr Nick Scriven, president of the Society of Acute Medicine, said in a statement yesterday: ‘While any plans to improve services across the NHS are always welcome, I am staggered that the key priorities released a day early by the Prime Minister overlooked acute and emergency care and hospital capacity.

‘The full plan to be released tomorrow will come on the day many health systems will be on black alert – the highest level of pressure on hospitals – so here’s hoping all will change. The harsh reality right now is that the NHS is at least 3,100 beds short of what it required last winter, more than 45% of consultant posts are unfilled along with 11.6% of nursing posts and the proposed green paper on social care is nowhere to be seen.”

Dr Jennifer Dixon, chief executive of the Health Foundation thinktank, also said that while the plans were “ambitious”, they will be difficult to implement. She told The Guardian, “This is a pragmatic plan with an ambitious vision to improve NHS care, but making it a reality will be extremely tough given growing pressures on services, widespread staff shortages and continued cuts to other parts of the health and care system.”

Medical professionals left 'staggered' as new NHS plan reveals focus on prevention over hospital care

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