Community Hospitals in East Devon

Exmouth Hospital

Exmouth Hospital

Jill Elson’s speech to the opposition motion

to Full Council 26 October 2016

It is important to recognise the challenges the New Devon CCG is facing and that we as a council are aware of those. We have a growing population, but with an increasing number of people over the age of 75 yrs, which is thanks to the success of the NHS.

We cherish our community hospitals. They were, after all, originally provided by philanthropic people or donations before the NHS began. Our Community Hospitals still receive legacies, donations and fundraise for extensions, specialised equipment and other comforts for the benefit of patients.

Our residents are telling us that they wish to be cared for at home – if it is safe, if it can be adapted or the client can move into a property that is suitable. They wish to be as independent as possible, living in their own homes.

In Seaton it has Hospice at home being provided by Exeter and District Hospiscare in partnership with Seaton Hospital League of Friends. It is hoped it can be rolled out throughout East Devon in the next few years.

In Exmouth we have Hospital at Home. Some patients, when they are discharged from hospital to home, they have many visits for the first few days, reducing over approximately 28 days, when they are fit to transfer to Social Services or other home care if required. Equipment is provided in their homes to achieve this.

All of us recognise some changes that have been made to the provision of services, with difficulty, as it is in addition to the increase in demand. It is now regulation that it has to be 1 nurse to 8 patients instead of 1 to 10 patients previously, since various public inquiries. Nursing Homes are also finding recruiting nurses very difficult. Some have deregulated to Residential Homes. The funding for Nursing Homes and Residential Homes by Devon County Council is less than that requested for private patients. The private owners are saying the County Councils across the UK are not paying sufficient fees per person. There is an extreme lack of personal care workers for ‘Care in the Community’. Recruitment is difficult and in many cases, they are viewed as low paid work and some are not paid for travelling between clients, which in a rural county can be many miles. Community Nurses are also required. Many clients have very complex needs.

At the moment, we need inpatient beds at our Community Hospitals, otherwise the RDE cannot discharge all patients, due to either lack of beds in nursing or residential homes or a package of care for them in their own homes is not available. We, as a Council do have to provide the Disabled Facility Grants – each home has to be assessed by an Occupational Therapist before work can be done/ ordered etc.

Community Hospitals have been transferred to the NHS Properties division from early this year. Are they going to charge commercial prices for the buildings? Community Hospitals are a resource for outpatient consultations, if the consultants can provide these locally, saving clients travelling to RDE or further afield.

Community Hospitals already provide dialysis, transfusions, X Rays, Eye surgery, minor operations, audiology and many more. Can these buildings provide other services, not just medical services? Budleigh Salterton Hospital has been trying for several years to change into a ‘Well Being Hub’ with the support of the community and the local voluntary organisations. It is hoped it can start next year.

All of us are aware that social isolation is an issue. More people being cared for in their own homes – do they receive a phone call, do they meet anyone, other than the care workers – who do not seem to have time to chat to their client, can they access transport to go out and visit places, do their own shopping etc. How do we ensure that the carers are looked after? If we do not care for their full time carers – majority are husbands or wives, they cannot care for their loved one. Do they have close family? Do their close family wish to take some responsibility for helping them?

The voluntary sector is no longer the ‘jam’ on the ‘bread and butter’ service but the actual service. It has to be recognised that larger charities like Hospiscare, receive NO grants from the NHS. The Exeter and District Hospice only receives £1.2 million per annum in NHS grant towards the cost of the ‘In Patient Unit’ (this is under review). Exeter and District Hospiscare needs £6.4m to provide all its services per annum. Many people do not know this. The Voluntary Sector is also having difficulty in finding enough volunteers now the pension age has risen and it has to raise sufficient funds – since Local Authorities have reduced their grants, low interest rates also means many trusts do not have as much money to give grants as before, but there is also increased demand. Lottery is NOT available for revenue funding. Many of us in the voluntary sector have had to change our constitutions to meet the many challenges and digital working. 

Jill Elson

EDDC Cabinet Member for Sustainable Homes and Communities

EDDC Councillor for Exmouth Halsdon Ward