Agenda item

Report by Coastal West Sussex Clinical Commissioning Group and Sussex Community NHS Foundation Trust.

Following notification on 26 June 2018 from Sussex Community NHS Foundation Trust (SCFT) that the Bailey Unit at Midhurst Community Hospital would be closed indefinitely to new admissions, the Chairman, on behalf of members, asked that SCFT be invited to the next meeting of the Committee to seek assurance that that there was sufficient capacity elsewhere in West Sussex to cope with any new patients who would otherwise have been admitted to the Bailey Unit and receive an outline of the Trusts medium to long terms plans for this service.  A report drafted by SCFT is attached to assist the Committee’s discussions.

The Health and Adult Social Care Select Committee is asked to consider whether it is sufficiently assured that the Sussex Community NHS Foundation Trust and commissioners have put appropriate measures in place, to ensure that there is adequate provision for patients now and in the future, who would have otherwise been admitted to the Bailey Unit at Midhurst Community Hospital. 

17.1   The Committee considered a report by Sussex Community NHS Foundation Trust (SCFT) (copy appended to the signed minutes) which was introduced by Dr Richard Quirk, Medical Director (SCFT) who told the Committee that: -

·        The closure of Bailey Unit was a temporary measure due to staff shortages which had led to an increase in incidents and complaints

·        Due to concerns over safety, the number of beds available had been reduced to eight, but the staffing problems continued, leading to closure whilst care in Midhurst in future was reassessed

17.2   Dr Rowena Hill, Riverbank Medical Centre, Midhurst raised the following concerns and points: -

·        After a previous temporary closure, Bailey Unit had reopened with only one staff vacancy – why had so many more vacancies arisen?

·        Why was the situation not discussed by the Committee at its 22 June meeting, which was two days before the closure?

·        Was the latest closure temporary or permanent?

·        The medical centre would have sent 12 patients to the unit if it had been open last month

·        There had been no increase or planned increase in the number of district nurses in Midhurst

·        The manger of Pendean, Midhurst, was unaware of a contract with SCFT for the use of its beds by SCFT patients

17.3   Roger Bricknell, Trustee and Secretary - Friends of Midhurst Community Hospital and Riverbank Medical Centre raised the following concerns and points: -

·        Had SCFT looked into the reasons why staff had left the Bailey Unit?

·        Would the number of clinics at Midhurst Community Hospital increase?

·        Would the Pearson Unit continue?

·        A Frailty Unit in Midhurst would be welcomed

·        A £1m legacy was available for structural works on the community hospital

·        Part of the site could be used for housing

17.4   Marie Dodd, Area Director, SCFT, told the Committee: -

·        The ‘One Call’ system was responsible for arranging the night sitting service and allocating patients to beds (including at Pendean and Cavell House, near Shoreham)

·        Pendean and Cavell House were high quality provision that had been used over the August Bank Holiday

·        Nine beds had been opened at Salvington Lodge, Worthing

·        Continued recruitment at Salvington meant that staff could be flexible and transferred to Midhurst if necessary

·        There was capacity in the community nursing team, but more people were needed for the sitting service

·        Most of the people who used the Bailey Unit came from Worthing and would rather stay closer to home

·        66% of Bailey Unit staff were agency

·        Four attempts had been made recently to recruit a ward manager for Bailey Unit

17.5   Amanda Fadero, Transition Director, Coastal West Sussex Clinical Commissioning Group (CWS) told the Committee: -

·        The governing body of CWS sought assurance that the alternative capacity was secured and how this would be monitored.  This was particularly important for winter resilience planning and any potential requirement for additional capacity. CWS was working with SCFT to do this

·        Flexible staffing arrangements have been explored

·        CWS was liaising with primary care through the local community networks

17.6   Summary of responses to Members’ questions and comments: -

·        Beds at Pendean and Cavell House were spot purchased without problems

·        SCFT worked with local authorities to get packages of care in place to help people remain at/return home, but there was a shortage of good providers

·        SCFT thought that the situation could be mitigated so did not bring the issue to the Committee earlier

·        The move from acute beds to primary/community care requires a review to reflect the changing needs and demand of the population. A review of community bed usage was taking place – this would involve developing community bases from NHS, community and voluntary sector assets

·        The review of community beds was clinically driven and led

·        The CWS Estates Strategy was looking at what facilities would be needed in the future

·        The Sustainability Transformation Partnership was reviewing estate assets, IT and digital and workforce solutions

·        The staff vacancy rate for SCFT was variable in different teams, at one it had been as high as  27% in one team. The situation was improving with no vacancies in Bognor Regis or Chichester – turnover was 13%, similar to NHS community services across the country. Particular information for rural areas could be provided

·        Staff that left were given exit interviews – reasons for leaving included people retiring for the second time, difficult journeys to work, the stress of extra shifts due to staff shortages and unwillingness to change ways of working

·        A frailty hub was being explored as an option for Midhurst

·        The possible number of intermediate care centres was limited by available staff and affordability

·        It was possible to send patients to units in Hampshire and Surrey

17.7   Resolved – that the Committee understands the rationale behind the closure of the Bailey Unit, however, it is not completely assured that the plans in place will meet the needs of the West Sussex population and would like to consider the outcome of those plans for community provision as they develop and the impact of the upcoming winter period.