Letter of reassurance from Andy Evans, CEO of Great Yarmouth and Waveney Clinical Commissioning Group – July 2015



Our approach to Halesworth and the proposed new community based model of care

As part of the process of the Shape of the System public consultation we have already received extensive feedback from both the public and local clinicians, including Cutlers Hill surgery and Halesworth Health. There is a clear match of ambitions between the CCG and Halesworth’s local population and so it is possible to be clear about the CCG’s view of how we proceed.

Our commitment to all of the population for which we are responsible, right across the CCG area, is to provide good locally based care which takes the best of national practice and to adapt it to local circumstances. The proposal enshrined in the Shape of the System consultation document is that we take forward the development of community based out of hospital care, the creation of community hubs and reduce the traditional reliance on a bed-based model of care. This is better for patients, carers and families, allows us to look progressively at replacing old and out of date buildings and also uses our scarce resources better.

But the way we do this is to graft the best of the community based model onto the well established local ways of working across our varied geography and current arrangements. There is no single way to do this across the whole CCG and so we can legitimately look at each locality separately.

Halesworth, as a community, has a plan to develop a new integrated health and care centre and a progressive view of looking at healthy lifestyles and the CCG is very supportive of this plan. The development of a nursing/care home on the campus is a very helpful development on which we wish to build and it offers a positive way forward to addressing the current problems resulting from having in-patient beds on the first floor of an old community hospital building which is increasingly difficult to maintain to 21st century standards.

The CCG wishes to implement a model of care based on treating patients in their own home whenever possible but with GPs able to look after people locally in a bed-with-care if that isn’t possible and also having the current ready access to an acute district general hospital whenever necessary.

To that end it is possible to confirm a number of important principles :

– We plan to maintain local community hospital beds in Patrick Stead Hospital until we have replacement facilities available. It is our intention to commission NHS beds in the new Castlemeadow nursing home (which will not be chargeable for users as part of an NHS episode of care ie. they will be free even though they would be in a privately run facility) to be built on the site near to the Cutlers Hill surgery. So the plan is not to close Patrick Stead Hospital until we have replacement beds-with-care available, and ideally that will be in the new nursing/care home.

– It will be the Cutlers Hill GPs and local clinicians who will be responsible for selecting the patients who need to be treated in the local beds-with-care. It will be they who decide on the level of care in the beds-with-care and we expect this to be similar to the bed usage in the Patrick Stead Hospital currently. This will include IV treatment and other day case treatments. We want to treat as many Halesworth people as we can in Halesworth.

The CCG’s quality team will monitor the standards of care being delivered to ensure they remain at a high level.

– We will plan the arrangements for the local out of hospital team with the Cutlers Hill GPs and other clinicians. That means we will be tailoring arrangements to local needs and not just replicating the Lowestoft team model without amendment.

The performance of Cutlers Hill in looking after people at home and locally is already good and so the discussion will be about how we can make arrangements to take the most appropriate and useful parts of the model and improve current performance even more.

– The local arrangements when decided must provide the same levels of access eg. 7 day services and be within the local “fair share” of spending, as with all other parts of the CCG.
The costs will cover payments for the local GPs to provide medical cover to the beds, the core cost of the beds and the costs of the out of hospital team.

In summary, the CCG is keen to support the implementation of the Halesworth Health plan by keeping more people at home or locally using an out of hospital team approach and beds-with-care in the new Castlemeadow nursing/care home. The Patrick Stead Hospital will eventually close so that services are the best we can achieve and are delivered in up to date facilities.

Andrew Evans
Chief Executive
30 June 2015