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Can care in community really make up for loss of Whittington Hospital beds?

PUBLISHED: 14:51 03 March 2013

NHS generic ward shot. Picture: Christopher Furlong/Getty.

NHS generic ward shot. Picture: Christopher Furlong/Getty.

2010 Getty Images

Bosses insist sending elderly home is better for their health – but doctor and community leaders raise concerns.

Professor John YudkinProfessor John Yudkin

One of the main justifications for the Whittington sell-off is that many patients would be better off at home.

The plans, which have sent shockwaves through the community, include the possible closure of wards and beds and the loss of hundreds of staff.

Hospital bosses argue that this can happen because “care in the community” services are better placed to deal with many patients, especially elderly people with chronic conditions.

They say if elderly people can be moved back home more quickly, the hospital no longer needs as many beds – and it is good for the patient’s health and quality of life.

History repeats itself? Demonstrations march to save the Whittington Hospital's A&E department in 2010. Picture: Polly HancockHistory repeats itself? Demonstrations march to save the Whittington Hospital's A&E department in 2010. Picture: Polly Hancock

The question arises, though, of whether care in the community services can deliver as promised.

A Care Quality Commission report issued this month revealed that, across England, a quarter of home-care services for the elderly are failing to meet some quality and safety standards.

The report was highlighted by Professor John Yudkin, a retired doctor who worked at the Whittington for 30 years.

Prof Yudkin, of Huddleston Road, Tufnell Park, whose father was a Whittington consultant for 20 years before him, fears community care services will struggle.

The Whittington HospitalThe Whittington Hospital

He said: “I’m not convinced that the things that delay people’s discharge and cause ‘bed blocking’ can be treated with community care. They need to test this.

“No improvement in community services, whether GPs, district nurses or home helps, is likely to solve the problem of ‘bed blockers’.”

Along with the loss of nearly half the site, the Whittington’s strategy – which has already been rubber-stamped by the board – would see the number of adult beds fall from 360 to 300, while 500 of its 4,000 staff would be cut.

Two of the three wards that care for older people, Cloudesley and Meyrick, are earmarked for closure.

Professor Yudkin finds it worrying that the Whittington is discussing closing beds when occupancy averaged 93 per cent last year.

He added: “The idea that this 93 per cent bed occupancy can be managed on 60 less beds seems ludicrous.”

Cllr Janet Burgess, Islington Council’s executive member for health and wellbeing, backs the view that older people are better off spending less time in hospital.

However, she feels more needs to be done before cutting back on hospital beds.

She said: “The long-term aim is for people not to spend large amounts of time in hospitals – but the services must be set up first.

“There are not yet enough [services] to make the reduction, but it is a long term aim of everybody working in health services.”

She added: “We feel that [these plans] were rushed through and not discussed beforehand. Catherine West [council leader] and I are now asking for a further meeting to discuss the situation.”

Whittington Health, the body that runs the hospital, employs hundreds of district nurses who visit homes and it also manages small community clinics.

So if elderly patients are moved home earlier, Whittington Health may still provide healthcare. Much of the day-to-day care like washing and feeding, though, would become the responsibility of Islington Council.

It’s possible then that cutting beds for older people could increase the burden on adult social care services run by the council.

Cllr Burgess said: “The proposals are very non-specific, so we don’t yet know what they would mean for social services. But people are scared and we don’t want them to feel scared of the future.”

Cllr Claire Kober, leader of neighbouring Haringey Council, also raised concerns, saying: “Residents should have access to high quality, local health provision and I would like to understand how facilities will be improved to ensure this continues.

“I am deeply concerned about provision for those elderly, chronically sick residents, who it’s suggested will be better off at home: what care will the trust develop to fully support them and their health needs in the community?”

Many in the community share these concerns and have made it abundantly clear that the sell-off will not go ahead without a fight.

The Gazette backs them with its Hands off our Whittington campaign in support of the Defend the Whittington Hospital Coalition.

A march is being staged on March 16 – visit www.dwhc.org.uk for more information.

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