11.15
|
Background Information: |
The Oxford Community Hospital (Oxcomm) existed on the Churchill Hospital site for a
number of years closing in May 2008 due to issues regarding facilities
design, maintenance and control of infection. Alternative provision for
community beds was made at other community hospitals within Oxfordshire and
at the Albany Care Home in Headington. In the autumn
of 2008 the Oxfordshire PCT outlined to the Health and Overview Scrutiny
Committee (HOSC) proposals for the re-provision of community services
formerly provided by Oxcomm. In March 2009 Alan
Webb, Director of Commissioning for Oxfordshire PCT, made a commitment that
20 beds would be available for community rehabilitation by October of this
year while a longer term proposal was being developed. Community Health Oxfordshire (CHO) has been
commissioned by the PCT to provide the service. It has now been confirmed
that the service would be provided by CHO on the John Radcliffe (JR) site. |
|
|
Carol Knott from CHO, Sarah
Bright of the PCT and Tony MacDonald from the ORH will describe the plans for the
two phases of development of a new community hospital for Oxford: Phase 1: Provision of 20 beds
on the JR site in an existing ward refurbished to an appropriate standard
which will be open by October of this year. This provides an interim
solution. Phase
2: Development of a
self-contained unit on the JR site to be open by summer 2010 |
|
Why has it been
included? |
To provide members with an update and an
opportunity to comment on the attached paper (JHO9) and presentation. |
Minutes:
The Oxford Community Hospital (Oxcomm) had existed on the Churchill Hospital site for a number of years, closing in May 2008 due to issues relating to facilities design, maintenance and control of infection. Alternative provision for community beds had been made at other community hospitals within Oxfordshire and at the Albany Care Home in Headington. In the autumn of 2008, the Oxfordshire PCT outlined to this Committee proposals for the re-provision of community services formerly provided by Oxcomm. In March 2009 Alan Webb, director of Commissioning, Oxfordshire PCT, made a commitment that 20 beds would be available for community rehabilitation by October of this year whilst a longer term proposal was being developed.
Community Health Oxfordshire (CHO) had been commissioned by the PCT to provide the service. It had now been confirmed that the service would be provided by CHO on the John Radcliffe (JR) site.
Carol Knott from CHO, Dr Peter von Eichstorff, a Practice Based Commissioning lead for the City and Dr James Price, a specialist in care for the elderly, ORH, working in several of Oxfordshire’s community hospitals, gave a presentation on a document which was before the Committee entitled ‘Community Health Oxfordshire, City Community Hospital, Communications Strategy (version 1)’ and, at the invitation of the Committee, formed a panel in order to respond to questions.
Dr Price commented that there had been very positive engagement with the various partners in relation to the model, adding that the PBS partners were very happy with the way services would be delivered for their patients.
Q Would patients residing outside of the City be able to use the facilities offered by the City Community Hospital?
R (CK) We would like to get patients as close to home as possible. There are very definite criteria for patients admitted to wards.
(JP) No Oxfordshire community health services have an absolutely defined geographical area. We have to take into account the clinical needs of the patient and the facilities provided. If a bed is not available at the Oxford City Community Hospital then there will be alternative facilities at other community hospitals. We juggle with this every day, looking, not simply where the patient lives, but where their relatives live, where the appropriate facilities are and the needs of the patient.
Q Is the
sensory garden on the same level? Would it be possible to have the number of
beds available and how many of the patients got their first choice? What makes
it a community hospital rather than merely a ward in the JR Hospital?
R (CK) The sensory Garden will be on level 4 – it is currently being developed.
With regard to the bed numbers, the Commissioners will provide a written answer to that. The Hospital offers up to 20 beds on a flexible basis. Physically there is a footprint of one ward at the moment. It would be difficult to push extra beds in but, if necessary, we would use escalation beds elsewhere. An additional improvement has been that we have separated the sexes.
(JP) Within the 20 bed arrangement for the City Hospital, there will be no escalation beds. However, the acute sector have well thought through plans for escalation bed availability for the whole of Oxfordshire. This sounds rather inflexible, but, for example, it would be more convenient for people living in the peripheries of the City, such as in the Botley and Littlemore areas to go to Abingdon Hospital. We work within the constraints of the system to find a solution. The refurbishment will deliver, within an acute medium, the best quality physical environment possible. He added that the staff approach would be very different in relation to the post acute, therapeutic area.
Q Once phase
2 is up and running, will you have the ability to increase the numbers of beds
available if the situation is deemed to be not working?
R (CK) Yes – the JR flexes its space. Within the confines of the physical footprint, there are adjacencies which could be used if needed in phase 3 possibly.
(JP) We need phase 2 to be future proofed. Arrangements have been rather ad hoc in the past, we are looking to a more logical provision on an incremental basis.
Q Will there
be a review after 12 months?
R (CK) Yes – there will be an ongoing review.
Q Will Oxfordshire
PGs receive priority over beds for their patients? Who decides how this is going
to work?
R (JP) The patients admitted will be divided into two groups – those acute patients who are receiving rehabilitative/palliative care and those patients residing in the community; operating between the doctor on the ward and the senior nurse. They will have the final say throughout all the community hospitals, liaising with the professionals who want to refer and admit patients.
Q Will there be special provision made for car parking at the JR Hospital?
R (CK) There has been no special provision made for parking.
Q Will the progress
of discharged patients be monitored?
R (CK) Yes, their progress will be monitored by social care, medical and nursing staff.
Q Will this help
the situation in relation to delayed discharges of care?
R (CK) This is being regulated. There is an emphasis on bringing the numbers down. It is believed that there is a downward trend.
Q Has any training
been put in place for auxiliary staff for the care of vulnerable older people?
R (CK) This is very high on the agenda. Training is all competency based.
Q You seem very
confident that 20 beds are sufficient for Oxford City. Do you plan to roll
out this model of care to other community hospitals?
R (CK) We need to look at the whole picture in the light of improvements to length of stay etc. At the moment 20 beds is an appropriate number, but this will ne reviewed. There has been investment in specialised stroke beds elsewhere and investment in the total number of beds has remained the same. We would be happy to review it, if necessary.
(JP) There will be times when Oxford residents will require 30 beds or 15 beds. We can give no guarantee that we will be able to offer a bed in Oxford to Oxford residents – sometimes patients will have to be treated outside of the Oxford boundaries. If it becomes necessary the commissioners and others will have to take a further look at the situation. There has been huge progress during the last few years in terms of improvements to the quality of patient care. This is ongoing and very positive.
Q What about
provision for those areas outside of Oxford? You say that the overall number of
beds will not change – have you taken in account the projected rise in population?
Will there be an impact elsewhere?
R (JP) I have no doubt that Oxfordshire has sufficient hospital beds - whether they are in the right place is an important consideration as there are a number of patients in hospital beds who could actually be in their own home. The issue in the medium term is about the reshaping of the number of beds. An immediate problem is the delayed transfers of care. It is important that we do not duplicate what is available nearby. The JR has a specialist day care facility on level 4.
Councillor Larry Sanders, a local City councillor, raised the following points:
The Committee thanked Carol Knott, Dr James Price and Dr Peter von Eichstorff for attending the meeting and for responding to their questions. They expressed their satisfaction with the plans to date and were pleased to receive clear assurances about the funding of the project. However, they reiterated the need for ongoing formal and informal consultation with the Committee, users, voluntary organisations etc and the importance of maintaining a degree of flexibility over bed numbers.