Response to interview with Jeff James, former CEO of two Wiltshire PCTs
For once, I agree with Jeff James. The Neighbourhood Teams are an excellent way of getting patients out of expensive hospital beds sooner.
However, one size does not fit all and the trends of the time were not exactly followed by Wiltshire PCT. The predecessor organisation (Kennet & N.Wilts PCT) far from being at fault were, if anything, ahead of their time in designing locally delivered services that were flexible.
Following the Government mantra of “We are moving care closer to home,” Wiltshire PCT, under huge financial pressure, reorganised in such a way that resulted in elderly patients being scattered across Wiltshire, often far away from their homes, as they continue to be. The ward at Savernake takes patients from all over Wiltshire and Marlborough patients are not of course, guaranteed a place at Savernake. They are sent wherever the empty bed stands, because that makes good financial sense. I understand that.
Although bed numbers at Savernake were not reduced, it was the very services that kept patients out of those beds and away from A&E, that were. The Minor Injury Unit (MIU) and Day Hospital were closed. Day Hospital was a half way house, taking in patients living at home (not occupying expensive hospital beds) and enabling them to access multidisciplinary treatment in a well equipped hospital. A sort of “outpatient plus” unit for the elderly or long term sick.
As for "Moving care closer to home” in the case of the MIU – well that’s a complete farce and Jeff James must know it. Ask any patient which hospital is closer to home in the Marlborough area – Chippenham, Trowbridge, GWH or Savernake? That closure flew in the face of the guidelines of the day and Professor Alberti’s thinking.
However, the past is gone and we must look to the future. However, I cannot help but wonder if Marlborough shot itself in the foot back in 1999 when the Marlborough GPs floated the idea of making their base in Savernake Hospital. There was an outcry from locals. Mayor Stewart Dobson planned to hold a public meeting for townspeople to air their views. The GPs decided to stay put.
Had they relocated, the now expanding amount of services a GP Practice can deliver would be based at Savernake and it could be something approaching a Primary Care Centre. With daytime GPs and Out of Hours based there, the possibility of urgent care being dealt with increases. Savernake could once again serve the wider community with an increased range of care on offer. I wonder if our NEW Commissioning Group could be persuaded to re-visit such ideas along with The Great Western Hospital Foundation Trust.