DECEPTION OR INEPTITUDE?
We know we speak for the entire community when we say how grateful we are for the wonderful, dedicated NHS staff who have delivered the most extraordinary care for nearly a year now, and are now rolling out the vaccine programme so efficiently. But as we move through to the next phase, we need to keep our eyes on how the whole package of health and social care is being delivered, and so recent developments involving the discharge of patients from hospital have caused us concern.
Over the past couple of years much emphasis has been placed on discharging patients from hospital as quickly as possible, with a desire to assess them back home or in a ‘step-down’ location, usually a community hospital, known as ‘Discharge to Assess’ or D2A for short. The problem is, as always, that there is a lack of staff in the community, and a shortage of suitable beds or accommodation for patients who need them, in an environment where they can be helped back to mobility and health in a process known as ‘reablement’.
In late November an unexpected announcement of 28 Discharge-To-Assess beds in a new purpose-built care home in Penzance took us all by surprise. We investigated, as we had many misgivings about whether this facility would indeed be open by January as was indicated, and we raised many questions about it.
However, at last week’s Kernow Clinical Commissioning Group’s Board Meeting, it became clear that this would not now be happening, despite the service having apparently been commissioned. We are now told that these beds will be for specialist dementia residential care in the future.
We find the whole situation disappointing, frustrating, and frankly misleading. It is evident that there is insufficient capacity in the system to deal with the number of patients requiring step-down care from Treliske. Some of these can be cared for at home – although domiciliary care is in short supply, and reablement at home even more difficult to find. Other patients will need to move on to permanent residential or nursing care, where it is hoped (but not assured) that reablement can be provided for them wherever possible. Others, however, need a stepping-stone back to home in the form of residential accommodation, with rehabilitation and reablement an essential part of enabling them to get back on their feet. This enables discharge from Treliske to another setting; traditionally this would have been to a community hospital but, as we all know, Penwith no longer has any community hospitals. Indeed, as was highlighted at last week’s Board meeting, patients from West Cornwall are being discharged to care homes as far away as Torpoint and Callington. We find this totally unacceptable.
We feel let down in this and, despite all the pressures of the pandemic when all we want to do is support our NHS in the battle with COVID, we feel that we have to speak up about this issue as otherwise it will slip under the radar. Meanwhile our vulnerable residents are not receiving the care and treatment they should, partly at least due to the continuing obsession with “reducing bedded care” in the NHS.
Rather than empty promises about a service we shan’t now see, we call on the combined NHS and Social Care organisations to deliver an assessment and reablement service which is fit for purpose for the residents of west Cornwall. Our families, friends and neighbours deserve nothing less.