WEST CORNWALL HEALTHWATCH COLUMN APRIL 2019

www.westcornwallhealthwatch.com                                          westcornwallhealthwatch@yahoo.co.uk

The West Cornwall HealthWatch AGM last month welcomed two guest speakers - Dr Neil Walden, a local GP who heads up the Penwith Locality Group, and Kate Shields, Chief Executive of the RCHT.  Both speakers described the current situation and future plans for community care and acute hospital provision respectively, before taking questions from the audience. HealthWatch’s annual report was also presented at the meeting, a summary of which follows:

The 2018 AGM had taken as its theme “Integration, Transformation or Consternation” with wide-ranging discussions.  Those discussions have continued throughout the year, as the hard-working committee has grappled with Integrated Strategic Commissioning, (no longer Accountable Care Systems or Accountable Care Organisations) the Naylor Report, Strategic Estates Planning, Shaping our Future, Case for Change, Towards a Healthier West Cornwall, Models of Care workshops etc, as well as the government’s Ten Year Plan. We do wonder if and how all the players in the system will manage to work successfully together too!  So, through an exhausting round of meetings and a mountain of paperwork, we are still not sure where we are headed.  All we can see is that we have a staffing crisis, a lack of funding and no clear way to provide what is needed for the patients who are waiting longer and falling through the gaps in provision.

As for the Edward Hain saga of confusion and constant change – you couldn’t make it up!  It has received no inpatients for over three years now, and has gone through scoping exercises for new buildings onsite, and a pilot winter project with Age UK offering day centre-like services.

The Penwith Integrated Services Community Plan and a two-year process of engagement, of which Edward Hain is a part, is now underway.  Members are participating, but with some scepticism about the outcome, it must be said.

Members have taken part in regular meetings of PICF and WCH Community Forum, as well as their local PPGs, and attended a range of Board meetings over the year, in addition to holding meetings with Helen Charlesworth May, Derek Thomas, Jackie Pendleton and community nursing team leaders.  They have voiced their concerns about Patient Transport, Parking charges at Treliske, Physiotherapy waits, Pressures on GP practices, Ambulance cuts and intolerable waits, The 111 service and Helston MIU

We’ve had encouragements in

1. St Michaels – plans to provide much of the county’s elective surgery
2. Radiotherapy – our centre of excellence remaining in the county
3. WCH becoming an UTC (from an UCC) – but alongside that concerns about its patient profile
4. Devolution to localities – our own Penwith locality is developing local initiatives with something of a ‘can do’ attitude

We’re disappointed that though we regularly raise Patient Stories we don’t very often see the changes these stories call for, though with a few successes around community nursing and continuity of care, and mental health issues.  And, just sometimes, the letters we send receive helpful responses.

Perhaps the single most frequently recurring theme is about ‘care in the community’, and the repeated mantra that people are better off at home than in hospital.  We have repeatedly challenged that, as we avowedly continue to make the case for step-up step-down beds in Penwith, whether for assessment, re-enablement or end-of-life care.  We all know that not everyone can be adequately cared for at home, for a range of reasons.  Neither is parking them in a private residential or nursing home always appropriate (I’m afraid that some of our Patient Stories reveal that all too clearly).   Moving very sick or incapacitated patients back home, dependent upon an overstretched general practice which cannot possibly and shouldn’t anyway be expected to take on 24 hour care; or reliant on volunteers (reminiscent of decades past when it was ‘nuns and charity’, to quote one of our members) -  neither is the way it ought to be.  It is quite clear that trying to provide appropriate care at home rather than in a community hospital is going to be more costly and more staff-intensive – at a time when we have both a staffing and a funding crisis.  Of course we know that many people would rather be at home, and in many cases they will benefit from this – given adequate support.  But when all the messages coming out are about “the shift towards out-of-hospital care” we have to continue to fight for the needs of those who need care in a hospital, and need it locally. 

After twenty-two years, West Cornwall HealthWatch continues to be closely in touch with its roots – the community in which we live and serve.  The feedback we receive from this community is reflected in the messages we pass on whenever we speak or write.  It is clear to us that we are their voice.  Our committed team includes some newer members who have found their niches, and all the team bring skills and qualities to the table.

Marna Blundy 31.03.19