RESIDENTS in Holsworthy need to prepare for another battle for their hospital, warns a town GP.

The rallying call comes only months after community beds in Holsworthy Hospital were ‘saved’. They were retained in a major review of hospital bed provision in North and West Devon.

But Dr David Hillebrandt, a semi-retired GP from Holsworthy, says newly drawn up plans could eventually lead to the closure of four community beds in the town’s hospital and a decision to do so would not need widespread public consultation.

The NEW Devon Success Regime’s ‘Case for Change’ document, published last Thursday, shows Holsworthy Hospital is currently running with less than its optimum 16 beds — suggesting that the hospital is financially inefficient.

If an action, such as reducing the number of beds, is deemed by North Devon Healthcare Trust’s board of directors as an ‘operational matter’ it does not need to be taken to public consultation and can be managed internally.

If a decision is a ‘strategic matter’ then it must be taken to the public for consultation before a motion can be passed.

Dr Hillebrandt last year urged residents to make their views known in a public consultation to decide where hospital beds should be located in Northern Devon. He said: “Reading between the lines we were aware that at some point the community hospital beds would come under fire, but no-one had realised that it would be quite this soon.”

He said a decision to close a few beds at Holsworthy Hospital would be classed as an ‘operational matter’ by the trust. This allows them to make a decision, if it is deemed to improve the operational side of the hospital, and can be done with minimal public consultation.

“The problem I see is that in carrying out the ‘operational’ action of closing four beds, it is likely to escalate into what is known as a ‘strategic matter’ as the strain on nurses and medical staff is increased. This will lead to further public consultations that I am afraid will once again put the hospital at risk of closure.”

The number of community beds across north, east and west Devon (NEW Devon) are already being cut, as the ‘Case for Change’ document states that 40 beds need to go for financial reasons.

The document suggests that although the number of community hospital beds has been reduced there is still a large amount of space in those hospitals that is not being used. It suggests around one third of bed space is going under-used or simply left empty.

NEW Devon suggests the figures for Holsworthy stand at 16 beds in use with 12 being un-used/under-utilised space.

The report states: “The cost per bed for community hospitals is higher than the cost per bed for acute hospitals (up to £750 per day) and higher than the average costs for a community hospital bed elsewhere (around £285 per day. This space could be used for something else, such as other services or community spaces.”

Dr Hillebrandt has previously voiced concerns that cuts to the beds will result in elderly patients having to seek alternative places to receive medical care, with some already having to travel as far as Barnstaple.

He said: “The system requires there be one trained nurse for every eight patients a hospital treats. Running the hospital with 16 beds will make the figures a political game and I fear they are setting the hospital up to fail as the services they are able to provide are being cut.

“It costs around £1.38 per day to look after a patient, the nurses and GPs do the job they do to provide a service to the public.

“At the current time, due to previous cuts, patients under the ‘care of the elderly’ scheme are not being seen as often as they should and this is becoming dangerous.

“Holsworthy Hospital has 16 beds shared between local GPs and the consultant-led ‘care of the elderly’ team based in Barnstaple. Due to restraints, they are only able to visit on limited days for around an hour, three times a week.”

Dr Hillebrandt said that since hospitals work in units of eight beds for maximum staffing efficiency/cost-effectiveness, if that number dropped the hospital would inevitably become less cost-effective in terms of unit cost per bed. He is concerned this would make it ‘a target for closure’.

“The Holsworthy GPs have already offered to take over all the beds to protect their patients, but so far the North Devon Trust have declined to engage in discussions.

“It is interesting to note that few members of the North Devon Healthcare Trust’s board of directors are local to the area.

“They have limited local knowledge and it is a shame they seem unwilling to discuss the future of community beds with those who have an insight into the problems of provision of rural healthcare for an elderly population.”

The ‘Case for Change’ document concludes that: “The next six months will be about local people and care staff working together to discuss and plan how services can be redesigned, and start to make changes where possible, so that there are great care services, across the board, for all local people. This may require formal consultation with local people and it might mean that organisations look different to what they are now.”

A spokesman on behalf of the NEW Devon Success Regime said: “The high level of interest and engagement in the Case for Change document is pleasing and exactly what we want to see. Of course we recognise that people will want to know what it means for their local area.

“The Case for Change sets out a compelling argument for why some things need to change in the NEW Devon area, but we don’t yet know what that means for individual hospitals, communities or services. At this time there are no plans to change any services at Holsworthy Hospital.

“The next step in the Success Regime process is to start listening to local views and we will be actively promoting opportunities for people to get involved.”

Dr Hillebrandt concluded: “Do the people of Holsworthy and its surrounding area have the energy to mount another campaign to save our local hospital?

“I hope that the residents of Holsworthy, and the surrounding area, remain vigilant over the next few months as we need to prepare ourselves for yet another battle to ensure we retain this valuable service should the trust’s operational decision escalate to a strategic one.”