THE urgent and emergency care executive lead for Cornwall and the Isles of Scilly, Karen Kay, and the head of locality support for the NHS Kernow Clinical Commissioning Group, Paula Bland, gave an update on Shaping our Future’s (SOF) plans for the programme at the latest Bude Community Network Panel meeting at the Parkhouse Centre on Monday, January 8.

The subject of hospitals, urgent cares centres and minor injury units in the county have been in the news recently as reports of minor inury units closing in North Cornwall have had to be denied by senior figures including the Cornwall Council leader Adam Paynter, and NHS Kernow’s chief officer, Jackie Pendleton.

In November 2016, all the major public sector health and care organisations published an outline plan to improve services based on the NHS England Five Year Forward View and Devolution Deal for Cornwall. This programme of work is known as ‘Shaping Our Future’ and is the number one priority for everyone working in health and social care, including Cornwall Council with the following three aims: Improve the health and wellbeing of the local population; Improve the quality of local health and care services; Deliver financial stability in the local health and care system.

Over the coming months, Ms Kay and Ms Bland along with others have been tasked with formulating a programme for SOF to move forward.

Ms Kay said: “We’re working on a model of care and the messages we’re hearing from people are that they want services in their local area. We haven’t got a specific model but we’re still doing our thinking and planning and we’re trying to shape our future as we go along.

“We’ve already had a couple of co-production meetings but we’re not ready for public consultation yet. We’ve had some semi-public meetings and we’re working through options of different services.

“Our third set of meetings are at the end of February and we’ll probably have to have more in April. We’re determined to keep going with them until we have a clear plan. When we get together for the next co-production meetings we’ll talk to people about draft specifications about urgent care centres. We’ve also got feedback from GPs, nurses patients and participation groups but we need to make sure we go about it in the right way.

“Another thing we’re looking at is reducing travel times. We’re working with a group to work out how long people take to get to different areas and we’ve got groups working on care, the planning phase and the delivery phase, and local groups on different approaches and how they work. All of this will help us make a long-term decision.”

Ms Bland then talked about some of the issues facing them.

She said: “There are nine practices in North Cornwall and they’ve all been facing the same issues. There’s been an increase in appointments but the number of GPs aren’t there. There’s been a fall in them. Nowdays, lots of people who go to medical school don’t even want to become a GP, but we’re looking at ways to try and combat that and we’re also trying to work collaboratively to see how we can get GPs interested in specific areas. These are the types of issues we’re facing!”

Lucille Opie, representing the Bude Stratton Neighbourhood Plan, mentioned how two or three years ago there was a public consultation at the Ivor Potter Hall in the town, to which Ms Kay said: “The information gathered from that was used at the start of the Shaping our Future about 18 months ago”, while the chair of trustees at the Bude-based charity Exercising for Mobility, Janet McCulley, asked: “Why are there no specialist Parkinson’s disease centres in Cornwall?”

Ms Kay replied: “We know that remote areas such as this need remote clinics and one of the challenges, is about needing to be in two places at once. We need to have clinics such as that which are available at least once a month. People often choose quicker over nearer!”

Ms Bland said: “In the Isles of Scilly, people now are having video discussions with consultants and it may work in certain remote areas, especially where there are work force issues.”

Ms Kay explained the thinking behind the scheme: “The current set of services don’t meet the level of demand. There’s not a lot more money to create more of what we’ve got or increase members of staff. We’re driving it nationally and the current way isn’t fit for the future. Ultimately it’s about seeing and treating or keeping people healthier at home to try and meet the demand of acute services.

“In Cornwall there’s not a lot of community infrastructure unlike in a lot of other places. We know we have to work smarter, especially without cash. It’s about working out the right models and coming up with a range of solutions nationally. We need to engage with everyone in Cornwall.”

A number of the audience then asked about the rumours going around that many of the minor injury units (MIUs) in the county could close, but Ms Kay was quick to play down the stories, saying: “The stories about the MIUs are not true. Nationally they are trying to create 150 urgent care centres. NHS England have asked how many in Cornwall would meet the criteria. West Cornwall did as do with a bit of work Camborne and Redruth and the site at Treliske while Liskeard and Launceston would as well. People are jumping to conclusions but just because the others don’t meet the urgent care centre requirements doesn’t mean that they’re going to close.”

Cllr Lea Deely, who is also the deputy mayor of Bude, said: “Most MIUs are about ten to 12 miles at the most and if the one at Bude closed it’d be ridiculous as Bodmin is around 30 miles away and Barnstaple is 46 miles, we need to keep it open.”

There was an even stronger response from the chairman of The League of Friends of Stratton Hospital, Ray Hockin, who said: “I was told by Phil Confue (chief executive of the Cornwall Partnership NHS Foundation Trust) that nothing would happen. If it did in the summer we’d have massive problems as the hospital is often packed. We’ve got the best community hospital in Cornwall and four beds, which aren’t even being used, when they could be. But please take mind of our location, you’ll have a hell of a shout on your hands if it’s closed.”

A member of the public, Peter Hillenbrand, echoed this statement, adding: “We are the furthest away town from a district hospital in the country. Please remember us in your planning, we have a superb MIU. There’ll be absolute fury if anything happens to it!”

In response, Ms Kay said: “Before anything is decided we need to do site visits to look at infrastructure, parking and transport links etc. We need to tick some boxes but sometimes remote locations make it hard. All options are open but we need to look at things such as x-ray facilities and what will GP practices look like.”

In reply, Mr Hockin said: “We’ve also got a theatre, new buildings and x-ray facilities so there’s no reason why we can’t be one!”

Ms Kay continued: “As things stand, the CCF and Cornwall Council have to make those decisions eventually but it won’t be a simple process. You’ve got to go through a number of boards for different things and then eventually NHS England will sign it off. It’s a complicated situation.”