RESIDENTS of Holsworthy and beyond have started their campaign against any closure of beds at the town’s community hospital with gusto.

As reported in last week’s Post, it has been confirmed that Holsworthy Community Hospital’s inpatient beds will close temporarily due to concerns over high agency nurse use, low bed occupancy and staff sickness.

But Geoffrey Cox, the Conservative MP for Torridge and West Devon has warned there is a ‘strong possibility’ the Northern Devon Healthcare NHS Trust (NDHT) will not restore beds.

Staff members at Holsworthy Hospital were told in a private meeting earlier this month, that the temporary closure would take effect from March 31.

The Trust said the hospital is ‘to close temporarily under urgent measures, due to significant safety concerns’.

However, all other services at the hospital, including consultant outpatient appointments and day services, will continue as normal.

The Trust told Mr Cox that ‘the need for community hospital beds has significantly decreased and that there are considerable problems in recruiting staff for Holsworthy Hospital’.

In response, Mr Cox has said he believes ‘there must, therefore, be a strong possibility that the Trust will not restore those beds’.

In a statement, NDHT explained that its decision to temporarily close beds at Holsworthy Hospital is separate to the work of the Sustainability and Transformation Plan (STP) and will have no impact on the ‘Your Future Care’ consultation.

The decision was taken by the board of Northern Devon Healthcare NHS Trust and was endorsed by the NEW Devon Clinical Commissioning Group (CCG) and management team of the STP.

The Trust gave three reasons for the decision of temporary closure, they were: Sustained reliance on agency staff to cover staff sickness and keep hospitals open; Recruitment difficulties due to national skills shortages; Decreasing bed occupancy and not all beds being used.

Andy Ibbs, director of operations and strategy for the Trust, said: “We have a duty to our patients to ensure that there are enough nurses on shift to care for them while in hospital and that those nurses have the necessary skills to deliver high-quality care.

“We have exhausted every possible solution and we are now in a position where we cannot effectively sustain inpatient services at Holsworthy. We have also had to put measures in place to support services at South Molton.

“We know this will be disappointing for the local community and we share their sadness over this temporary closure. We have worked really hard to address these risks and have made every effort to recruit and retain staff as well as develop other options.

“Both community hospitals are supported by staff from NDDH where possible but this is risking our acute inpatient services and we must focus our clinical resource where patients most need it.”

Holsworthy banded together and at short notice pulled together a protest on Friday, March 3, to show their support for the hospital and its staff.

Mayor of Holsworthy, Cllr Jon Hutchings, said: “Considering we pulled the event together at very short notice it was very well supported, it really shows the passion Holsworthy has to support and save its hospital. I think everyone, including myself, is shocked and disgusted at the decision.”

The Trust has said that it is working with NHS Northern, Eastern and Western Devon Clinical Commissioning Group (NHS NEW Devon CCG) to ‘develop a model of care that will enable [them] to continue meeting people’s care needs across North Devon and Torridge within the resources available’.

It has suggested that the future could be a new ‘care at home’ model, with people being cared for at home by loved ones and care staff instead of taking up community beds.

Trustee of the Holsworthy Hospital League of Friends John Allen said he was ‘extremely disappointed’ in the Trust’s decision and criticised the suggestion ‘care at home’ was a viable option in Holsworthy.

He said: “It is extremely disappointing that the Trust has had to resort to closing the hospital on the grounds of safety. It has been the Trust’s intention to close the beds at Holsworthy Hospital for several years, but when they have held consultative meetings in the past, there has been overwhelming evidence that because of its isolated location and poor transport connections, its closure made no sense.

“I am not surprised they have difficulty recruiting staff when they cannot offer security of employment at Holsworthy Hospital when they have this continuing agenda to close the beds.

“Care in patients own homes is fine for some, but it is well documented we have a growing population of elderly people, many living on their own in isolated locations where this type of care is unsuitable and not practical.

“Our location makes us a special case and our rapidly growing population makes it essential we retain the beds in our hospital.”

Practice manager at Holsworthy Medical Centre Jane Wells said she shared the sentiment of many that this situation was ‘disappointing’, she said: “We are, as a practice, very disappointed with the decision to close the beds. We have huge concerns over where patient care will take place now. The most local step down beds to us are in Barnstaple and Exeter, there is no provision closer to home.

“We had no notice of the closure and I have no confidence that the beds will be reopened, when asked if they have reopened beds after temporary closure they said no — they appear to have already made their decision. We like everyone else are quite shocked but are desperately sorry for patients and staff who have done such a fabulous job over the years. However, we still work for the NHS and are committed to maintaining a service for the public while we are still here.”

Among its reasons for temporary closure the Trust said there has been a decline in the number of patients being admitted to Holsworthy Hospital. They suggested this reduction in bed occupancy has lead to the deskilling of clinical staff because there are a declining number of patients.

Commenting on the suggestion that ‘low bed occupancy’ was a reason for temporary closure, Dr David Hillebrandt said he blamed it on the lack of knowledge district general hospitals have of Holsworthy Hospital and questioned why more wasn’t done to share this knowledge.

He said: “I wonder how much effort the Trust have made to ensure all the staff responsible for discharges at the district general hospitals in Plymouth, Exeter and Barnstaple [NDHT] are aware of the availability of beds at Holsworthy Hospital.

“If efficiently used they might reduce pressure on those other hospitals experiencing bed shortages.”

Barry Parsons, Conservative Devon County Councillor, said he disagrees strongly with the Trust’s suggestion that the ‘reduction in bed occupancy leads to the deskilling of clinical staff’.

He said: “This is just awful, I have said for a long time that they [the Trust] would be back for our hospital.

“They suggested that the optimal level of bed occupancy for a hospital is 80% and that Holsworthy Hospital is falling below this.”

The Trust said hospitals seek to have an occupancy level of between 80% and 85%, a higher figure being unsafe.

Cllr Parsons explained that from April to July the figures suggest the hospital was running with bed occupancy of around 72.9%. From August to September figures went up considerably to 93.2%.

There was a decrease over the Christmas period, reaching figures as low as 65%, which Cllr Parsons said was to be expected, with figures gradually climbing back to normal levels in the new year.

He said: “Over the Christmas period there is always a step down in numbers of patients who are in for elective surgery, people don’t want to be operated on over the festive period so of course bed occupancy will decrease.

“They say that staff sickness equates to 11% of the staff but what they haven’t said is what the discrete figures are. 11% is really misleading in this case but goes towards reinforcing their message as it makes it sound as though a relatively large proportion of staff take sick leave at the same time.

“If there are for example 23 staff members then that would only equate two people off sick. 11% of 100 staff members would be a completely different story but it seems they have their own agenda and they are sticking to it.”

The Trust also suggested in its statement that it has experienced ‘significant difficulty’ recruiting for clinical vacancies at the community hospital but Cllr Parsons put this down to what has previously been called ‘the black cloud’ that hangs over hospitals in Devon under threat of cuts.

He said: “It is like having Damocles over the place. Who wants to work there with such uncertainty looming over the hospital, they can’t really blame recruitment difficulties when they are creating the problem in the first place.

“Their communication has been awful throughout this. They have just landed this on staff and hit them with it. It is not the message that will engender any trust. I really feel for my community as it is an elderly population around here and factoring in the rurality of its residents this decision is a terrible one. But I promise I will fight tooth and nail against this!”

Rob Sainsbury, chief operating officer of NHS Northern, Eastern and Western Devon Clinical Commissioning Group, said: “The CCG supports the Trust’s approach to ensure that patient safety is maintained.”

This sentiment has not been shared by many however, who feel the decision will not maintain patient safety but will endanger lives. For example one doctor allegedly told Cllr Philip Hackett, district councillor for the Coham Bridge ward, that ‘people will die because of this decision’.

Cllr Hackett said the Trust made ‘hollow promises’ a year and a half ago to keep inpatient beds at Holsworthy Hospital.

He said that the Trust’s announcement of a temporary closure of beds at Holsworthy Hospital ‘raises concerns over the whole process’.

“Less that two years ago the NEW Devon Clinical Commissioning Group (CCG) held their consultation — the meetings in the Memorial Hall which attracted between 400-500 concerned residents — over their proposals, which resulted in the proven ‘need’ to provide 40 community beds in the Northern locality, which were to be split with 20 beds each in Holsworthy and South Molton.

“With a stroke of a pen 20 became 16 for operational reasons as beds are modeled in units of eight.”

After fighting together for a long time people in Holsworthy believed they had saved their community beds. Many were surprised by the announcement that just a year and a half later the community beds they had fought so hard for were to be closed.

Cllr Hackett said: “Disgracefully there was an attempt to ‘bury the bad news’ by the Trust announcing its decision late on the same day that the proposed bed closures for Whipton, Okehampton, Honiton and Seaton were saturating the media.

“Clearly last week’s announcement undermines the credibility of the Trust. If their consultation found there was a ‘need’ for beds. All efforts should have been made to secure them, especially as with the announcement of further closures there will be no community beds between Stratton and South Molton.”

Cllr Hackett said he spoke to Robert Sainsbury back in 2016 after the initial consultation. He said three distinct options were put forward by Mr Sainsbury at a meeting for the CCG/NDHT to keep the beds open.

Alternative solutions discussed included beds being run with local GP cover — this is now in operation.

Cllr Hackett said: “From my understanding the doctors are currently paid to cover 12 beds, and have offered to cover the remaining four beds pro rata. This has been rejected by the NHS, and this may be the main reason why there is not the ‘full occupancy’, which is one of the reasons given for closure.”

However, Cllr Hackett questioned whether the trust had really ‘explored all the options’ “The second alternative which was discussed by Robert Sainsbury in 2016 is to have the beds consultant led from the North Devon District Hospital in Barnstaple. This option appears not to have been explored. The third option put forward was to have the care led by nurses on site, which again in not discussed in the 12 page Stakeholder Briefing issued announcing the temporary closure.”

Cllr Hackett said the CCG are allowed to make ‘temporary’ bed closures, but they must hold a consultation if they want to close them permanently. He raised concerns over this and said: “This, I believe, is a permanant closure by stealth as there is no indication that the trust will restore the beds.”

Following their announcement the Trust has published dates for a series of engagement events. These events, they say, will provide an ‘opportunity for people to understand more about the rationale behind our decision and express any concerns or anxieties they might have’.

Drop-in sessions will be held in Holsworthy Community Hospital on Monday, March 20, from 10.30pm to 1pm and on Thursday, March 30, from 9.30am to 12pm.

There will then be two sessions of public meetings in Holsworthy Memorial Hall on Thursday, March 23, from 3pm to 4.30pm and from 6pm to 7.30pm.

A meeting held last night (Wednesday) was set up by the town council and Dr Alison Diamond, chief executive for Northern Devon Healthcare NHS Trust was expected to attend and answer any questions about the recent temporary closures.

Residents in Holsworthy have set up an online petition, so far it has over 1,000 supporters. To sign the online petition visit the website www.change.org/p/doctor-john-womersley-save-holsworthy-hospital