This Comment, originally published as a letter to the editor in The Cornishman, 4 November 2021, can be downloaded as a pdf file here.

It was heartening to read in The Cornishman that our acute hospital at Treliske has set up a ‘reablement’ ward to help older patients regain their mobility and independence after treatment, while at the same time training healthcare workers in the skills that they need for this purpose. It is a hugely significant development for an acute hospital, because unlike the current official guidance (usually slavishly followed) it appreciates that older patients in particular need a stage of recovery and reablement between their treatment and discharge, and that providing this will release sorely needed beds and thereby allow a speedier flow of patients through the Emergency Department. It’s a good example of joined-up thinking! Congratulations to Frazer Underwood, who is spearheading this development.

There is an important question here for Cornwall’s health and social care managers. Helping patients with recovery and reablement is not a new idea for hospitals, but in the past it has been carried out in community hospitals, with the acute hospitals providing major surgical and medical treatment. Unfortunately NHS Kernow, Cornwall’s clinical commissioning group, has been pigheadedly insisting that we are over-provided with hospital beds, and has been doing its level best to close community hospitals. The Edward Hain hospital in St Ives is the latest to go under, leaving Penwith with none and local residents who are still recovering from treatment discharged from Treliske to a care home or one of the remaining community hospitals up to 70 miles from their home territory. It’s good that the deficiency in recovery and reablement services is being remedied now, but should it have been left to Treliske to do it?

NHS Kernow is currently in the process of being absorbed into Cornwall’s new Integrated Care System. It is to be hoped that a more insightful approach to the role of community hospitals will prevail from now on. A good start would be to integrate all Cornwall’s NHS hospitals, acute and community, under a single management.