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Reprinted from The Cornishman, July 4, 2019

The new set-up at the Edward Hain hospital building in St Ives is receiving plaudits for its work as a day centre. Plans are being developed for a ‘community-based model of care’. But the loss of inpatient beds is being glossed over.

Inpatient beds at Edward Hain community hospital were ‘temporarily’ closed to new admissions in February 2016.

They are still closed.

Those beds had been used intensively – on an average night 93% of them were occupied – and they were much used by Penwith residents: in the 12 months before they closed they held 174 patients, almost two-thirds of whom lived in Penwith.

Mostly they had been treated at Treliske, the acute hospital, and were now recovering. They were well enough to leave Treliske but not yet well enough to go home: they were still in need of rehabilitation. With the former Poltair community hospital closed and sold off there is now no community hospital with inpatient beds in Penwith.

The latest performance report to the Royal Cornwall Hospitals Trust – the acute trust – tells us that in April 2019 nearly 600 bed days were lost on account of delayed transfers of care caused by patients waiting for further non-acute NHS care, following completion of their acute treatment.

The report says: ‘These will be patients waiting for onward care, including community hospitals, for rehabilitation.’

Losing 600 bed days in one month is equivalent to having a ward of 20 acute beds continually unavailable for that month!

So what’s being done in Penwith to help Treliske out?

The new day centre being trialled in the Edward Hain hospital building is not receiving any referrals from Treliske, so clearly this service is not compensating for the loss of inpatient beds at Edward Hain.

Many patients benefit from the rehabilitation provided by the community hospitals, which are run by the Cornwall Partnership Trust, but for the past three years the Trust has shown no interest in providing community hospital beds in Penwith.

If the admittedly-elderly Edward Hain building is unsuitable for present-day needs, it is time to consider replacing it with a modern community hospital hub with inpatient beds.

We hear a lot about developing community-based models of care, but what is being done in the here and now, as well as in planning the future, to relieve Treliske of the patients waiting for onward non-acute NHS care for rehabilitation, and still needing beds?

Last month NHS England published an ‘implementation framework’ for its Long Term Plan.

This requires the NHS in local areas to make plans that will give priority to ‘actions that will help improve access to care for their local populations, with a focus on reducing local health inequalities and unwarranted variation.’

It is precisely such an inequality in Cornwall that in Penwith we now have no local access at all to inpatient beds in community hospitals. Our residents are losing out, and the acute hospital at Treliske is consequently short of a ward too.

At West Cornwall HealthWatch we are asking: How are local plans for the NHS being drawn up, and by whom?

Are we going to learn what they are at a point when there’s no time to change anything?

Will these plans provide for the badly-needed inpatient beds in a community hospital setting?

Is any thought being given to integrating the management of acute and community hospitals in Cornwall, to enable the smooth progression of patients from acute care to rehabilitation that is so badly needed?