Agenda item

Attending for this Item from Worcestershire Health and Care NHS Trust (WHCT) were:

Andy Sant, Medical Director

Mel Roberts, Service Delivery Unit Lead for Community Care South Worcestershire

The Committee received a presentation on the proposals for change for Stroke Services - Community Specialist Rehabilitation Services.

Community Specialist Rehabilitation Services is the pathway for patients following a period of time with Worcestershire Acute Hospitals.  For stroke patients, WHCT currently provide 32 specialist stroke rehabilitation beds across 3 Worcestershire sites:

·         8 at the Princess of Wales Community Hospital, Bromsgrove

·         8 at the Timberdine Community Unit, Worcester

·         16 at the Evesham Community Hospital.

Stroke Consultant cover at the 3 sites is already being provided by two organisations and there is often a reliance on locums to cover shifts.  Stroke admissions to Timberdine and Evesham have had to be closed on several occasions since April 2016.  The picture in Worcestershire is not unique and there are national shortages of Stroke Consultants, with less than 1,000 across the UK.

The County's Stroke Strategy Forum has recommended that all stroke specialist rehabilitation beds be centralised on one site to ensure safe services remain available.  It would also provide an opportunity to create a centre of excellence and provide increased opportunities for staff. 

Evesham Community Hospital provides the best opportunity to meet this proposal, with 32 beds available.  The existing beds at Bromsgrove and Worcester are proposed as general rehabilitation beds.

A six week engagement exercise will take place with Staff, stakeholders and the general public via a number of forums, with the hope to start the new service from mid February 2017.

In the ensuing discussion, the following main points were made:

·         It was clarified that the proposals only affected stroke rehabilitation beds, not Acute beds

·         Transportation to and from Evesham for visitors was highlighted as a concern as the average length of stay was 30 days

·         When asked whether the current model was preferred if resources were available, it was reported that neighbouring Authorities were also experiencing problems with recruitment, therefore there was no alternative

·         General rehabilitation beds continued to be in demand due to demographic changes, mainly the health needs of the elderly

·         When asked how the proposal fitted with the Sustainability and Transformation Plan, it was stated that care closer to home was key and providing increased general rehabilitation beds in Worcester and Bromsgrove would support the principles

·         The community teams have excellent links with the Acute Trust and are able to provide support for up to 6 weeks.

Brendan Young, representing the Worcester Stroke Forum was invited to speak and commented that he was a patient voice for stroke patients and carers who had seen much change in recent years, with increased partnership working and organisations jointly working to increase outcomes for patients.

He was optimistic about the future and noted that much progress had been made recently to maximise resources and reduce length of stay.  The Community Team had received national recognition for its good practice and although he had heard concerns about transportation, referred Members to the differing community transport schemes around the County.  Overall he was in total support of the proposal.

Peter Pinfield, Chairman of Healthwatch Worcestershire reminded Members that the engagement process was not consultation and to be mindful of the difference.  He also reported that transport concerns was a recurring theme.

The HOSC agreed that although transport was an issue, clinical safety was paramount importance, and that the Committee was supportive of the proposals as outlined.

The Chairman thanked those present for a useful discussion.