Gale's View - Care Quality

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January 29th 2015

I was talking, very recently, with a senior consultant at one of our local major hospitals. He had just spent a weekend, having volunteered to do A&E duty, reviewing in-patients` notes while he was not otherwise engaged seeing Accident and Emergency patients. He is that kind of guy. What he discovered shook him and it shook me when I heard about it: a very significant number of the patients had no need to be in hospital at all. They had been treated and they needed to be either in “step-down” or convalescent care or they needed to be supported but at home. And yet although millions of pounds have been stripped out of the East Kent Hospitals Trust budget to enhance Community Care and to keep people out of hospitals there are no places, apparently, for those patients to go to.

The Care Quality Commission, good at dishing out criticism but not so good at receiving it, might like to consider that the largely excellent Hospitals Trust that it criticised is now having to do the same amount of work or more with less money while the funding that was supposed to be treating patients in the community does not appear to be reaching the parts that it was supposed to reach. (The net result of the CQC report was, as we have heard recently, to make it still harder for our Trust to recruit the new consultants and doctors and nurses that it needs to treat a growing number of patients who feel that they are being failed by Primary Healthcare).

I mention this because, at the end of last week, I visited The Bay`s excellent Age UK Centre. These calls are worthwhile and hugely informative and I learned a great deal from the other organisations that the site in Reculver Road plays host to and from Age UK as well. I learned, for example, that there are beds available that are not being commissioned by Social Services, whose task it is to try to ensure that hospital beds are not “blocked” by those who have no need of them. Why not? When it is less costly and better for the patient to provide proper respite care, recuperative care and support than it is to utilise a hospital bed, why are we not taking advantage of facilities that are available and on our own doorstep?

And why is it that, with services being transferred from the Queen Vic Hospital (albeit without the promised subsidised transport facilities that we were told, during the “consultation” would of course be available) and spare capacity in our excellent local cottage hospital and hard-raised funds available through the League of Friends, we are not now capitalising on another and state-owned asset and removing patients from A&E hospitals to be cared for closer to home?

I do not believe that this is due to a shortage of money. I think that it is due to a failure, on behalf of the Care Commissioning Groups and NHS England, to properly prioritise and utilise the massive sums of money that Government has made available. There are fault lines running right through much of the National Health Service and if the agencies responsible for Primary Healthcare and Community Healthcare are incapable of addressing this issue then Government, in the person of the Secretary of State for Health, is going to have to do it for them.

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