Beware CCG’s bearing “gifts”... in support of Norman Lamb

Despite overwhelming public opposition, on the recommendation of West Leicestershire Clinical Commissioning Group, Leicestershire Partnership NHS Trust is pressing ahead with completing withdrawal of all services from Ashby & District Hospital in North West Leicestershire and intends to put the site for sale to the highest bidder.

A main plank of the CCG's argument has been its investment in 'home care' services such as "virtual wards" and 'Intensive Community Support'. These are intended to forestall unnecessary acute hospital admissions and reduce delays in acute bed releases (a.k.a. bed-blocking). But the decision to close Ashby's 16 community hospital recuperative/palliative beds flies in the face of common sense given that community hospital stays can play a vital role in both of those objectives. This was seemingly recognised by Simon Stevens when he became Chief Executive of NHS England in 2014 but has been brushed aside as an argument by NHS Leicestershire & Lincolnshire.

So, Norman Lamb is absolutely right to flag up that the now common practice by local authorities of stipulating just 15 minutes per home care visit is utterly outrageous. Not every visit will need longer, but for the care home visitor to stand any chance of getting to know the person they are seeing they must have the discretion of longer face to face time for conversation and observation, getting to know the person and gaining their confidence. This will draw out concerns, and may give vital clues to any emergent medical conditions or health deterioration, the sorts of concerns that could necessitate clinical, nursing or "virtual ward" care. None of this is helped, of course, if the person being visited sees different visitors week on week or if the visitors live miles away and have little local knowledge. And if the person visited is on the point of discharge from hospital, in the absence of family or friends to do this it is important there will be someone they know to see them after they get home.

Norman Lamb is also absolutely right that the Care Quality Commission must be given powers to inspect local authorities on these issues. And Eric Pickles has yet again spouted tosh in reply by expressing concern such a step could "create more bureaucracy". Experience over the past eighteen months has shown me that the NHS and social services are awash with bureaucracy. What we desperately need is an oversight body with teeth to bang their heads together, to unravel all the knots of reports and mission statements they tangle themselves up with, get back to focusing on an NHS which meets the needs of patients, not squeezing patients to fit prevailing dogma.

So, if you are approached by your local Clinical Commissioning Group wanting to talk about "improving community health care" in your area - be warned! Whatever assurances they might give you, there is every likelihood that at the end of their 'public consultation' health care provision in your locality will be worse, not better - but an awful lot of time and paper will have expended in achieving that.