Thursday, November 25, 2010

Changes at West Cumberland Hospital:

The Whitehaven News reports that changes to services at West Cumberland Hospital are taking place – including rehabilitation, palliative care and children’s ward.

Local NHS Trust's management chiefs say the changes – which have been worked on by hospital clinicians and GPs – do not mean a reduction in the quality of service or safety, and are in line with the national shift of care away from acute hospitals towards more people being treated in the community they say.

The number of beds on the hospital’s stroke unit (Ullswater) has reduced from 18 to 14, because rehabilitation beds for head injury patients (but not stroke patients) has moved to Carlisle.

Mike Walker, director for the North Cumbria University Hospitals Trust, told the Whitehaven News:

“The consultant retired and it was a difficult model to run for the whole of North Cumbria.

“It was decided that it was more efficient to run the inpatient service on one site. There is also a move to have more of those patients treated in the community so there is less need to have neuro rehabilitation beds.”

Palliative care has currently been moved to the stroke unit due to a shortage of staff as a result of sickness, added Mr Walker. He said it was not something that had been done through choice and that the plan in the hospital redevelopment was to locate those patients in the Copeland Unit (community beds unit managed by GPs on the WCH site).

Under the plan, the Copeland Unit is to move to Overwater Ward, which is said to be bigger and will also provide room for palliative care (a total of 25 beds). Palliative care staff will move with the patients, providing the same specialist care in a specialist area. Some nursing staff currently on the Copeland Unit will be upskilled in palliative care, said Mr Walker, to care for the lower dependency patients on the unit.

The children’s ward was reduced from 21 beds to 15 over the summer and is said to be working well. Of those, eight are for assessment and seven are inpatient beds, although the assessment beds can also take children overnight if needed.

“We are trying to focus on the whole service provided rather than just counting beds,” said Sandy Brown, a Trust director. “The vast majority of children get assessed and are able to be discharged the same day.”

The aim is to have one team of staff providing a service between a child’s home to hospital treatment. Depending on what level of care is needed, some may be assessed at the hospital and then cared for in the community while others may need to stay in hospital. It means that some staff in the community would have to be “upskilled”, said Mr Walker, so that more children can be cared for in the community. “The teams do work together but we need to make that bridge stronger.”

“There is a fine balance as we are down-sizing, sometimes it doesn’t quite match. There are very good skills in the community, but what we need to do is upskill them more. There has always been a good flow of patients (between the hospitals and the community) and we need to build that bridge even stronger.”

Moving more complex out-of-hours surgery to Carlisle’s Cumberland Infirmary, from West Cumberland Hospital, is expected to start in January. It was agreed as part of Closer to Home consultations and was said to affect only a small number of patients and that if someone was not well enough to travel, the surgeon would have to go to the patient.

There are difficulties in recruiting anaesthetists to both hospitals, said Mr Walker. He said there was currently enough to cover the work but there are problems in recruiting middle-grade staff.

He said they were looking at different ways to provide the service and said that there needed to be anaesthetics on both hospital sites.

Other services at the hospital will remain, such as A&E which will become part of an ‘emergency floor’ which will include hospital doctors, GPs and out-of-hours teams; maternity services, and intensive care unit (six beds in total).