REPORT OF THE

HEALTH REVIEW COMMITTEE

PART II

SCRUTINY OF PROPOSAL TO CLOSE THE MOUNT HOSPITAL

1. In May 2004 the Health Review Committee indicated its support for proposals from Eastleigh and Test Valley South Primary Care Trust re-provide rehabilitation services for older people living in the Eastleigh and Winchester areas that supported:

· Home care and community services, including night support/sitting services


· Integrated day hospital facilities with input from therapists, primary care, social services and the voluntary sector


· Locally based 24 hour inpatient provision


· ease of transfer to and from acute care


· Improved access across the area


The implementation of this proposal would mean that the current use of The Mount Hospital would cease.

2. Following the Committee's response the PCT confirmed that it would share the next stages of the reconfiguration process with the Committee and gave an assurance that the services currently provided at The Mount site would not close until alternative provision was available. The running of this site is the responsibility of Winchester and Eastleigh Healthcare NHS Trust (WEHT).

3. On 30 June 2004 the WEHT Board resolved to close the inpatient service at The Mount Hospital at the end of August 2004 on the grounds of safety subject to discussions with the Health Review Committee. The County Council was advised of this intention on 1 July 2004.

4. Following consultation with the Chairman and the Chairman of the Working Group on The Mount the Chief Executive determined that the matter should be dealt with as a select committee scrutiny exercise with evidence from WEHT and other interested parties.

5. To support the formal scrutiny process the committee sought additional information from WEHT on:

· The contingency plan agreed with the PCTs


· The `trigger' that initiated this phase of the contingency plan


· The immediacy of the risk to patients


· The extent to which partner organisations, including PCTs and social services, were able to contribute to this decision

6. At the meeting on 27 July 2004 the Committee received presentations on the proposal to close The Mount from Eastleigh Borough Council; Hampshire and Isle of Wight Strategic Health Authority; Patient and Public Involvement Forums affected; Hampshire Social Services; Eastleigh and Test Valley South Primary Care Trust; Mid Hants Primary Care Trust and WEHT.

7. In order to provide a clear framework for scrutiny, at the meeting, the Committee explored the following issues in more detail with each presenter:

· Were the reasons for not going out to consultation adequate (If the Committee considers that the case for not going to public consultation are not adequate then the following points, drawn from the Committee's criteria for assessing substantial change to health services need to be considered)


· Will there be changes in the accessibility of services for the people using the service


· Is the change based on clear evidence and best practice


· What impact will the proposal have on the wider community and other service providers


· Is the proposal to close the beds at The Mount Hospital in the interests of health services in the area of the Committee

8. After considering all the evidence Members took the view that the reasons for not going out to consultation were adequate inasmuch as there was a significant clinical risk to patients these services should need to close at the end of August due to staff vacancies. They accepted that there needed to be proper planning for this eventuality and that the inpatient services at The Mount Hospital were fragile and it was to the credit of staff that they had been sustained.

Members did, however, express deep disappointment that, some four weeks after the Trust deciding to invoke the contingency plan to close The Mount in-patient service, so little progress had been made in terms of discussions with partner organisations to identify the options for continuing to provide these services locally. They required further evidence that this engagement had taken place. They took the view that it was insupportable that the local NHS was not fully communicating in this respect.

9. The Committee made the following resolution:

That:-

Should the Trust proceed with the planned closure, the Committee would expect there to be clear and unequivocal clinical advice that all other options had been exhausted. Subject to this it recommended that:

(a) The Winchester and Eastleigh Healthcare NHS Trust Board defer the proposed closure until 30 September 2004 to enable all options to be fully explored with partner organisations.


(b) Eastleigh and Test Valley South Primary Care Trust and Mid Hants Primary Care Trust initiate immediate action to explore the scope for brining forward their planning of the new service model.


(c) There be a jointly agreed contingency plan put in place setting out clearly the triggers for further action and who would be responsible for initiating this. This would be headed by a consultant with the pre-requisite professional knowledge of rehabilitation services.


(d) Should the point be reached where there is no other option but to transfer patients, all risks to patients are fully assessed with the involvement of carers, families and the responsible clinician.


(e) Impact on the other services should be inpatient beds close are defined and communicated to the Committee.


(f) The Trust should respond to the relevant recommendations within 28 days, although given the pressures on the staffing position it may be appropriate to respond earlier than this.

10. This supports Aims 1, 4 and 5 of the Corporate Strategy.