GEllison

Last updated 01:00, Thursday, 11 October 2007

By Gillian Ellison

A WHITEHAVEN GP says he would not support any health plan which would be detrimental to local residents.

And David Rogers has this week spoken out about the new Closer to Home proposals saying they will provide much better services for people.

Dr Rogers, a partner in the Flatt Walks practice, said patients would see big improvements under the proposals which are out for public consultation.

“I was born here, I work here and I want the care that’s provided for Cumbrian residents, particularly in West Cumbria, to be the best that it can be,” he told The Whitehaven News. “I would not want to be part of a plan that didn’t aim to achieve that.

“We have to be pragmatic as well – there’s a set amount of money available. But it’s not about saving money, it’s about providing better care, about getting patients the right level of care at the right time.”

He said, in general, health staff working in the community and GPs were very positive about the plans which aim to shift the emphasis away from people being treated in acute hospitals and instead provide improved community services.

“For many years we have never been able to build up community services, there’s not been a facility there to help prevent patient admissions to acute hospitals. Patients have been admitted by default because there isn’t an alternative that’s easily available. We are admitting too many people for too long,” he said.

And he said many patients, particularly elderly people, are often generally unwell and although they require care, they may not need to go into an acute hospital but are admitted because there is no alternative.

“Where possible, people can be treated in their own home. Where they are a bit more unwell, they can go into a step-up facility (such as a community hospital) or if they are unwell enough to require an acute hospital then they can go there. When they are better they can move back into a step-down bed (community hospital) and then go back home. The only step-up/step-down beds available currently in Copeland are at Millom hospital and a few in Pow Beck, Whitehaven.

“If you give patients a choice, they would rather stay at home. It is making sure that that is safe and that they are well cared for. It’s not about cheaper care, but about improving the patient experience and care.

“And it does not mean that relatives will be doing the caring, that will be provided by health and social care teams.”

An example of how community care can be improved, said Dr Rogers, is in the treatment of the skin infection cellulitis.

Where the infection is severe, patients require drugs given into a vein by injection. But there is currently no alternative in Copeland to allow this to happen other than in a hospital.

However, this is soon to change and instead patients will receive the treatment in the community.

Copeland will have its own ‘locality group’ under Closer to Home which would decide what services would be provided where to best suit the needs of the local community.

Dr Rogers is leading that group in Copeland and he will be joined by other GPs, practice managers, a financial adviser, representatives from district nursing, physiotherapy, patients and the public.

The preferred option includes community hospital beds in locations such as Millom, Workington, Cockermouth and also 20 at West Cumberland Hospital, which Dr Rogers said will be a valuable facility for Copeland patients.

Some have questioned whether improved community services will be at the cost of poorer acute hospital services and whether the bed numbers are sufficient.

But Mr Rogers said: “The patients and users are the winners in this. There is obviously going to be a shift of resource from secondary care to community care.

“Some beds are being used for step-down care in West Cumberland Hospital at the moment because there isn’t that facility in the community. Although there may seem to be a drop in bed numbers, there’s enormous scope to improve efficiency.

“Secondary care needs to work more efficiently and at the moment they don’t have the ability to utilise community care but they will have.

“If efficiency is improved and there is step-up and step-down care beds then I don’t see a problem in the bed numbers.” But he said that acute hospital care facilities could not be reduced without the community system being in place first.

Another major concern is the transferring of out-of-hours emergency surgery from the West Cumberland Hospital to the Cumberland Infirmary.

“It’s important that when emergency surgery is looked at, what comes out is a robust and safe service.

“The concern is what is meant by emergency and complex surgery and how many people that will affect. We are told that it won’t affect many people.”

Other challenges ahead, he said, could involve training staff and possibly financially.

“A big issue is the re-training for secondary care staff to allow them to work in the community.”