Decision On Fate Of Babington Hospital Expected ‘In June’
Health leaders are considering people’s views about plans to move health services from Babington Hospital to a new, purpose-built facility in the town.
The move follows months of engagement by NHS staff, which included talking to people in Belper’s streets and the town’s farmers’ market, and information and details about how get involved being delivered to thousands of households. Leaflets and further information were also available at libraries, GP surgeries, clinics and other public venues.
In addition to views which were shared face-to-face, more than 170 people gave their opinion via a written survey.
The feedback will be considered and then shared with Healthwatch Derbyshire for further independent analysis. A report will go to the CCG’s governing body for a decision on next steps in June.
Currently Derbyshire Community Health Services NHS Foundation Trust (DCHSFT) is commissioned to provide a range of services for patients from the hospital in Derby Road, including community therapy services, physiotherapy, podiatry, falls prevention and intermediate care.
But difficulties posed by increasing maintenance needs and limitations of Babington Hospital’s building, and an ongoing review of Belper health services, has prompted leaders at NHS Southern Derbyshire Clinical Commissioning Group (CCG) to plan to move all existing services from Babington’s site – including Belper Clinic – to a new development in Derwent Street, closer to the centre of the town, with a new model of “bedded” care offered.
Clinical chiefs at the CCG, which plans and pays for health services, have worked with professionals that support patients to develop the plans. These have been shared with NHS staff and clinicians, and Belper Patient Participation Groups (PPGs) – which work with GP practices to make sure patients and carers get involved with, and influence their services.
Dr Paul Wood, practising GP and Chair of NHS Southern Derbyshire Clinical Commissioning Group, said: “We worked in partnership with staff from Derbyshire Community Health Services NHS Foundation Trust to talk to as many people as we could, to take on board all views, both for and against.
“Wherever possible we will incorporate ideas in the creation of the new, purpose-built facility. We’re keen to maximise all available health and care resources so patients get the best support, now and in years to come.
“People are living longer – which is great news for everyone working in the NHS – but that creates different patient needs, particularly the ongoing support needed for long-term conditions, and we must take these into account when we forward plan so the right care is available.”
Derbyshire County Council is developing land in Derwent Street to provide 40 new residential care home beds for their service users, and create a new library for Belper.
Locally there has been signification opposition to the proposals with protests, petitions and regular meetings being held by the Belper SOSNHS group.
Keith Venables said: “NHS managers are trying to impose a £280 million cut in health Service provision across Derbyshire. Rather than seek the necessary funds from NHS England and the government, they are putting pressure on us. But people are speaking out, from Belper to Chesterfield to Swadlincote, protests are taking place and we think have an effect.”
The CCG and DCHSFT have worked with the authority to explore opportunities for providing health services from the same site. DCHSFT purchased land in Derwent Street from the county council, on the understanding it could be sold back if a decision was made to not move services to the site. The Trust currently rents the Babington site from NHS Property Services, which has owned it since 2013.
Services will continue to be offered from the Babington site until the new Derwent Street facility is ready to house services, unless exceptional circumstances – such as flooding – make this impossible.
Dr Wood added: “We carefully reviewed options and discussed these with local GP practitioners to make sure our plans were sound and had the support of clinicians.
“The local GP practices have written to the CCG during the engagement period to confirm their support for the proposals.
“We wanted to be sure that the superb patient care currently offered by professionals can carry on being offered – but from a suitable building which is specifically designed to be used for modern health care, or out in the community, in people’s own homes when it is best and appropriate for them.
“We want to invest in extra community support and adapt to these needs so people can carry on with their lives with the help they need and we use beds wisely and well for those that will benefit.”
I think it’s important to not that “move all existing services from Babington’s site – including Belper Clinic – to a new development in Derwent Street, closer to the centre of the town, with a new model of “bedded” care offered.” is at best unbelievably misleading, and probably should be edited to immediately say ‘campaigners point out that the ‘new bedded care’ means to loss of all nursed hospital beds, and so it is untrue to say all the services will be moving. ‘
It is not true to say that all services will be moved to the new facility as there will be no beds that will have 24hour nurse cover, the statement of “a new model of bedded care” actually means in the event of needing 24 hour nurse led care for rehabilitation or palliative/ end of life care the people of Belper will be sent out of the town to Ashbourne, Ripley etc.
It’s untrue to say that the CCG have sought out public opinion before drawing up plans for the closure and then sale of Babington, whilst ‘moving’ services. This is at best misleading. They caveat the keeping Babington open with the possibility of flooding which might cause it to close. I was at an Engagement meeting for the 50+ in Belper when Clare X from the CCG told the group Babingto had flooded that very morning and that was just one of the reasons why it wouldn’t work. It turns out that a pipe had burst! If a pipe burst in my house I wouldn’t sell It off to a developer because if flood risk; and they wouldn’t want to buy it! And yet NHSEngland apparently already have plans on how to dispose of the site! The one paid for by the Parish of Belper and the surrounding area. The one that was built locally and is part of our heritage. The one that was transferred to NHS property Services in 2013 so they could charge half a million pounds rent a year for a building they then wouldn’t maintain. I say let’s take our Community Hospital back! Derby A&E, merging with Burton, is frequently too full to accept admissions. We have a population of 24000 plus the surrounding towns….community hospitals developed organically because of need. Let’s save Babington and bring back more of the services that have been moved away. More services that are now less accessible. Stop the privatisation of our NHS!
This article is lacking most of the important information required to understand what is at stake.
The ‘consultation’ was about a decision already made – in clear breach of the NH rules about real consultation not fake consultation.
The full information required to make a judgment has not been supplied to the public. What is needed is a formal public consultation with all the relevant information available, NOT a partial set of information given to the public to ‘engage’ with a decision which has already been made. It is vital that matters of this importance are not presented to the public in ways which deny them the information required and before, not after the decisions have been made. I hope that Healthwatch Derbyshire will take due note of these factors in assessing this survey.
The following questions and objections to the decision making process and lack of information are shared by the Campaign Group NHS/SOS Belper of which I am secretary.
I am also writing in my capacity as an Amber Valley Borough Councillor for Belper with deep concerns about the health of our residents. I have undertaken research on behalf of that council’s Scrutiny Committee into the role of the council in the wider aspects of policy which impact health inequality, some of which are highlighted in the Derbyshire STP. I have as a result recommended that the council makes an explicit health impact assessment of all its policies and of its draft Local Plan.
The Pre Consultation Business Case document, which is linked to the public page of SDCCG on the Joined Up Care Belper proposals, says this on page 5
”It should be noted that approval of the proposals will still be subject to:
i) Public Consultation”
This promise, which has been frequently and consistently made to the public by the SDCCG since 2015, has been broken. It is symptomatic of the conduct of the SDCCG that we are signposted to a document which immediately reminds us of that broken promise.
”Communications and engagement has been an integral part of the planning in Belper. Along with a fundamental desire to involve local people, the CCG has statutory duties under section 242 &244 of the NHS Act 2006 and section 14Z2 of the Health & Social Care Act 2012.” page 27
I disagree with the above statement. The pre engagement process in 2015 is described thus:
”The pre-engagement phase of Joined up Care in Belper was launched on 1st October 2015 by a presentation with all of the local PPG Groups. The engagement programme used a number of routes used to gain engagement of people from Belper and the surrounding areas. This includes information being available at key local venues, direct mail outs and meetings with key stakeholders. The overall objective of the engagement was to encourage local people to complete a survey in which they were asked to score on a scale of 1 to 10 (with 1 being the most important) the following aspects of local service provision:” page 27
SDCCG managed to get a grand total of 84 survey forms completed in five months – this is not evidence of a commitment to engage local people.
CONSULTATION WITH OTHER BODIES
The public have not had sight of the presentation made to NHSE about Joined Up Care in Belper plans. Nor have the comments or the reasoning behind the NHSE advice been made public – Why not ?
The SDCCG and DCHFT management say their proposals for Joined Up Care – Belper, including the decision not to have a full public consultation, have the support of the Derbyshire Health Scrutiny Committee. Why were the discussions at Derbyshire County Council Health Scrutiny about Joined Up Care in Belper held in private twice ? No details whatsoever of the discussion or the evidence provided to the committee at those meetings is available to the public. So how can the public know that this process was fair? One member of the scrutiny committee said at the last meeting that he did not agree with everything he was presented with by SDCCG and DCHFT and no memory of this all being agreed by the committee.
There has been a presentation to Belper Town Council but no presentation to Amber Valley Borough Council – the planning authority. I have found no evidence of any conversation with AVBC on the future of the Babington site since 2012/13.
COSTS OF OPTIONS
Seven options are identified as having been considered with only one being judged financially ‘ viable ‘
Why was NHS PS Ltd not been asked to provide a costing for upgrading work on the Babington to compare with the minimum figure of £5.9 million to be expended on the proposed new build in Derwent Street? When asked for this comparative figure by the Chair of Derbyshire Health Scrutiny at its last meeting the SDCCG Chair did not reply. Why not?
Many assertions are made about the likely future running costs of the existing site compared to the proposed new site – none are backed up with reference to detailed documentation which can be accessed by the public.
The Pre Consultation Business Case document which was linked to the JUCB public page omits appendices 2, 6, 7 and 8 – I have asked in writing of the communications team the reason for this and for them to be made available to the public. I received no reply and they were not made available.
The public are being told that there is not an economic case for bringing the Babington to the required standard but not given the information required to assess the validity of the judgement and, in all probability, nor has the Scrutiny Committee. In those circumstances to ask if we agree with the proposal to move services out is not valid or acceptable and does not conform to the duties of any competent NHS organisation in regard to consultation as referenced above.
The information in this ‘Business Case’ document about the future of the Babington site is so sloppy that as of today, 30th March, it still said:
”The planned disposal of the Babington Hospital should yield a capital receipt of £1.25m, ( IS THIS CORRECT seems very low? ) based on current estimates. ”
This begs the question – are any of the figures supplied CORRECT?
Another document – Babington Case for Change – not available on the public engagement website, but can be found by those few with the time and ability to do so – says this:
”In recent months, local people have mounted a campaign to ‘Save Babington Hospital’. The focus of this campaign has been on the buildings, rather than the services provided within them.”
This is an outright lie – the local campaign group has always been focussed on the NHS services first and the building issue has been presented accurately as a combination of questions about its viability and suitability for NHS services and its value to the community as a well know listed building in the DVMWHS Corridor.
THE SITE
The long standing neglect of the site by its owners is shameful, as is the recent scaremongering which is a major feature of the case for moving NHS services. In a video of William Jones which only very recently appeared on the JUCB public web page he says this: ”I have been desperately worried for the last seven years ” about the
condition of the buildings. This means that since 2011 he has been managing health provision in a site which should and could have been properly maintained and upgraded – and that he has feared a major incident affecting patient care for all of that time without insisting that something was done ? We also have to ask why NHSPS ltd has been allowed to charge our local NHS locally millions in rent while neglecting the buildings?
There has been ample opportunity over many years for the NHS, AVBC and the County Council to work with NHSPS ltd and other partners to deal with the issues of upgrade, flood risk and under use identified through multi user partnership approach to the whole site. There is no evidence of this having been considered in any of the 7 options presented.
Planning permission for the new site has only been awarded so far to the County Council in outline form. So £5.9 million in NHS funding has we are told been allocated to a building of which we have no details and has no planning permission – due for completion in 18 months. Why the hurry to get the public survey over without any detail about this?
PARKING
William Jones says that ALL NHS sites have parking issues – well Babington does not, unlike the obvious limitations on the new site, together with the equally obvious access problems from the A6. His absurd description of ‘extensive public parking’ in Belper Town centre will be greeted with hollow laughs by residents and visitors
STAFFING AND THE MODEL OF CARE
A very successful and skilled staff team, acknowledged as such by CQC, is going to be broken up with ‘no guarantees’ (William Jones) of being redeployed.
The proposals state that the NHS nursing staff posts will be reduced from 11.39 WTE to 1.03 and HCA posts from 13.09 to 0.25. WTE. Plus the loss of 1WTE ward manager. There are no clerical or housekeeping staff identified in the new structure – will the building clean itself and have no reception? There is no detail about the changed staffing structure.
Assertions that County Council staff will be delivering services have not been backed up by any documentation and must be seen as a huge risk in the light of the major crisis in Social Care funding which is steadily getting worse. Assertions about the availability of bed availability in care homes also need examination as there is a deepening crisis in this sector – where is the documentation of these risks? There is no risk analysis whatsoever applied to the model of care or anything else for the new centre in the documentation available – even the published STP plans acknowledge the need to do this and did it.
Travel to other community hospitals, which as far as we know could be the next to be closed or downgraded as a result of the NHS funding crisis, is not a minor change for patients or families.
Dr Wood asserts that there will be wrap around care at home where suitable for elderly patients and fears on this score are groundless – there is ample evidence that this likely to be a pipe dream, as Belper residents already know from very painful experience. NHS staff and Social Care staff, mainly women, are already paying the price for the dysfunction in community care resulting from fragmentation of employment, poor pay and shortage of staff – as everyone but Dr Wood seems to know.
When looked at together with the bed losses how can this all be described as ‘not a major change’ and therefore ‘not needing full consultation’
the future of the Babington and of its NHS services deserves better. This deeply flawed process needs to be stopped while a full public consultation with considerably more information available, in clear and comprehensible form is undertaken as promised and as needed.
Dr Paul Wood, in another video very, very recently put on the JUCB page (for a survey begun in January,) says that the views of the public will be carefully ‘analysed’ and ‘looked at’ before going further – but we have only one option on the table and all the important decisions have already been taken. The public faith in the validity of NHS management and consultation processes was severely undermined by the secrecy imposed on STP planning by the government. This feeling of betrayal has poisoned relationships and has been identified explicitly by the local SDCCG and other STP partners as a problem which was imposed on them.
However, when given the opportunity to run their own full and open process without interference, since the NHSE view of the right process was advisory only, in regard to the future of Joined Up Care in Belper, the managers of SDCCG and DCHFT have made exactly the same mistake as with the STP.
The STP plans were eventually published, with hundreds of pages of detail, which allowed the deep flaws to be seen and have been the subject of challenge all over the country, including Derbyshire. We have yet to see how the plans for, to quote Dr Paul Wood, a ‘heroic’ level of bed reductions and equally heroic assumptions about limiting NHS costs by £240 or £280 million can be realised in an even remotely convincing update since 2016. We have seen nothing about the prospect of limiting County Council social care costs by £100 million.
Similarly opaque and secretive plans for rapidly implementing ACO or ACS structures in STP footprints, including Derbyshire have been challenged in the courts and these attempts to impose them in a hurry and behind closed doors have been halted – for now – as far as we know.
Seemingly having learned nothing from this experience, SDCCG and DCHFT have made no such full disclosure of the JUCB information needed. Soothing videos and assertions without back up detail are not good enough.
Cllr Maurice Neville
If honesty, common-sense and logic were allowed a fair say in what is proposed for the future of Babington Hospital, then no one would be writing letters of complaint. Unfortunately, I fear that any argument put forward by level headed people who wish to state their objections, is lost before it is even given utterance.
This ‘debate’ is not one that allows any halting of a process already set in motion by those who believe their ideas – and only their ideas – are the ones worth listening to and endorsing. We are being kidded – and kidding ourselves – if we don’t realise that there is no considering of ‘people’s views’ by health leaders, DCHSFT or any other organisation. The process has started; there has been no true ‘consultation’ and the public has not been supplied with all information relevant to enable a considered decision to be made.
What a sad world we live in when those that were elected and trusted to look after our best interests, give only part of a picture and retain information that could enable us to make wise decisions about this historic building and the way in which our local healthcare could be managed in the years to come. And make no mistake, parts of Babington Hospital have Heritage listing, so woe betide anyone foolish enough to think that it could all be demolished.
How can an official statement be issued saying that the SDCG managed to get 84 survey forms completed in five months and further information be published saying there had been face-to-face engagement with local people and more than 170 people gave their opinion via a written survey? What was happening in all that time? These statistics are ridiculously small considering the number of residents that live in Belper. For something so massively significant to the lives of Belper people there should have been far more done to honestly inform the residents on what long term effects this action would have on the community and given the opportunity to make their thoughts on the subject both heard and considered.
Progress is good and should never be stopped but what is on the table here is regress masquerading as improvement. How sad that a population of more than 20,548 and 8,790 households (according to the 2001 census, so I’m sure that number is presently even greater) have been diminished by the pitiable total of opinions revealed by the SDCG.
I love the idea of Belper having a ‘suitable building which is specifically designed to be used for modern health care’ as was stated by Dr Wood – who wouldn’t? But what will really happen doesn’t sound as if this will really be the case, or perhaps Dr Woods idea of ‘superb patient care’ is different to the ideas of those who will have to endure the consequences if all this goes ahead. Belper may well end up with a sparkling new facility that is closer to the centre of the town but if that resource does not have the capability to provide 24-hour care, then all the promises made by those driving these changes will be negated. When someone facing end of life/palliative care must be accommodated in another town, then the distance travelled presently to reach Babington will appear as nothing.
The present site at Babington Hospital has been neglected for years but could be upgraded and properly maintained, using the millions that the NHS has allocated for the proposed new building. Babington has ample open space around the site with plenty of areas for car parking. In a town like Belper where parking is difficult, this must be a big plus. Care homes are facing problems finding available beds and yet it seems that the meetings at DCCHC about Joined Up Care in Belper have been twice held in private with no details of the discussions or evidence provided being made available to the public.
Shakespeare wrote that ‘Something is rotten in the state of Denmark’, but looking at the present situation festering in Belper I fear that this town may well have to endure something similar for some time to come.