At the start of September, the NHS began a consultation on fundamental changes to healthcare in Torbay and South Devon. They brought their roadshow to Dartmouth Academy on the 15th September. We were delighted to see the two meetings crammed, with over 700 people attending the sessions.

Many views were expressed, both positive and negative, but mostly trying to seek reassurance that the consultation would be meaningful, be acted upon and the promises delivered. The legacy of the Minor Injuries Unit has left a degree of scepticism in the community.

The first meeting surprised many of the audience when part way through it was announced that the Riverview Nursing Home was the likely site of a new community health hub. The logic of this is powerful and we agree, but the message was not well delivered. In the second meeting, it was explained from the outset that this was the probable solution.

Dr Eynon-Lewis spoke passionately about the benefits this new model of care would offer, and broadly speaking we at Dartmouth Caring would agree. Inevitably with changes on this scale there is anxiety and uncertainty but from the work we have seen and are involved in with the Intermediate Care Organisation (ICO) we have reason to be hopeful. The ICO is the part of the NHS managing this change, along with the Clinical Commissioning Group.

From our point of view, the benefits of having all health professionals under one roof, at a site where there is parking and which is adjacent to a bus route (with a small modification) are powerful and offer real synergy. For us, this is preferable to the four sites in Dartmouth currently, with almost no parking!

The key concerns which have been expressed were in relation to:

  • the services that will be available;
  • transport to and from hospital appointments;
  • the number of beds that are going to be available in Dartmouth;
  • end of life and palliative care;
  • recruitment of the necessary care workers to support people in their homes;
  • training of those working in the care sector to drive up the quality of care;
  • and many other issues.

We were reassured that all the services, with the exception of the X-Ray service, will be maintained in Dartmouth.

Transport is an issue and one that we feel acutely. The engagement of the NHS with us, and others such as Totnes Caring, has been proactive and began before the consultation started. Together we are already looking at how the demand for travel to and from hospital can be better managed and how the teams of volunteer drivers across the area can be increased in number. Public transport is not an area the NHS have direct control over but, like us all, they can lobby for a better evening service for our community and for a better link to Torbay hospital by bus.

For many of those I have spoken to since I came into role, the issue is not just the transport needs of the patient but those of their relatives who cannot visit due to the constraints in the public transport infrastructure. We will be making these views heard in our discussions with the ICO and NHS transport.

Beds: The numbers of admissions over the past few years do suggest that the number of beds to be provided at Riverview are likely to be sufficient and that this will be reviewed after 6 months offers further reassurance.

Our main concern surrounding bed numbers is to do with end of life, palliative and respite care, particularly with the reductions in support that will be available from Rowcroft. Dr Karin Chopin is a crusader on this point and is holding the ICO to account on their planning for this aspect of care. In addition, we have had positive communications with the ICO and Rowcroft about finding a solution. Many of our clients are at this stage of their life and we are very committed to exploring how we can contribute to this aspect of care.

Dartmouth has an extra element to this issue, many elderly people in our community live a long way from their families and do not have the traditional familial support on their doorstep – they desperately need support from the health and care sector. While most of us would prefer to die in our own homes, to those who live alone this is a nightmare and we must ensure they are treated well and with respect in their last days.

We work with literally hundreds of people in our community often for short periods prior to an admission to hospital, after their discharge, or through a short term need. In many cases a degree of care is needed in the home. We do not provide the care in the home but we spend considerable time supporting clients, finding the appropriate level of care and the relevant people to meet this need. There is a real shortage of carers in the community and a poor supply of school leavers and other adults coming into caring as a career.

Recruitment of the necessary workforce: The aim of the new care model is to manage more care and health needs in the home, something that cannot happen if there is no-one available to fulfil this role.

It is clear that the ICO recognise this and we are in advanced talks with them and the NHS training team to create a tangible strategy to deliver more care workers to the local labour market. A key aspect is working with local schools to raise the profile of caring as a real and positive career route, one that offers stability, progression, growth and is in a growing employment market nationally, as the population ages. Apprenticeship are available and already being delivered successfully in Torbay. In our next newsletter I will be able to bring you up to date on these exciting developments and what is actually happening, not just what we plan to do.

Alongside recruitment and career progression are the on-going training needs of those already working in the sector and of those joining, to ensure that the best quality of care is provided to all in our community when they are in need.