NHS bosses say the health service in Staffordshire needs to move away from bed-based care to ensure it is sustainable in the future.
Staffordshire and Stoke-on-Trent’s controversial Sustainability and Transformation Plan (STP) recommends that dozens of community hospital beds remain closed, to help plug a projected £542 million funding gap.
Senior officials responsible for the STP appeared before city councillors on Monday to explain the reasoning behind the plan.
They told members of the adults and neighbourhoods overview and scrutiny committee that a major ‘culture change’ was required across the health system, in order to make it fit for the future.
A large part of this will involve the creation of around 23 locality-based multi-disciplinary teams, who will work in the community and provide care aimed at keeping patients out of hospital.
Programme director Penny Harris told the committee that Staffordshire was currently too reliant on hospital beds.
She said: “This is a system-wide plan – it’s not just about any single organisation. It’s really important that we read it as a statement of our direction of travel.
“The way we provide care isn’t sustainable for the future. The proposal is to move to locality-based care. Part of this involves the development of integrated care teams.
“But this won’t be a case of us imposing one single model of care on clinicians. The reorganisations needs to be bottom up.
“Another thing that needs to be addressed is beds. Historically we have been investing significantly in bed provision in Staffordshire, so we have more than you might expect to find in a community of this size.
“Over the years we have focused on bed-based services, when we should have been investing in community provision. That is something we have failed to do. Through the STP this direction of travel needs to be reversed.”
The STP recommends that community beds at Longton Cottage Hospital and Cheadle Hospital remain closed, along with 20 beds at Burslem’s Haywood Hospital. But the plan does not mention the beds at Bradwell or Leek Moorlands.
A public consultation on the future of the community beds is due to start in May.
STP medical director Dr Bill Gowans insisted that care in the community was better for patients.
He said: “We need to provide care in a community setting. Why do we need to do that? It’s not about money. Most people want that. They want to be at home for as long as possible.
“If older people stay in hospital beds longer, they will lose their independence and their support structures at home can dissolve.”
Dr Gowans also talked about the need for ‘de-medicalisation’ to help reduce the pressures on the NHS.
He added: “If you go back 100 years ago, when families had crises, they would naturally look to access advice from different figures, which could be the church, or elders in the community.
“We have a different sort of society now, where a lot of these problems are now medicalised. For example if someone is experiencing anxiety or depressions, or if they have a long-term health problem that’s affecting their employment.
“De-medicalisation is about looking at whether it is more appropriate to access non-medical help.”
The committee heard about plans to use digital technology to improve the delivery of NHS services. This could involve installing pressure pads in a patient’s home to monitor their physical activity.
But committee chairwoman Joan Bell expressed concerns over whether this approach would be suitable for everyone.
She said: “I’m not sure if an elderly patient would want to access the NHS through technology like this.”