Plans to close the inpatient unit at Rutland Memorial Hospital and reduce the number of hospital beds across Leicestershire have been branded ‘pure insanity’ by a senior doctor.
Consultant geriatrician Dr Alex Miodrag received a round applause from members of the public after speaking out at a meeting organised to update people on proposals for health and social care services over the next five years.
Leicester, Leicestershire and Rutland’s draft Sustainability and Transformation Plan (STP) was published in November last year.
Proposals in the 80-page document include losing the in-patient beds at Rutland Memorial Hospital, downgrading Leicester General Hospital and closing the maternity unit at St Mary’s Hospital in Melton Mowbray.
A meeting organised by East Leicestershire and Rutland Clinical Commissioning Group was held on Tuesday at Voluntary Action Rutland in Oakham.
CCG chief executive Tim Sacks and clinical vice-chairman Dr Andy Ker explained that the NHS is under major financial pressure – with a predicted £400m deficit in Leicester, Leicestershire and Rutland within five years.
A major part of the STP is delivering more care to people in the community and their own homes, co-ordinated by their GP – freeing up much-needed beds in accute hospitals.
Dr Ker said eldery patients regularly stay in hospital for longer than they need to, because although the reason for their admission had been treated, there was not adequate support in the community for them to be sent home.
If approved, the change to a new integrated care system would result in the loss of 281 hospital beds across Leicester, Leicestershire and Rutland – a reduction of 13 per cent.
Dr Miodrag, a consultant who works in Leicester, Leciestershire and Rutland, claimed removing the beds would lead to “an absolute meltdown situation”.
Referring to a fictitious patient called Mrs Miggins used during the meeting to help explain problems with transfers of care from hospitals, Dr Miodrag said: “Things are really bad already.
“We get daily e-mails saying ‘we need beds, we need beds’ and ‘we want discharges’.
“Well loads of those discharges are Mrs Miggins’s who will be dealt with by so-called community services.
“Mrs Miggins will go home and will have barely warmed her bed up and she’ll be joining the queue at the LRI (Leicester Royal Infirmary) again. That’s the situation now, and you get rid of these acute beds you are going to magnify that and will have an absolute meltdown situation.”
He said pateints who are sent home unable to stand, use the toilet, or in a confused state were highly likely to fall, hurt themselves or fall ill at home, leading to another stay in hospital.
Dr Miodrag said that he had been a consultant for 34 years and had seen many changes, adding: “My predecessors would be turning in their graves if they knew what you are proposing. It’s pure insanity.”
About 80 people were present at the meeting and a majority cheered, applauded and banged their tables following Dr Miodrag’s intervention.
The current population of Leicester, Leicestershire and Rutland is said to be 1,061,800 and Mr Sacks told those present at the meeting that it is rising and ageing.
He said GP’s workloads had risen by 40 per cent since 1998 and although the amount of money spent on the NHS in our area is due to increase, it will not cover costs unless action is taken to deliver services in a more efficent and effective manner.
Mr Sacks said: “Currently £1.6 billion is spent on the NHS in Leicester, Leicestershire and Rutland. That will rise to £1.8 billion in five years time which sounds great – an extra £200 million.
“But it’s a false position because the cost of care will be more and we predict a shortfall of £400 million.”
He said the government has set three challenges: to improve health and wellbeing; improve care and quality; and improve finance and efficiency, adding: “We hope, if we get it right, we will have community services where care is co-ordinated by GPs, there is less need for hospital visits and more care at home.”
Leicester General Hospital has been pencilled in for downgrading because no other city has three accute hospitals, and resources could be focused on the Leicester Royal Infirmary and Glenfield Hospital sites.
If that happens, there will no longer be an intensive care unit, maternity unit, or operating theatres there.
The maternity unit at St Mary’s Hospital in Melton Mowbray, where around 160 births take place ever year, could be closed along with the unit at Leicester General Hospital which has around 4,000 births, in favour of a new, larger unit at the Leicester Royal Infirmary site. But concerns were raised at the meeting over traffic congestion around that location, plus a lack of parking spaces.
Mr Sacks was keen to stress the STP document is only a draft and the views of members of the public will be listened to carefully when a formal consultation is launched in the summer.
Another meeting organised by the CCG will be held at the Falcon Hotel, in Uppingham, tonight (Thursday) between 6.30pm and 8.30pm.
The draft STP document can be viewed at www.bettercareleicester.nhs.uk
Plans to deliver more health services in the community, rather than at major city hospitals, could see the number of outpatient appointments at Rutland Memorial Hospital in Oakham soar.
Currently, people from Leicester, Leicestershire and Rutland attend around 42,000 appointments each year – with around 16,000 of these taking place in Peterborough, 16,000 in Leicester and only 5,000 in Oakham.
Clinical commissioning group chief executive Tim Sacks said he would like to see consultants from a wider range of disciplines, such as opthamology and urology, hold appointments at Rutland Memorial Hospital. He said the site could handle up to 12,000 appointments each year, or more.
Mr Sacks was asked if two operating theatres at the hospital, currently used only for storage, could be recomissioned but he said that was unlikely to happen.
Patients who had seen a consultant locally and who then required surgery would still have to travel to Peterborough or Leicester for their operations.
The NHS non-emergency 111 phoneline service in the East Midlands could be revamped to help take pressure off hospitals.
Tim Sacks said only 13 per cent of people locally who call 111 will speak to a clinician - the rest will speak to a call centre worker who uses an algorithm to work out the best course of action.
He said: “The algorithm tends to push people towards the acute care option, often unecessarily.
“We want 60 per cent of people to be clinically assessed.”
Plans for better co-operation between the nurse-led minor injuries and illness unit in Oakham and the out-of-hours GP service were also mentioned.