Introduction

An important part of this work has been considering the role of Edward Hain Community Hospital. This has been something local people have been asking us about for some time. The work to consider the role of the hospital has concluded.

This work has told us the hospital is no longer able to provide health and care.

This document will describe how we have got to this point, and what permanently closing the hospital could mean for the community clinics that still operate from there.

No decision has yet been made as we now wish to check we have captured and responded to what this means for local people. This document will therefore tell you how you can have your say. It will also tell you how and when the decision will be made.

The work to improve the care and support we offer to Penwith residents is ongoing.

Delivering the right care and support for people living in Penwith

This document describes the work done to consider the role of Edward Hain Community Hospital in providing the right health and care support to people. This has involved us talking to people who live and work in Penwith.

Dr Neil Walden has worked as a local GP and is the clinical lead for this work. He helped us review Penwith services and the future of Edward Hain Community Hospital. He says that:

“Since January of 2019 it has been heartening to see the ideas and issues being brought to the health and care conversations on needs and services with our local stakeholders, staff and public.

“Building on previous workshops with local staff, volunteers, patients and carers we now feel we better understand people’s needs in our area.

“Some of the key messages include keeping care at home and close to home where safe to do so, as well as ensuring that if people need a stay in a bed their care is centred on their individual needs, wellbeing and ongoing independence, with the outcome where possible being a safe return to home.

“Your thoughts and comments will be gratefully received during this extended engagement. They will also help us to understand how the public can continue to be involved with local conversations. These conversations involve local health, care, voluntary sector and community teams and GPs in primary care. These teams work together in the Penwith Primary Care Network and the West Integrated Care Area. Your thoughts and comments will help these teams to continue to improve local services for our local communities.”

What is this report?

This report sets out our work to consider the future of Edward Hain Community Hospital taking into account all the other services available in the area. Lots of people have been involved in this project. They have given their time, views and ideas. These have helped us to understand local needs and how services are developing and responding to these. We called this group of people our ‘community stakeholder group’. They are people who live and work in the local area. The group also includes people from the hospital’s League of Friends, West Cornwall HealthWatch and people from patient participation groups. The group also includes local GPs, Cornwall and parish councillors, health and care and voluntary sector staff including staff who have worked in the hospital.

Together, we developed and evaluated potential options for use of the hospital. We discussed how each option could meet people’s health and care needs. We also discussed what role Edward Hain Community Hospital could have in delivering each option. Read more information about our engagement work.

Reviewing Edward Hain Community Hospital and its role to provide health and care

The outcome of this work tells us that the hospital is no longer able to provide health and care. This means that it is not suitable to re-open the 12 inpatient beds.

This also means it is not suitable to continue to deliver the podiatry and mental health clinics that run there.

While the outcome was clear, a decision has not been made yet.

Why is Edward Hain Community Hospital no longer able to provide health and care?

The evaluation found there to be lots of reasons why the hospital is no longer suitable for health and care provision.

Evaluation examples

• The hospital can only provide 12 beds. An independent clinical group called the South West Clinical Senate recommends that 12 beds is too small. The expert senate clinicians say that a minimum bed number for safe, efficient and reliable staffing is 16.
• The building was designed as a house and not a hospital. It has narrow corridors and small doorways. This means people on a bed can’t get out in a fire. A lot of money would be needed to make it safe in the event of a fire.
• The hospital site is within a residential area. We cannot do any building works to make it bigger.
• The wards are too small. They are below what the national guidelines are for good inpatient care. Having small rooms means that the space to move equipment and walk around the bed is reduced. This means people may be at risk of falling or tripping. Staff may also not be able to use equipment safely.
• The inside and outside of the hospital does not meet the standards of the disability act called the Equality Act. This means if you have mobility difficulties, need a stick or wheelchair or are frail it is hard to move in and around the hospital.
• The people most likely to need to use such a facility would be elderly and frail with a range of physical disabilities. The site would therefore not provide safe care.
• Modern inpatient care needs a greater standard of environment than the site can provide. Indeed staff who work there do not think the environment is appropriate to deliver good quality care.
• It would need 29 new nurses to support 12 beds.
• The layout of the building means it is unsuitable to care for people with dementia.
• There is no medical imaging such as an X-ray or CT scan. This means it cannot diagnose problems and people would need to go elsewhere.
• The site is too small. It cannot offer different types of services.
• The building is old and it costs a lot to maintain. This is not good value for money.
• The limitations of the age and structure of the site mean that it is not possible to address all of the concerns with the current building.

How we have worked together so far – introduction and background

We will now tell you a little bit more about this work.

Local health and care organisations have been working with people who live and work across Cornwall and the Isles of Scilly. We have been talking about how to improve the way services work together. This is important. It will help people receive the right care, at the right time, in the right place and from the right person.

As part of this work, we have been talking to 3 communities about the future of their community hospital. We started this work in 2019. The 3 hospitals are Edward Hain Community Hospital, St Ives; St Barnabas Community Hospital, Saltash; and Fowey Community Hospital. None of these hospitals have provided inpatient care for several years because of fire and safety concerns.

We have worked with each town and the nearby area separately. People who live in each area have met with local health and care staff. This has helped us to understand what local people need and how each of the 3 hospitals could meet these needs.

This has helped us to understand local needs, where services work well and where we can improve.

While this work has taken place, health and care teams have improved and extended the services available locally. This is part of our commitment to provide as much care as we can in people’s homes or local community. The more we work in this way, the more we can help people to remain independent and healthy. This is 1 of our priorities so we think about it all the time. It helps us to decide how future health and care needs can be met.

Read more information about our engagement work.

Who will make the final decision

NHS Kernow’s Governing Body will make the final decision at a meeting held in public. They will receive a report which summarises the work with people in St Ives and Penwith. It will reflect the feedback we receive by 4 November. They will use this information to make a final decision about the future of Edward Hain Community Hospital. The Governing Body includes a number of local GPs and lay people to ensure people are at the centre of our decision making. The Governing Body will meet on Tuesday 1 December 2020. Find out how to attend the December Governing Body meeting.