Stakeholder update on Governing Body decision

Summary of decision

We will work with local staff to move the community clinics to a safe and appropriate environment in St Ives. This means Edward Hain Community Hospital will close permanently. The site will no longer be used for health and care services.

The Governing Body’s decision comes after careful consideration of more than 18 months’ work with local people reviewing the use of Edward Hain Community Hospital. Each step and decision have been agreed with people from the local community, GPs and other health and care staff.

The Governing Body considered all feedback received. This included the results of an evaluation panel made up of people from the local community and health and care staff.

The Governing Body also considered community feedback during 4 weeks of extra engagement with the wider public of Penwith. They discussed proposals from Cornwall Council’s Health and Adult Social Care Overview and Scrutiny Committee.

What does the Governing Body decision mean?

The Governing Body’s decision means:

1. Inpatient beds at Edward Hain Community Hospital will not re-open. The hospital will close permanently. The site will no longer be used for health and care services.
2. Existing community clinics will be moved to a St Ives location.
3. Penwith Primary Care Network (PCN) will continue to develop the local model of care.
4. Penwith PCN will continue to involve the community through Penwith Integrated Care Forum.
5. We will offer our support to Penwith Integrated Care Forum to plan a commemoration with local people and the League of Friends. This will celebrate the role of Edward Hain Community Hospital and the Edward Hain family over the last century.
6. We will do a fresh review of our bedded services across Cornwall. This will consider service developments over recent years.
7. We will monitor the impact of the new 28 bed care home in Penzance. This is due to open in early 2021.

Feedback from the community

Between 7 October and midnight on 8 November we undertook an extra 4-week period of public engagement. This was approved by NHS Kernow Governing Body. This allowed local people to have their say. We also contacted the people who attend the community clinics at the hospital to seek their views. Read our engagement and communications report (PDF, 619 KB).

During the 4 weeks we asked the community for their feedback on the findings of our earlier work. We asked people to tell us how it might affect them if Edward Hain Community Hospital was not available. We asked what might help with their concerns. We also asked hospital clinic attendees how they would feel if the clinics moved elsewhere in St Ives.

The engagement feedback raised the same points we discussed with local people over the last 18 months.

The key points were:

• concerns about the lack of community hospital beds in Penwith
• travel time, cost and inconvenience to attend services
• ideas for other uses for Edward Hain Community Hospital
• requests to keep the building open as a hospital
• the importance of the building to the community and its cultural heritage
• wanting the community clinics to stay in St Ives

This reassured us that we have captured and considered all views.

Health and Adult Social Care Overview and Scrutiny Committee feedback

On Wednesday 25 November we presented our findings to Cornwall Council’s Health and Adult Social Care Overview and Scrutiny Committee. The committee were asked to scrutinise and feedback on the process. They were invited to comment on how the needs and experiences of local people have shaped the model of care in Penwith.

There was extensive debate during the meeting. Councillors supported of a move towards a more community-based model of care. They were also supportive of an enhanced service offer from West Cornwall Hospital. They expressed concern about the loss of reablement and rehabilitation beds in Penwith. This was particularly due to the new model of care still being in development. Members were concerned about some people receiving care in community hospital beds further from home. This is due to the pressure on beds. COVID-19 bed distancing measures have made this worse.

Ongoing transformation of out of hospital care

The Governing Body also considered the ongoing enhancement of out of hospital care since the Edward Hain community beds temporarily closed in 2016. There have been many changes. There are more services provided in the community to support people to remain well at home.

Recent service changes in west Cornwall

• West Cornwall Hospital becoming a centre of healthcare excellence with more ward-based rehabilitation.
• More west Cornwall residents discharged from the main hospital in Truro to West Cornwall Hospital.
• A new community assessment and treatment unit at West Cornwall Hospital. This unit is open all day, every day. It provides rapid assessment and treatment from a multi-professional team for the frail and elderly. These teams can help avoid hospital admissions.
• More local people being admitted directly to West Cornwall Hospital rather than Treliske Hospital in Truro.
• More discharges from West Cornwall Hospital to people’s homes instead of another hospital.
• 2 more beds at St Julia’s Hospice in Hayle.
• A neighbourhood hub in Hayle helping more people at the end of life to manage their symptoms at home.
• More community support workers in home-based reablement teams so more people are seen at home.
• Each GP practice has a social prescribing link worker to help people remain well and to connect to local support.
• More consultant geriatrician support in primary care means we see people more quickly.
• Advanced nurses working in the community 7 days a week delivering specialist care that used to happen in hospitals.
• Local GPs recruiting more physiotherapists and mental health practitioners.
• A new 28 bed care home in Penzance, due to open in January 2021. This will provide people discharged from hospital with care and support for up to 6 weeks. This is part of additional capacity for the winter period and will help us move to the new model of care. In the medium term, additional beds will provide much needed specialist dementia beds.

What happens now?

After careful consideration NHS Kernow’s Governing Body confirmed the recommendation that Edward Hain Community Hospital is not viable for health and care provision. The hospital will close permanently. We will work with local staff to move the community clinics to an appropriate environment in St Ives. We have shared the feedback from the clinic attendees with Cornwall Partnership NHS Foundation Trust (CFT). This will help CFT plan the best location for the clinics.

We will continue to develop a local model of care which will treat people closer or in their own homes. Penwith PCN will lead on this work. Local people will help shape this work through the Penwith Integrated Care Forum.

Cornwall Council’s Health and Adult Social Care Overview and Scrutiny Committee were concerned about access to beds in the area. We will review the number of beds needed across Cornwall considering service developments to provide more support in people’s homes. This has been speeded up by our response to the pandemic.

We will also consider how a new Penzance care home impacts on short term reablement support. The care home will provide 28 beds and will focus on people who are well enough to leave hospital but need extra support. The length of stay for individuals will be up to 6 weeks. This will be free. In the medium term these beds will deliver specialist dementia and complex care. This will increase bedded reablement capacity in the west of Cornwall. Community services will continue to improve. This addresses some of the committee’s concerns.

West Cornwall Hospital is already providing good access to hospital assessments and beds. There will be additional investment to build a new modern outpatient and urgent treatment centre at the hospital. This will mean more local people can attend the hospital. Progress will be monitored by the Penwith Integrated Care Forum.

People are concerned about travel time, cost and inconvenience to access services. Penwith PCN want to ensure there are more local services to reduce travel. As the services at West Cornwall Hospital and the services in people’s homes improve there will be less need to travel.

The transport support available will be promoted by the Penwith Integrated Care Forum. There are volunteer transport schemes including vehicles that can fit a wheelchair. There is a single telephone booking system that can help people book transport. There is also NHS funded transport for people with medical and financial requirements.

The Governing Body recognises the role played by Edward Hain Community Hospital. It has cared for people’s families for almost a century. Local people feel connected to the hospital due to its historical and cultural significance. The Governing Body decision about the future of the hospital in no way takes away from its role so far. However, NHS Kernow has a duty to supply healthcare in buildings which are suitable for 21st century care.

Edward Hain Community Hospital is the property of NHS Property Services. We will offer our support to the Penwith Integrated Care Forum to plan an appropriate commemoration with local people and the League of Friends. This will celebrate the role of Edward Hain Community Hospital and the Edward Hain family over the last century.

More information

If you have any questions about our engagement work you can email our engagement team.