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NHS Kernow’s website closed on 30 June 2022. Visit the NHS Cornwall and Isles of Scilly Integrated Care Board website for information about our health and care services.

Saltash integrated community services FAQs

Questions raised during the conversations.

Volunteer drivers are needed. Could this be subsidised?

There is a patient transport service available for people who are unable to get to their NHS appointments. To be eligible, people must need support or assistance during the journey to their healthcare appointment. People who think they may qualify should phone 01872 252211 (Monday to Friday 8am to 8pm, weekends and bank holidays 9.30am to 5pm).

Volunteer Cornwall also runs a community transport schemeemail Volunteer Cornwall.

Community Enterprises PL12 hire out Hopper buses and run a regular link service on a Wednesday connecting people from Saltash with stores in Fore Street and at Carkeel. They also run day trips to local attractions. If you have any questions about the Hopper services, call 01752 848348 or pop into the Hub at 4 Fore Street, Saltash. You could also email the transport team.

Could more clinics be run by nurses, and could St Barnabas be used for this?

St Barnabas already runs several clinics. These are provided by staff from Cornwall Partnership NHS Foundation Trust (CFT) and consultants from University Hospitals Plymouth (UHP, formerly known as Derriford). The CFT clinics include nurse and therapy led clinics such as physiotherapy and memory clinics. The consultant-led clinics are supported by CFT healthcare assistants. In the 12 months from February 2017 to March 2018 there were about 3,000 clinic attendances. Most of these were for physiotherapy.

Use of the hospital for ongoing provision of clinics will be included in part of this review if the local stakeholders wish to explore this.

Is there money in the system to open St Barnabas to inpatients now?

St Barnabas is temporarily closed to inpatients. The 9 beds in St Barnabas are split over 2 floors separated by a mezzanine. For safety reasons, this restricts the type of people who could be treated as inpatients. The doorways and lift do not allow for transfer of people in a bed. This presents a safety concern from a fire evacuation point.

Staff from St Barnabas hospital were transferred to Liskeard hospital to support provision of safe staffing levels for the larger number of inpatient beds. This was due to staff recruitment challenges in Liskeard.

The backlog maintenance costs to look at some of the above environmental building concerns was estimated in 2016 as a minimum of £1.3 million. Even completion of these may not guarantee the site is fit for inpatient use.

NHS Property Services owns the building and is responsible for the backlog maintenance. NHS Property Services is unable to invest large sums of money into a building where there is lack of clarity on its role and future. This engagement process will determine the future role of St Barnabas Hospital.

All backlog maintenance requests for any local building will be subject to a prioritisation process.

All potential options for the future use of St Barnabas will be explored as part of this engagement process. Each option will then be evaluated against a list of agreed criteria.

Could a hub for activities be a new use for St Barnabas?

All potential options for the future use of St Barnabas will be explored as part of this process. Each option will then be evaluated against a list of agreed evaluation criteria.

Can St Barnabas be sold?

The hospital is owned by NHS Property Services and leased to CFT. CFT is the main provider of services in the hospital. The hospital can be sold if it is no longer required for the local health system.

Can the hospital be knocked down or extensions added at the back?

In theory yes, subject to planning permission, a requirement by the local health system to the proposal, and enough funding.

Can the use of the hospital be changed?

Initial legal searches show there are minimal constraints or restrictions on the hospital (such as covenants and listings). A more detailed assessment will be undertaken on any preferred option. The use can therefore be changed subject to planning permission, a requirement by the local health system to the proposal, and sufficient funding.

If St Barnabas is sold can the money be ring-fenced for Saltash?

Initial queries suggest the site is marketable. Monies generated from a sale are recirculated into the health economy on a needs basis. This is assessed nationally. Any funds received by NHS Property Services from a sale is invested back into the NHS by the Department of Health and Social Care. This is unless there is a business case to invest the sale proceeds in Cornwall. This business case will be submitted through the health and care partnership. The outcome will be determined nationally.

Could we have a 16 bed hospital?

All potential options for local services will be explored as part of this process. Each option will then be evaluated against an agreed list of criteria.

What are the waiting times for people in Derriford waiting to come back to Saltash?

We have requested data for this and will include as soon as possible.

What impact has the temporary closure of St Barnabas inpatient beds had on the wait times for people at Derriford?

We are awaiting data to show the waiting time for people in Derriford who live in the Saltash area.

Can delays from Derriford be lowered?

Teams from Saltash and Plymouth communicate daily to ensure every opportunity is made to improve current processes. The conversations include reviewing people and providing solutions to enable them to be discharged as soon as possible. Reducing delays is a priority.

CFT staff are now based in UHP, which aids these discussions. The focus from the CFT team working within UHP is to discharge people to their home with relevant support rather than to a community hospital bed.

Who controls where section 106 money is spent?

There has been a disconnect between health, planning, housing and development of accommodation with care needs. We expect that to change. Cornwall Council has recruited a strategic commissioner for accommodation with care. NHS Kernow and Cornwall Council have jointly funded a post to decide how section 106 monies can be spent. Conversations are already taking place about the Broadmoor housing development.

Could they bring the Derriford consultants to St Barnabas and run the outpatient clinics there?

There are already 4 clinics with consultants from UHP. The clinics are colorectal surgery, ear, nose and throat (ENT), gastroenterology, ophthalmology and urology. In 2018, approximately 500 people were seen. Increasing the consultant-led clinics would require more staff. All potential options for local services will be explored as part of this process. Each option will then be evaluated against an agreed list of criteria.

Could we have a purpose-built facility which could accommodate GPs, health and social care and provide convalescent beds?

All potential options for local services will be explored as part of this process. Each option will then be evaluated against an agreed list of criteria.

Could GP surgeries offer more services so people have more things done in the community before going to see the consultant in Derriford?

GPs are part of this engagement process. All potential options for local services will be explored as part of this process. Each option will then be evaluated against an agreed list of criteria.

Can we provide a community service for people who are frail entirely without hospital beds?

There are models around the country where people who are frail are managed in the community by multi-agency teams. The closest model to us is Torbay. Our local community teams have already visited to see what can be done in Cornwall.

Is there any sort of restrictive covenant on St Barnabas?

The initial legal search indicates there aren’t any covenants. We would have to make a business case to put to the health and social care system. This would then be decided nationally.

Is there different funding available for improvement?

The level of investment would depend on use. An inpatient unit would need high investment. The use as it is now (clinics) is not as much, due to no overnight stays. It is the same principle in terms of a single pot of money.

Is the upkeep being done?

There are 75 staff there running clinics. The building is currently fit for that purpose.

Can we get figures prior to 2015 when it was an out of hours rather than just 8am to 3pm to show a better picture of the usage?

It can’t be compared as a different service was run from St Barnabas than Liskeard. The proportion of people that went to Liskeard stayed the same.

Why wouldn’t the MIU at the GPs treat my son’s leg recently?

There are limitations, especially if an X-ray is needed. In the case of a child, they would almost certainly send on to Liskeard. It would be a clinical decision.

When is the transfusion and infusion unit going to start?

We need to have the right patient need and staff available for this. It wouldn’t be 7 days a week. It might not be cost effective. Acute care at home can do IV fluids/ antibiotics and some medications. We are trying to expand that in care homes to keep people out of Derriford. We are also looking at intermediate care and support services. The health and care partnership are investigating our current resources. They can look at how intermediate care in Cornwall can best work.

A person using the transfusion unit would spend 8 hours in a chair. Not many patients would be fit for that. The room could then not be used for anything else. The lift doesn’t take beds so upstairs rooms would not be suitable for patients. The benchmark must be clinical need and patient safety.

What happened when staff from St Barnabas moved to Liskeard Community Hospital?

Moving activity from St Barnabas to Liskeard made it easier for staffing. The average length of stay reduced from 21 to 14 days. Productivity in the locality improved. There was a reduced referral rate to manage the increased input in Liskeard. This also reduced pressure on Derriford.

The Home First Service with generic support workers (GSWs) meant many more people were seen for reablement at home (93 per month in addition to baseline reablement). There are 8 GSWs for each area.

Is adult social care involved with current discussions?

Adult social care representatives are on the project group and distribution list. They are also working with the health and care partnership.

What is extra care housing?

Extra care housing combines accommodation with care and support services. The care is like that provided by care at home services and can flex according to people’s needs.

The facilities and care provided will vary, but extra care housing schemes usually include:

  • self-contained adapted flats or bungalows
  • on-site care and support staff, providing personal care and domestic services
  • emergency alarms throughout the scheme, with 24-hour help available
  • communal facilities such as a lounge, dining area and garden

For more information visit Cornwall Council’s website.

Who owns extra care facilities?

It depends on the delivery of care. There can either be 2 providers, 1 providing the housing and 1 care, or 1 provider delivering both care and housing.

Who runs extra care housing? Is it NHS or private?

Extra care housing is not an NHS facility. It is housing with care.

Cornwall Council is in the process of establishing a strategic partnership to deliver extra care housing in Cornwall.

Read more about the strategic partnership.

Do residents pay to live in extra care housing or is it funded?

There are 3 elements to the cost of extra care housing:

  1. The cost of buying or renting your own home including utility bills.
  2. The service charges associated with your home for maintenance and any communal facilities.
  3. The cost of your personal care, lifestyle support and domestic support.

The amount you pay will vary depending on your situation and income. You may have to pay for all the costs, or you may be entitled to benefits to meet some or all of them. The intention is that both the rented units and the shared ownership units will be affordable.

How do we know what MIU services the GPs provide or where we should go for what services?

NHS Kernow’s help us help you campaign can help when people are deciding where to attend.

The following list gives guidance on some of the types of injuries and circumstances a GP minor injuries service can help with:

  • cuts, lacerations, abrasions
  • simple local infections
  • cellulitis within 5 days of an injury
  • simple fractures
  • animal and human bites
  • insect bites and stings
  • removal of foreign bodies
  • soft tissue injuries
  • epistaxis
  • minor head injuries
  • burns
  • bruises due to trauma
  • eye injuries

A GP minor injuries service can’t help with the following:

  • 999 call (unless attending crew speak directly to the GP)
  • any person who cannot be discharged home after treatment
  • any person with airway, breathing, circulatory or neurological compromise
  • actual or suspected overdose
  • accidental ingestion, poisoning, fume or smoke inhalation
  • blows to the head with loss of consciousness
  • sudden collapse or fall in a public place
  • penetrating eye injury
  • chemical, biological, or radioactive contamination injured patients
  • full thickness burns
  • burns caused by electric shock
  • partial thickness burns over 3 centimetres in diameter
  • new or unexpected bleeding from a body orifice if profuse
  • foreign bodies impacted in bodily orifices, especially in children
  • foreign bodies deeply embedded in tissues
  • trauma to hands, limbs or feet substantially affecting function
  • penetrating injuries to the head, to lacerating or penetrating injuries involving nerve, artery or tendon damage

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