Sidmouth GPs: ‘We’re gravely concerned at threat to hospital beds’

Copy of a letter to the chief officer of the Northern, Eastern and Western Devon Clinical Commissioning Group.

We would like to express the great concerns held by all GP partners at Sid Valley Practice about the proposed closure of beds at Sidmouth Victoria Hospital.

This hospital is a vital resource which helps enable us to deliver the high standard of care to our patients, which we hope to maintain in the future.

We are the only GP practice in Sidmouth, which is located 15 miles from the nearest acute hospital, with a large proportion of frail and elderly patients in comparison to other areas in the country. Access to the hospital helps us to manage our patients more effectively, in a setting closer to their homes, at times of acute illness.

The hospital also enables us to manage patients with long-term conditions who require regular day case medical care, for example, blood transfusions and intravenous infusions of drugs. This service is highly valued by patients and their relatives who may otherwise struggle to travel for treatment elsewhere.

Another vital role of the community hospital is to provide on-going medical care and rehabilitation for patients from the Royal Devon and Exeter Hospital who are not well enough to be cared for at home, but do not need the specialised facilities of the main acute hospital. For many patients this can prove to be a vital episode in their care, enabling a far more successful discharge home to take place.

As GPs we also work very closely with the palliative care team and frequently use the hospital to care for patients with terminal medical conditions. In this context the hospital is a vital resource for inpatient management of patients requiring admission for symptom control for a period of time during their illness, and for end-of-life care in situations when it may not be appropriate for the patient to be looked after at home.

In addition to the provision of these services, this year Sidmouth hospital has been granted approval by the General Medical Council to support a trainee doctor (Foundation Year 2) as a permanent member of the medical team. This has been an enormous asset, and has enabled us to care for patients with increasingly complex medical conditions. The F2 doctor works closely with the GPs who remain responsible for overall management of patients, and also works closely with the consultant physician specialising in elderly care medicine who visits the hospital for a weekly clinic and ward round. This F2 role is unique to Sidmouth hospital and has proved to be a great success in providing excellent medical care and continuity for patients. It is also a highly valuable training opportunity for doctors in training, and it would be deeply regrettable if this new position became withdrawn as a result of changes to the community hospital.

The above is by no means an exhaustive list of the services we provide at Sidmouth hospital, but gives some insight into the enormous variety and complexity of clinical work that is carried out, and the high level of commitment from members of staff and the dedicated team of nurses and general practitioners who all strive to provide the best possible care for patients in our community, in a setting close to home and family.

We appreciate that this is a time of financial crisis within the NHS and it is vital to provide cost-effective care. However, we are gravely concerned that closure of the hospital beds would leave a large void in our ability to care for patients appropriately. A likely consequence of this would be an increase in the number of acute admissions to the Royal Devon and Exeter Hospital and an increase in the duration of acute hospital admissions, which would cause a rise in the overall cost to the NHS for acute medical care.

There are proposals for providing alternative models of care in local communities. However, such models of care are yet to be agreed and will take time to test and establish. Moreover, there will always be patients who are too unwell to be cared for at home, even with enhanced care in the community, but who do not need all the facilities of the RD&E. These patients are best cared for in the community hospital, both for the sake of the patients and their relatives, and also because this is a more cost-effective than the alternative. Therefore, with the current resources we have in primary care, closure of Sidmouth hospital beds would leave a great void in our local medical services. Over time there will inevitably be continued increase in demand for healthcare and despite future alternative models of care in the community, we believe that there will always be a need for a community hospital service in Sidmouth.

For these reasons, general practitioners at Sid Valley Practice are strongly opposed to the proposed closure of beds at Sidmouth Victoria Hospital.

Dr Mike Slot; Dr Andrew Rosewarne; Dr Duncan Hall; Dr Nick Read; Dr Jo Kinder; Dr Ross Dell; Dr Louise Knight; Dr Sara Hadfield; Dr Joe Stych; Dr Jane Coop; Dr Amanda Beasley; Dr Sara Riley

Sid Valley Practice