Is this the end for the small rural hospital?

June Barton, of the Hornsea Cottage Hospital League of Friends.
June Barton, of the Hornsea Cottage Hospital League of Friends.
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Plans to close three rural minor injury units in the region have caused a public outcry. Mike Waites reports on the campaign to safeguard the future of community care.

Hornsea’s hospital still holds a special place in the community nearly 100 years since it opened. Funded by public subscription, the building is a memorial to those who lost their lives in the Great War and was built by local people still coming to terms with the shattering impact of the conflict.

It treated its first patients in 1923 and down the years has provided a range of services to patients, much like many other small hospitals around the country. Campaigners successfully fought attempts a decade ago to close it and only four years ago it received more than £2m of investment for a major refurbishment.

Yet those same campaigners fear its future could again be in jeopardy under plans by NHS officials in the East Riding to close its minor injuries unit (MIU), as well as those in Withernsea and Driffield. June Barton, of Hornsea Cottage Hospital League of Friends, was at the vanguard of the fight to save the hospital 10 years ago and early this month was alongside local MP Graham Stuart to deliver to NHS chiefs a 10,000-strong petition opposing the closure plans.

She said: “It wasn’t built by the NHS – it was built by the people of the community which is why there are such strong emotions if the ‘powers that be’ try to close anything.In its heyday it was just like a major hospital is today.”

The unit’s closure would force people to travel 12 miles to Beverley or more than 15 miles to Bridlington for treatment.

“An awful lot of people retire to this area and a lot of them have to give up driving, there are a lot of families who don’t possess a car and people can’t afford taxis,” she said.

The proposed shutdown of the three units is part of moves by officials at NHS East Riding of Yorkshire Clinical Commissioning Group (CCG) to significantly reconfigure community care.

NHS officials say the units are unsustainable, dealing with between five and 10 patients a day in the 12 months to last March. The Hornsea unit saw 3,140 patients, with a further 2,800 treated at Withernsea. The unit at Driffield’s Alfred Bean Hospital dealt with nearly 7,500 casualties.

Instead they plan to open two or three urgent care centres in Goole, Beverley or Bridlington designed in part to take pressure off Hull Royal Infirmary’s hard-pressed A&E unit where attendances rose by a crippling 12 per cent in the three months to September compared with 2015.Their estimates suggest nearly 9,000 unnecessary A&E attendances from the East Riding could be avoided by the changes.

They say the centres will be better equipped to deal with non-life-threatening illnesses and injuries and they will also have improved staffing, preventing temporary closures of units due to shortages as happens sometimes now. Clinical staff will also deal with higher volumes of patients enabling them to retain and improve their skills.

The approach has won backing of senior doctors from the region’s clinical senate which said maintaining the existing six minor injuries units was not sustainable in the longer term, primarily due to the difficulties recruiting clinicians with the required skills to provide a consistent level of service, compounded by low usage.

Alongside the changes, 24 community beds mainly used by the elderly will be axed from Bridlington and Withernsea hospitals. Officials say care will instead be better tailored to patient needs through the provision of intensive rehabilitation and short-term care packages provided potentially at the East Riding Community Hospital in Beverley, in care homes or patients’ own homes. This will also be cheaper.

In Withernsea, people face losing both the minor injury unit and 12 remaining community beds from their hospital which originally had 22 when it became one of the first private finance initiative (PFI) projects to be completed in England nearly 20 years ago. Marian Mead, of Withernsea and District Health Forum, said people faced a 40-mile round trip to Hull’s infirmary or further to Beverley for urgent care if the changes went ahead.

“We’re out on a limb here. We really need someone to come out here and do that journey and they’ll realise how silly it is,” she said. “I can’t believe it’s happening – we’re just hoping they’re going to pause and rethink it. It’s a wonderful little hospital, with wonderful staff and everybody loves it – it’s desperately needed and we need the beds as well.”

What particularly angers campaigners is that of the four options being put to a public consultation due to end next month, none include creating urgent care centres at their hospitals because they do not represent “value for money”.

June Barton said: “The plan they’ve drawn up is flawed because they’ve come to these decisions before they’ve even consulted – they’re trying to impose their will on us. It does put a question mark over the hospital. If they take services away, what else are they going to take away? In that sense, the minor injury unit is pivotal to our hospital.”

Opposition to the plans has not just come from local people but also four GP practices in Holderness which have written to CCG officials calling for a rethink, pointing to the rurality of the area and its poor transport links amid official predictions some practices could expect to deal with 15 additional patients each week following the changes.

Family doctor Gina Palumbo, the CCG’s clinical chair, said the four options had been developed by the CCG, GPs, nurses and patient representatives, and GP practices had been involved.

“Our clinical aspiration is to provide a safe, high quality and consistent urgent care walk-in offering for everyone across the whole of the East Riding,” she said. “We have a number of options, which see consistent services open 16 hours a day, 365 days a year.

“Whilst it is recognised that some people may have to travel further to have their needs met, this would be in an urgent care centre one-stop shop that is well equipped and open longer hours, into the evening and at weekends, which will provide a better experience for patients.

“Ambulance crews would be able to take patients to these centres instead of A&E, if clinically appropriate, keeping them in the East Riding area and taking the pressure off A&E.

“This is not possible with the current MIUs due to inconsistent opening times and staff shortages often leading to temporary closure.”

NHS officials, grappling with financial pressures, rising demand from patients and new national care standards, will make a decision in March.

Campaigners will tomorrow meet in Beverley for the final of three demonstrations against the plans and are vowing to continue their fight hoping, according to June Barton, that “common sense will prevail”.