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Report of the Airedale, Whafedale and Craven Clinical Commissioning

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Report of the Airedale, Whafedale and Craven Clinical Commissioning Report of the Airedale, Whafedale and Craven Clinical Commissioning Group to the meeting of the Health and Social Care Overview & Scrutiny Committee to be held on 12 December 2013 Subject: Coronation Hospital, Ilkley S Summary statement: The ownership and management of Ilkley Coronation Hospital, and responsibility for commissioning services, changed on 1 April 2013 following the government’s changes to the NHS. This report summarises the current status of the hospital from the perspective of all the local NHS organisations, confirms partner commitment to expanding services in Ilkley and discusses the future direction of integrated care in the Aire and Wharfe Valleys. Portfolio: Adult Services and Health Report Contact: Sue Pitkethly, Chief Operating Officer, Airedale, Wharfedale and Craven Clinical Commissioning Group Phone: (01274) 237317 E-mail: [email protected] Report to the Health and Social Care Overview & Scrutiny Committee 1. Summary Until 1 st April 2013, Coronation Hospital in Ilkley was the responsibility of NHS Airedale, Bradford and Leeds. Following the government’s reorganisation of the NHS landscape, the buildings and land on which the hospital is built transferred to the ownership of NHS Property Services Ltd, whilst the majority of patient services continue to be provided by Airedale NHS Foundation Trust (ANHSFT) and Bradford District Care Trust (BDCT) - both trusts pay rent to NHS Property Services Ltd for the use of the building. From 1 April 2013 Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG) took on responsibility for commissioning the majority of the services provided at the hospital. This report brings together the current status of the hospital from the perspective of these NHS organisations, confirms the commitment of the organisations to continue to develop services in Ilkley and discusses the future direction of integrated care in the Aire and Wharfe Valleys. 2. Background and Context 2.1 Ilkley Coronation Hospital Built in 1904, Coronation Hospital has been a landmark in the local community ever since. However it has long since outlived its original purpose with parts of the hospital showing clear fatigue and some areas in need of significant improvement and investment. In recent years there have been a number of proposals to develop the Coronation Hospital site. Most recently, in 2009, the former NHS Bradford and Airedale – the primary care trust (PCT) - conducted a formal public consultation on proposals for the expansion of community-based health and social care in Wharfedale including plans to invest in a new Coronation Community Hospital. A newly built Coronation Hospital - coupled with an increasingly important role supporting a bigger and better range of services in the community – was seen as a critical element of the PCT’s vision for modern, equitable, integrated health and social care services. People who responded to the consultation said they would prefer the hospital to remain close to the centre of Ilkley and suggested the kinds of services they would like to see provided at the hospital. There was an acknowledgement that the current site presented a number of challenges including excessive traffic congestion, lack of parking, poor public transport links, and the unsuitability of the compact site to house the range of services being suggested or to provide for future expansion. Four options were originally considered: redeveloping the existing site, re-providing the hospital on a new site, carrying out minor refurbishment of the existing hospital or complete closure. Whilst the preferred option was to rebuild on the existing site, an alternative site not previously consulted on became unexpectedly available. The PCT with the support of the Council’s Health Overview and Scrutiny Committee agreed to investigate the alternative site. Following investigation the PCT concluded that use of the existing site would be the most appropriate for any future developments in lIkley. This was confirmed at a meeting of the PCT’s Board in September 2010 where it agreed that a Wave 4 LIFT programme (value £3.3m) would be developed, incorporating Ilkley Coronation Hospital and two primary care premises, subject to assessment following publication of the government’s Comprehensive Spending Review that autumn. 2 Report to the Health and Social Care Overview and Scrutiny Committee The deteriorating national financial position including that of the NHS and the abolition of PCTs as part of the Health and Social Care Act implementation meant that the funding identified was no longer available. As a result the plan for the redevelopment of the hospital could not be progressed as they could not be financed. The plans to expand community-based health and social care in Wharfedale were, however, implemented. In June 2012 1 the Department of Health issued guidance to PCTs about the requirement to transfer property ownership by 31 March 2013 to successor bodies (either to NHS Property Services Ltd or to those NHS organisations who are the majority users of properties.) Following rigorous due diligence, Airedale NHS Foundation Trust - the majority user of the hospital - decided not to accept ownership of the hospital due to the extensive maintenance and refurbishment investment required. The Trust remains committed to developing services in Ilkey but with an oversubscribed capital budget including a significant backlog maintenance requirement for the Airedale General Hospital facility (which is over 40 years old) coupled with the organisational requirement to make 5% year on year efficiencies, is not in a position to take on the financial responsibility of running and maintaining Ilkley Coronation Hospital. On abolition of the PCT on the 31 st March 2013, Ilkley Coronation Hospital transferred to the ownership of NHS Property Services Ltd, where it remains today. 2.2 Changing nature of health care provision NHS England’s “A call to action”, sets out the future pressures from the increasing numbers of older people and those with long term conditions that threaten to overwhelm health and social care services. The resulting increase in demand with rising costs threatens the financial stability and sustainability of services. This means we will have to make fundamental changes to how we deliver and use health and care services in the future, by harnessing technology, integrating more services and putting people in charge of their well being. When Ilkley Coronation was built over a hundred years ago, the model of health and social care was very different to what can be provided today. Today there is a greater emphasis on self care, with people supported to better understand their long term conditions, and a shift to provide more care at home/closer to home wth services increasingly provided at home/in the community, enabled by technology. In response, health care providers including Airedale NHS Foundation Trust and Bradford District Care Trust are increasing their investment in community based integrated teams to better support patients in their own homes (including in nursing homes and residential care homes) and are using technology to increase support such as using telemedicine to connect patients in their own homes with health care professionals remotely. As a result providers are rethinking their use of and need for all buildings as they look to make the best use of physical and financial resources to meet increasing population demand. 1 DH Guidance on planning for property and estates transfers, June 2012, Gateway Reference 17722 3 Report to the Health and Social Care Overview and Scrutiny Committee Health and social care partners, through the local Transformation and Integration Group, are continuing to discuss how best to bring services together in a way that is patient centred and co-ordinated, with a view to further engaging with the public once proposals are fully developed. Any future proposals for Coronation Hospital would be the subject of public consultation. 3. Current situation 3.1 The estate Although it has been a landmark of the local community since it was built in 1904, Coronation Hospital has long since outlived its original purpose. At best, parts of the hospital show clear fatigue whilst some areas are in need of significant improvement. In its current state the hospital premises are not now suitable for providing health and social care in a modern environment and little can be done to reverse the situation. Ongoing maintenance to the estate is provided by the landlord, NHS Property Services Ltd who have plans to invest upwards of £300k in the next 18 months to keep the building operational. 3.2 Services currently provided at Coronation Hospital A range of community and outpatient services are provided at Coronation Hospital by Airedale NHS Foundation Trust and Bradford District Care Trust. These include a range of diagnostic procedures, outpatient clinics, assessment and rehabilitation services. A list of the current clinics operated by each Trust is attached (Appendix 1). Activity profiles for Airedale NHS Foundation Trust by service are attached (Appendix 2). These demonstrate that activity in 2012/13 is slightly more than the previous year. In addition to the activity delivered at Ilkley Coronation, both Trusts have also increased the provision of community based services in the Ilkley area. Both Trusts are reviewing how they provide care in the future. There is no doubt that more services could be delivered closer to home. The challenge is how to make best use of resources to sustain and ideally improve the patient experience. Whilst new service models are being developed, both Trusts have confirmed their commitment to continue to deliver services from Ilkley Coronation Hospital. 3.3 Commissioning of services Health services provided for people living in the Aire and Wharfe Valleys are commissioned by Airedale, Wharfedale and Craven Clinical Commissioning Group (CCG) and NHS England 2. Those services provided at Coronation Hospital are commissioned by the CCG from BDCT and ANHSFT who pay ‘rent’ to NHS Property Services Ltd for the space they use.
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