Code BA A1 C A2 C1 A3 C2 A4 C3 A5 C4 A6 Freetext No. Preferred Option

Safe Effective Care Within a Budget: - Public response to feedback form Raw data

Key: Preferred Option/s Code All beds at NDDH B 2 community sites A Bideford and Holsworthy A1 NDDH + one other CH Site C Bideford and Ilfracombe A2 NDDH and Bideford C1 Bideford and South Molton A3 NDDH and Holsworthy C2 Holsworthy and South Molton A4 NDDH and Ilfracombe C3 Holsworthy and Ilfracombe A5 NDDH and South Molton C4 Ilfracombe and South Molton A6 Other freetext

No. Preferred Reasons (inc criteria) Ilfracombe Least Reason (inc Criteria) How well have Other options Do you understand Questions on home Anything else Staff (Y/N) option code solution preferr we explored home based care? based care ed the options (1 - option 4) code

1 C2 : NDDH could provide the Not B Option B: All beds at NDDH. Not well at all Your explored options are limited, some What you say cannot no I fear that the NHS is N best continuity of care included This is the least viable in that are non-viable, and all appears to be be believed. It is shortly going to for frail and elderly because it terms of access, with many based on short term expediency that is simply unworkable. almost self-destruct. patients following is not viable patients who would prefer to driven by the need to save £11m of the What will happen, There are too many admission and treatment in the be nearer to home and their NDHCT budget in this financial year. It despite all other factors that are for an acute condition. It 2015/2016 relatives. NDDH is an acute should be borne in mind that to isolate the protestations to the in play, a lot of which would provide ready financial hospital with a broad range hospital care needs for North Devon into a contrary, is that the you have not access to consultant year. of expertise in this area. It is single short term view is in my opinion elderly will be mentioned that expertise and diagnostics However it not well experienced in the flawed and will lead to disaster. In short it neglected, impact on your and reduce effects of should be care of post acute recovery will not work. There should have been inadequate care decisions. For trauma on elderly and strongly and rehabilitation, as is the provided a scoping study covering the plans that are not fit example how is the frail patients through considered case for all acute NHS immediate 1 - 5 years, medium term 5-10 for purpose will be trust paid for by way moving them to a to replace hospitals. Consultants and years and longer term 10 - 15 years needs produced, if at all. of treating and caring satellite site following the medical teams are more for the various communities. Instead it People will not for visitors in the their acute care. community geared and experienced in appears that short sited knee jerk reaction receive adequate end county? What is the Holsworthy community bed acute medical and trauma has led to tramline thinking. There seems to of life care. The cash flow situation hospital is able to provide allocation treatment. End of Life care in have been no "end goal" other than the incidence of with regard to these rehabilitation care at NDDH at NHS hospitals is generally drive to save money because of the current complaints will rise. payments? Is it not following stay in an acute the earliest poor, as is palliative care. political will to reduce current spending to When you can time for the NHS to bed at Exeter, Plymouth opportunity NDDH is no different. enable growth. I think a more robust and produce something start claiming or NDDH. Access to . NDDDH Palliative care and end of life substantial case could have been made to that is payment for self NDDH from the environs bed care requires an expertise of Government to avoid the current situation. understandable then inflicted injury i.e. around Holsworthy is occupancy its own and the extra burden Fundamentally all that is being achieved is I can start asking sports accidents or virtually impossible to the does not placed on acute medical the abandonment of satisfactory care of the questions. At the accidents at work majority of relatives due currently teams and their elderly in order to pay for re-educating a moment there is too and the longer term to no viable transport have any management would render generation who self inflict illness and injury little information on implications?. The links other than car. NHS community this option non-viable. and demand far too much without the which to base any use of GP surgeries staffing at Holsworthy is bed willingness to pay. practical questions. and medical centres 2 A Ilfracombe & Torrington The elderly & infirm Y Community Hospitals, cannot look after Beds necessary at top & elderly & infirm bottom of our area relatives. The cover provided looks ok on paper but does not work well in practice.

3 A4 Both isolated B Option B: Access issues 3 Do you have step up Y communities long way / step down from Barnstaple resource. How will you fill gap in cover availability on which so much of this relies.

4 C 4 N 5 A We feed a very large C Option C: Distance for S.M. 4 No Start living in the real N rural area. One of the patients. Lack of public world!! You will not largest in Devon. Paying transport from 6.45pm from be saving costs by nurses to travel around Barnstaple. Cost of travel. taking beds away this area + travel cost will Cost of paying nurses to from our community give you a far greater travel & travel times! Rural hospitals. Paying [illegible] than looking areas would have great nurses to travel etc. after them in one place. difficulty getting to you. will cost as much if Particular elderly people not more than having who don’t drive. them in place.

6 A4 (Holsworthy + South B Option B: Patients, families Impossible to answer as I am not an expert The increase in I couldn't see how to N Molton (or Ilfracombe) 1, have to travel excessively. If and don't understand the roles of all the community care staff fill this in online. I 3 a b c d, 5, 7 Holsworthy all community hospitals different management layers & didn't seem to have can't believe that is furthest from NDDH & close, care staff will also organisations involved. been costed. there are only 11 public transport is non spend a larger part of their Apologies if I missed carers in Holsworthy existent in the southern time travelling, to deliver it but only had a area as shown in the parishes in Torridge for care in the community. couple of hours to table. I know at least accessing NDDH (and read all the info. And 6 and I only know a getting back again!). heard about local tiny proportion of the Admission levels to consultation event population. We have Holsworthy are high. after it had already lost our happened, from the community hospital weekly newspaper. at Winsford, Halwill Junction, please let us have some Holsworthy beds. 7 A4 Difficulty for relatives to B 4 Care in the home will I nursed my late N visit if patients were in never work in this husband for the last N.D.D.H. This is approx 1 very rural area. It 12 months of his life - hour drive - 2014 the cost would be a disaster if he was upstairs and of hospital car from Holsworthy hospital bed ridden. I tried Holsworthy to Barnstaple closed. care workers but, was £31 - taxi would be they arrived when much more. they could often 3/4 - 1/2 to late. If I had not been able to do all the caring myself my husband would have been lying in soiled and wet pads for hours. My husband was lucky I was able to do the care. What about the partners who would be unable to?

8 A1 Holsworthy patients have B Option B: A lot of people I 4 Option 0 do nothing at all what happens I understand it but A lot of my family N a lot of frail people + find personally know when they then? putting this into members have died it hard to travel to were at the end of their life practice when nurses in Holsworthy Barnstaple. We have they wanted to die at are already pushed to hospital. The poor transport links. Holsworthy hospital, people their caseload. atmosphere is so Holsworthy hospital don't want to die miles away different. A lot more should be kept because from family at NDDH. friendly. By cutting it’s the furthest than the beds there will bed other hospitals. blocking , NDDH will never cope. Community staff will not cope with workload. 9 A4 (Holsworthy + South B Option B: Not enough beds How - people at The longhouse will N Molton (or Ilfracombe) now, access for family, lack present in work with the Holsworthy meets all of transport. Impact on local Holsworthy hospital hospital for the aspects of the criteria. communities. Impact on only stay until they benefit of patients, Ilfracombe, South Molton patients being kept outside are able to return carers and family - it are both rural. It is not their own community. home - what is the needs the hospital to only the people and their alternative? For the function effectively families living in the terminally ill, for all. towns, it is the people Holsworthy is a from outlying areas. haven for all the family. 10 A4 A great deal of money N/A B Option B: One site at NDDH, 4 I understand what A longer N has been raised for the distance to travel. you are proposing consultation, not hospice next to the but do not agree with over a holiday period, hospital and medical the proposals in this with more meetings centre in Holsworthy. It regard. on separate dates makes no logical sense to (rather than 3 on one then close the hospital day). there after. It is 30 miles to Barnstaple hospital a long way to visit, a long round trip. Similar distances apply to South Molton.

11 A4 The least worst option of B Option B: Transport, visiting, 4 Local - needs to have local services. I live 8 miles from End of life care is very N a disastrous chapter in not the place for end of life Holsworthy - a 16 close to my work. the way care is provided. care. mile round trip. This This area has a high They are both serving is a rural area - not proportion of elderly rural communities with everyone lives in couples / singles who older / vulnerable people towns. As always you have very few not able to get transport are putting an urban relatives in the area. to Barnstaple. Both are model into a rural They need to have 'newish' hospitals. setting. care in the local hospital not to die alone in N.D.D.H.

12 A4 They are the two most B Option B: Barnstaple is too 4 Could have consulted local doctors before Yes we understand N rural areas millage given far away and is heavily used the meeting. but do not believe it is from the towns not the and understaffed one ward is possible to make it furthest points in the used agency nurses at work in this rural area! And very little enormous cost. area. There is already public transport a shortage of care available. workers in Holsworthy.

13 Other (only Poor transport links to B Option B: NDDH explained in 4 Only Holsworthy. Yes I understand, but Just keep the hospital N Holsworthy NDDH. Elderly unable to Q2. I can't see this will beds at Holsworthy. listed) travel so far. They feel work effectively, We need them! isolation being far away people won't get the from family. care they deserve. "Money before care" that’s the problem as always. 14 A1 Local need. Almost non B 4 Most people in our area have had no idea How long will carers There is no point! N existent public transport that meetings were being held regarding have to visit on each and distance of travel the issues. We now have a situation where occasion. What from Holsworthy. End of options have been forced upon us. The happens to home life care in your own consultation process has been forced upon visits if the weather is home means many hours us having had no say before. bad and carers when people will be on cannot get around their own for long due to floods snow periods. frost ect.

15 A One being Holsworthy, B Option B: Naturally it is the 4 Make more use of the local hospitals by I don't think it will be To emphasise the N Holsworthy is nearly 30 wish of each community to having more consultant / our patient possible to put into strong feelings in miles from NDDH. It is keep their local hospital. appointments held there. action a successful Holsworthy to keep essential that we keep "home care" service our local hospital our local hospital for the by October, - if the open - which has benefit of patients & hospital closes, - good facilities. We visitors alike. especially facing the don't want the long winter months. journey to Barnstaple - re time, cost of travelling, stress of limited parking etc. tec.

16 C2 Holsworthy is a long way B Option B: The same answer 3 Holsworthy covers a Please listen to the N from Barnstaple, the as given at question 2. vast rural area it strong feelings of the facilities and staff are would be a huge task people in the exceptionally good at to be able to care for Holsworthy area. We Holsworthy we want to these patients in have such a good keep our hospital. outlying areas. hospital - please don't take it away from us!

17 A (Only Holsworthy listed). Cut back on B Option B: To far too travel, if 4 There were no answers given and question Not to have so many These meeting are N Because Holsworthy is things that patient is in hospital along were not answered. people in NDDH costing a lot of the furthest away from are time. walking around with money if a decision is NDDH it takes an hour unnecessar pieces of paper in made quickly that from Holsworthy to y. I.e.. So there hands doing would save a lot of NDDH and that’s only if many office nothing. Then would money. You would traffic is good. staff. be money to keep soon get your 11 our local hospitals million back. open. 18 A4 Both the above are B Option B: (NDDH beds) 4 Encourage current staff to progress up from I understand the hub Holsworthy do Y relatively new buildings Holsworthy is too far from HCA to registered nurses & beyond - look to idea, but there needs palliative best and and able to here. Staff from Holsworthy home before away. to be more offer excellent care accommodate palliative will not make this journey investigation into and support. North & relatives can stay when for shifts so why would the carers, physio, Devon hospice are time is precious. Both elderly residents of provisions, for elderly often full to bursting areas can accommodate Holsworthy. living alone and & this could help people from out of area. transport for people families in many Specialist nursing to access hubs and ways. Pensioners allowing relatives time to NDDH. can't afford £200 say goodbye beautiful round trip taxi fare. grounds and excellent People should not die care (CQC agree). in wards with curtains round, miles away from families many do not want to die at home but with support 24 hours!

19 Other (only Beds at two community 4 I understand your N Holsworthy hospitals. Holsworthy intentions, perhaps it listed) needs to stay because of works better in the isolations of the towns but when surrounding parishes. We looking after people are 36 miles from in the country, it Barnstaple, an hour or means a lot of more has to be allowed, travelling between for distance, speed patients on narrow restrictions and volume country lanes, taking of traffic, poor public much longer to get to transport connections. each one also these care workers are only paid the minimum wage, plus their millage. 20 A4 Both sites have poor B Option B: NDDH only. 3 No where has it shown other options other How safe, which you Everything these days N transport links to Increased use of this site than hospital closures. What about state is a priority, can is run by budgets Barnstaple. Ageing must reduce it's critical care reducing admin posts? patients be in their understandable in populations & rural capabilities. Not everyone own homes if they lots of ways. But outlying populations. has a car o access to public live on their own with surely front line Holsworthy has just had transport the elderly or / and only a carer coming services are the last an outreach centre built infirm would be penalised by in once a day for a things that should be on the site next to the not being local. Plus visitors limited period? Surely cut. Especially with hospital & it would seem to patients in hospital can't they would be "safer" an ageing population absolutely ludicrous in always use public transport in a hospital where that can live in the circumstances to & haven't always got access staff are, hopefully isolation. Look close the hospital. to a car. on duty 24 hours a towards cost cutting day no risk there of internally before the infirm falling & taking such drastic not being found for action in the NHS hours or scalding that has surely now themselves trying to forgotten its reason make a hot drink!! for being here! 21 A4 A) There are very obvious N/A B Option B: A) Access to NDDH 3 Everything is "funded driven"! We have a I do question the The North Devon N difficulties associated is extremely difficult for gap in funding of £11 million! I have no guarantee of "safe" Hospice outreach with a lengthy and many residents of the more doubt that the NEW Devon Clinical health care being centre named "The infrequent bus journey rural outlying towns and Commissioning group (NEW DCCG) works delivered in people's Long House" will form Holsworthy to villages. B) Car parking at to a formula. My overriding concern is that homes in those hopefully open in Barnstaple. A change is NDDH is currently very this formula is used time and time again. It borderline cases September 2015. It then required in order to difficult and would become is most probably outdated (a bit like Council where someone will enable patients travel from Barnstaple even worse when some Tax Bands!) and desperately requires an might really be better and their families in bus depot to NDDH and community hospitals are immediate and realistic update based upon off having 24 hour Holsworthy and the this additional leg forced to close. C) I contend the size of our area, the difficulties of protection in a surrounding area to increases the overall that community hospitals coping with a diminishing public transport community hospital access a range of journey to approximately are far less frenetic and system in a rural environment, the as opposed to specialist care and 1 hour 20 minutes present a much more increasing age of inhabitants (many of perhaps a single one support in cases of allowing for a relaxed environment that is whom retire to Devon and inevitably hour visit from a cancer and other life "connecting time staffed by happier require greater medical care than would nursing officer. limiting ailments. between bus services". personnel. This can only be younger folk), etc. Do we push hard Where is the "safety" Many folk in the For the elderly the good for the welfare of enough for increased funding - or push in the other 23 hours Holsworthy area have disabled, and for those inpatients (aiding a quicker hard enough for a realistic re-assessment of the day? "fought tooth and who do not have their recovery) and visitors alike. of the funding provided to us? Only this nail" and have own transport or cannot week the chancellor, George Osborne, has devoted considerable find someone to drive registered his concern at the apparent time and effort them, this is extremely "flight from city to countryside" as more through the demanding - if not nigh than 60,000 people a year are seen to move organisation and the impossible. Let us not to rural areas. The chancellor claims that support of fund forget, too, that the the lack of housing is a "scandal" and he raising events to help Holsworthy to Barnstaple wishes to ensure that children are not the Long House bus depot services forced out of villages because of the lack of achieve the (routes 58/71 finish affordable homes. The government wants necessary funding for 22 C The distance, and poor, Bideford because it's close to 3 Because of the distance would effect Yes Holsworthy hospital N with little or no transport Barnstaple (10 miles). whether appointments can be kept or (opened 23 years & with large population missed. ago) is to be this best of very elderly / old options - no contest! people. Ask any doctor in Devon & only or any local patient. 23 A If I have to Option A as B Option B: Not practical for 4 Yes - keep all hospitals open. Perhaps a few I understand it but do At the consultation N long as one of the two is far reaching communities as less chiefs and a few more Indians might be not agree. on 20th August 2015 Holsworthy, selfish we are here in Holsworthy & more practical. Perhaps more consultation we were told the maybe but that’s how I surrounding villages. with our doctors might have helped. hospital was not feel. Pity you don't have closing & the staff option D - leave well would still be alone & keep community employed so what hospitals unsitu. If it's not saving are you broken why fix it. making as care in the Holsworthy is a 70 mile home would involve round trip and some car travelling costs plus less patients do not even more concerns in the have a bus service from community would be some villages around needed to reach Holsworthy. distant patients.

24 A1 These hospitals are used Ilfracombe, South Molton & 3 I understand. How Both of my parents N mainly for the elderly. Barnstaple all too far to much will the extra have been nursed at People living in rural travel. nursing staff cost to Holsworthy hospital districts will find it almost visit all rural areas after treatment at impossible to get to and wouldn't it be Barnstaple and both Barnstaple, Bideford & just as cost effective said whilst they were South Molton using to keep the beds in well looked after at public transport. the hospital were Barnstaple, coming terminally ill people back to Holsworthy and the elderly can hospital was like be nursed 24 hours a coming home. Please day. don't take this away from the people of Holsworthy my mother after 6 week had to go into a nursing home where she never received the same attention that she did in Holsworthy hospital. 25 A4 Ideally keep them all. B 3 We understand it but We are totally against N Both are serving a large are not sure that it any form of rural area. In the case of will work in practice privatisation & think Holsworthy it's distance until you work closely that reserving a room from 3 major hospitals & with social services, in a private care the lack of public patients will be at home is the thin end transport. risk. of the wedge.

26 A4 Holsworthy & South B Option B: NDDH not easily 4 I feel strongly about N Molton are the furthest accessible from Holsworthy. the closure of away from Barnstaple. hospital beds in community hospitals. They are essential in every rural community. Caring in the home does not work. Too many elderly people are left alone for too long before a carer calls in they need the continuity of a hospital care in which to convalesce.

27 A4 Both sites are very N/A B Option B: This option does 2 Who will deliver the There is firm N accessible, good parking nothing to meet the needs of care to patients in evidence to support etc. Buildings are in good rural locations with little or their own home? the theory that order. Both have high no transport links, has no What level of training patients who have elderly population with advantages at all. will they have? How regular contact with limited transport will they be family and friends, Holsworthy is 30 miles recruited? Who will make a quicker form NDDH, South they be accountable recovery from illness. Molton 12 miles could to? This is much easier if serve large rural area. patients are hospitalised nearer to home ie community hospitals. 28 A4 Holsworthy is essential B Option B: Too far to travel 3 Maybe you should have consider expansion I understand what I wish we had had N choice, so rural and for patients and visitors. and development of community hospitals you are saying , but I access to the remote from DGH, Poor environment and poor and closure of NDDH. We have Derriford , have fears that it will documentation inadequate public road access. Staff not RD&E, Musgrove, Treliske and good things not provide before the meeting. transport low car familiar with elderly care going on at Bodmin NDDH is poorly situated comprehensive care Holsworthy ownership. Both hospital delivery. for the population it is supposed to serve. we do not have afternoon meeting building modern and enough quality social was packed, and ran flexible maybe care now. Leader of out of time, time Holsworthy manager DCC says health will could have been could advise SM manager be transferring funds saved if staff had not on staffing recruitment to DCC to cover the had to read out the and retention! I feel extra social care proposals first. I private sector needed. Your paper would also like to be accommodation says S/S will be assured that general availability is less investing resources waste of resources is pertinent, the public has into community being looked at, so a right to NHS care from health!!! Which is much history of new NHS staff at NHS staffing correct! We know computers / new ratios. I regard loss of that patients are nursing stations / South Molton renal currently sometimes excess meetings / services as a trapped in hospital duplication of simple disadvantage for beds because S/S tasks across sites. patients, not outweighed cannot put packages The hubs sound by space achieved, it in place. I'm also interesting - maybe offers better concerned about the they could facilitate environment and easier frequent use of the the taking of blood, road access. word "may" in your at present if my GP pink paper. [Holsworthy] needs 29 A Beds at two community B 4 Yes, total rubbish. Government figures, N hospitals. Only site listed predominantly rural was Holsworthy. Better areas are to serve the community experiencing net less travel miles. internal inward migration of more than 60,000 a year how will you ever cope by reducing beds. 30 A (Only Holsworthy listed). B My reasons are because of 4 Yes. What about the proposed 60,000 Yes I do understand Surely you should N Better serving the local the travel problems and people A YEAR that are meant to be moving how you intend to look at bed blocking. community and far far what I said earlier about the in to the local areas. How does that equate look after people Less beds, less fewer miles to travel. Long House being built. with closing hospital beds. Obviously you've living in towns. Just hospitals more bed Also the 'peoples' money not done your homework. remember they don't blocking…..common has been raised for the have a 70 mile sense. You ruined Long House (the hospice journey and they can many a local out reach unit) soon to also pop onto a bus community when be opened. Right next or take a taxi. Yes you local hospitals were door to Holsworthy certainly treat and closed in the early hospital. look after them 2000's. The winsford better. Just listen to hospital at Halwell. I the people who live state my case. in the rural areas, find out their views and problems not just taking accountants and managers points.

31 A4 Distance from NDDH, B Option B: Distance involved 4 N poor public transport, from Holsworthy and the use Holsworthy hospital of Acute beds unnecessarily, purpose built opened in increasing waiting lists. 1992. Facilities very good with plenty of scope for increasing and diversifying. 32 A4 We have lived in N/A B Option B: For the reasons set 2 Within your budget restrictions - no. Listening to people At the meeting I N Holsworthy for over 60 out in my response to who are receiving attended "sensible" years - we did not move question 2. care at home questions were here to retire. Our three services, the system answered well. I felt children moved away to appears to have there were a number further their careers, the some difficulties - eg of "personal" nearest being 60 miles. irregular timing of circumstances put We have no other visits, changes of forward which were relatives. Should one of personnel to name a not necessarily us need community couple - can they be relevant to the hospital facilities we overcome in some overall picture. would be alone for the way? spouse to visit and NDDH would be long and not easily reached by public transport, distance to travel on a regular basis haven't the criteria set out by you, our choice is simple to make! 33 A4 Good staff commitment. B Option B: Journey to NDDH 4 GP led community beds with rehab for Yes but not I was told by my GP I Both buildings in good too long from Holsworthy. elderly in local hospitals, with domestically convinced that the needed to go to A&E condition. Distance to No idea of local visits from OT and Physio for follow ups. demand for NDDH about 3 - NDDH from Holsworthy circumstances so to assess Problems more likely to be picked up domestically care will 3.30pm. No greater than reasonably. homes OT's and physio's will sooner. overwhelm nursing ambulance so had to Lots of older people in spend lots of time travelling staff and "care pay taxi £60 but most area one ward in NDDH and not working. assistants" will find were on school runs. will be overwhelmed by that they have things Taxi came from frail elderly and bed thrust upon them. Bideford about 5pm. blocking will occur. Also Discharged from communities would be holding ward asked involved and not feel that nurses about managers are centralising transport home, services for their own shrugged shoulders. benefit. Time about 10pm taxi called for me. Took me first to ATM to get money. Home late £100 lighter. No assessment - living alone - moved to Holsworthy 2 months earlier - no family nearer than Taunton. No apology. Had Pneumonia. Ideal if I was taken to the community hospital 34 C2 Of the options C I do not believe NHS N Holsworthy is the has enough care staff furthest away from to cover all those Barnstaple. From who will need it at Clawton or Ashwater it is home. This was nearly 40 miles to stated quite plainly at Barnstaple. South Molton a meeting of PPG of is nearer 10 miles from N Devon at a meeting Barnstaple. in Bickington by staff member of N Health when asked the question.

35 C2 I am a resident in B Option B: 2 hour round trip 3 Yes. N Holsworthy. Holsworthy to Barnstaple, from is the furthest Holsworthy if you have a car - community hospital away 3 hours by public transport from Barnstaple. at least. 36 A4 Because of distance from B Option B: What happens if 4 The humanitarian point of view. Reduce I have heard what Cottage hospitals N NDDH. Patients being there is a flu epidemic. How middle management staff and review and you say, it will not have always served discharged from main on earth do you imagine reduce wastage. work. Devon in this the county well, staff hospital need more than they will cope? area has an aging are second to none. 'home care' especially if community treat Their loss would be living alone possibly them with respect & tragic and many miles from understanding. devastating to the relatives. community.

37 As many community Closing Holsworthy hospital 4 You've been devious in your methods. You DO NOT have the You seem to N based hospital beds as beds for any reason would When did you advertise your intentions? infrastructure to concentrate on possible to be kept open. result in devastating Where did you advertise your intentions? nurse people at elderly. However More younger people are situations for terminally ill How did you advertise your intentions? home! there are many dying of cancer and need patients of ALL ages. Stop wasting money ie get equipment younger midage to be close to families returned sanitised and reused. Get people suffering from NDDH is far to far to visit equipment in smaller quantities. Get in cancer. on a regular basis. We house laundry. Hotel services stop sending are not all capable of out to privatised companies. In house - jobs caring at home. - wages.

38 A1 Holsworthy hospital is B Option B: Too far away not 4 No, because all Yes, my sister had N perfect in every way. the friendly atmosphere people do not wish to carers and they Especially for the older Holsworthy has. Far too busy be cared for at home. didn’t even know people so why change to have time for elderly They would rather go how to use a hoist. things. patients. in to Holsworthy Put on rubber gloves hospital for nursing before they got to care. the door. How friendly is that! 39 C2 Holsworthy is less B Option B: Patients and their 4 Why do the cuts all have to come from Care in the home is a I think you have N accessible to NDDH than home circumstances are not community hospitals. Reduction in some good idea in concentrated your Ilfracombe, Bideford and known personally to NDDH expenditure at NDDH eg reducing the principle, but almost attention on clinical / South Molton. Transport staff. Home care is often not numbers of expensive agency staff would unworkable here. medical care. The links from Holsworthy are appropriate for elderly help. Holsworthy hospital already has Even if the numbers psychological effect poor. Many patients in patients living alone and in discarded and loyal staff who live locally of nurses and care of being cared for in the Holsworthy geographical isolation. and know the community. workers could be the safe surroundings community are Visiting for relatives and increased (doubtful) of a hospital 24 hours geographically isolated. friends is too remote from the distances they a day cannot be An aging population is Holsworthy. would have to travel compared with home Holsworthy, lack of and the limited time visits from care places in the care homes with patients would workers. Too many and an influx of new be unacceptable. here live alone and in residents overloading the Although Holsworthy isolation from existing options. has care homes, beds neighbours. are not easily available there.

40 A1 I live in Holsworthy and NDDH because it is We want to keep our Like most people in N on many occasions have impossible for most people local hospital where this town we are had relatives as patients to make daily visits to sick & people feel close to concerned & very in this hospital. (I have at elderly family. Due to the family & friends upset at the thought this present time) it is long distance & expense of when ill. of losing our much impossible to travel to travelling so far loved & appreciated Barnstaple everyday & hospital. We cannot patients need to see allow this to happen. family.

41 A4 Holsworthy is remote - B Beds at NDDH only - patient 4 Look at leaving community hospitals and Yes, but this could I Geography of N poor public transport and fear going to Barnstaple and look at saving money through cutting admin feel cost as much as Holsworthy and a 60 mile round trip. We feel removed from their and red tape. retaining bed and I growing aging have a excellent hospital, families. don't think it will community - we need good local staff who work, it certainly more hospital beds often know the local does not work now! not less. patients. Local private care units, seem always full and are poorly equipped for short term nursing. 42 A4 Transport and B Option B: The extra influx of 4 You should have considered retaining all The only way you can N accessibility to NDDH patients would be more than four community hospitals. look after people from Holsworthy and the NDDH infrastructure effectively twenty South Molton is most could manage without major four hours a day is in difficult especially in the expenditure. hospital not in there winter months. own homes as residential and nursing homes in the Holsworthy area are usually full.

43 A1 Holsworthy has a huge N/A B Option B: NDDH is already 3 Do not cut any community hospitals at all! Ridiculously It is shameful that N catchment area. overcrowded and regularly optimistic to talk such a huge swathe Population in Bideford. "bed blocked". It is also far about home care etc. of rural England and Distance factor in too far away for easy visiting its population should Holsworthy and etc. be treated so badly surrounding villages. by its health authorities.

44 A (Only Holsworthy listed) I B Option B: Beds at NDDH - 4 As no one at meeting could confirm if this Care in the house I felt that the N am not happy with any how can they be called would make the relevant savings, I feel that does not work for all consultation was just option as it was clear at community beds unless they this decision has been made on no real also it takes a time to going through the meeting that no real serve the community which evidence at all and there for beds should get into place. motion so you can costing had taken place would be Barnstaple. They remain and other option explored, these Everything sounds tell us what you too see if this is the only are not community bed for meetings alone with venue hire staff etc good on paper the already know what options. I have chosen A the people who don't live in must have cost a lot of money. practicalities are very you are going to do. because I feel all that community - they are different. All questions communities need just hospital beds to there appeared to be community beds so this placed in an acute hospital. answered with was the best option of a complete your form bad lot and obviously I and send it in and to have to say were I would be told there is no go for my comments. question of losing our What's the point of giving hospital only the us this option when it beds was ridiculous was clearly stated at what is a hospital meeting that this was not with out beds?!! a real option. 45 A (Only Holsworthy listed) Bideford as it is only 9 miles 4 No, because being in Some areas of the N because we are 30 miles from Barnstaple where as a local hospital and NHS are wasting to away from Barnstaple. Holsworthy is another 20 being sent straight much money, it is no The other options are miles further away with a home is no the same wonder we are in less miles with better large catchment area. standard. Carers in dire straights. There transport links than the community are are to many chiefs Holsworthy. The nursing only allocated and not enough homes in this area minimum time to Indians. There always (Holsworthy) have not dress, feed etc for appear to be to many got enough trained staff. approximately a half people not doing very Please, please, we need an hour per visit, this much at the hospital, some beds in our does not help very whilst the doctors hospital. vulnerable people and nurses working who need extra help their socks off!! to recuperate before they then go home.

46 I don't think any of these 4 I do think it critically important to listen to It would be better to N options will work. The what the local communities are saying! And try and find the distances involved in people are very clear that what is being money needed for travelling are too great. proposed in any form will not work. keeping the The kind of care available community hospitals locally in the community open. Working with hospitals is far better the communities in than anything that is this would gain so found in the larger much good will and hospitals. probably a surprising amount of financial support! 47 A4 This combination serves B Option B: NDDH. It would be 3 There is a huge Terminally ill patients Y the local community a tragedy to loose shortfall in availability often prefer to be in best. Both hospitals are community beds especially of care staff to look hospital to die. This is modern builds & capacity for palliative care patients after people in their my direct experience. to increase beds if who wish to be near their own homes. Where 2 young mothers required. Residents of families. Worry that when will these staff come have ended their Holsworthy especially will NDDH is in escalation from? A lot of care days in community have great difficulties [illegible] beds will be packages will / do hospital recently and visiting elderly sick already filled & no room for require 4x day double their children (some relatives if beds go. GP admissions. up care, this will only primary age) have Community hospital & GP increase [illegible] been able to visit beds prevent a lot of community beds. freely before and acute admissions to after school. This NDDH. would not be possible if beds close. The Long House does NOT have beds only day care facilities. I do not understand why having a hospice (not beds) at Holsworthy is seen as a "weakness" surely it is a strength?!

48 A Accessibility & locality. N/A B Option B: Beds at NDDH. 2 Yes. No. N

49 A1 Holsworthy hospital is B 2 None. Not able to answer Everybody seems N needed because of the that question as I satisfied with wide range of the could not attend Holsworthy hospital outlying and rural areas it meeting. because of the covers and its easy wonderful care it accessibility for visiting provides to the relatives. community. 50 A4 If I had a choice I would B Option B: Distance to travel 4 Consultations with our local GP's would I fully understand and The catchment area N keep the status quo keep to see loved ones. have made me trust you a lot more. once again state you for Holsworthy all beds open. will never afford it community college Holsworthy is a vast rural and never recruit covers a vast area area with many people enough staff to run it. with thousands of having transport people 60% elderly problems and access to this alone is an NDDH would be very indicator of the area difficult, where beds in you need to cover. Holsworthy are essential Beds in this town is a for care and for those must. who want it end of life, care in the community you will never afford or recruit staff to run it.

51 C3 16 beds not A Option A: Other community 2 Yes. Car usage figures are N possible in hospitals even farther away irrelevant unless they time scale than NDDH. are for people aged but possible 60+. They are the in 2 to 3 ones who have to years. travel (most likely). Meantime Care at home would option B. be great if sufficiently trained people available but this would cost more in the long run.

52 A4 One in North Devon one B Option B: Distance, no new 4 Where are all the Y in Torridge both have beds - and beds being new staff coming lowest % of car owners. swallowed up when winter from what happens Holsworthy is the least pressures take effect. in very bad weather accessible. Holsworthy is when roads are the furthest from NDDH closed. South Molton the next. Holsworthy easiest to recruit and retain staff both are relatively modern.

53 C2 I am a resident of B Option B: It’s a 2 hour round 3 Yes. N Holsworthy. The trip from Holsworthy to community hospital in Barnstaple if travelling by car Holsworthy is the and at least 3 hours by furthest away from public transport or longer. Barnstaple. 54 None Wishful thinking! Back to the drawing N board. You should not even consider closing beds at Holsworthy hospital.

55 A4 Both units are modern. B Option B: For reasons stated 4 Cost cutting exercises to senior & How will you fund the It has been stated N Flexible and capable of previously. intermediate admin staff at NDDH trust. acquisition of nursing that patient recover accommodating any home beds. and rehabilitation can surge. Also length of been severely journey to NDDH by impacted when that public transport - poor person is remote toad links. from families + friends.

56 A4 Holsworthy is a must - B Option B: NDDH the 4 I understand what we We are 28 miles from N poor public transport, psychological impact of are being told but Barnstaple when aging population, remote being taken so far from have no confidence someone is unwell geographical location. home, family and friends in that the service the added stress of Excellent building and many cases impedes promised would be the journey is almost loyal staff in place. Local recovery. (I have many delivered. From too much to bear - private sector care examples of people experience care in particularly with the homes usually full to improving when moved back the home is very elderly. Family capacity and seem to Holsworthy). My own difficult to source and support of the uninterested in short mother begged me not to what is promised patient becomes term care. "let them take me back to rarely materialises much more difficult Barnstaple". and in my mothers at this distance. case too little, too late.

57 A4 South Molton has B Option B Centralisation of all Quite well Not enough information to know. My fear is that Our community is N modern facilities and services makes things very without beds in the continually eroded would keep a community impersonal and causes great community private with mass Hospital in each region. difficulties for transport at a care with associated centralisation. time when many elderly personal expense will Pyworthy village is people need to feel that prevail. Is this dying on its feet as sense of community that is correct? the pub closed, post rapidly disappearing from office closed, school our society. You also state closed, shop closed, that Bideford is increasingly no vicar, no under pressure because community spirit NDDH is over crowded. because people don't get together. 58 A5 Both sites furthest away Have a B Beds at NDDH Hospital. The Not well at all For Holsworthy looking at options in No...but do you? Don't bother with N from Barnstaple. word with actual ideal solution is if adjacent health authorities ie What is closing any of the Damien there has to be one is beds available at Stratton...or Okehampton both units...as you seem to Hirst if at NDDH to cover Bideford much more accessible from Holsworthy. put it forward as we money is a and South Molton, Then have to do this...but problem have Ilfracombe and you don't just get on Holsworthy. with caring for people...the government will come up with the cash.

59 A4 HOLSWORTHY IS B NORTH DEVON DISTRICT Not well at all WAISTED PAPERWORK AND FORM FILING HAVE YOU COUNTED N FURTHEST SITE FROM HOSPITAL BED BLOCKING THE COST? ARE YOU NDDH HOLSWORTHY HAPPENS NOW MORE SERIOUSLY AND SOUTH MOLTON PATIENTS CAN ONLY MAKE EXPECTING TO LOOK ARE RELATIVELY NEW THIS PROBLEM WORSE AFTER PEOPLE BUILDINGS CHEAPER BY RUNNING CARS AROUND TINY ROADS? HAVE YOU DRIVEN AROUND OUR VILLAGES?

60 A4 1. HOLSWORTHY is the B Not well at all COST CUTTING ON ADMIN PAPER AND WHERE IS THE N easiest to recruit and USELESS FORM FILLING MONEY COMING retain staff 2. FROM TO SEND HOLSWORTHY and S M STAFF AROUND THE are relatively modern COUNTRYSIDE TO buildings with a flexible CARE FOR PEOPLE IN layout. 3. HOLSWORTHY THE VILLAGES? HAVE and S M has some YOU COUNTED THE capacity for surge 4. COST OF CARE IN THE HOLSWORTHY is the COMMUNITY? IS furthest site from NDDH THIS CARE JUST NOT with the longest and least GOING TO HAPPEN? frequent bus services 5.HOLSWORTHY has lowest % of residents who are car owners 6. HOLSWORTHY has close links to North Devon Hospice services 61 A We need every existing n/a DO NOT CLOSE ANY MORE Not well at all You need to look again! You are leading us N community hospital bed! WARDS! back to the dark ages No infrastructure in and not caring about place. No public patients, who should transport to speak of. be your priority! Closure of local minor injury units. 999 response patchy! NDDH 40 miles by car approx. Exeter 40 miles by car approx. Plymouth 40 miles by car approx. ALL LOCAL COMMUNITY HOSPITALS NEED BEDS! I would like to be able to visit a loved one or friend, which would not be possible because of the 80 mile round trip.

62 A4 : Holsworthy is nearly 40 B Beds at NDDH are simply too Not well at all ? Yes, keep existing beds out in the local No, I do not ? I have personal N miles by road from the far away for the rural area communities where they belong understand how experience of the main hospital in currently served by removing Holsworthy excellence of care at Barnstaple, and the Long Holsworthy hospital hospital beds will in Holsworthy hospital House day centre is any way contribute and hope that it will about to open alongside. to "looking after" continue to provide people in the essential services for immediate area the people of the area for many years to come 63 None of the The above suggestions Not well at all The people who proposed this needs to N above have not been properly start thinking how can we relieve the major options thought out or costed. hospitals particularly A&E. Start thinking would go We have in the future an straight. 1) Minor ailments cough's colds anywhere to increasing ageing that people turn up at A&E with refer them meet the population, increasing to their GP. 2) Drunks. This is a self inflicted needs of the population. We already condition if they turn up at A&E charge North Devon have bed blocking, major them for police, ambulance and hospital population. hospitals on black alert care. 3) Sort out the GP services and For the time (can't take anymore funding so that they go out on home visits. being all the patients) cancelled 4) Sort out the ambulance service so that hospitals operations by the score. proper cover for the area is achieved. should Moving more and more remain. to a health care into he Future home is not a good idea. needs can How are you going to then be meet the medical needs accommodat of the community in bad ed without weather or when road too much closures through expense (ie accidents etc occurred. increase the bed allocation from 74 upwards).

64 A Site/s only at Holsworthy Not well at all The cost would be better to keep in one To get carers to N no public transport to get place with the best of staff and food and people at home may to Barnstaple. The staff you are a person not a number. have to travel many are the best you can wish miles apart and there for in a one local building is not that many help with other friends working hours in a coming to visit as Exeter, day. The carers will Barnstaple & Plymouth end up stressed out are about 40miles each not being able to do a way no public transport good job. to fit with visiting times. 65 A 2 community hospitals B We do not have anywhere to Yes - but there is a Y with bed either end of place terminally ill and very shortage of carers - the North Devon District frail that need more than and rarely more than area would aid inpatient nursing home care, cannot 1/3 complement of care of terminally ill and stay at home and should not DNs. The rapid very frail who are be in NDDH. access/single point of inappropriate to admit to care/RIC teams NDDH. response has recently been "call an ambulance" because they have no capacity!!

66 A4 Holsworthy town is 30 n/a B Although I agree it is good Not well at all I cannot understand I think you should N miles from Barnstaple medical practice to have how elderly widowed take time to many out lying villages patients where all patients like myself understand how vital are more. This isolates procedures are available the can be cared for at this area is. If patients from medical distance from Holsworthy is, night when alone and someone is care and causes great and lack of public transport, unwell. It would be discharged in the late stress and expense for is a big problem. very stressful and afternoon or later next of kin especially the detrimental to my there is no means for elderly. recovery. them to get home apart from an expensive taxi on the good will of a relative or neighbour. 67 A2 Both these hospitals are Previously A4 As far as (No Suggestions) is Not well at all Looked into the costings of turning offices You have not fully Home care is proving N best suited to serve the existing concerned Holsworthy and etc at Ilfracombe back into wards. costed keeping not to be working surrounding community wards have South Molton for the reason people in their and is putting much with the least amount of been of too far to travel. homes, with the more strain and travel. turned into equipment you put in expense on the offices etc. you have not taken family unit, which will Relocate into consideration have far reaching these and the health consequences in return them implications for home months and years to to bed trained family caring come. spaces. 24/7 which in the end There used puts even more strain to be in on the health service. excess of 20 beds. It is capable at moment of 12 so only 4 more will be needed.

68 A Concerned that if in B Quite well Yes, but concerned re N NDDH bed pressure for getting correct skill acute (esp in winter) mix of staff ready to would mean the beds be able to enhance were not free for right community teams. patients. Resulting in Very tight timescales. more pressure on May result in community services and increased pressure in 1° care (gp's etc). community and 1° care if suitable staff and resources not available - may then result in more emergency admissions/readmissions and more pressure on the beds in general. 69 A1 Holsworthy has the Ilfraco Easy access to Barnstaple. Not well at all Made savings in other directions. Where do you think Dr Beeching axed the N greatest need, it is a fairly mbe Other reasons as stated on you will get suitable railways to the West new purpose built page 12. carers enough to do Country to make hospital. There is room this? Certain people savings, the biggest for consultant interviews without relatives mistake ever made and treatment. The would be left alone and we have been distance to Barnstaple is after the carers have suffering ever since. very difficult for some gone. They would Please do not do the people and the support need to be in same. of family is vital. hospital.

70 A4/ None of Because of possible bed B Reasons given in Q1 Not well at all Yes, cutting down on admin and I understand but your I strongly disagree N the above as blocking and winter bureaucracy pressing far more funds from plans are inadequate with "Hospice" being all beds are alerts NDDH should not the Government. and already not a weak point in needed in be an option. Best option working. Today my Holsworthy's favour. community is A with Holsworthy and 86yr old neighbour North Devon Hospice hospitals. South Molton. Both who lives alone told chose to locate the Holsworthy and South me her catheter Long House adjacent Molton are very rural. came out. She to Holsworthy Holsworthy is the most phoned for help at Hospital because of remote from NDDH with 9.50pm and it was the towns and in poor transport links. It is past 2am when help order to have access modern with a highly arrived from to beds in dedicated staff. Barnstaple. Holsworthy Hospital Holsworthy is a fast for their patients. Do growing town, yet there not remove them! are pockets of poverty in the area.

71 A4 Holsworthy because of its B The smaller hospitals have Quite well I can see where you are coming from but You need to consider N distance from NDDH. more time and patience in Holsworthy is not the hospital beds to close weather in the Accessibility to hospital, the rehab of people and are we will be more isolated than we are now. winter. Our roads are only one bus would allow able to spend time talking to not always treated you to visit patients and relatives and explaining and people can be that would be 4 buses, 2 what is going on. cut off for days. Also changes, not acceptable the family units are for older or disabled not there like we people. Both hospitals used to have. We are newer built - less have a lot of retired upkeep. people moved here. 72 None of the We all need the hospital To close any of them at all. Not well at all Not possible as you Keep the hospitals N above. more not closing o them. Holsworthy like all of the said at the meeting open. others are needed. you have not got the care staff.

73 A4 Holsworthy is the B All beds at NDDH is not care Quite well I understand but Y furthest community closer to home. don't agree. hospital from NDDH. South Molton is the second furthest which would meet all the other community hospitals patients if they were closed. Holsworthy is far from easy to access from NDDH if you can even access it. There are only 5 buses from Barnstaple to Holsworthy a day and 6 from Holsworthy to Barnstaple. The road the bus travels on is horrible and with all the stops makes a very long journey. If elderly, frail patients need to be visited by relatives the bus journey is not really a good option for relatives to be able to transport clothes etc to NDDH. Holsworthy has very few taxis and getting access 74 A Holsworthy because of Bidefo Because they have excellent Not well at all 6 wks is really not enough time - end of life What is proposed is I believe that more N the distance and location rd public transport links to care is better placed at community not sufficient as there facilities could be to all major hospitals and NDDH but really no one hospitals than NDDH. One ward would not are not nearly provided at very poor public wants to see community be enough to cope if all beds were moved, enough nurses/carers Holsworthy transport link and cost of hospitals reduced but to see people would suffer more hardships. to cover the vast area Community Hospital taxis etc is very them used more. especially in the and more outpatient expensive. Plus Holsworthy clinics and possibly a Holsworthy is an catchment area. minor injuries unit excellent community could be explored. hospital. 75 C2 As a unit, Holsworthy B Centralising all of the Very well £11m is the shortfall, £5m is the figure for The concept of the 1) Keep people N scores well in many of community beds at one community support which leaves £6m wellbeing and health posted on the criteria checks. The location for such a large elsewhere to be found in savings. If that hub sounds and developments. 2) Set location of NDDH is 30 geographical area and rural was £10m, perhaps the community cut seems progressive out how the £11m miles from NDDH and community does not work. could be say £1m? but are there any shortfall is made up. gives a perfect base at Regional hubs are essential. assurances of 3) We are 6 months the bottom of the longevity? The physio into the financial year geographical chart. facility at Holsworthy and presumably as is superb and should no action has taken be extended and place , you are £5.5 improved. adrift already? 5) Get the CCG to the table!

76 Holsworthy Holsworthy Hospital the It will cost more to visit Not well at all A lot of the N very best of care but help people at home because of government do not at home or lonely and the area we live in the understand the live out of help from hospitals are at least 40miles distance we have to transport and also the away no transport to get travel to get to staff who are trying to there for visiting times and hospital. They have come and visit you when so we need Holsworthy buses and trains on the weather is bad the Hospital to stay open. hand to get to their patients are far apart so hospitals. we need to keep Holsworthy Hospital where you get the best of care from everyone. You can still see your own DR my DR is A. Howlett. 77 A4 Holsworthy too far a B What impact would this have Quite well Keep all 3 open, cutting back on agency and Yes If we loose our beds Y distance from NDDH. on other services at NDDH? middle management. at Holsworthy Ageing population - no Would this mean it would Hospital, would this public transport. South loose it's clinical operations? mean we could not Molton covers a very And the people of North have the renal unit remote area. Population. Devon having to go to Exeter from Derriford (Exmoor) extreme for routine operations. Hospital here at weather conditions. Holsworthy. I know they are interested in having beds at Holsworthy surely this is a very valuable opportunity not to be missed. Also ND Hospice Longhouse has just been built (with no patient beds). They built the longhouse on the understanding of beds and nursing support are available.

78 A1 We have very poor B NDDH already seems to be Quite well I worked at N transport links to NDDH overflowing and Holsworthy Holsworthy Hospital making it nearly is the furthest from for 11 years until my impossible for people to Barnstaple. retirement in 2013, travel there. so I have seen first hand how important it is for families to be able to visit regularly. This would be impossible if the patients were in NDDH with very poor transport links. 79 A3 or A4 These hospitals have To close community Not well at all Dementia patients are at most risk. I feel I understand this Y greater catchment for hospitals altogether would due to the nature of people not wanting or situation but don't dementia and rehab to be a catastrophe - we unable to understand their needs and agree due to lack of enable independent lives haven't got enough carers to general wellbeing. staff and unable to after hospital care. accommodate the areas now give these patients plus would they be getting full care in their full care and dignity that homes. Also a they are entitled to. relative could take care of mum and dad but they probably wouldn’t be able to commit as well as first intended.

80 C2 Holsworthy furthest from B Poor transport links. No Quite well N NDDH others nearer overflow facility. NDDH. Transport links from Holsworthy to NDDH are very poor.

81 A1 With the amount of new C With the extra traffic on the Not well at all Not when your mind is made up the way it You won't be able to You are making N build within rural roads and more to come it is. look after the people decisions that will communities we need will make it difficult to get to in rural areas because affect the health and Local Community from outlying villages and you do not have the lives of many elderly Hospitals to take away hamlets. All that will happen money or the staff to people who call the pressure from NDDH. is that you may have extra effectively create a Devon home. People who live in rural beds but you still have the Care Closer to Home areas are having their staff shortage. Perhaps it package. public transport cut so it would have been better to would be difficult for have had an in house family and friends to visit investigation and sort out Barnstaple Hospital. the real problems. To Local Hospitals will save summarise I would say that on emergency vehicles before you take away the being used to transport beds get the health care at patients to Barnstaple. home up and running. At the moment you do not have enough home health workers. I feel that you are making a mistake. 82 A NDDH is simply too far B It cannot cope. A&E will not Not well at all Having more local services. Money can be Yes. More patients to Will parking at NDDH The main problem N for anyone in the be able to cope. There will saved by contracting locally based NDDH which means a be expanded? If so at with A&E being full is Holsworthy area to travel not be enough beds. NDDH companies than regional or national ones. 3 hour round trip at what cost? How can because of the lack of too. In busy traffic it can cannot cope with winter NHS procurement is not providing value for busy times for people this possibly be social care beds that take 1 hour 30 mins to pressures now let alone with money and there is too much waste that from rural considered to be creates bed blocking the hospital. This has to the extra pressure from could be avoided with greater locally Holsworthy areas. better care for in a hospital. be by car as bus services community beds. devolved services. Extra fuel costs. patients and their are non existent. All local loved ones? nursing homes are full. Closing Holsworthy Hospital would be a disaster. NDDH A@E would be in an even bigger crisis as beds used for social care reasons would not be available. There are people that are well enough to leave NDDH wards but to sick to be at home. My father has had wonderful cancer treatment because of the services at NDDH, Derriford and Holsworthy that also cared for my wheelchair dependent mother whilst my father was 83 A1 Transport difficulties to B Transport issues in a very Quite well What about community beds in No there is no in N sites further away, rural Torridge area. Only surrounding areas & how this may impact depth explanation, I although the document close & accessible (weak on decision making e.g. Okehampton, worked as a talks of public transport points in criteria) if you live Stratton, Tiverton?, or are these already at community nurse from Bideford to NDDH & in Bideford, TORRIDGE IS capacity. until 8 years ago the town being most VERY RURAL, what about the when these services accessible & % of car rest of us? Includes villages were being reduced ownership in Bideford, like Hartland, Welcombe & & staff had to cover this ignores the position those not even living in a impossibly large of those living outside of village. Poor care of elderly geographical areas, Bideford, we live 15 miles in busy general hospitals. particularly out of south west of Bideford Lack of understanding of the hours. In recent but within Torridge. difficulties of the above by times home based There is no public those proposing this option. care has been transport to connect to No community hospital delivered in 15 min NDDH. By car it is a 50 inpatient beds in Torridge. slots with insufficient mile plus round trip from continuity. home to NDDH with parking difficulties & costs once it is reached. I had to do this on several occasions when my mother was ill, each time I was relieved when she was transferred to a community hospital which made visiting & supporting her much 84 A4 There should be a choice B we hear a lot about "no Quite well N for the patient, as in beds" and people being kept other countries, as to in A&E whilst a bed is where people would sought, also that the elderly rather be cared for. Some are bed blocking at NDDH, countries include the so surely NDDH needs all the patient in discussions beds it can muster. regarding their discharge from big hospital and onward care, some choosing home care, some community hospital and some nursing/residential care. Evidence already shows that loneliness in the elderly causes depression and mental health issues. Not everyone has relatives or friends to lean on. These vulnerable patients would often prefer to be cared for in a community hospital situation where they have support and company. If older people are lucky enough to have 85 C2 NDDH could provide the Not B This is the least viable in Not well at all Your explored options are limited, some What you say cannot I fear that the NHS is N best continuity of care included terms of access, with many that are non-viable, and all appears to be be believed. It is shortly going to for frail and elderly because it patients who would prefer to based on short term expediency that is simply unworkable. almost self-destruct. patients following is not viable be nearer to home and their driven by the need to save £11m of the What will happen, There are too many admission and treatment in the relatives. NDDH is an acute NDHCT budget in this financial year. It despite all other factors that are for an acute condition. It 2015/2016 hospital with a broad range should be borne in mind that to isolate the protestations to the in play, a lot of which would provide ready financial of expertise in this area. It is hospital care needs for North Devon into a contrary, is that the you have not access to consultant year. not well experienced in the single short term view is in my opinion elderly will be mentioned that expertise and diagnostics However it care of post acute recovery flawed and will lead to disaster. In short it neglected, impact on your and reduce effects of should be and rehabilitation, as is the will not work. There should have been inadequate care decisions. For trauma on elderly and strongly case for all acute NHS provided a scoping study covering the plans that are not fit example how is the frail patients through considered hospitals. Consultants and immediate 1 - 5 years, medium term 5-10 for purpose will be trust paid for by way moving them to a to replace medical teams are more years and longer term 10 - 15 years needs produced, if at all. of treating and caring satellite site following the geared and experienced in for the various communities. Instead it People will not for visitors in the their acute care. community acute medical and trauma appears that short sited knee jerk reaction receive adequate end county? What is the Holsworthy community bed treatment. End of Life care in has led to tramline thinking. There seems to of life care. The cash flow situation hospital is able to provide allocation NHS hospitals is generally have been no "end goal" other than the incidence of with regard to these rehabilitation care at NDDH at poor, as is palliative care. drive to save money because of the current complaints will rise. payments? Is it not following stay in an acute the earliest NDDH is no different. political will to reduce current spending to When you can time for the NHS to bed at Exeter, Plymouth opportunity Palliative care and end of life enable growth. I think a more robust and produce something start claiming or NDDH. Access to . NDDDH care requires an expertise of substantial case could have been made to that is payment for self NDDH from the environs bed its own and the extra burden Government to avoid the current situation. understandable then inflicted injury i.e. around Holsworthy is occupancy placed on acute medical Fundamentally all that is being achieved is I can start asking sports accidents or virtually impossible to the does not teams and their the abandonment of satisfactory care of the questions. At the accidents at work majority of relatives due currently management would render elderly in order to pay for re-educating a moment there is too and the longer term to no viable transport have any this option non-viable. generation who self inflict illness and injury little information on implications?. The links other than car. NHS community and demand far too much without the which to base any use of GP surgeries staffing at Holsworthy is bed willingness to pay. practical questions. and medical centres 86 C2 We strongly believe that We are not The evidence of how The Holsworthy area N the Holsworthy Hospital in a position the Trust is rolling cover a very large Beds should be kept to out the home care area and is remote open. Our additional comment provision was form a large hospital. preference is the Hospital on this interesting and it was I has poor road links at Ilfracombe, but we point as we good to hear that to NDDH which many were told that this is not were not progress is being people are reluctant viable, so we would opt given made in the to use. Many for the NDDH. We have sufficient Torrington and potential visitors to personal evidence that information Ilfracombe areas. patients would not there are a significant at the However, we are not be able to travel to number of people who meeting. convinced that this see relatives and are living alone. We are service has been friends, whilst they Holsworthy is ideally concerned working for long regularly do call in at situated to serve the that the enough to provide a Holsworthy surrounding community. various convincing case to Community hospital. Recruiting staff is not an options replace the vital These visits are so issue. Public transport is have not services which our therapeutic to the virtually non existent, been Community Hospital patients. The especially in the rural costed. provides. community made a villages and hamlets. significant financial Taxi’s are not available contribution to the for the trips to NDDH or Hospital when it was another Community built and the strong Hospital (Bideford and League of Friends NDDH). Many people, continues this especially the elderly do support. In addition not have access to a car. the Locals have made 87 C2 You pointed out, that We do need the main Not well at all Their far to much money spent on agency Yes I understand, it's N Holsworthy was 29.5 Hospital at Barnstable, but staff, and people walking around with clip ok keeping people in miles from NDDH yes we also need Holsworthy, boards their homes as long ,but I live at. Ashwater, years ago you closed as they not only got which is a another 6 Winsford at Halwill, The home help ,but their miles . We only have one reason for this was the cost, comes a time when bus a week, which only and the patients would go to ,family and home goes to Holsworthy for Holsworthy, where their help is not enough. A market day. The road to would be enough beds friend of mine father Barnstaple is narrow and provided. Surely to easy the went to Holsworthy winter time not at all bed blocking at NDDH it's Hospital for the last good seems to be sensible to keep 10 days of his life, he Holsworthy. had Wonderful care, and he saw a lot of his family and friend there, but if he had gone to Barnstaple it would not have had a good end. 88 A4 Holsworthy is very vital B Beds at NDDH would be no Not well at all I have no idea but money needs to be Not really I am sure Yes, my mother in N to the surrounding rural different than being in the prised out of central Gov. They always seem intentions are good law was in area. Home care is not district hospital to find cash for what they want to do. but if you live out in Holsworthy Hospital very easy in the villages the sticks you are at the end of her life and out in the country. very vulnerable when and Dad was able to People need to be near you are ill and alone. visit every day all day, their friends and family so were all the family when they are frail and able to pop in for five ill. A short visit from mins when in town. several people spread This wouldn't have over the day is possible been possible farther to Holsworthy hospital away. Other family but faced with an eighty members have been mile round trip to in for short times and Barnstaple (as we would the ability to visit is be in Ashwater)visits very welcome. would not happen so much. Please keep Holsworthy open, people in this area really need this facility.

89 A4 Both are relatively new Not well at all Yes and poorly N and serve the considered in my communities well opinion 90 A4 The best solution so that B One site at NDDH as this is at Quite well N people do not have to least an hours drive from travel too far to a Holsworthy and difficult to community hospital get to on public transport. particularly elderly people who need to attend the hospital or visit 91 C3 Ilfracombe already closed A1 You haven't told us the criteria for any Where are the N and will cost too much to closures! district nurses reopen and take too coming from? long. Bideford has the second largest catchment area and already providing other useful services. Holsworthy is too peripheral to close, as is South Molton. 92 C2 HOLSWORTHY IS THE A & B OPTION A & B WOULD BOTH Quite well TOO MUCH MONEY SPENTON AGENCY YES, I UNDERSTAND, HOLSWORTHY IS A N FURTHEST COMMUNITY UNSATISFACTORY, THE STAFF, MORE FORWARD THINKING BUT DON'T THINK IT GROWING TOWN HOSPITAL FROM THE POPULATION NEEDS A MAIN REQUIRED TO EASE THIS, AND TOO HIGHLY WILL BE AND IS LIKELY TO NDDH, AND HAS A HOSPITAL FOR ACUTE PAID ADMINISTRATORS OUT OF KEEPING SATISFACTORY,AND NEED ITS MODERN CATCHMENT ARE CASES, NEARER THAN WITH THE AREA AND PEOPLE THEY SHOULD CERTAINLY NOT AND WELL STAFFED COVERING REMOTE PLYMOUTH OR EXETER, BUT BE SERVING. PROGRESS FOR HOSPITAL MORE NOT DISTRICTS EVEN TO HAVE ONLY THE NDDH PATIENTS OS STAFF. LESS IN FUTURE, FURTHER FROM NDDH. WOULD INCREASE 'BED- ANECDOTELY HAVE WHAT IS THE POINT BLOCKING' AND MAKE BEEN TOLD THAT OF RAISING ALL THAT SERIOUS PROBLEMS FOR CONTRARY TO MONEY FOR THE VISITORS (NOT JUST REPORT AT MEETING LONGHOUSE APPEAL ELDERLY IN HOLSWORTHY , IF THE HOSPITAL RELATIVES)NEEDING TO THE SYSTEM IS NOT FALLS INTO DISUSE? I VISIT ON A LONGER TERM WORKING WELL AT WANT TO RE- BASIS WHO WOULD OFTEN TORRINGTON EMPHASISE HOW HAVE TRAVEL TIMES OVER VITAL IT IS TO 90 MINS EACH WAY. UNDERSTAND THE DIFFICULY OF TRAVELLING TO NDDH FOR SO MANY PEOPLE, PUBLIC TRANSPORT IS NOT AN OPTION, AND TAXIS WOULD BE PROHIBITIVELY EXPENSIVE. HOLSWORTHY WILL NOT GIVE UP ITS 93 A1 Location distance. No South South Molton because it has Not well at all I thought the intention was not to shut local I understand you What about people Yes I thought we N public transport for Molto Barnstaple and Tiverton not hospitals. We are all living to be so old that want people cared 10 miles or more were promised that accessibility at all. n so far away. They will have we cannot look after each other at home.in for at home, but from town who are in local hospital would access by bus which the our case we are 94 and 85 and cannot drive when the carer rural areas?. How are not be shut. people in the Holsworthy ourselves and long distances not an option. leaves the house it they to be cared for? area will not. Please note Strokes recently in one of us who cannot can be a long time Are you going to this. look after the other. Carers not available before they see provide a live in nurse either!! Local hospitals do help to prevent anyone else and a lot until the patient is on bed blocking in major hospitals while social can happen in that their feet. In the local services sort out things both financially and time, when people hospital one nurse availability. are not well. would monitor more that one patient and help them to get back on their feet? If you shut Holsworthy hospital where would the Holsworthy patients go. Living near the Devon Cornwall border we are not permitted to go to Launceston hospital which would be nearer. 94 A4 Local Hospital beds for B 1.Because this will be a loss Quite well Savings in other departments may not have Yes the proposal is But what about the I really think that N rural areas served by of service to the rural areas, been explored The new head of NHS care in the rural areas will the there has not been community hospitals are and whatever is claimed as England has stated his support for local community and this urban clients ,who enough time to essential. 1. Distance the merits of care in the hospitals so why is this not reflected in the can be very good but are easy to access, consider the options from services at community, they are no local policy? as mentioned above have preference over and to put forward a Barnstable Hospital 2. substitute for rural hospitals. it has its restrictions. the clients in the policy which is Local care at Holsworthy 2.This option will drastically Whether you will isolated areas financially viable and Hospital is first class why restrict friends and relatives have enough because it will be can be demonstrated change, my mother was to visit the patients in qualified staff and cheaper to service to the people as a extremely well looked hospital 3.If Barnstable has a funds to implement urban clients? workable plan to after by the hospital. 3. bed crisis at any time there is this policy is in serve the Care in the community a danger that the designated question. communities. has it's restrictions, with community beds will be the best intentions such used. 4. It can cost up to £40 services have their for a return trip to limitations, through Barnstable from Holsworthy distance, poor roads and but up to £50 from the access to isolated outlying areas. 5. I am a homesteads, time taken Trustee Director of to get to the clients. In Holsworthy Rural transport winter when there is and we run a volunteer car snow and ice on the road service and it would cost me access is only possible £45 if the service was using 4*4 vehicles. 4. available. 6. Transport for Access to the local those non drivers or with no hospital is so important private transport are very for friends and relatives restricted as there is a visiting, in many cases it dearth of public transport. 95 A4 Holsworthy serves a wide B Very poor transport links. Quite well N rural area (as does South Distance from communities Molten).Transport links served by Holsworthy. from the outlying villages are poor or non-existent making it difficult and expensive to reach Barnstaple or other community hospitals. The unit at Holsworthy is relatively new and has the capacity to expand. It is well supported and valued by the local community. Has a good fund raising history through the League of Friends. 96 A4 I feel that these are the B Not well at all Yes ? I would like to think Y two community hospitals that which ever two that are further away and community hospitals are required more due to that would hopefully distance to travel. be chosen will be looked into how to use other services like x ray appointments , out patient clinics , non emergency follow up appointments and other such things and utilised in a way that would reduce a lot of people having to travel to NDDH or RD &E for appointments that would take 10 minutes , it would reduce the carbon footprint, relieve the pressure of parking at busy times (which is now all the time). Lets utilise the fantastic staff and buildings that we 97 C CH do have a role but I B all the money into NDDH - Not well at all No In Torrington we N understand their financial non into the community! have lost our beds - limits. We need proper community care was cover and community good initially from geriatrician nurses but slowly it is reducing. Less funding, less nurses, nurses off due to stress.

98 A Holsworthy + 1. Distance B They are already Not well at all Holsworthy is a very N from NDDH to overcrowded and are always modern hospital with Holsworthy, poor roads stretching their budget a lot of space so beds which causes difficulty. could be kept open There are a high number and other services of people in Holsworthy provided, i.e. x-ray who use the hospital - instead of using like to be visited by NDDH resources family and friends Always lived in Did not Holsworthy and think understand - personally - Ilfracombe Obviously lot of time and money has gone the need for beds in was in the Very unfair to all into this but too much time before, we have cannot see how this please keep our 99 C2 Holsworthy running. B communities quite well very little time now. will work at all. hospital open N

You could have what about the very had better rural areas? For many why do I get the speakers around impression the Barnstaple would not work if answering the SM/Exmoor/villages decision has already red alert or as increased questions at the community care will been made and that these are areas where population puts more need sessions. If you be too sparse. It is the consultation is communities are too for acute beds. Please want sensible already difficult to just to say we spread out for effective remember needs of single comments you get district nurse help consulted fully? Lose help. Loneliness leads to people - they need help should have due to staff numbers - community beds and depression - community when it is needed, not had a ballpark that will only become increase bed blocking 100 A4 beds help avoid this. B several hours later figure available. more critical. at NDDH N 101 C4 Community hospitals B transport links to the Quite well leave well alone yes. Look after hols we feel this has all N beds close to home Holsworthy areas worthy people at been too quick least 35 miles away from their family and friends led to believe Ilfracombe not included. 102 A4 accessibility when living B More beds should be made Not well at all Yes, but care in I feel more beds N in a rural area for available not less in the CHs community is not the should be made relatives and friends. for an ageing population. answer when available in all CHs, Holsworthy is a new patients just this would relieve the hospital - less discharged from bed blocking in main maintenance - a quiet hospital especially hospitals. And pleasant site near to the when living alone or patients waiting for health centre. Poor with another elderly care packages or care transport links to other relative i.e. no night home places. Perhaps sites cover and could be wastage and on their own for up unnecessary staff to 14 hours a day. should be cut. Hospice due to open only as an advice service not with beds. 103 none community beds should this consultation is a waste travel times and N not be cut. Travel times of money and the money public transport and rurality should be should be spent on patients should be taken into taken into account account life exp should be taken into account. I believe this will get worse if community beds are closed. CCG is a layer of bureaucracy which is too expensive 104 A3 More people live in NDDH is too busy, too Not well at all why include NDDH? They are understaffed Yes, but cannot no confidence in this N surrounding areas of CHs. frightening place to visit and I have no confidence in the follow up understand how you decision-making. Very good staff at CHs. when on my own. Cannot visits at home if I am unwell. Several late can provide the Think you have Difficult to access NDDH, always rely on family to take visits by community nurses before - not service you say you already decided car parks often over-run. me. Have to visit renal unit their fault - too few staff! can. I cannot walk far now at SM and have used and have to rely on public Bideford. transport to get to appts

B 105 A4 Both of these Hospitals Not well at all yes, but you do not N are country hospitals have sufficient nurses with a lot of rural areas or carers to cope where transport is with our elderly limited. B Not closing any hospitals at all. Lot of houses populationbeing built in area, we also need MIU and end of life unit 106 A4 NDDH should never be an Not well at all no I don't My Mum died in N option. NDDH struggle to Holsworthy Hospital. cope with what they've got When we got the call now. They'll never cope with it only took us 5-10 the option you intend minutes to get there. If she had been at NDDH she would have died on her own. ABC You really need to look at the budgets again and what people really want 107 A4 Both hospitals are at the B Lack of transport possible Quite well Yes No N extremities of the stress on older patients catchment area. increasing cost to NHS to n/a look after extra patients. 108 A4 With reference to B Too far to travel for Quite well The new hospice which would, I Yes But is there enough Holsworthy hospital N Holsworthy relevant Holsworthy residents and understand, have been served by doctors carers to look after continues to serve points: 1,2,3 - lack of surrounding area. Too costly +/or staff from the hospital (Holsworthy). everyone in the the community public transport including in terms of transport and community. Can they extremely well. Staff taxis, cost of transport. 4 parking. Very distressing and drive to all these are caring and a,b,c,d,e 6,7 & 8 tiring for anyone having to patients in all provide as happy as increasing house make regular visits to weathers? What is possible atmosphere development. relative inpatient. the back up if this is for all patients. None not possible? of us wish to lose it.

n/a 109 B Better continuity of care n/a A1 No cover for east side of Quite well More or less - just cannot believe that it Y and access to diagnostics region - both hospitals miles think it is is efficient use of and specialist from Ilfracombe and South undeliverable with trained staff time to nursing/therapy. More Molton. present have them driving central for more people, staff/financial around the better transport links into restrictions. countryside thus NDDH. None of the dramatically reducing community hospitals tome spent with each would feel victimised. patient. Company is so important to elderly people living alone.

110 A4 Holsworthy meets n/a C Poor access from rural Quite well resource drugs from competitive suppliers. looks like a lot of No doubt you have N 1,2,5,7,8, and ranked Devon. The savings would keep smaller hospitals shuffling of paper, already decided what highest. Access and travel open. Look at top-heavy administrators for maybe the patient you intend to do and to NDDH are very redundancy. will be eventually be this is the ritual you difficult. Not everyone treated/cared for. have to perform. who is with Holsworthy doctors lives in Holsworthy. For many in St Giles in the Heath, add 12 miles to 29.8miles to reach NDDH.

111 C2 Holsworthy is very n/a A3 Not far from Barnstaple Very well Yes I understand Holsworthy people N isolated and a fair raised a lot of money distance from Barnstaple. for their hospital not Holsworthy is not a that long ago, now wealthy town and not they are raising everyone has a car to money for the travel to Barnstaple. hospice. Will this go the same way? 112 A3 Both South Molton and n/a B The hospital is struggling for Not well at all The cost of giving 24 hour care to patients The principle of care N Bideford have excellent beds now, there would not in the community (their homes) - the full in the home sounds buildings and facilities, be enough capacity for after care needed - would cost more than a good but patients why waste what we care. Also, patients feel community hospital stay. recovering from have? South Molton 'better' leaving the main surgery/strokes etc covers a wide area and hospital for continued care need far more visits with no beds at in community hospitals near per day would be Ilfracombe, is the only their families. inadequate for those option for North Devon. unable to get to the Bideford would be a hub toilet or needing for surrounding area in regular meals (ie that part of North Devon. diabetics). Such visits by carers have proved inadequate - listen to people who have experienced it ie, putting patients to bed at 6pm and not visiting them again until 11am the following day - visits very brief - not enough time for proper care such as a community hospital provides.

113 A4 Ability to recruit and n/a B Lack of ability to increase Not answered why not look at other ways at saving Not considering rural How can you cover Need to look at how Y keep staff - Holsworthy. beds - distance to travel. moving CCT working 7 days a week - more area and time it takes 24hr care at home? Trust and social Rural area. Bad transport Lack of continuity of care staff to expedite transfers out of NDDH. to travel from patient services work links. Holsworthy furthest (care closer to home). to patient. together - this needs away from NDDH. Owner to be more of cars down. conjoined. Ask staff at floor level for ideas. 114 A4 Both serve outlying n/a B Too far to travel, large Not well at all Not close any community hospitals. Not everyone lives in N communities. Ilfracombe number of elderly residents the town - this would and Bideford can easily with no transport - public not be practical access NDDH by public transport useless. bearing in mind the transport. distances the villages are from the town. 115 A4 1) Holsworthy is furthest n/a B 1) not a good idea to put all Quite well No and I don't think Have you tried using older people living N away from NDDH it 2) your eggs in one basket. 2) you really know your 'plans in place' alone can be very also has the lowest % of people get better quicker if either. Bad weather during floods, heavy proud and don't want residents who have a car not isolated in a large will result in people snow, ice? to make a fuss, often 3) Relatively modern hospital where difficult for being cut off from saying they are ok hospital 4) has some people to visit. 3) infection professional help no when they are not. If capacity for surge. South risk higher if larger groups of amount of 'plans in they are in Molton 1) Hospital built unwell people together. place' will stop community hospitals with flexible layout 2) people being able to they can be some capacity for surge get help. monitored more 3) car ownership 2nd closely. lowest 4) lots of elderly living alone.

116 A4 South Molton and n/a B Consultants cam easily visit Quite well Very hard to hear presenter at South You obviously expect traditional nursing N Holsworthy very rural patients in community Molton meeting. family or neighbours care is still provided areas, some extremely hospitals to provide care - in at South Molton - it is isolated. Therefore lack this day and age they hard to have of help, neighbours, work full time more someone in bed who limited. SM Hospital is a already. is unable to reach a solid & maintained drink on their table building with enthusiastic i.e. NDDH recently! staff. 117 C2 Holsworthy has the most n/a B My father, Aunty and cousin Very well You quote that N isolated community and all went to Holsworthy which Holsworthy is well little public transport meant they could be visited supplied with nursing unlike Bideford, by friends and family . homes with capacity Ilfracombe and to some Barnstaple is over 35miles but these beds are extent South Molton. It is from our community with no not empty. I a purpose built hospital public transport to access its personally bed and has facilities for services. A recovering or blocked at NDDH last people recovering from dying patient need to see year, when following operations which are all their families on a regular an accident, I on the level. basis which is impossible for couldn't go home many who cannot drive but until more mobile, friends would take them into they wouldn't send Holsworthy. me to Holsworthy (which only had 4 patients at the time) but took me 10 days to find me a bed in a residential home. 2 other people in my bay on the ward were also looking to go to Holsworthy. I was well treated at the home but it wasn't really suitable as it took two people to get me on a stair lift. 118 A4 Geographical spread, Privately A2 Both of elderly/poor Quite well Torrington not included in this - has that Seems plausible on Is there a pilot trial Recent day surgery at N building funded, construction with in-built issue been decided? The NDDH option has paper but will only be running? If not, why NDDH: unnecessary condition/flexibility, exemplary inflexibility. Inexplicable most to recommend it from facilities/staff as strong as its not? pain relief demographics, care training staffing problems. Proximity point of view, but 'local' health care weakest link. There is prescription we could homes, re-use of RD&E community to NDDH giving very poor provision like the 'cottage hospital' is still a a small number of not return, though renal services space. bed unit for coverage to other areas, potent psychological symbol for a positive demanding 'heart- unopened and Once established as the career such as Torrington, recuperative outcome. Getting section 106 sink' patients using besides having all the community bed sites, opportuniti Holsworthy, South Molton. money to build 5 bed customised units in up resources pain relief/anti- staffing difficulties would es in this Ilfracombe/Bideford from new. disproportionately - inflammatories be overcome with better country and what is the team advised. Sling worn stability/training/ career abroad. going to do with an for 4 hours in total - prospects. Reasonable Could be elderly patient, living could not be care home availability industry in absolute squalor, returned. It is these which could grow 'surge' leader - with no relatives? daily expenses that etc. could also need stringent be assessment to make combined savings. Why are the as a gallery parking fee non- for the payers not followed (very rich) up at NDDH? This Damien loses the tax payer Hurst. Sorry vast fortunes I do not annually that could know the go along way to previously benefit patients. explored solutions. 119 C2 Meets criteria 1,2,3,5,7,+ n/a B Centralising beds is the Quite well Who knows? There were no costings. Yes But where is the N 8. Holsworthy is opposite of care in the money coming from? geographically remote, community. Greater At the consultation spare capacity, routine likelihood of bed blocking at meeting you were treatment could be NDDH. Remoteness from not able to give any transferred from NDDH. Holsworthy/Bude - 2 hour figures. What would Combination of health round trip and £100 plus be the savings from centre, longhouse and taxi. the options given? hospital can relieve How much extra pressure on NDDH. would be spent on care in the community? You had no answers. How are we supposed to make an informed decision? 120 A4 Both are relatively new n/a B This is too centralised an Not well at all It would have helped if you'd really listened Who is ultimately This has taken far too N units. I believe both on option leaving all the other to what people had to say! Your answers going to pay for this? long! I believe it is one level and serving towns folk no option but to were to well prepared. If you discharge also (like many other isolated communities in travel to Barnstaple. Elderly people early back people) just a paper as much that the area people can't do this it is too home and they need exercise! At the last covered covers outlying stressful. long term care, early meeting before the farming area. discharge pays for 6 public consultation - weeks care which people were even effectively shovels off being asked to make NDHT problem of choices without the funding onto DCC relevant data! social care and the council tax payer!

121 A I prefer South Molton n/a B We need small hospitals for N hospital. My husband age getting better before going nearly 87, I am 85 and if home. South Molton is closed I should not be able to visit him. It is lovely little hospital and very well looked after and staff are wonderful. We are 8 miles from South Molton.

122 A South Molton - we are a n/a B Living in South Molton area if Not well at all It's ok having a Have you considered N very rural area so we someone from molland community hospital S.Molton is a very need to keep S.Molton Anstey way has relatives in in town for people in rural area in bad hospital open, even if Barnstaple and no relatives the town not for weather (snow) only given 16 beds. there is only one bus a week country areas, villages get cut off. If coming to South Molton on transport very poor you have a patient Thursdays for only a few in some areas so local needing care in the hours. hospital (S.Molton) home how do you get needs to be kept to them? Are they open. just left? A1 Bideford has the best n/a B When there is winter surge Not well at all In view of the closure of several care homes The plans sound well Will you have enough Elderly spouses will N resources and is vital to there will not be enough day care services should be initiated to on paper but may be staff to cope? have difficulty caring the local community. inpatient beds to cope with facilitate therapy sessions for more patients difficult to put into for their frail, Holsworthy because of the demand throughout in one place. practice, i.e. the disabled partner and the distance from North Devon. distance carers and will need a lot of Barnstaple and poor therapists will have support. Will you transport links. to travel and volume need agency care of traffic in the workers to provide summer months. this support?

123 124 C2 S.M, Bid & Ilf all have a n/a A5 As a non driver I would find Quite well Care in the What happens in bad N regular bus service to it very difficult if not community is fine as weather when a NDDH, Holsworthy does impossible to visit a relative. long as it runs carer cannot get to not. As we live in South smoothly and all the patient? We live Molton hopefully we agencies work on the edge of would be sent to together. Exmoor and the Barnstaple! weather can be very bad. 125 A4 Both cover very rural n/a B Lack of space and car Quite well I gather the CCG have wasted more money. Care packages - they If less money was N areas. South Molton has parking facilities. Wouldn't If this hadn't have happened these sound good and wasted on the best hospital ratings give the same care and consultations would not be necessary. people try their best admin/management, and space to expand. knowledge that a local but there are just too NHS bed closures Care packages seem to hospital can provide. many bad reports for wouldn't be have been pressured to it to be seen working necessary. I believe often too lengthy to set efficiently. that anyone new to up and inefficient when our country should in place i.e. early and late pay in to the system visit times. for 5 years before getting the benefit of our wonderful free NHS system.

126 A4 Maintains beds in local n/a B All beds in NDDH would have Quite well Yes Not convinced care in N hospitals. Quality of S.M to replace urgently needed the home can be building. Post-op beds for other reasons. provided to a high recovery and standard. Present rehabilitation close to anecdotal evidence home. No other state run not re-assuring. facility in S.M. 127 A4 S.Molton hospital - n/a B Would mean fewer beds for Quite well Yes. However the You say cost is not N modern building & nursing at NDDH - bed care in the part of your excellent facilities. blocking would be increased. community is not considerations Importance of palliative Patients would be taken out always suitable and however you start by care & end of life care of their home environment. the number of carers saying you need to having given at S.Molton of nursing staff would save money but are already. Important for need to increase unable to give any family visiting - especially greatly. savings costed for older relatives. Loss of these options. Beech House in S.Molton has meant fewer places available in care home.

128 A4 NDDH is too far from N/A B See section 2. My daughter 3 The consultation process is very short. I feel How will the young It is unfair that staff N Holsworthy. My daughter while looked after superbly it is unlikely that all these forms will be be managed who are who have chosen to with multiple injuries was in Derriford quickly went looked at and taken notice of for unbiased not suitable for care work in a community not looked after downhill in NDDH due to lack report to be produced in the time. There at home and may not hospital should be satisfactorily in NDDH but of functioning equipment were many questions which were unasked go into a nursing "shunted" to other was very well cared for but soon improved in the due to lack of time last night. home as they are jobs but there has during 15 weeks bed rest community hospital with the only registered for not been any talk of in a community hospital. right equipment and good the elderly. All redundancy money South Molton services nurses. nursing homes in this being paid. Exmoor area good split of area are full - where beds. will anyone requiring nursing care be managed?

129 A (Only Holsworthy listed) N/A B Beds at NDDH the hospital is 4 The facilities at the Long House could all You say you are going You said they are not N The distance from already overcrowded, their have been included in the Holsworthy to look after people closing the hospital Holsworthy to NDDH. budget is always stretched. hospital. in their own homes but closing the beds Poor roads but there is not how many hospitals inconvenience for enough carers in the do you know that visiting. Holsworthy is a town to do this! don't have any beds big catchment area, the People will suffer in them! Why didn't hospital is necessary for because of this. you send to the local people. meetings someone from the CCG? But you sent the engineer instead. 130 A4 Holsworthy has hospice N/A Ilfraco Ilfracombe - it would cost 2 Yes I can see the logic The concept of care N links. South Molton has mbe too much to upgrade this in your proposals. in the home is great, the renal unit site to hospital. Money that is not RD&E have set up my concern is how expand into day care & available in your budget. care for patients are we as the trust outpatients. being discharged going to cope with following hip surgery. the extra expenditure Worth exploring how of travel, staffing, they have done it. equipment etc to give this service.

131 A4 These two areas are N/A B 4 Not closing community hospitals but Yes but feel services country fed with expanding to accommodate hospice would be too transport not so readily facilities where local people can have stretched to cope available. friends & family visit more easily and also a with demand this minor injuries dept brought back. being a retirement area. 132 None None keep them all open. Read above B More beds at NDDH 4 Keep all community hospitals fully open, it Based on natural Keep all community N Holsworthy needs its travelling problems for older seems more sensible and realistic. overview its not hospitals open I fear hospital. Looking after people. realistic. you have made up our community. your own mind anyway.

133 None The process is flawed not N/A n/a Any of the above. 4 You should invest up North Devon N consistent, rushed not front to make the Healthcare are joined up with the CCG, savings later. backward looking local medics and the and not looking at community. best practice across the country. 134 A N/A B Because of the distance 4 Yes, but I don't think We need a hospital in N factor and the time it takes it is effective. In my Holsworthy. I attend to get to NDDH as well as the experience liaison the Q.E. in cost of travel for loved ones. between hospital & Birmingham every medical centre / month and Exeter district nurses every month in the doesn’t happen. I future on going care have never known a could be taken by G.P. to visit for at Holsworthy. We also least 2 years. During live in a socially my 4 month deprived area with a recuperation from poor transport minor surgery I never structure people saw a nurse or Dr at struggle to attend home. and to visit. 135 C3 Ilfracombe and NDDH You can A4 3 Maybe. Yes. No. N option C and A if have a split Ilfracombe is included. ward. Use High deprivation, poor the kitchen transport. NDDH is which is not central easy to get to used for from Ilfracombe. beds.

136 None This exercise is a My only All 3 All 3 of your options see my 4 Tell the truth 99.9% of Ilfracombe people The laugh a minute If you won't give us a complete con all spin and choice is a reasons, overleaf. want a 16/20 bed Ilfracombe hospital. The care in the 16/20 Ilfracombe bed lies. 16 bed NHS stop running this con exercise where community driven by hospital and you cottage all spin, liars and taking the public for mugs. the latest tory con bill won't !!!! Just shut hospital for it will end up like the up & SOD OFF. Ilfracombe. last tory scam for Cut the people with mental wages & health problems. expenses of Most roam the NHS staff to streets fail to take maximum their drugs and 100 of £50 000 plus members of the per year. public being Stop murdered every year spending by care in the 3.3 billion community nut cases on bank, thanks. agency and foreign staff. £11 000 for a locum Dr to work a 4 day weekend is a classical example of the NHS 137 Option D. Keep beds in all N/A 4 Patients will naturally want to stop in their Take a hard look at N outlying hospitals. This is own homes as long as possibly and only go non productive staff, more suitable for them. to hospital when they need full time care. many are highly paid Local nurses are and train more young available. nursing staff to save employing expensive agency staff.

138 A NDDH bed pressures. N/A B 4 Who will look after Y Rural community need the patients community beds. medically. 139 A4 Both relatively new N/A B All beds at NDDH - Too far 4 Originally told the community hospital Care closer to home FACT - patients Y buildings with ability to for community care. No would have inpatients or become a hub. works for some admitted to hospital adapt to change and suitable transport - rehab Why not have both. Holsworthy already people some homes community hospitals cater for surge. patients respond well to lots does. Day cases, clinics (we could expand) are just not suitable when no emergency Holsworthy very rural 30, of visitors if home not and keep inpatients. for pts needs. care can be found 40, 50 miles always from possible. Palliative care Adaptions / (this happens quite Barnstaple, Plymouth & patients and relatives equipment takes often). Palliative care Exeter respectively. Too appreciate surrounding and time. Lack of carers patients & families far to consider ability to adapt to specific available even for need somewhere community care in needs. emergencies. Not close for patient be NDDH. enough NH places able to die with available - we have dignity (choice) patients waiting for (preferred place of placement. death). Long term rehab (young patients) need regular visitors family / children).

140 A Holsworthy and Bideford N/A B Patient centred care surely 4 Leave community hospitals alone - create Private sector are I am a student nurse Y or South Molton. includes the need to be apprenticeship nursing positions to tackle struggling to provide and am already Holsworthy is a must it is nearer home in a quieter and staffing issues. Appreciate the patient's beds and placements, deeply concerned the furthest one and is a more relaxed environment, right to choose where to die, understand there are not enough about the state of the life line to rural where patient limitation due the need for complex patients to need to be HCA's or nurses in NHS and work life. communities. Due to its to time constraints are nearer home. Consider having to die alone communities to care The closing of nature it is a closer step reduced, family can come in a busy hospital because your loved ones for patients at home. community hospitals to home with the and and visit much easer. Loved cannot come, have compassion. Do you not think really concerns me as gardens and dinning area ones can have easier access staffing should not be I do not think these yet still has the skills to to palliative patients NDDH is tacked as a priority? decisions are being deal with acute and constantly at capacity during If nursing was not a made by anyone in palliative patients. Many the winter. degree and was an rural communities. If patients from this area apprenticeship I can only you could see would die alone in acute assure you more that this hospital is hospitals due to travelling people would apply. not only a life line for distances. patients but also for local staff would want to provide high quality care in a more family orientated environment. 141 A 1st Bideford and Close B Option B. People from 3 Yes, however, I do 1. The Longhouse in N Holsworthy or 2nd Ilfracombe' Holsworthy - especially the not really understand Holsworthy (new Holsworthy & South s beds and elderly partners of patients how you will be able hospice building) Molton. Holsworthy's run more simply cannot get to NDDH to give adequate care does NOT contain isolation is a key factor clinics for easily. It's cruel to effectively in the community. beds for sick / end of for many. Also the people with separate elderly couples How will you be able life care. It offers distance home carers chronic when one is dying. to recruit enough therapies and have to travel here is and conditions adequately trained support only. 2. The time consuming. such as nursing staff (not figure of 149 care Holsworthy is modern physiothera carers) to ensure beds is misleading. At and well equipped. Local py, so they patient safety? any one time, there care homes are full. don't have are only two or three Holsworthy can also help to ravel into vacancies which is with surges in demand NDDH on a why people wait so with up to 26 beds. regular long to be discharged basis. from hospitals if can't go home.

142 C2 Holsworthy at least 1hr N/A B Option B for all the reasons 4 It is impossible to How you will visit N 20mins drive from any outlined in question 2. compare people someone at home 4 main hospital (2hr 40min living in towns with times a day during round trip) i.e. - all the various the winter in this Barnstaple, Plymouth, options available, to area when even the Exeter. Available the Holsworthy very main car park in transport for elderly, rural isolated area. Holsworthy is shut disabled, mentally during snow challenged - is virtually conditions let alone non-existent in this area all the side roads and with a local taxi charging estates. How said sick £40 for 16 mile journey - person who needs There are now no visiting 4 times a day wheelchair accessible copes in-between the taxis in Holsworthy. A lot visits if living alone or of elderly in local with elderly carer and population. also how such a service can possibly be more cost effective and safe than looking after them in a community hospital. 143 B Free care in hospital. Get N/A No No any small hospitals. 3 Need info on what will be lost for the NDDH No Holsworthy is off our N people to pay B&B. option. patch. Please explain Cheapest, With good the Okehampton community respite, impact. rehab & DN help.

144 C2 Holsworthy is 60 mile N/A A 1 No NO Local needs for local N round trip to NDDH. people. Holsworthy is 2 miles round trip. 145 C2 Acknowledge need to N/A B You risk isolating both 3 Yes Y reduce costs but also patients & their visitors due understand need for to limited finances & community hospitals transport links. Rural areas / especially in rural communities rely heavily on communities eg their community hospitals. Holsworthy due to transport links, geographical areas etc.

146 None. Ilfracombe, Torrington, N/A All 3 All of those given. 1 Mothballing Ilfracombe, Torrington, The focus are not NDDH will be plagued N South Molton and Bideford to assess the problems for such a problem on by bed blocking once Holsworthy will all be Holsworthy & South Molton if they are the the rural areas. the number of needed in the medium to only cottage hospitals left. available beds in long term. Ways should cottage hospitals is be found to reduce costs reduced. of keeping open the buildings with mothballed beds until needed. Holsworthy is definitely needed now as well as in the medium to long term.

147 A1 The area has a large N/A B Option B. All beds NDDH. 4 Holsworthy has an N number of elderly - Access to hospital approx 30 ageing population. retired people who do miles away. not drive. Transport links are not good for visiting in NDDH. 148 A Holsworthy plus one N/A B NDDH the reason mainly 4 I feel you do not have You have already cut N other. Need to have distance and local area any idea how your Holsworthy beds hospital in such a large covered. plan for care in the please do not even area and distance from community works I consider any more. NDDH. have had first hand knowledge how this does not work. 149 A4 Situated furthest from N N/A B NDDH how would this help 4 Care in the home not N D Hospital with bed blocking at NDDH? adequately catered Distance - difficult for for. relatives / friends to visit.

150 C4 All services at NDDH N/A B All your eggs in one basket. 2 Save money by capping huge salaries & Care in the N under one roof. South Another hospital needed in golden handshakes for top executives and community requires Molton is a modern case of a 'surge' i.e. bad cut out bonuses. lots of staff for the hospital with good winter, few broken bones various teams potential for coping with etc. involved. Are you a rising population & any sure you can recruit 'surge' occurring. & retain enough people to maintain a good adequate service?

151 A4 South Molton & N/A B Parking is already an issue, 3 Cost savings in other areas rather than Will provision of day Population increases N Holsworthy, one in North especially if you have an reducing beds. Would need to understand care be made are happening Devon one Torridge. Both afternoon appointment all departments costs & budgets to come available for these everywhere have relatively modern traffic queues on approach up with any options - what is the cost of who need it - either therefore why reduce buildings. Both areas roads and after drop off. producing all of this literature and holdings for personal care or beds? No evidence or have lower car ownership Many patients in community meetings? companionship? Care costing's provided and limited public beds do not require acute in the home will take the show that any transport (particularly care. Capacity to Flex? More more staff, will they option will show later in the day & delays to these awaiting be allocated enough savings to keep weekends) both have operations. time with patients? within budget capacity for surge, have therefore surely work long serving staff teams. needs to be done on Can accommodate non- this before hasty acute patients that decisions are made require nursing. Lots of eg personal health local supporting leagues budgets costing NHS of friends providing 23 million. facilities & equipment.

152 A1 I live at Holsworthy it is N/A Bidefo Bideford 19 miles away. 4 N 30 miles to Barnstaple rd and just to visit someone that 60 miles round trip, to far.

153 C Central access. N/A A Travel concern. 3 How will some N people manage. Less beds - more people. 154 A4 Because they are newer N/A Holsw Holsworthy as I think South 3 Yes, but what Y hospitals that have the orthy Molton has a bigger rural happens to that capacity to increase area to cover and our patient in there own when the winter increase population is growing. home how is there of patients happens and food & fluids it does every year. implemented. I am concerned that this area is not going to happen. I have worked at South Molton hospital for 26 years it is a lovely place to work all the staff work as a team to provide the best care for the patients. 155 A4 These two community N/A B This would prove difficult for 3 Yes - keeping all community hospitals open! Yes - but sadly care in Staff employed on N hospitals are at the patients and members of Once a community hospital is closed, it will the home seldom home care visits need extreme limits of this families to access in winter never reopen and we are experiencing a works especially to be English area of North Devon. months particularly. rising population placing more demands on when the patient speakers and well Consultants could then resources. lives alone and trained. The whole hold patient remote from operation must be appointments at these neighbours. closely monitored by two community reliable supervisors! hospitals. Sufficient time must be allowed for care staff visits.

156 A (Only Holsworthy listed) N/A B Accessibility to NDDH from 4 Yes, but can carers go I think that you are N NDDH is furthest away Holsworthy and time taken round to all the just looking where from Holsworthy, difficult to get from Holsworthy to villages they have to you can save money to get to if not a car NDDH. in the time they are and have not given owner / driver, public given. consideration to transport is not good. older people who Older population and need the services of therefore not so many local hospitals. car drivers.

157 A (Only Holsworthy listed) N/A B 4 It is inconvenient for N Going to NDDH means a people to visit 2 hour round trip. patients as a lot don't have the transport.

158 A (Only Holsworthy listed) N/A B 4 Leaving Holsworthy as it is. For local people its N Other hospitals are a two easy to visit people hour round trip. and not do the two hour round trip as a lot do not have transport. 159 A4 Holsworthy is remote N/A B Barnstaple can't get there / 3 There is no option in my opinion why take Young families who N with poor transportation Holsworthy is remote with away a good hospital with excellent care work / children links to NDDH. I wouldn't poor transportation links to with very cleaners standards. commitments can ever have my did go to NDDH. Expense of transport have close to home Barnstaple hospital again to & from NDDH parking is care and more (disgusting care). free not having to worry visiting hours with when you with relative going leniency. You can get parking meter so more time better care as the with relative / more houses hospital isn't as big being built were are people and manic as the going to be cared for. other main big hospitals. My relative has received excellent care and compassion from all staff. Nothing has been a problem just excellent care and service. Very, very clean hospital. 160 C2 It is vital that Holsworthy N/A B Beds at NDDH Barnstaple as Not well at all Monitoring the patients more thoroughly Yes - but towns are Please consider the N Community Hospital is explained above (sec 2) so that they are able to access the correct much easier to cost of this retained within its hospital for their needs i.e. if no longer manage than vast arrangement i.e. the current use. The acute they are taken to Community rural areas which can purchase and running distances for travelling in Hospitals who have the facilities for on- be inaccessible at of 4x4 vehicles to this area, which is such a going care before being sent home to a well certain times of the access isolated rural rural, scattered managed system of care year individuals and community is impossible communities as well to successfully manage as the time wasted under any other scheme. for travelling The cost of closing a between visits of perfectly well equipped highly qualified staff modern hospital in order who would be better to provide community employed treating nurses and doctors to patients in one travel vast distances in building! Also what order to successfully care would happen if the for patients 24/7 defies hospital is closed but all logic. My feeling is the rural community that patients should be team has not been correctly monitored so properly that they are given the implemented before acute care at the NDDH the closure - at a Barnstaple and then minimum the rural more rapidly sent to team would need to community hospitals for be in place before on-going care before any beds are lost. leaving for home at the 161 A Holsworthy and one I cannot B All the reasons and benefits I Yes refuse to accept the reduction in No I don't. When I I am appalled by the N other non-Barnstaple comment have raised in 2 are not community beds being imposed on you asked the question at disjointed way this Hospital. The distance on this deliverable if the Holsworthy without the NDCCG detailing how it is going the consultation consultation is being and lack of good public since no hospital is closed. to support the communities where these what your plans were carried out. The transport from the information beds are removed. Also there appears to be for the Holsworthy NDCCG and Social Holsworthy area to was no detailed planning on how alternative area if you were to service must be party Barnstaple. From presented services will be provided locally if a close the hospital: a. to this. I accept that Holsworthy town to about this community hospital closes. Furthermore to provide free the NHS must make Barnstaple Hospital takes at the your head of operations stated at the transport to difficult choices but at least 60 minutes on a Holsworthy Holsworthy meeting that reallocating Barnstaple for for patient safety and good day. I liv in Halwill meeting. community beds to Barnstaple would have family's of patients care quality to be and the bus service is a knock on effect on other, already that would have maintained all only once a week. The stretched, resources and services. previously been provides must work benefit and strength of located locally b. to together. I feel having beds in provide palliative strongly that by Holsworthy means that care for patients progressing with this family can easily visit using the new plan in isolation the patients - professionals Hospice c. to provide NDHT is letting down tell me that this speeds sufficient extra our community. The recovery. How will district nurses no one board needs to be families be able to visit on the team had this stronger and refuse older patients or young information. In fact to entertain any of children? Also the new the impression given these options until all Hospice is about to open was that no detailed parties are involved. next door to Holsworthy. planning had yet The point of its location been carried out. It is was to support patients impossible for users needing palliative beds in of your service to 162 A4 Because beds are needed n/a B Option b as the hospital does Quite well Not really because u Keep Holsworthy N in the community not at not need that extra didn't even realise we hospital open it is the the main district hospital. responsibility as it is didn't have an only answer to this Holsworthy is so remote extremely busy ambulance centre. awful situation as and has poor transport There is already a stated we are links it is a 60 mile round shortage of carers to extremely rural and trip with very poor roads cover this large area very remote. Think of and an extremely bad bus and family members using the brain service and Holsworthy fill in to allow their instead of thinking covers a large extremely family members to money. Give a damn rural area. stay at home so about people and answers to how you what they really need are going to ensure and want not just there will be ample what it looks like on carers would be nice paper. We do have feelings and aren't just numbers. 163 A4 The distance of n/a B Does not provide a Not well at all No costings provided, no details of how I understand, but Holsworthy is an area N Holsworthy to NDDH, 30 community hospital, it is the much money would be saved with each feel that services are with poor transport miles is too far for district general hospital. Too option, or how much it would cost to already stretched in links, whether private relatives and patients to far to travel from increase care in the community. the community, feel car ownership, taxi or travel. Community beds Holsworthy. The beds would that losing public transport. It is should be in the probably be used by patients community beds the furthest from community in which they in the north of the area i.e. would be a safety NDDH. The care serve patients. Barnstaple, Braunton, concern for patients provided at Holsworthy has poor in that community. Holsworthy is public transport and very Home is not always exceptional. It poor taxi service, It would the safest or provides excellent be virtually impossible for appropriate place to end of life care that many to attend NDDH. It be cared fore. could not be is a purpose built compared to care Hospital which provides provided in nursing excellent care and homes. It is often services for patients and difficult to get an their families. urgent placement in a home locally.

164 A4 HOLSWORTHY IS n/a B BEDS AT NDDH SHOULD BE Not well at all LEAVE THINGS AS THEY ARE TODAY. A LOT YES. BUT OVER THE YEARS N LOCATED APPROX 30 KEPT FREE FOR THOSE WHO OF LOCAL MONEY HAS BEEN DONATED COMMUNITY SEVERAL FAMILY MILES FROM NDDH, NEED THE EXPERT MEDICAL HERE AT HOLSWORTHY OVER THE YEARS. HOSPITALS PROVIDE MEMBERS HAVE VISITING FRIENDS AND CARE AVAILABLE. FOR WE WANT TO KEEP BEDS HERE IN OUR THE CARE AND SPENT TIME AT THE FAMILY AFTER A DAYS THOSE ON WAY TO MAKING HOSPITAL FOR THOSE RESIDENTS NEEDING NURSING THAT HOSPITAL HERE IN WORK IS A NIGHTMARE! A RECOVERY, IT'S FAR MORE THEM. PEOPLE NEED HOLSWORTHY, HOLSWORTHY AND SENSIBLE TO BE PLACED BEFORE THEY ARE WHERE THEY HAVE DISTRICT VERY RURAL, BACK NEARER TO HOME WELL ENOUGH TO RECEIVED THE BEST APPROX 70 MILE ROUND WHERE FRIENDS AND GO HOME, OR WHEN OF CARE UNDER TRIP TO NDDH. NOT ALL FAMILY CAN VISIT MUCH COMING TO THE END SOMETIMES QUITE RESIDENTS HAVE CARS MORE EASILY, BUT STILL OF SADLY A STRESSFULL OR ACCESS TO A BUS HAVING EXPERT CARE AT TERMINAL ILLNESS. SITUATIONS. WHEN SERVICE! PATIENTS TEND HAND. MY MOTHER-IN-LAW TO MAKE A MUCH WAS NEAR TO THE BETTER RECOVERY END, A PHONE CALL WHEN THEY ARE BACK IN MEANT WE COULD THEIR LOCAL ALL BE WITH HER, COMMUNITY SADLY WHEN MY SURROUNDED BY OWN MUM PASSED FRIENDS AND FAMILY. AWAY AT NDDH THE VISITING IS MADE SO PHONE CALL DIDN'T MUCH EASIER. ALLOW US TIME TO BE WITH HER AT THE END (30 MILES AWAY) ALSO THE COMMUNITY HAS HELPED FUND THE NEW LONGHOUSE 165 A Holsworthy All towns need more n/a B too far away of course, but Not well at all Keep all local hospitals and get rid of admin, No No. N +1 local care for you already know that so for example the bloke that was speaking at convalescing. Holsworthy this is a waste of time and the Holsworthy meeting was a total prat is very rural, miles away money and waste of time and money, all he from anywhere, also wanted was "feedback" but we all know some of the surrounding 110% of the people want our hospitals kept villages are even further open. We all know it's cut and dried away. The distance to go anyway. to NDDH for visiting patients and for follow up clinics is too far.

166 A people recover better in n/a B loss of any community Not well at all smaller units nearer hospitals home and family rather than a impersonal larger unit 167 A Holsworthy + Both locations serve rural n/a B Closing all community N Torrington communities hospitals would cause bed blocking 168 A Keep community Ilfracombe B Going to NDDH. 4 Think about our elderly relatives, what No, you will be We need community N hospitals open. We need is closed as future have they to look forward to if our unable to safely hospitals - care in the community hospitals a bedded community hospitals close. deliver care community is not near rural areas - for unit. especially to patients working - unable to example South Molton in rural areas at get carers specially community hospital take night. double ups in rural patients, Lapford, West areas. What happens Anstey, Ilfracombe. at night. Palliative patients being put in nursing home's as no care available in homes. (Some preferences to die at Home NOT being met now!! let alone if hospitals shut.

169 C 1, 2, all of 3, 4c,d,e, 5, 6, N/A A 3 N 7, 8. 170 C4 Increased availability of N/A B I believe there is a need for a 3 Not entirely clear. N beds at NDDH plus beds rehabilitation / old people for rehabilitation at care in the community away South Molton. from major hospital. 171 B Beds at NDDH. Given that N/A A2 Cost of Ilfracombe refurb / 2 Rapid access is Y most community poor Bideford site. relatively difficult to admissions come from access, will the NDDH this option gives quality / safety of greatest equality for the care be equal in the north / mid Devon community in "hyper regions. Public transport active phase" i.e. to Barnstaple is better immediately after provided than to assessment of needs. Holsworthy / South Molton etc for visiting relatives.

172 A (Only South Molton N/A Holsw Holsworthy hospital. This 3 How will the main hospital in Barnstaple Would the day nurses Once you start N listed). Very good orthy hospital is too far off the cope if they are on 'black alert' which I cope, they are closing hospital beds facilities on the ward, road and sometimes short of know they often are? Where would struggling now. there is no going excellent nursing and staff. Barnstaple put patients? Also we did not Equipment is not back. Staff leave or care. Ideal location have a bad winter this year, what will always available to be get jobs elsewhere. exceptional staff. happen when we do? delivered to patients BEDS ARE GONE. homes. Where will you put these sick patients when Barnstaple is full? 173 A3 Both South Molton N/A B NDDH - Too far away for 4 Not enough staff can Communities need Community Hospital + rural areas. Not everyone be recruited to give community hospitals - Bideford - Both have lives in Barnstaple - not adequate care in the Poorly + dying large elderly everyone has transport. Not community - patients should have communities. Take everyone has the money to especially at night. choices where they patients from large rural travel. would like to be areas. Given a choice treated. There are patients like / need not enough carers / community hospitals - nurses in the Both easily accessible to community to cope NDDH for appointment / with demand - care emergency treatment. will be compromised. Don't our elderly + sick patients deserve better then this. Listen to the patient - There voices should be heard. 174 A We need hospitals locally Stop B Distance to travel for 4 Keeping all local (cottage) hospitals open. No. Who will pay for N to prevent bed blocking spending relations and beds at travel to Barnstaple. as in Truro hospital. We money on Barnstaple would be And how can do not need bed blocking administrati blocked. Barnstaple cope as in Truro. on. when people who cannot look after themselves can not be sent home.

175 C2 2 N 176 C2 2 N 177 A4 Modern buildings. B Beds at NDDH. Where are 3 Costs. I feel this is something that needs Not happy with this. Do not know if N Limited public transport beds being made available looking into and cannot believe it will not Care in the home ok savings will be made late in the day and also from. Parking already a be cheaper to keep community hospitals. for some, but whichever way is weekends / holidays. problem at certain times and loneliness, a few chosen, seems this Good staff - long serving. availability of transport. home visits a day will should be looked Can cope with wide not help & how long into. Many people range of patients. Very will these visits last? are moving to the good league of friends Also weather south west so able to buy & support conditions & problems will equipment in hospital - distances to travel - increase. (Maybe we especially South Molton could be more should stop older travelling then with people moving here patient. so freeing up beds).

178 C2 Holsworthy has an B Because I feel it is essential 3 Yes, but I'm not sure N overriding need for local for a wide rural catchment the reality will match beds - based on area that Holsworthy keeps the theory. geography, low car its beds. ownership and lower incomes and ageing population. The other local bed options do not provide clear enough advantages so beds could go to NDDH and the vacated space be used for other services locally. 179 A4 Holsworthy 1) Excellent Not B NDDH - the whole point of a 3 3) Concerned that we now seem to be in Very concerned that The Holsworthy N staff. 2) Numbers likely to relevant in community hospital is that if discussion with a different group of people! this is impractical in hospice centre was increase. 3) Transport (or the time not for acute care but as a the area surrounding built on the lack of it) and the scale transition until care can be Holsworthy as your understanding that 3 distances involved and a allowed. provided at home or for carers may well have beds would be major problem for those who are terminally ill. difficulties when the available at Holsworthy & district weather is bad in Holsworthy hospital 4&8) difficult to predict rural areas with badly for terminally ill the future! However at maintained roads patients. Your travel present the local hospital times in the is of enormous benefit to information pack are patients and their incorrect. The time families and friends. 5&7) from Holsworthy to both good at Holsworthy NDDH from & South Molton. 6) This Holsworthy does not is good in Holsworthy but include the time from not necessarily available the bus station to the in an emergency. 9) Not hospital. that has been made apparent for Holsworthy South Molton selected because it is similar to Holsworthy geographically otherwise I do not know enough about the hospital to comment further - transferring people from 180 A5 The two are spaced apart B 4 You won't have N to cater for the rural enough social care to community. tend to the recently discharged patients in their home for the whole day or few which patients need on coming out form hospital.

181 A More beds in community B Bed - blocking and travelling. 2 Yes. No. hospitals will reduce bed blocking in general hospitals. 182 C4 I can see good rationale Don't B I would be concerned that 2 Probably not, given the economic Interestingly we have We need to work on Y for centralising all care to believe some - all - of the beds circumstances at present. already lost our beds improving liaison & one site but have grave Ilfracombe would be lost to community over 10 years ago & communication concerns that pressures is a viable hospital patients, especially have very few between primary & will cause community option - if they were not in a residential beds here secondary care & to beds at NDDH to be should be designated, separate unit yet admission rates work on relationships taken up by urgent fully specifically geared to are low as local between community admissions during developed retirement. healthcare team nursing & GP periods of escalation. A as a operates a fully provides to have a designated site fully community integrated service in positive impact on geared to rehab would be hub to close conjunction patient care. good. support with GP practice. care closer to home initiatives.

183 A4 Holsworthy must have a It is not. Ilfraco Ilfracombe distance cross 4 Discharge from NDDH for oaps ets will on When you run out of How could this be N community hospital as mbe country route & anywhere occasion be late at night and they will have beds at NDDH what considered without other options are to south of Barnstaple has to go to pay for a taxi may be at 2 or 3 in the then? What about consulting the local faraway in time and via Barnstaple to get there. morning. Personal history of that with my bed blocking which doctors. Why don’t distance never mind the father in law in Sidmouth & RD&E hospital. will become more you reduce the weather and state of the common. With managers who can't roads. The bus from increase in minimum manage and reduce Holsworthy takes much wage many care their salaries and longer than one hour 5 homes will close and more particularly minutes and they were with council cuts no their consequential promised 3 terminal beds likely hood of them pensions and put the for the local hospice use. staying open. Who management where will PAY?? it belongs with the consultants. If Holsworthy hospital beds go what will happen to the hospice which was built by public subscription??

184 None. None of these options. 4 I live a stone throw N away from Holsworthy hospital how ridiculous to have to go to Barnstaple. 185 A4 Keeps patient local, aids B NDDH, only. What if there 2 A new hospital at Bideford, no change. Most people in our Holsworthy has an N visiting, often supports were a fire or infection area (which has most excellent league of local doctors, for short there? Ilfracombe & South parishes) live in the friends: A physio term care and therapy Molton too distant. rural parishes, many department. Houses especially when in very primitive a day centre (3 days a treatments / drugs are conditions. A lot week). There may be changed. Less stressful retire here with few times when the transport, many do not relatives around. One Longhouse (hospice) have cars. Many homes nurse cannot be in 4 will need a bed-night, are small / out dated. A parishes at once, but under doctor's stepping stone to home may be have 4 in a supervision. post op. ward sharing some equipment.

186 A4 Holsworthy has no public B Distance & transport. N transport on Sundays.

187 A1 They are building 90+ I haven't got a preferred 3 Reduced! It sounds N houses in Holsworthy option. I think this country is like they will be more people and less going backwards not closed. That how it beds if Barnstaple forwards seems at the hospital happened to meetings. close a ward with MRSA what happens then!

188 A3 Excellent purpose built B It will not be used like a 4 Come onto wards and speak to staff in the What will you do with This should not be Y hospitals. Good transport community hospital - it'll end community and NDDH for their opinion. people who require about saving money. links for families to visit. up as a general medical help over night 10-12 It's about giving the Large rural community ward. Patients feel safer and hours is too long to best possible care carers are unable to get it's quieter in the community leave "VULNERABLE" and unfortunately to homes as easy. - they always say it's the best people. Shortages of that cannot always night's sleep they've had. community / home be done in people's carers - where will homes. Every year they come from?? Barnstaple has winter pressure. What will you do with 60 odd less beds?? 189 A4 Rural area, older people B All beds at NDDH. Harder 4 Coming to the affected hospitals & I have concerns that South Molton is vital Y living alone harder to get access, busier environment spending time on the wards with staff to care out in the to NDDH as a care at home. Modern already, not contusive to see how the hospitals work. community will not resource for further purpose built buildings palliative care patients. be robust enough as rehabs & palliative maintenance easier & Parking already a problem. we are already seeing care in a modern, cost effective flexibility at No flexibility? Impact on this due to rurality. calm & professional South Molton to flex to acute admissions. environment with a 28 beds. Associate dedicated team. specialist on site to take Community beds help patients from all over NDDH free up acute North Devon not just beds. patients registered to local GP surgery. Easy access from all areas to South Molton. 2 hospitals at better geographical areas from NDDH.

190 Ilfracombe, Bideford, Reduce All. As in previous answer 4 Problems of weather South Molton may N Holsworthy, South manageme population growth, transport on the moors not have some public Molton to all be retained. nt i.e. availability. taken into account. transport options to Because of expected managers. NDDH but the rural population growth in the area has poor or non- area. existent links therefore your statement about it being neutral is a false premise!

191 A4 This option would still B All beds located at NDDH - I 4 Keeping all community hospitals open and What will happen KEEP THE Y save money while feel this is a unrealistic putting the patients first. Reducing the cost when Barnstaple is COMMUNITY BEDS allowing care in the option. As North Devon is a of agency staff and creating a viable long full? Will the new AND PUT THE community to still take rural area transport is a real term option rather than creating a option even save PATIENTS FIRST!!! place. Both sites are new issue for people within the disposable one. money? Are people and do not need much community. I feel this option from all over North upkeep. South Molton is selfish and discriminative Devon expected to also has a very low % of to people living in rural areas get to NDDH to care homes so there is a and is not a cost friendly receive care? huge need for sites like option. this with such a large increase in population. 192 A Mainly elderly patients & B NDDH struggles now with a 4 It is already a struggle Y these patients are cared lack of beds & staff how on to provide care as for a lot better in earth are they going to cope there are not enough community hospitals with 40 more beds. Also carers around & than in busy / short parking is already a patients will need staffed acute hospitals. nightmare. Patients are 24hr care & also a lot better looked after in of patients need community hospitals closer double up care! to their homes.

193 A4 Both have very rural B Community hospitals play a 4 Look at making other cuts! Less Yes I understand but locations patients + big part in supporting people management, pay higher rates of overtime realistically will it families will have a long who live in rural localities to permanent staff to give them the work! What happens way to travel to visit or most are elderly who have incentive to do extra hours to cut the at night when for appointments. older friends and family who agency bill as lots of staff are part time. patients are alone Limited public transport. will find it hard to make the and feeling unwell People are elderly or journey from home to and unable to call for have limited income to Barnstaple with limited help to get a drink or be able to afford public transport. go to the toilet. transport on a regular basis.

194 None. Beds at 5 hospitals as The community has made it Not an option as area Having just nursed N they were. Holsworthy to clear they have no faith too spread out. How my brother at home stay open. Transport non- whatsoever in this directive on earth do you think with a terminal existent furthest away from government and plead you can do care in illness. I know you from NDDH or Exeter. for you to go back to them the community cannot afford care in More older people with the message. A cheaper than the community for locating to area. More specialist can see at least 20 community hospitals. terminal patients. At housing. Building in good people in situ but about 4 People get better one point during a order. with travel in community. quicker in a safe bad day we had 2 environment close to carers, 2 community their families so nurses, 1 OT, 1 community hospital hospice nurse, all at saves you money. the house at the same time so what happened to all the other patients that they were due to call on as he was having a crisis and needed help. 195 A4 South Molton is modern C 1 community & rest in 3 No hard financial details of money saving I do understand and I I would like to ask N useful and well run / NDDH. This will not deliver were forthcoming. Decisions like this must fail completely to see about return to maintenance low. good service to the be based on facts and accurate figures to where money can be NDDH in 'discharged Holsworthy because of necessary communities. be convincing. saved eg 2 or 3 to home' patients in the miles from people can care for areas where there is BARNSTAPLE (to serve up to 20 patients in no community the community). Both hospital but how hospital care i.e. is serve their communities many staff to treat there evidence as yet well and provide valuable patients wide spread. that direct to home needs of the community. In the community discharge is better or and at what cost? worse for patient. Travel expenses will be incredibly high.

196 A1 Holsworthy as central to Preferred B Not to have to travel to 4 As I see it would be It was announced on N the community and to keep 16 NDDH as patient or visitor. preferable to have the TV some months around. This will help to bed in patient go home ago get rid of all stop bed blocking at Holsworthy from hospital this is community beds, NDDH. Patients would community not always possible that the health trust prefer to be near their hospital. for some, with their & others put a own home's as I know a illness. If a patient is matron in charge of patient was in hospital transferred home the hospitals. The for 4 months would not who will care for surgeons & doctors be able to stop that long them as carers are to look after patients. at NDDH. As from only on minimum The money paying Holsworthy to NDDH is wage in most cases. your committees 35 mile each way for would pay for the elderly to visit. defect in the NHS.

197 A Option A frees up beds in B See No.2 3 Look at your ways of working with someone Yes. Please consider the N NDDH. Barnstaple is a running a large private company and see if patient as well as the very long way from some you could be more efficient eg waste of stats. of the towns. Care in the medication. Return of frames, walking home is not always sticks etc. suitable for people. People get better quicker when in their local community. It is very tiring for older spouses to do the travelling. 198 A1 Holsworthy / Bideford This is what A6 South Molton / Ilfracombe. 4 Leaving the situation as it is. Money has How do you intend to This was so obviously N not Ilfracombe. South you are The journey from been wasted just by putting all this into recruit enough a case of ticking Molton, Ilfracombe, paid for. Holsworthy would be operation. Finances as things stand at accredited carers to boxes. This is an Bideford & Barnstaple impossible. We can't even present against "savings" that will be made care for the frail & extremely rural area, are all in a cluster. get a taxi to the local health against money spent on this exercise has very vulnerable difficult road, Residents in Holsworthy centre & another taxi not been satisfactory explained. elderly. We have had extremely long lonely & district face a journey company has closed down the terrible lanes - caring of between 30-50 miles & this week. Any taxi company experience of poor agencies do not like difficult route. In Holsworthy also does quality carers hastily this scenario as they Unacceptable in 21st school runs only leaving put in situ because can make much century!! 2hours for other people to there was no room in easier money in hire them. any care home or towns we need our local hospital. local hospital Resulting in this desperately. Why are persons premature you rushing this death. Traumatic for through?? everyone. This will happen again.

199 A Beds at ALL community B Listen to the people of 4 You've got to listen to all communities and Care in the home' is a The care my late N hospitals. If that is Holsworthy. It is NOT safer fight to save all community hospitals - cut totally flawed idea. father received at impossible then option A. to be at NDDH option B back on needless expenditure such as GET REAL - care Holsworthy hospital Holsworthy should where staff are overworked administration, pointless training courses workers are not was FAR superior to definitely be included & cannot give truly personal (experience of sister working in NHS). trained nurses, that he previously because of isolated care. Families need to be Experiment living in Holsworthy & make cannot possibly received at NDDH. As community and distance able to visit daily without daily journeys to NDDH with children in tow manage to cover a family we were from NDDH + poor public having to travel for hours when your ill and see how exhausting & such a vast, rural deeply concerned transport (+ expensive and pay unaffordable taxi / financially difficult it is. Experience reality. community at all about the lack of safe taxis). Holsworthy is such fuel costs. My dad received times of day / night. care at NDDH for my an isolated community. appalling care at NDDH but They may be 'cheap' father as well as my There is NO public exemplarily palliative care at staff for you to pay mum and so relieved transport from my farm Holsworthy. but NOT SAFE staff when they could at Pancrasweek. I have for patients, I know finally be transferred MS and not always able this from personal to Holsworthy. I to drive - taxi costs are experience & I've personally have hideously expensive. heard the same from multiple sclerosis, How can my farming so many others. Care five children and live husband with my five homes & social on a rural, isolated children realistically visit services are really dairy farm SAFE care me when in hospital if struggling as it isl. is in Holsworthy with not near our home ???? nurses without the stress & financial burden of long journeys to NDDH save money by reducing managers / administrators. 200 C2 Barnstaple for life saving Why not Whichever one you choose 3 Yes transport especially in rural Devon older Yes but it is just not If we as a country as N care, Holsworthy we consider will have positive + negatives people on their own + don't forget just how good enough all very Cameron says can need this local hospital Stratton as so good luck with it all. Get insular young people are will they really well at home care spend millions on especially for our local an option the MP's down here to have care for their family without strings doubt don't forget we are Syria surely to god care. Distance close to they have a real look pen pushing is all it! an ageing population this government can our GP it’s a new hospital 24hr minor very well boots on the a local old fashioned spend on keeping our well run good space local illness cover ground make a difference! maybe cottage NHS local hospitals staff. Good parking its up or L'ston hospital would suite viable, no I'm not + running could be both all Holsworthy has being anti anyone but expanded. Don't forget hospitals the staff the skill the just stop & think! Holsworthy has had more are space and local properties built so more revamped support. local care needed. surely with those two & Holsworthy our after care would be exceptional + its LOCAL.

201 A3 South Molton & Bideford N/A B Barnstaple only - very short 4 Yes keep them all open, help to alleviate Yes - pretty As I am a type 1 N have far reaching areas sighted and stupid to put all bed blocking. Devon is "retirement" haven, hopelessly if what I diabetic with a lung which they can help. your eggs in one basket, we need every facility available, open and hear is true. All your disease and no one to Transport is a problem especially if there should be running properly. schemes depend on a look after me, I find and here hospitals are some sort of disaster i.e. fire. backup of family / your proposals very vital to the communities. friends / neighbours scary to say the least. The forum was a waste of when you get it time, no one answered a wrong! I do not have question properly, they any of them. From just dodged the issues, or what I see you get it changed the subject. If wrong quite often. these people are in charge I fear for the future. 202 A1 Already a new building B Distance to Barnstaple for 2 Many outlying areas Holsworthy is needed N built for use as a hospital. many low wage area so are completely cut because the outlying We are a long way from nearer the better (fuel) off in adverse districts are a high % Barnstaple our community spirit is lessened. weather how do of elderly. population in outlying patients then get Holsworthy is ideal villages is elderly, this looked after even 4x4 fort convalescence means the carer at home vehicles are not with treatment is also elderly unless the enough. needed, so accessible NHS provide full time by elderly partner. care + nursing, doing this Home treatment is they would not save too much for elderly money as it means 1 to 1 partner at home = nursing. stress + physical.

203 A Because its very close to N/A B 4 Consulting the local people first. Explain to me. No I'd like to continue N home need for this money but it will fall on deaf isn't everything. Keep ears! money in our own country we need it!!

204 A Keep services local. B Large, impersonal, parking, 3 N Friendly & often knowing transport. staff helps patients feel at ease & surely aids recovery. 205 A4 Expense of transport to + B Barnstaple to far to travel, 3 Compassion & the excellent care Not sure. Can they have end of N from NDDH. having no transport, parking maintained, very clean, nothing too much life care delivered at fees at NDDH free at trouble so I think Holsworthy should remain Holsworthy rather Holsworthy, preparations for open than a nursing home people going home with also care in elderly carers or no carers. Holsworthy is excellent, better than you would receive in bigger hospitals i.e. Barnstaple.

206 A Prefer option A because N/A B No transport. 4 No - You explained to Fed up for the idea. N this is in my local area. me. 207 A4 Access to NDDH - B Option B - Where is the 3 Concerns that care at Y Holsworthy very poor capacity for an additional 40 home very difficult to quality of buildings. beds? Issues with finding arrange in some Bideford to expand care at home will delay areas. outpatients, keep MIU, discharges in NDDH as it treat day cases + develop does in the community sites other services. currently.

208 A (Only Holsworthy listed) B How will you be able My parents, brother, N Local hospital adjoining to get enough carers sister in-law cousins medical centre much to cover such a wide and friends have nearer than NDDH. rural area? stayed at Holsworthy Better for visitors, hospital over the relatives etc to travel eg years. So I know how Holsworthy 9 miles vital this wonderful NDDH 40 miles. service is. Please keep beds at Holsworthy.

209 A4 (SM has a ? By it). I am 78 B NDDH you are only a 3 How will district When my husband N years and have MS I lost number. nurses be able to was in Derriford I had my husband in 2014 and cope. People long to travel by taxi at a he was in Derriford distances apart / do cost of £45 a time it hospital I am not able to say there will be 24 took at least an hour drive. If I need hospital hour cover. So there to get there after a care please God would be in lot of shouting I Holsworthy hospital will Holsworthy hospital managed to get him be there for me. where there is 24 to Holsworthy but he hour care and fully died after 4 days but trained staff. at least he was a person not a number and I could visit whenever I wished night or day the final few days were wonderful after a terrible time in Derriford. 210 A4 Both hospitals are the B Beds only at NDDH. There is 4 Elderly people do not want to be a long The care in the Holsworthy hospital N furthest distance from virtually no public transport distance from their family. They are quite community just beds were full last NDDH. The roads from from Holsworthy and even often at the end of their life and need to be doesn't work as they week and could Holsworthy are narrow car travel is not easy and able to have family close at hand but be are not enough probably have taken and dangerous. dangerous if you are lucky taken care of by professionals. carers to date so an more if available. It is you can do the journey in an extra burden on always another hour. them will first not stepping stone for work. The safety of people recovering patients will be at from serious injury or risk. surgery where they can still receive professional help. In the safety of the hospital.

211 A4 Location, transport, cost. B 2 Utilise community hospitals more. Take pressure off N Elderly difficulty to travel. NDDH that's the Families difficulty to reason for cottage travel, cost. hospitals, also keeping community together.

212 A4 or C2 Geographical isolation / B We need to keep our 4 I understand that you I feel we need to Y accessibility. New community hospitals for all feel you; have too keep all our hospice built next to the reasons discussed in the many hospitals beds community hospitals Holsworthy hospital they criteria, accessibility & lack & want to transfer if possible but if any will complement each of public transport. the resources to have to be closed it other. Holsworthy looking after patients probably should be hospital a relatively new in their own homes Bideford because of purpose built building but I don't think we its closeness to with good facilities. have enough NDDH. resources now for that or in the future the community nurses & social care teams are really stretched & can't always meet demands. 213 A4 or A1 Patient choice for place N/A B Lack of consideration of 4 How will you cope Y of care. Patient choice for patients choices & rurality. with winter bed place of death. Rurality. pressure, if the Lack of transport flexibility to increase infrastructure. Ease of bed number at access for family. Holsworthy hospital Modern facility. Lack of is lost, when NDDH access to emergency often runs on Amber support in the or Red alert. community. Inability to spot purchase emergency care in nursing or residential care. Flexibility to expand bed numbers to support NDDH when they are on amber or Red alert. High elderly population. Community nursing team already working at full stretch with limited capability for increased work load. Retirement of two senior trained district nurses (one six months ago and one scheduled for Sep 15) 214 A or C Either A or C to retain B Having all beds at Barnstaple 4 See below. As a practice we The local Y beds at Bideford. To location (B) is not providing share the CCG communities will not optimise visiting community beds however concerns that the accept bed closures accessibility for patients they are managed. safety of bed closures without a fight! families from the is predicated on the Torrington area. provision of extra community staffing will this be in place before the beds close? 215 None are suitable for Yes, the There has been no 4 Stop paying millions of £'s to Europe to How can help be N reasons negative to alternative information regarding long prop up their economies we as a tiny island available by full time criteria's 1, 2 or 3. is to make term care for those who cannot supply these amounts. We have medical carers / Criteria No's 4, 5 & 6 are sure that need it and are alone. There very little industry, we are losing land that helpers when people pie in the sky options No. clerical have been rumours that should supply us to maintain our food are unable to cope if 4 can only make certain super those whose assets exceed supply + increasing wages as per J.O. will old & helpless & assumptions which manageme £23000 will be required to certain stop us from being able to supply living alone with no require constant nt is pay. So if a person has eg a nurses to cope with community nursing. friends or relations. fulfilment. Since we have devolved, home worth £25k and has The odd drop in to no housing for many bring back no more money to employ change sheets etc etc especially those alone & real long term carers will she won't help. Care elderly and no carers can matrons have to sell her house to pay homes are afford or will be able to who know them. unaffordable, staff afford paying for help. what they are / will be too are doing costly even when and consult over 100 patients with Devon have been waiting carers. months for urgent surgery which due to shortage of surgical of nursing staff & hospital beds etc etc and of those patients. Already nearly a 1/3 have died due to lack of money basically to supply demand for everything it is 216 C4 or C1 NDDH + S Molton or I fully B As I feel having beds Too completely! Too much money has been I understand your I for one was asked N Bideford as they already understand distributed throughout the spent on it. However I do realise that you "intentions" how it to retire in October have a renal & stroke unit why hospital, in times of 'surge' are obliged to do all this by law. will work out is 2011 as I was over set up there. I feel this Ilfracombe these beds will be required another matter. Will 65, although I was will mean "all our eggs / is out of the & patients in community there be enough very happy to beds are not all in one picture. beds will be sent home, not community staff to continue my job (see basket. Those patients necessarily at the best for service the increased below). The reason who need less medical or these patients & the care patients treated was because the other high equipment package. "closer to home"? I NDDH had to save £8 base care could go to the doubt it, they just million that year, so community hospital aren't out there. all over 65 had to go whilst the others to & not be replaced. I NDDH. If in the event of a can't come back now 'surge' beds are as I'm no longer withdrawn at NDDH, at "registered", I would least there will still be have needed to do so some beds at the many hours practice community hospital. each year. NDDH when available is best, though not perfect, for people from Lynton to get to by public transport. 217 Preferred option is to B Distance visitors, carers & 3 No notice was taken of the original Yes, and I also At the consultation N keep all 3 community patients have to travel discussions when the preference in all areas understand that very meeting the NHS hospitals open. especially for end of life care. including Torrington that no community little consideration trust member told Otherwise option A. 35 miles or more in hospitals should be closed. The beneficial has been given to the meeting that Holsworthy + one other surrounding villages across effects on patients and their families and those who live in whatever decision probably South Molton. 3 poor unlit country roads. carers together with the shorter recovery those rural areas the trust came to a, b, c, d) Holsworthy is Keeping Holsworthy open time have been consistently undervalued. outside those towns could be changed by minimum of 35 miles would also benefit patients where distances can the CCG. Which from NDDH with very on Holsworthy side of be up to 50 miles. seems a enormous poor transport links. Torrington. waste of time & Other hospitals are money. The opening impossible by public remarks of this leaflet transport. 5) Holsworthy P3 says "we feel that is only 20 years old with looking after ...... good modern facilities. 7) provides a better Patients from NDDH can service. I would be discharged earlier to hopeful if the Holsworthy. 1) Easy to sentence began "we retain staff. Not listed know". As it is we opening of Longhouse know that hospital centre for hospice care services are more close to Holsworthy efficient & have means a more integrated better outcomes service. when delivered close to home.

218 A4 Shebbear is a very rural B Lack of public transport 2 What happens when If people can't visit N village with a scant bus (none at night) from rural there are no beds in the sick this is proven route, NDDH is at least 3 villages. The distance too far NDDH? Will extra to have a negative busses away whereas for most to visit sick transport be put on effect on their Holsworthy is close relatives. More often there is for rural villages to recovery which access. The village is an alert on at NDDH with no have access for means longer about to expand with a beds available, what will treatment / visiting? hospital stays, taking new housing estate happen then. up beds for longer about to be built which and may lead to means hospital demand higher mortality rate. will be greater, we must consider the elderly & young who use public transport. 219 A4 South Molton hospital - N/A B Destruction of badly needed 4 Think this should have been costed first We understand , but We have no N modern building, good rural community hospitals. before putting it to the public. are doubtful this will confidence in the nursing staff already in Community hospitals of use work i.e. in bad new proposals of place, access to NDDH, in case of Red alert situation. weather conditions + community nursing serves rural areas from Difficulty for relations with community nurses which despite their Exmoor to Barnstaple. no private transport to visit becoming dissatisfied skills cannot provide Holsworthy - serves rural (especially evenings). with continual the 24 hour care community. travelling instead of sometimes needed. full time caring.

220 C This option would help to I feel that there should be 3 I would prefer there to be NDDH and 2 Great care need to be N distribute hospital cover some community provision. community hospitals available. taken so that patients to the widest area of the staff ratios and mixes are are not discharged North Devon different for recovering from acute care too patients rather than those early back to their needing acute care. Support homes where therapies (e.g. physio) can sometimes there is be more integrated in a no one to oversee community hospital setting. their care.

221 A5 I feel that the two area I The service The total of beds being at 2 Not that I am aware if. My question is how No. N have selected are the would be the main unit would cause will the patients be extremities of the North improved extra traffic and pressure for cared for twenty four Devon are so would for call out the emergency teams and hours a day in the therefore serve the times for admission teams. community. Bearing surrounding communities the in mind there are no far better than all the emergency residential beds to services being at the services rely on. NDDH. and also save time due to the road access. 222 A (Sites chosen Bideford & B I think my response earlier is 4 Here's an option, employ more full time No I do not. No, I think the above N Torrington). Small reason enough! nurses and stop using agency ones! is sufficient and as I community hospitals are Another option - get rid of managers and said before, probably a very important part of get matrons, stop paying what is obviously no point in me filling the community for too much to managers and other top paid this in at all because closeness not only to employees. Here's an option, put all the all this is has already benefit patients, but afore-mentioned together!!! been decided!! family members too. I think it is a big mistake for these smaller hospitals to be closed, because in the longer term, they will be needed and what will happen then, after all the bed space will either be sold off or used for other purposes without the ability to convert back - who is going to fund the reinstatement, including funding for new buildings - not something the Trust could ask the 'community' to contribute to. Where is the money that will supposedly be saved 223 A Ideal would be beds at Explore See above. See above. Y two sites plus NDDH This more fully is due to the geographical the nature of North Devon financial and transport logistics for cost and patients and visitors, as I effectivenes feel the options are not s of the able to meet our current community needs. managerial structure above the ward level including senior posts. Review where money is being spent on outside consultanci es and explore the redirection of the monies identified to support 224 None. Beds at all community Solutions Any cut in local/community 3 Do you have your own monitors. Both are needed. N hospitals. All relevant are your provision. Will there be extra criteria have been job. input of resources presented to the Trust. into Ilfracombe when the Tyrell closes?

225 B I see no point in getting 4 Do not get rid of any beds any were in The care at home ?, I have said in the past N rid of beds in our area, north Devon. not enough staff to , that the when the Barnstable enable this communications hospital always needing a programme to work , department at the bed to send the as it should. Barnstaple is not fit recovering people to. for purpose . also, the number of people and old people is increasing , that is coming to live in north Devon . 226 A2 As both cottage hospitals As I am not B I greatly admire the excellent 2 No. Yes. No. N serve areas of above privy to the service provided by NDDH average age and lower proposed but believe it should not be than average incomes we budget for used for convalescent need to have beds which 2015/2016 purposes, with inevitable are available for patients financial bed blocking. I believe that living locally who do not year, I am we should retain the two own their own cars and not able to cottage hospitals beds (both find the use of public make a of which were part funded transport difficult. This meaningful by local public donations) for option also makes it proposal. use for convalescent easier for friends and The present patients and as a possible family (probably in a arrangeme overflow to NDDH if we have similar situation) to visit. nts worked a serious epidemic. well in the past , why change it?

227 A NDDH can have some Open some B Just beds at NDDH - see my 4 Cut the costs of overheads. Reduce the What are you going N very ill people in it which kind of above explanation. As well management and look at using the cafes to to do with the old could carry contagious shop or as it would still mean that help fund differences. buildings? diseases or illnesses cafe which one other community (dcif). Along with this will help to hospital would be closed. every time I have visited feed money friends in the hospital back into over the past few years I the have found it to be not hospital. very clean, depressing Where and the patients just patients want to get out of there. and visitors Where as the other can possibly smaller hospitals are go. easier to clean, more cheery and also most contagious diseases or illnesses are sent away from there. They are also more convenient to get to. Another problem is that you could not guarantee that extra beds at NDDH could be allowed to go towards the patients that would spend their time at the smaller hospital. Also if 228 B Option B: Beds at North B Keep thinks as they are and find a solution The government N Devon District Hospital to do this. were trusted to (NDDH). The community provide more funding hospitals do provide a to the NHS, but it different type of service would appear to be to a main hospital for not enough. many reasons, most of them socially based. Once the community hospitals have gone they will never be replaced. The government were trusted to provide more funding to the NHS, but it would appear to be not enough.

229 C2 Please explain your B If this option were 3 See my comments N reasons for identifying implemented no town would about the use of the preferred option have beds at their local mobile carers in below and outline how hospital. There would be Question 2. this meets the agreed problems with accessibility criteria: At 30 miles from which would be worst for Barnstaple, Holsworthy people in and around hospital is the furthest Holsworthy who do not have away so its importance is a car and who would be the self-evident. Moreover furthest away from the town has the lowest Barnstaple. percentage of car ownership and buses are infrequent. The hospital was purpose built and has a flexible layout - also the recruitment and retention of staff is easiest there. The use of mobile carers in the villages and hamlets around Holsworthy in particular would not be suitable or appropriate owing to the deeply rural nature of the area with many properties being very difficult to find. 230 A1 Community hospitals B Community beds in NDDH 4 Working alongside CCG and public to come I do not feel you Everyone I have N provide excellent safe for the above reasons in part up with a safe viable option instead of 'intended' way of spoken to who has care for reablement so 2. trying to unilaterally bulldoze through looking after people been to consultation patients can return to NDHT management plans. in the towns will be meetings has said appropriate safe safe as I expect will that Alison Dymond community living. I do be understaffed and and her team have not feel the North Devon put patient's safety at 'glossed over' Healthcare Trust can risk. awkward questions. provide safe 'community beds' - I expect this will become an overflow for acutely ill patients where patients needing rehabilitation don't get the quality care they do in the community hospital. I also don't trust NDHT to provide 'Care in the Community' - District Nurse posts are often unfilled and practices often receive messages that DNs can 'only see urgent cases'. I expect as a result of NDHT management decisions that unfortunately North Devon could be faced 231 A3 South Molton - As it is N/A B 1) Poor access for patients 4 Leave it as it is, community hospitals paly a I understand the N the geographical centre visitors. 2) Complete loss of vital role within local communities. proposal, but doubt of North Devon Bideford - community hospitals would very much that it will Will capture people who be a backwards step. 3) Non be achieved. The live further to the North acute patients in an acute uplift in community (particularly if other site hospital is not sensible or staffing will never be is South Molton). viable. achieved to be able to provide a safe and adequate service for people within their own homes 24/7.

232 C2 Holsworthy is furthest B Nddh alone. Too difficult for 2 Understand N from Barnstaple. Last Holsworthy older people to intentions. not sure year I was in Barnstaple 3 get to and from. the set up at present times with no visitors at is ready. all as we have no car. 233 C2 Holsworthy furthest B Transport difficulties and 3 I have read how you N away and with worst cost for patients and their intend to look after public transport links. relatives. people in towns Holsworthy a poor area where beds are lost economically with many and I do not believe people not having access this is, in any way, to a car. Current hospital satisfactory. in Holsworthy relatively modern with a flexible layout which could help cope with projected 7.9% population increase by 2026.

234 A1 The round trip to NDDH C For the reasons given above. 4 Leaving the situation unchanged and Not at all and have Having only just N is over 70 miles and we making any savings needed elsewhere. little faith that you opened the have no public transport can and particularly Holsworthy Long option. Equally we are so given the home House which is both pensioners and care provided to a reliant on beds at concerned about our dying neighbour in Holsworthy hospital continued ability to drive. 2014/2015. The care it would be a farce provided by and double calamity Holsworthy hospital to the local rural in his last days was community if excellent and greatly Holsworthy hospital appreciated by all is closed. concerned. 235 A4 Ilfracombe cannot meet B No community hospital 3 How much extra N bed criteria and Bideford beds, all based at NDDH. funding has been is close enough to Patients are already in a guaranteed and are Barnstaple whereas vulnerable position being ill the staff and training Holsworthy and S Molton enough to require already in place? I can meet the needs of hospitalisation, they will be think not. their own and other greatly distressed nit to communities nearer to receive support by way of them than Barnstaple, visits from family and friends Holsworthy in particular and I believe this will hinder being the furthest their recovery. Many people distance from Barnstaple do not have their own with very poor public transport and public transport available is a transport is not adequate to vital asset to both say the least. Care in the patients and their community is a good idea families. but insufficient resources put patients at risk. Last winter this was highlighted by bed blocking at many hospitals due to patients being kept unnecessarily in hospital due to insufficient care available for them in their own community. 236 A4 Holsworthy is the N/A B Option B is my least 3 Seek more funding to retain all the I question how Holsworthy needs it N furthest of the preferred option because it community hospitals. patients will fare community hospital community hospitals requires all patients and when they have to be to remain open! from NDDH. It is very their families and friends moved so far from difficult for family throughout North Devon to their home members and friends to make the long journey to communities when visit their loved ones in NDDH. Having a dedicated they need inpatient hospital due to the ward at the regional hospital care, and how they distance and lack of does not constitute a true will manage with just suitable transportation community hospital. periodic home visits links. North Devon from nurses or other Hospice is about to open health care a day centre in professionals, which Holsworthy which will is no substitute for provide a base for the presence of hospice consultants and round-the-clock community nurse health care specialists to deliver professionals in a outpatient care and also hospital setting. to support the work of the community hospital and its patients requiring hospice care. If Holsworthy Hospital is closed, families and friends of hospice patients who need inpatient care will once 237 C2 Holsworthy is further Its not and I B I do not believe that NDDH 3 No, not considering that the CCG dropped I do understand. The Long House at N from NDDH than all the do not would cope with all 40 beds. this back in your laps. The man answering Holsworthy is non other options. Transport believe that They already struggle with the questions at Holsworthy coped very bedded and I fail to is difficult. There is a any money Red alert status. The food is well and should be commended. see how this was ageing population around should be poor. Re tender the supply considered a negative Holsworthy. Holsworthy spent on it. of this. Sick people need to Holsworthy. At is a relatively new It is an good food and nutrition one of the meeting hospital with excellent asset and FACT . Also maybe some organised by the staff and very few bank should be people have to wait a long CCG, Stephen staff. Also the adjacent sold off or time for their prescriptions Roberts CEO of the Holsworthy Doctors used for a from the pharmacy. This hospice clearly told Surgery overall score specialised needs connected thinking. me that it would help was Outstanding by the use such as This may explain why some Holsworthy Hospitals CQC. The hospital could re hub as people are discharged later case to remain in use have achieved a higher there than expected. That said I with all beds open bed use if the Doctors at seems to be can understand that having and to take in end of Bradworthy Surgery both everything in one place life patients. referred patients there, increasing would be good re which at present they do drug diagnostics, however the not as it suits the practice dependenc Hospital is out of date and manager and his Dr /wife y both in fragmented, another asset partner who are closer to Ilfracombe to sell off in the future. Re Bideford and Barnstaple. and build ground level only This should not be Bideford. between Bideford and allowed to happen. Local Sorry but I Barnstaple. people should be sent to have not their local hospital. read any Regarding putting the other 238 A1 B NDDH penalises elderly in 4 Spend the NHS budget better and don't yes - the dn and care Would you be happy Y rural community. waste it on 1 obscene amounts of money workers and complex if your elderly/sick on agency nurses - focus on sorting out this care teams are going mother or father alarming situation please. 2 Procurement to be spread very lived in any of the system - its worse than poor, when the thinly! more rural areas for same items can cost different NHS Trusts their local IP Ward to vastly different costs. close? We need to balance the books financially, but this is not the way. Look at the year in, year out spend, on private agency nurses and the bank nurse system, its a dreadful amount of money. What a waste of the taxpayers money. I would far rather you focused on getting this staffing situation sorted out first and spending your budget more efficiently.

239 A Preferably option A as I B This completely negates the 2 N believe that more beds benefits of people remaining available in the in their own communities, community will lessen and increase pressure on the load on NDDH, and NDDH. also allow people to be closer to their communities. 240 B It is with regret that I put Don't see the point of only 4 Money could be saved at hospitals. Reduce Yes, using volunteers N option 2. We will have one community hospital. waste. Zimmer frames, commodes, and . bed blocking on a many other items of equipment not reused. tremendous scale. Some It's scandalous that our hospital is patients will be borrowing equipment on a long term basis ( discharged too soon for over 4 months at the moment), from Red their own good. The Cross because they cannot afford to buy private care system will their own. This charity does not exist to not be able to cope with prop up our NHS but it is increasingly doing the increased numbers of so. Patients discharged at 5pm and Support referrals. However, 2 at Home expected to provide a volunteer to community hospitals go and do shopping for them. It's ludicrous. could not cope either. No thought involved. Just "pass the buck". Perhaps the money saved As a volunteer I feel I can say these things. from running them will The very few staff at Red Cross, can't. enable more beds to be provided at the main hospital. On the sadder side; loved ones may not be able to be with patients during their last moments because they will have too far to travel. Bus services have been cut everywhere which means people living in the country are becoming more and 241 A4 BOTH HOSPITALS ARE just BEDS AND NNDH 4 KEEPING ALL THE COMMUNITY HOSPITALS HOW CAN NDDH N THE MOST ECONOMIC OPEN AND PUTTING THE PATIENTS COPE WHEN IT IS TO RUN AND ARE IN THE FIRST.EVERYONE IS ENTITLED TO CARE ALREADY ON BLACK AREAS THAT THE CARE IS THAT IS IMMEDIATLEY CLOSE TO THEM , ALERT IN THE NEEDED. THE MAJOROTY OF PEOPLE IN NORTH SUMMER AND THATS DEVON ARE IN NEED OF CARE AND I FEEL IT WITH THE USE OF IS DISCRIMINATIVE TO MAKE ALL OF THESE COMMUNITY PEOPLE TRAVEL TO NDDH. HOSPITALS.

242 A6 I feel that this gives The local Holsw Holsworthy, this is too far 3 N better access for elderly hospital is orthy from the main hospital and folk to be nearer their already would make transfers back homes I would choose there and in in emergencies a lengthy Ilfracombe and South refurbished process. Molton. not too long ago. 243 A2 We are semi-rural area Use of GP C This ignores the nature of 4 Will the Just because the N and this is more likely to beds. this community and the fact infrastructure truly government tells you meet the needs of the that many people do not be put in place - if, as to make cuts doesn't community. have good public bus access it argued there are mean you have to do to services - also due to not enough nurses to this. We can protest government cuts. staff community and fight back - for hospitals how will the sake of the you find extra community and for community nurses? the country and for the NHS.

244 A6 Community beds are B The elderly need dedicated 3 Yes I do Understand N needed at both beds within their local but don't think it will Ilfracombe Tyrell and community for them. Having help those really in South Molton as we both none will not help the past need and the have a large proportion and current bed blocking community's they live of Elderly people living in being experienced by every in. the community. These hospital. beds are needed even more especially as the Council respite, homes and day centres have closed.

245 C3 I think it's very important The beds 3 I don't think you have N to keep Beds, to free up are already the staff to put this beds in the Hospital. there, so into use. why not use them.

246 A2 Beds in Ilfracombe a The same B With only beds in Barnstaple 4 I have no idea how N must. Such a busy town, way as you hospital friends and family you intend to look and large rural propose to are not as easily able to visit. after people where surrounding villages, fund a 16 With elderly restricted to beds are removed. especially in summer bedded unit public transport and often Perhaps not at all. months when population in Bideford, not in amazing health With life expectancy booms. Likewise Holsworthy, themselves this will put an already shorter in Bideford. South immense strain and Ilfracombe loosing molton. unnecessary stress upon all the community beds Residents in parties involved. will only reinforce Ilfracombe this even more. are not dead yet, we need a facility too! 247 A4 Rural isolation, N/A B Travel for rurally isolated 3 Keeping all community hospitals in ND open No, because we don't No community beds N population, lack vulnerable people. could have been treated as a high priority yet know which should be closed transport, % elderly, option. towns these will be because: Care closer growing population and the issues will be to home for (including ageing different. increasing elderly population), genuine care demographic cannot closer to home. be delivered adequately if they do. (I have personal experience of the difficulties this causes for elderly patients who have to stay in NDDH longer and their carers who get ill due to the stress of extensive travel to NDDH).

248 A1 Bideford has a high A6 Ilfracombe + South Molton 2 None I can think of. I understand that I know at the N population of elderly It is not financially viable to more people will be moment care residents and a low get Ilfracombe hospital up cared for at home agencies are number of residential and running before winter. rather than struggling to fulfil placements available. South Molton has numerous remaining in hospital. packages of care. An Long term this could care homes in the area increase in people mean people having to which could support hospital being discharged to travel further to visit a discharge if needed, e.g. be cared for in the loved on in hospital short stay while a package of community could should Bideford be care is sourced. well involve the need closed. Holsworthy for carers support. appears to have scope to This could increase expand the site if the unfulfilled necessary in the future. packages of care the DCC have. 249 A1 There is a lack of public B Poor transport 4 Care in the N transport for non car infrastructure, hospital sight community is all very owners or drivers to visit is not big enough - car well but who is going family and friends. These parking nor building for an to do it - families are places are needed in the ever growing North Devon not always available community as we have a population. Further difficulty or able. Care large non-locally born in recruiting staff because of agencies are always population who may be the mileage having to be seeking to recruit elderly and have no travelled to commute to staff in what is a low family in the area to care work. paid, un-social hours for them but do not job which people just necessarily need front do not want to line hospital care. undertake. Local Therefore releasing beds newspaper job advert and staff to care for page will show that those who do need more every week. in depth medical care.

250 A B and C are not options- Ilfracombe C Band c are not options as 3 Move funding from secondary care- reduce After 40 years N community care is low hospital is explained above. The fact services at nddh-urology ophthalmology- training and working key minimal investigation unfortunate they have been suggested I'm happy to go to Exeter if I need my in Barnstaple and supporting reablement ly not suggest to me that the trust cataracts or prostate done but I certainly subsequently as a and good deaths (where financially decision makers spend too don't want to go further than my local GP which management is not viable. much time on Raleigh hill to community hospital when, as I will, I die. included long stints possible at home). It also make unbiased and sensible on PCG,PCT and reduces bed blocking. alternative options. acute trust board as NDDH is an acute facility community director I with a c21 culture based formed my personal on investigation and opinion of local treatment of the sick. I healthcare decision personally cannot think makers. They talk the of a worse place for my talk, cow tow to death. The last 50 years strategic ha or dss of acute care has delayed directive and seem to death but the quality of know little of what the gain in years is very goes on in the name questionable (Lancet of health care off the 2015). the community in site of the NDDH. The Barnstaple have close jewels in the crown access to coe beds and a of local health care hospice. A frail elderly are the community investigation unit, whilst hospitals. We have to an appropriate usage of save £10 million secondary care funding is pounds this year- a totally inappropriate think out of the box- use of community care close NDDH for a 251 C Being mindful of the dire Not C C, not economic option, see 2 N state of NHS finances in applicable. above. isn't viable to keep beds everywhere. Bideford has the largest Community Hospital and the best equipped one. Considerable funding has been invested there and there are good outpatient clinics such as OT and physiotherapy on site which also have input to the wards. Torrington, Ilfracombe and South Molton do not have such extensive staffing on site.

252 A I believe that it is B More beds at NDDH. 2 N essential to keep families together whenever possible, and for the Trust to acknowledge that travelling is not easy of everyone. 253 C2 NDDH has better road A Using 2 community 3 Using community hospitals instead of I understand and Y and bus links from the hospitals. NDDH for Clerical staff in Ares within the agree with the South Molton and Com Hos that would prove difficult to principle although Ilfracombe areas which accommodate patients who may have poor not confident the would assist in families mobility etc. service provided will visiting. If NDDH was be very high. used for more of re-hub post CVA for example there are teams already here to continue care. Could prove more efficient and better outcome as patient not meeting so many different staff. Holsworthy for longer term or for the more complex care patient. Easier for families to visit from Holsworthy, Bude and surrounding area.

254 A4 Holsworthy and South B All community beds at 4 Leaving the beds as they are, and if asked Where is the Winter is coming and N Molton can give enough Barnstaple. many people would willing pay an extra guarantee for the you are continuing to beds. Transport links amount on their Council tax to keep the funding and the staff put very vulnerable from Holsworthy to facilities at Holsworthy and South Molton. for this community people at risk. Barnstaple is extremely care. Last Christmas personally, I do not poor and to far for there was wish to ever be in a friends and family to visit considerable bed position of needing patients. Infra omen blocking due to lack community care, it does not have sufficient of community care. fills me with dread at bed capacity and What has changed the thought of Bideford is right next since then? getting old and in door to Barnstaple and need! has the benefit of good transport links. 255 A4 While I understand that B As explained in answer 1. 4 No idea, as no information about how you Found out about the N lower cost care can be got to these options in the first place. meeting in given centrally for the Holsworthy by over trust this is at the hearing a expense of your patients conversation in town. and their families having This form was hard to to pay higher costs to find and the list of travel there. This is meetings on the front simply passing the cost page does not even out to the users, it does have Holsworthy not take any meeting listed. The consideration into the meeting was very needs of the patient or poor as it was not family. In fact the aspect clear who had the of people wanting to be final decision, in fact cared for locally and the presenter even close to family and stated himself didn't friends is not been met fully understand the and will be much worse process! and impossible for some on low incomes.

256 A4 It is essential that B We don't need the beds at 4 Yes, but how are you I think you should N community hospitals are Barnstaple. expecting single talk to people who maintained. Sometimes I people who are are dying and see think NHS Trusts have no possibly dying to what they want - you idea of the difficulties manage their daily may well be involved when people are routine. Carer visits surprised. in hospital and friends four or five times a and families have to day won't help when travel 70, yes 70, miles to someone calls at visit them. How can we their home and they as a nation expect people can't even let them to do that. And if people in. have to use our virtually non-existent public transport they could spend all, and a friend got a quote of £200 for a round trip from Broadwoodwidger to Barnstaple. 257 A (Listed Holsworthy South B Barnstaple alone. Too far 4 Expanding community care. N Molton or Bideford) from home for many friends Need to retain hospital & relatives to visit. beds for increasing population. Large number of houses to be built in north Devon. Increasing age of residents. Local community care is not yet in place. Need for patients to have somewhere to go when home carers need a holiday or cannot cope.

258 A4 In addition to the items B Anything involving NDDH. 3 The positive aspects of each choice were I think I do; i.e by What savings are N listed in the consultation NDDH does an excellent job outlined well but little was said about the care in the home and being made in document there is: a) with its current negative consequences for each option. the use of private administration. There Poor access to NDDH responsibilities. However it is There was no financial data except of the hospitals. Again there appears to be three from Holsworthy. Access hard pressed in all aspects overall savings required. was no financial levels in Devon, i.e to Ilfracombe and South from car parking to an information to show The Commissioning Molton is even worse. inability to deal with surges. what these extra Group, the This would have a The number of cancelled costs would be and Healthcare Trust and negative effect on criteria operations last January bear what had been set in the hospitals. 3 b)Holsworthy hospital witness to that. Increasing aside to cover them. Sounds excessive to along with the doctors this burden would be e.g How many private me. practice, a chemist, and ridiculous. beds could be funded the recently opened Long and what extra House hospice forms a community staff modern medical centre would be required. I which provides an believe a significant excellent service. amount of the care in Reducing the the home burden will effectiveness of the fall on family, friends, group would impact all and neighbours. criteria c)There are approx. 10 beds in the hospital funded by the practice which would be lost if the hospital closed. Losing these beds would have a negative effect on criteria 7 d)The 259 A1 Holsworthy needs to stay B Barnstaple, need all the beds 4 Holsworthy is expanding all the time. Devon I guess you will have N open, as Patients and they can get. To much ward Hospitals are always having there budgets people in their their family would have shuffling, just to squeeze, cut, Maybe too many Chief's ??? homes, the Care Staff to travel for 2 hrs min, some-one else in. Nurses looking after them, just to get there and don't get to know the are all stretched to back. Yes, Holsworthy is patient, just Symptoms. breaking point A Community Hospital, as already. The Great the name suggest one's look after the "Community" for Good patient Properly and Reason. When family Checking on the members need time for Client, in there own themselves, there will be time and the Bad?? others to visit the patient, as Holsworthy People care. And with the Great Help, from the Doctors and Nurses, Every -one has Peace of Mind, that there loved ones are well looked after, even at the end of life. Respect and Dignity, not much to ask!

260 “Opposes the closure of Holsworthy beds”

261 A4 These are the two B 3 Utilize these N hospitals which are community hospitals further away from the , take the pressure main hospital (NDDH). off the NDDH and give more local services to local people. While helping the carbon footprint. 262 A4 Both are purpose built B Community beds at NDDH. 4 Investing in home carers in the rural setting. Yes, fully aware of It would be Y and well supported by It's a return to the awful Care in the community fails as it is currently the service proposed refreshing for the staff and the local "care of elderly" system that because of lack of staff to provide the and aware of the people making community. The absence used to be in place. service. The carers are not paid enough and service currently in decisions to listen to of a local hospital at not given travelling time so the only people place. what the community Holsworthy would cause willing to take on the jobs are the ones wants and address untold upset to patients forced to do it because it's the only job the savings needed and their relatives if they around and not because they are "caring" by working around had to travel to NDDH. people. Make it a job that has pride and the needs and It's a hard enough standards. If you are serious about Care At desires. Closing the journey when you are fit Home and reducing the need for all hospital beds is short sighted and young but if you are beds acute or community then this is the and there will be a elderly and not have gap in service that needs addressing. crisis in the winter transport it's impossible. months when the Holsworthy's specialty is acute hospital is the end of life care that it blocked because the provides and allows for patients ready to go people to be together at home have no way of this difficult time. If the getting there because patient was in NDDH the there is no care is just not there for alternative safety providing what is needed. valve. 263 A4 Holsworthy is the B The proposal for 40 3 Y furthest site from NDDH, 'community beds' within with South Molton next. NDDH is a non starter. These Holsworthy has lowest % would not be new beds - all of car ownership, making beds available in NDDH were the journey to NDDH or utilised during the 'winter any other hospital more pressures' previously. Any difficult - also least benefit of community beds frequent bus service. for the patients would be South Molton has second negated, due to the in lowest % of car accessibility and distances ownership - although involved with journey times. does have more frequent bus service. Holsworthy, being within North Devon and South Molton in Torridge would ensure both areas had community hospital support. Holsworthy are able to recruit and retain staff - when the threat of closure is not looming! Holsworthy has close links with the new Long Reach, Hospice building next door, but it will have no beds - the intention 264 A4 Holsworthy and South C All beds at NDDH. 4 Transportation from outlying areas to Y Molton are buildings NDDH should this be the preferred option. which were built recently End of life care and the relatives involved. and can be developed to make adequate arrangements for end of life care, where family are able to come and stay to be near their relatives when close to the end, this can be for anyone within the northern Devon area including Barnstaple and Ilfracombe and hospice care is not always available. the sites are serene and peaceful and the care is outstanding according to CQC. people living in these areas are out of area for NDDH and transportation is either not readily available or extremely expensive and a pensioner would not be able to afford to visit regularly this will have a 265 A5 Holsworthy and I have no B Whilst it provides all services 4 In short no. But how If taking away N Ilfracombe to retain knowledge centrally it does not consider can you provide care community hospitals community beds as these of the the patient or their relatives where there is no proceeds then there two units are furthest options so or visitors having to travel facility 24/7? will be a greater from Barnstaple and cannot great distances and time strain and usage of certainly Holsworthy comment. which for some would be ambulances to south is in excess of 1 1/2 impossible. Therefore the transport people and hours drive, these two patient would become other community would offer local isolated and is detrimental volunteers at who's community care. Many to their health and recovery, expense. This is ill patients relatives cannot or consultations with thought out and drive and with poor bus medical staff would not be centralisation does service visiting would carried out to promote not work, it has been become difficult and patient care. tried in many totally reliant upon the facilities only to being bus time table which reversed with 1-2 often does not fit in with years at great extra visiting or patient access. expense. The lack of family visits has a detrimental effect on patient well being and recovery times or indeed discharges might become impossible without further burden on patient transport. 266 A4 "Travelling to our main No B All beds at NDDH, as set out 4 The level of detail about the financial It is assumed What are the N hospice base in comment - in some of comments above. aspects of these proposals is derisory. rehabilitation and definitions of safe Barnstaple was just too as out of Furthermore, historical end of life care will and effective care? much for most people." area. financial data would indicate either be provided in There is insufficient North Devon Hospice that the unit costs of reduced number of detail about how the Chief Executive talking community beds within an NHS beds (so patients proposals will work. about The Long House acute hospital setting often may not be cared for How about giving development at exceed the unit cost of in their own locality), details of some case Holsworthy. I think that locally based beds. How will by outsourcing to studies showing how health professionals and the finances justify all beds nursing homes, or by the care really will be managers based in on NDDH site? care at home teams. delivered? For Barnstaple have no idea Care at home is the example, a 90-year of the distress for older most anxious part of old had major people of being admitted the future - it is not abdominal surgery to NDDH either for 24 hour, leaves many requiring a total of 3 themselves or their hours in isolation, months in NDDH (2 spouse. The need for places significant weeks) and acute and emergency burdens on family Holsworthy (10 care at NDDH is not and carers, and the weeks) before questioned; treatment social care part discharge home to and care is very good. remains a high risk care of spouse aged The burden and provision - it does not 84 years with visits difficulties of travelling to always deliver! by district nurses ( as NDDH are complex - Whilst the number of required) and social finding someone able to nursing home beds carers (2 -3 times take them there, impact has been stated - are daily). What is the on their own health of 2+ these fully staffed care pathway under hours round trip on daily available beds and these proposals? 267 4 Totally appalled at N even the thought of bed closures anywhere. With the building being allowed in North Devon with the major influx of new people to our area, hospital beds should be increased rather than the other way around. I do not believe there is any availability at care homes to take in your transient people (between hospital and home)and the GP 's in our area will be unable to cope. Your proposed timescale is ridiculous and is but an accident waiting to happen. 268 A6 This should serve the There is Please explain the reason for My husband has N widest spread of room to your response below Any Alzheimer's. I am his community services convert combination of units which sole carer. I need across North Devon. some make it difficult for friends respite too. A ground and family to visit inpatients. monthly memory floor space Ilfracombe has an aging cafe is no help. I need into population of 9000 +, soon time for my own well- another to be increased by the being. At least ward, There proposed new southern Burrow House and is a lot of development. It seems beds in a local wasted ridiculous that a town of this community hospital space in the size has no NHS community gave me hope that I building. hospital or respite facility. could have some me With the Ilfracombe needs a time. That Hope has existing community based hospital. now gone, I am First floor Bus services between totally isolated in my wards this Ilfracombe and Barnstaple own home. Or am I would give are particularly poor. being selfish? the minimum number of beds required. 269 A (Listed Ilfracombe & C Beds at NDDH. A lot of 3 N another). Having dealt people in North Devon do with elderly parents in not drive and find the buses the last 3 years of life I tiring and difficult. This have personal experience means driving a long way to of a lack of local hospital NDDH rather than a few care. I believe in the case minutes to a local unit. It of my mother she would means the person in hospital have lived longer as she is one of few and has plenty would not have been of attention rather than one infected with a nasty of many. chest infection which she picked up from the woman in the next door bed in an acute care lung ward. If she had been moved to a local hospital for the mobilisation which is all she was still there for having had the infection which caused her admittance dealt with - she would not have been exposed to those pathogens. Driving for nearly an hour each way to the hospital also put tremendous strain on my 270 A2 Smaller towns need beds Look at the B More beds in nddh This 3 it isn't a matter of N to avoid travelling etc for oversized hospital should already have just cutting beds, the relatives and patients manageme enough beds within its whole system seems who prefer to be closer nt structure structure. corrupt in that a to home to recuperate. within the manager is retired or current leaves and goes on a system. pension , yet later on appears back elsewhere on full pay as a consultant! Stopping this would save money. Additionally the stupidity of employing agency staff should stop now and managers start earning theory pay and recruiting staff themselves to fill long term gaps at a sensible pay level. 271 C2 Holsworthy is a Least preferred option is to 3 Yes I think that using N geographically isolated remove all community based resources to provide area with few public beds. In a rurally isolated care within the home transport links to the area it is impossible to is not economically wider area and deliver the equivalent quality viable when one Barnstaple which makes of patient care through calculates the it impossible for relatives keeping patients at home amount of time that to visit those who are and sending out services, to a highly qualified receiving cafe. them this is a waste of staff member could Furthermore due to staffing time and expertise. spend driving from nature of the area Equally one cannot ignore client to client when covered by the services the benefit for the patient of they could be Holsworthy provides being treated in a location treating several ensuring that these near to their home clients who are services are delivered environment where it is centrally located within the patients home possible to maintain links to within the are unpractical as it will home and community community hospital. take a substantial making it possible to move If one was to amount of wasted time patients more quickly out of calculated the time for staff to be travelling the hospital setting and back spent travelling from between patients rather into the home with a a patient in their than having a group of supported transition. home In The east of patients centrally located Inevitably having relatives in Holsworthy where care can be given. NDDH places a huge strain catchment area to Staff are much be utilised on the extended family, And the west with good giving both inpatient and thus increasing demand on weather and traffic outpatient care at a support services to support one would have to central location. these relatives. e.g. A wife allow 3/4 an hour 272 C1 Bideford hospital as it N/A. B NDH only - this is restrictive 3 No - I have not had Cuts should not be N covers a large area to more remote areas that access to any details made to the NHS. (Hartland, Clovelly,, are not central to NDDH. or proposals. The Government countryside areas around increase their own Bideford which are salaries year on year remote from NDDH). yet cut important frontline public services such as the police, Justice System and NHS. Working people pay National Insurance contributions to ensure they can access health care and the specialists who work in the NHS should not be put under further pressure. 273 A (Listed Holsworthy & 1 B Beds at NDDH for reasons of 3 Is closure the only option? Is there no way Can seriously ill N other). Holsworthy is distance and accessibility. pressure can be put on the government for patients with say, furthest away from the money for beds in rural areas? terminal cancer, be North Devon Hospital. It cared for at home, is 29.5 miles away, especially in poor Bideford is 11.6, homes without Ilfracombe 10.7 and adequate facilities? South Molton 13.3. Buses to Barnstaple from Holsworthy are infrequent and do not run in the evening, so seeing seriously ill or dying relatives or friends is almost impossible. Holsworthy Hospital is a well run purpose build hospital doing good work here where it is needed. Holsworthy is growing fast with lots of new houses being built. Many retired people are moving in and as they age are more likely to need care.

THIS IS WHERE NELIIE HAS PRINTED TOO! PLEASE DO NOT REMOVE THIS MARKER 274 C1 For Lynton and Lynmouth Not an A4 Holsworthy and South 2 Not within the financial constraints. Well understood and Well done. Just hope N and outlying villages. option I Molton due the distance that support the aims. the response you Bideford has the benefit would relatives would have to But worry that receive will enable not of very good road support. travel. enough fully trained you to make the and bus links. Expensive staff will be available. fairest option. option and poor parking facilities. 275 A4 Holsworthy & South B Beds at NDDH . This option 4 Leave the situation as it currently is. N Molton are better placed completely disregards the geographically to the fact that accessibility from needs of patients residing many parts of the rural areas in the more rural areas of of Torridge & N Devon, Torridge & North Devon. particularly by Public Furthermore the Transport to NDDH by buildings are relatively patients and visitors is modern and there is extremely difficult and more flexibility to cope costly. with increased patient numbers.

276 A (Only Holsworthy listed). B Having all beds in NDDH - for Maybe having 2 Community Hospitals N A lovely hospital with the reasons stated above. spread over the large rural area of North excellent staff providing Devon could be a viable option. Maybe you exceptional care. This should look at enhancing these hospitals. hospital is vital for this Maximum beds will most likely need to be end of the county. opened. Holsworthy once could take in 28 Travelling a 70 mile patients and has even been know to take round trip, of an hour patients within the dayroom area (although each way, to visit loved this did create 'privacy' problems at times) ones, keeping them Maybe a handful of beds in the Community supplied with clean Hospitals could be used for 'Respite beds' clothes, toiletries etc or again as they were years ago provided needing to visit daily much needed relief to carers for a holiday/ terminally ill people break from caring. I know this service can would be unimaginable. be arranged in local 'care homes' but Bus timetable is very perhaps the NHS could charge for this poor for this route and service as care homes do, generating extra people would be forced income for the hospitals. to used taxi's to get to and from the hospital. If people are stuck in Barnstable, awaiting care in the community to be set up and are away from home and/or lacking visitors they will become depressed that may impede recovery. How 277 A (Only Holsworthy listed). N/A. B My least preferred option for 3 Unfortunately I am not really able to give a Yes but while good in I have had experience N Holsworthy Hospital the many reasons given in considered answer to Question 5 as I do not theory I do not of both types of care:- serves a rural and Question 2. have enough information or in depth believe it is feasible in My father went in to isolated area where knowledge to do so. practice especially in Holsworthy Hospital provision of care in the Holsworthy given the at the end and his home is hard to maintain inability for many to passing was much effectively. It not only get to community more comfortable for serves the town of hubs on an him in a bed that Holsworthy but outpatient basis and stopped sores, he surrounding villages and the transport links to was surrounded by rural homesteads. The other hospitals for family, friends could distance between homes inpatients. visit easily and we felt makes care at home very supported and at difficult, leaves patients peace. Prior to that isolated and often my mother had without means of struggled at home contacting the services and getting help was when things go wrong as very difficult - after mobile phone network he had fallen and she signals are poor and was unable to move indeed in some areas non him it would have existent and the nearest been several hours neighbour can be a before help was considerable distance received had I not away. Many of the managed to get elderly patients live alone home from work 30 or are cared for by miles away to help. In elderly partners who contrast my mother 278 A4 The catchment area for B All beds in NDDH. Too far to 4 The financial saving should have been fully Unsure there are Keep Holsworthy N the community hospitals travel for elderly family and and properly costed before going to sufficient community Hospital open - it is a can be up to 40 miles friends. Due to bed pressure consultation so informed decisions could be medical staff to fully functioning, from NDDH. Bideford is in NDDH patients likely to be made. cover. relatively new closer to NDDH and good sent home for the building that provides roads so easier for community nurses/doctors first class care. Bideford people to get to to manage. Much less safe, NDDH than for someone, as District Nurse can only be say in Broadwoodwidger with patient for limited time who would have to travel whereas in Holsworthy 40 miles plus on poor hospital patient would have roads. Much better they support. can access support in Holsworthy. Need to know what saving financial will closing the beds make and what financial cost there is to the additional community nursing that would be required with less beds. These figures should be publically available in order to make an informed decision. 279 A4 Holsworthy is very N/A. B It leaves the south and east 4 Keeping beds open in more hospitals Yes I do but my main There is little faith in N inaccessible by public of the area with no including Bideford in addition to those in concern is for those the process you have transport, the fabric of reasonable cover and means my selection. who still need a conducted. I am an the hospital is good and that people from these areas hospital bed such as ex-PCT NED who has staff recruitment and will die away from home and those not yet ready been involved in the retention are excellent. family. This will undoubtedly for discharge or closure of community The presence of a add to their and their those who are at the hospital beds but Hospice is identified as a family's distress. end of their life. An from what I have weakness but as it is not acute hospital is no seen of the process residential it is actually a place for such and practicalities of strength or at the very people. They need to this consultation, I least irrelevant. The be where they are think it has been Hospice needs residential known and loved and dreadfully badly beds to function and where their family handled. Links to this closing the beds in the can visit and support consultation have neighbouring community them. Moving been incorrectly hospital will have a major everybody to referenced in impact on those who are Barnstaple is documents or else near to life's end in the downright cruel and the link is broken. Holsworthy area. South inhuman treatment Named contacts are Molton also has poor for an old and dying on leave and the public transport links and person. person to whom one locating the second is then referred is community hospital also on leave. there gives a more even Personally I am more spread of coverage inclined to think this across North Devon. The is due to building is also fairly incompetence on 280 A Keep Holsworthy and 1 B All beds at NDDH. Too far to 3 It does say in part of the document there If the ?£ spent on this N other whichever is travel for patients, staff to was not enough evidence to formulate an consultation and furthest distance from work and visitors on a daily opinion why was this? who was asked, many others had Barnstaple open. Many basis. Waste of money in where, and when? been given to NHS years ago when the making a relatively new then there would be Patients Charter was hospital like Holsworthy no need to shut released it stated that no which is more than fit for anything! Need to one should be more than purpose having alterations seriously look at all 35 miles from a hospital to make it suitable for other the ways money we are 38 from uses. Rural setting smaller could be saved, Barnstaple and Derriford! more personal aids faster locum pay for staff, My Father was in recovery therefore costing get rid of the nursing Holsworthy hospital for 4 less in the long run. bank system why weeks following a stroke, should outside the care he received was agencies be making second to none, both lots of money from medically and socially. NHS for admin work? Can you imagine for 1 Fine people for not minute all the travelling attending that would have entailed appointments to visit Barnstaple each without good reason. day a round trip of 76 miles! Elderly partners cannot face that distance to visit, elderly patients receive more local visitors more stimulating environment aids 281 A4 There was a real need for B Too far from Holsworthy. 4 Leave all the community hospitals as they Yes - it won't work in Holsworthy Hospital N this hospital when it was are. such a rural area - I covers a wide area - built and there is still a see you infer that most of it rural. need which will be towns are the only Community nurses greater when all the new places that need the will not be able to houses are built in the hospital. undertake this area. workload if it closes. 282 A Holsworthy and B Barnstaple because people 4 Yes I do understand If we close our N Torrington, Very rural can not get to this hospital as I am a senior care community hospitals areas and a lot of people very easily by car or public assistant. the hub of the want to be cared for in transport. community will be there own community to lost for ever. The be near family and local people will have friends who could then no were to go and visit them. will end up dying alone in a hospital because there family can not get to see them . People will die in unfamiliar areas very sad !!!!

283 A4 Both Holsworthy and B All beds situated at NDDH. 3 Status quo, but as the Trust has to save No I don't really The Consultation N South Molton First of all distance from £5m this is obviously not an option. Has the understand, as hasn't really given Community Hospitals NDDH and essentially that it actual loss of beds within the Community obviously more residents in these service isolated rural is a fact that patients recover Hospitals been fully costed? This was not qualified nurses and areas time to areas. Holsworthy in more quickly if they are in made clear at the Consultation last evening. caring staff will have assimilate and particular looks after family surroundings and to be employed, has evaluate all the patients who have to relative and friends are able this been costed and considerations on the travel up to twelve miles to visit frequently, especially where are the extra table. to Health Centre and if they do not have transport funds coming from to Hospital, with NDDH and have to rely on other fulfil this need. what being forty miles from peoples' generosity. Also, about the Rural Broadwoodwidger Parish there is the question of clients, how will they which has no public expense. be serviced especially transport. when having to drive 16 miles from Holsworthy say, three times a day? 284 A1 I am completing this form B 4 It needs to be shown before any See above. It has been talked N to point out the essential community hospital is shut that care in the about for years to need to retain community can work. It was mentioned at a provide more care in Holsworthy Community meeting at Bradford that 40% of the community, it Hospital. Bideford community Hospital patients don't need to needs to be shown Hospital would be the be in hospital. It would seem logical to start first that resources other most important care in the community on this group of are put in place and it Hospital to retain with it's patients. This would also allow further is effective. excellent stroke rehab on patients to be discharged from Barnstaple Elizabeth ward. to ease the pressure there. Holsworthy is further from Barnstaple than any other Hospital. It is a purpose built community hospital. Holsworthy hospital provided excellent care for my Aunt in the last two weeks of her life. She had been living on her own, 24hr care was the only appropriate care for her final days. Bideford Hospital is a well designed building which can provide excellent care in it's COE and stroke rehab units. 285 A (listed Holsworthy and B Central ward at NDDH. As 4 Go to your funders and demand more cash. Your plans are naive This looks like a N one other). Holsworthy is good as this hospital is it is We are a rich society and you are failing in and impractical. rationing plan similar very remote compared to too busy and too remote. your duty to your patients if you meekly to the ill fated clinical other towns. The Using this site pushes costs accept your budget as issued. Stop meekly rationing attempted journey time to onto other budgets and following orders, it maybe good for your last year. Barnstaple is long, individuals and overall will career but it is not good for us! expensive and almost save nothing whilst impossible by bus. You increasing anxiety and currently have no viable possibly the demise of some local medical cover in lieu residents of the more of the hospital and little remote areas. chance of getting this in place in the foreseeable future. The private sector is likely to become more costly as the minimum wage proposals come into force and in any event has a poor record of decent care. Your deficit is small in the scale of things and hardly relevant where you are mandated to provide proper services; adopting closures of local facilities on the scale proposed is both foolish and short- 286 C2 Treatment rec'd over the B Just Barnstaple as a distance 3 Yes. N past couple of months to travel both for patient and Initial diagnosis and visitors Large and noisy operation in Barnstaple because of the meet if then superlative nursing people More personal care at hols worthy. in smaller units cottage hospitals. 287 A Holsworthy. (This was Holsworthy. My dear dad passed N the only 1 listed). away at hols worthy hospital earlier this year. This was my dads, mums and the family s wishes. As he was at hols worthy hospital it allowed us all to be there with him when he sadly passed away. Had he been anywhere else we would not have got there in time. It also allowed his 6 grandsons to visit him regularly in his final days. Had he been anywhere else the boys would not have seen him, due to time and distance. And those final moments are the most precious and those memories you can never get back. 288 C2 HOSWORTHY NEEDS ITS N/A. A&B OPTIONS A& B, SEE ANSWER 2 KEEPING ALL EXISTING HOSPITALS, AND YES, IT IS NOT AN YOU MAY FIND WAYS N EXISTING HOSPITAL NO 2. SAVING THE MONEY ELSEWHERE. IMPROVEMENT ON OF CUTTING YOUR BECAUSE OF THE EXISTING CARE. COST, BUT THE COST GEOGRAPHICAL TO PEOPLE IN THE POSITION, MODERN AREA AROUND BUILDING, WITH ROOM HOLSWORTHY FOR EXPANSION IF WOULD BE NECESSARY, PLUS THE UNACCEPTABLY NEW LONGHOSE HIGH, NOT JUST IN HOSPICE BUILDING NEXT FINCIAL TERMS, CARE DOOR.THE AREA'S FOR PATIENTS AND ISOLATED AND POOR FAMILIES WILL COMMUNICATION AMOST CERTAINLY NETWORK MAKE IT DETERIORATE. EXTREMELY DIFFICULT, AND SOMETIMES IMPOSSIBLE FOR SOME FAMILIES TO REACH NDDH FOR VISITING. THE NDDH WOULD BE VITAL FOR NEEDED FOR MORE COMPLICATED MEDICAL NEEDS. 289 A4 Holsworthy has a B All beds based at NDDH. 3 I am very concerned The area covered by N recognised reputation, is Nobody would gain from this at the distances that Holsworthy Hospital furthest from Barnstaple option. Visiting would be community staff will is huge and there are and has poor transport very difficult for many need to travel and no bus services from links to NDDH. South people. Well established the attendant costs rural villages which Molton is also some sites would be lost with the which don't appear would make visiting distance from Barnstaple possibility of hospitals to have been Barnstaple and and this option would closing altogether. investigated. There Bideford unreachable give the greatest have been recent for many. There was coverage for the region. reports of a shortage talk at the meeting of of 800 nurses in the providing transport region and options if Barnstaple experiences in were the choice I Torridge would show really cannot see that the system if not valuable NHS money flawed is certainly being used to fund showing cracks. If transport for visiting. this was not the case There was also talk of then the people of taxi fares upward of Torridge would not £120 this is from be so desperate to re- Holsworthy from my open their hospital. village it is almost impossible to get a taxi to Bude let alone to Barnstaple!

290 C2 Lack of Public Transport. B All beds at NDDH. Under 3 Take Ilfracombe from the mix and sell it as How will Care Closer N Distance to NDDH. staffed. Can't cope on red an asset. to Home be initialised Ageing Population. alert status. Not personal ? Needs to be in Holsworthy has a good nursing experience. Poor place before closures. rate of nursing levels. food. Why did the CCG Excellent Medical Centre. hand this back to you Has many extended ? How much money families who need to be has been spent on able to visit loved ones. CCG set up and consultation ? 291 C2 Holsworthy is the B This would mean that no 3 See comments Relying on mobile N furthest distance from town would have beds at below. carers in the villages Barnstaple of all the their local hospital. This and hamlets around community hospitals and would lead to major Holsworthy would be public transport is the problems with accessibility, extremely ill-advised. least frequent and takes especially for people living in The areas are deeply the longest time. This is and around Holsworthy rural with very many a particularly important which is the furthest town properties difficult to consideration bearing in away from Barnstaple. find. Most of the mind the fact that of all roads are in poor the towns car ownership condition and they is the lowest in are not gritted in Holsworthy. The winter. Mobile community hospital in telephone coverage Holsworthy is purpose is notoriously poor built with a flexible layout and this would make and it has the fewest communication problems with the virtually impossible. recruitment and retention of staff. It would make no sense at all to close this hospital.

292 C Having read the N/A. A Two other hospitals being 2 No. I am sceptical about No. N consultation document left open. The costs and care of patients in this is easily the best logistics are prohibited. their own homes as option. It is the most community nurses modern and does not cared for my wife for have the staffing issues a few weeks, showed of the other areas. In me how to use a lung addition it has the lowest drain then I have car ownership and public been left to do it and transportation problems. am still doing it one year on. 293 A4 Your board says this B Why should Barnstaple have 4 Putting a and e in community hospital to What about the what happens to the N option meets the criteria everything ,living 22 miles take pressure and waiting times off countryside around redundant hospitals and to think as an old away if my relatives are Barnstaple. this towns. and the loss of jobs in person being stuck in taken ill to go 10miles to visit area. Barnstaple miles away is cheaper than 44mile from home is terrifying round trip for elderly not knowing anybody. people.no public transport after 5pm .the level of care is sometimes better than the big hospital as more personal.

294 A Because of the B Beds at NDDH only. This 3 Given the state of funding, I do not think so. N geographical spread of would not be in the best the area I believe that interests of long term or two community terminally ill patients from hospitals, situated at the remote areas. There needs furthest points from would be best served by NDDH would be sensible being close to family and and a good investment of community. Emotional and the trust's funds. Many personal support is people in need of nursing invaluable to all patients, care would benefit, and and especially in the above the District Hospital cases. could use resources for surgical, emergency and diagnostic cases. It would relieve the pressure on NDDH to provide beds for patients that could be nursed in the community hospitals. The welfare of patients in the remote areas of the trust would be better served if they were nearer to home and family, particularly in the case of end of life and long term needs. 295 A (Only Holsworthy listed). B All at north Devon district. 3 N Holsworthy community Not economically or socially hospital is incredibly as viable for patients to have important to local to travel so far. people. Its a nice fresh new building that deserves to stay an NHS hospital. It is invaluable to the older generation in the area to stay near the family they love in a hospital as nice as Holsworthy.

296 A4 Holsworthy is very N/A. B It leaves the south and east 4 Keeping beds open in more hospitals Yes I do but my main The fact that the CCG N inaccessible by public of the area with no including Bideford in addition to those in concern is for those has effectively transport, the fabric of reasonable cover and means my selection. who still need a disengaged must the hospital is good and that people from these areas hospital bed such as throw the validity of staff recruitment and will die away from home and those not yet ready your process into retention are excellent. family due to the poor for discharge or question. Surely in a The presence of a transport links and high those who are at the client - provider Hospice is identified as a costs of taxis. This will end of their life. An relationship you must weakness but as it is not undoubtedly add to their acute hospital is no have their active residential it is actually a and their family's distress at place for such participation, or risk strength or at the very a difficult time. people. They need to failing to meet their least irrelevant. The be where they are stated needs. Hospice needs known and loved and residential beds to where their family function and closing the can visit and support beds in the neighbouring them. Moving community hospital will everybody to have a major impact on Barnstaple is those who are near to inappropriate for an life's end in the old and dying person Holsworthy area. South - I know from Molton also has poor personal experience public transport links and with my own mother. locating the second community hospital there gives a more even spread of coverage across North Devon. 297 A4 Both are the furthest 4 Yes and I don't think Holsworthy needs N away from Barnstaple. it will work, and cost the hospital as it is so wise more expensive. far for people to travel to see family, plus it is a good friendly and caring atmosphere for recovery. 298 A2 Beds are need in this 2 Talk to nurses and doctors and speak with Yes I do after care Keep the beds look rural area as many the services provided by the hospital this packages with in the else where for cash people cannot afford to consultation hasn't reached out to many of community my next funding we don't get to North Devon the concerned. door neighbour died need a bigger hospital for a taxi its £30 because of an after hospital in North each way and with care package failed Devon. benefit cuts and and he was the sanctions people cannot mayor of Bideford afford to get to the main and he died in my hospital. arms.

299 B By keeping the beds at N NDDH more specialised help would be available. 300 A1 Probably the best B Barnstaple is too far away 3 Please consider using inpatient more Yes, I do. I am The inpatient beds at N geographical coverage. from where I live, near efficiently instead of discarding them. At concerned that the Holsworthy hospital Holsworthy. the public meeting in Bradford on the 4th of sheer scale and are crucial for us September, the NDHT chief executive said difficulty of travelling here. (I live in Black that inpatient beds were occupied on to people's homes to Torrington.) Another average 21 days per patient, and that this care for them may of my neighbours has was too long (and the patient should have have been recently stayed there been sent home earlier). The 21 day stay underestimated. For while convalescing meant that only 25 patients per month example, two days from a heart could be treated on the inpatient ward. She ago (15th September) operation, and her also stated that longer hospital stays are flooding of multiple husband (who is bad for patients (danger of infection, bridges and the elderly and partially incorrect medication, etc). Why not then closure of a road (at sighted, and who improve the efficiency of inpatient bed use; Brandis Corner) cannot drive) was send patients home when they are ready, meant that my able to visit her every shorten the average stay and increase the neighbour couldn't day (usually getting average number of patients treatable in travel from Black lifts from people in inpatient wards. Torrington to the village). He would Shebbear (about 3 have had great miles) to collect his difficulty visiting his prescriptions. In wife in Barnstaple. winter, travelling is While I am arguing in even more difficult. favour of keeping the inpatient beds in Holsworthy, I am convinced people local to other hospitals would have 301 A3 If the 3 options above are How do you B Beds in north Devon 4 Not closing the beds and looking at other How are you going to I am very concerned Y the only options , then I seriously hospital. Reasons as above. options to save money across the trust. be looking after that there is a HUGE would opt for Bideford think staff people differently in oversight of the hospital and south and the beds are reduced? care/services in the molton to remain open general What discussions/ community which are for a variety of reasons. I public can agreements do you going to be hit hard if think it is essential that begin to put have with social the beds are lost ( 40 we maintain beds in the together a services who are beds?). We are community ( and not financial going to feel the struggling to get within an acute hospital) year impact of bed patients discharged There would be too much planner. I closures? What from hospital as of a risk of these beds think this discussions are going there is a shortfall in being used question is on with GPs who are placements in inappropriately if they very going to feel the residential homes were placed at NDDH. patronising impact of bed and also care There are many other and closures? packages. services that run from unhelpful. the community hospitals We are not so if they were to close it accountant would be more than just s or beds that were lost I commission imagine. I think the ers of residents of north Devon services. need their community hospitals. I think geographically these 2 hospitals lend themselves to covering the north 302 A4 Due to poor public C Least preferred option 4 I expect we will be With this closure a N transport links it is because Barnstaple is required to make our possibility in the essential for services to already under pressure and a own way to future the fundraising be local. Apart from the long way away. Barnstaple, as the by local people for lack of public transport ill ambulance service is the long house people may not be able under such pressure appeal seems rather to travel to Barnstaple, according to the inappropriate. they may not have their news. How does a Instead of another own transport or be well person who lives in a layer of local care we enough to drive. remote village get to could be losing a Relatives may not have Barnstaple. Will the layer. their own transport and a funding from the prolonged period of closed premises be hospitalisation would put used to provide the severe stress on relatives same number of beds budgets. With the and services at proximity of the Barnstaple? As I am longhouse building it writing this there is a would seem to me news item about an prudent to have the ambulance service hospital open, creating a who took three hours hub for the care of to get to a heart people from the attack victim. Is this scattered villages around the care we are to Holsworthy, remember it expect in the future? can take over an hour to reach Barnstaple Hospital. 303 C2 The Barnstaple + B Concentrating all community 2 N Holsworthy combination beds at Barnstaple would offers the most efficient leave all other parts of north and equitable solution in Devon bereft of community my view. *It provides beds and, in particular would equity with one hospital leave Holsworthy (which is in North Devon and one more distant from NDDH in Torridge *Barnstaple than other towns in the can obviously offer the survey) out on a limb. highest level of specialist services and support. *Holsworthy is a modern, efficient, attractive hospital that can attract suitable staff relatively easily. *Holsworthy is ideally placed to provide a 'one-site' hub with a wide range of services, including GP and the new Hospice centre, located in the same place. *Holsworthy's geography also commends it. The town is a vital central place and service centre in a relatively remote area that is not well 304 A Beds should be at both B Beds only at NDDH. See 4 Leave as currently in place, and look Care in the The elderly N the community hospital reasons above re elsewhere for cost savings. I have watched community is not population is rising so sites (Bideford accessibility from anywhere many NDDH admin staff using the internet reliable, many carers should hospital beds, particularly) and NDDH. outside of Barnstaple. for personal use during work time as they are young, have no obvious supply and Population of Bideford seem to have nothing to do, and also common sense and demand. Do not area around 70k now spending 40 mins or more just chatting to very little training this place health with a high retired friends (not about work). Are they value for is from my problems on carers, segment who have no money-No. experience of 2 care they are not trained families in the area, business set ups. for it. This is a crisis public transport in Their time in the waiting to happen outlying parishes is client's home is over the next few dreadful, how can limited, and what years if you close patients be visited in the happens when they beds. NDDH-impossible, this walk out of the door, does not aid recovery. if a patient is still Care homes are being weak after hospital closed or are discharge they could overflowing, and when be on the floor or they have illness they soiled until the next immediately send care visit. residents to NDDH where beds are full due to continually being blocked due to a lack of moving patients out-a catch 22 situation-owing to a lack of care home places and non assessment by social 305 A4 Do not feel it is viable to B Beds at NDDH. Northern 3 Options have been considered well but This will only work if Y have any 'community Devon Healthcare trust disappointed that the trust chose to have there is an increase in beds' at NDDH. The site is supports patients across a public engagement meetings prior to availability of social already stretched and it very rural and widespread consulting with their staff. care access - more will loose the flexibility to area. There are significant nursing homes, increase acute beds at travelling times for patients residential homes times of crisis. South living on the outskirts of the and access to care Molton and Holsworthy patch. NDDH cannot afford packages are buildings are more fit for to loose current acute beds required urgently. purpose, Holsworthy has to be converted into Please consider the space for expansion if 'community beds'. impact that these necessary. Bideford is proposals have on all struggling to cope with services, not just the volume of work those directly undertaken there - the involved. Out-Patient space is not ideal as more Physiotherapy and more services have services across the also been added there. trust have already Car parking is extremely seen an increase in difficult. I do however complex care therapy have significant concerns being referred. These about the ability to staff would have Holsworthy from a previously been seen therapy perspective and by the community would consider this a risk teams but their whether Holsworthy increased workload stays open with hospital means they are being beds or as a community redirected to out- 306 A4 Although I do not agree B NDDH, for the reasons I have 4 Torrington should not have been closed Yes I do and my In my opinion this is a N with the decision to close given above. down nor Ilfracombe, transport links are so comments above false economy, I can any beds, due to travel poor and also you have left patients clarify some of this. only cope with my implications for elderly requiring end of life care and transition Patients are now at husband with agency visiting close relatives from hospital to home in a very poor state. high risk, especially if and family support. and poor transport, at My husband was taken seriously ill in they live alone, they End of life bothers least there is better Cornwall last year and then had to be are extremely me considerably and parking at the 2 options I admitted to Bideford (taking up their vulnerable. Agency's where the services have given and also not valuable bed space), he was not well just cannot provide have previously been the struggle of navigating enough to come home needing further sufficient service. in place they should around NDDH, which is intense physio and medication regime. He Visits are not regular have remained. I will horrendous for parking needed intense nursing until a home care in timing, staff do not only be happy when I for elderly and disabled package could be provided. This was not always turn up and can be absolutely and once inside is not readily available either. Agency care is not then its up to the assured of 24 hr care easy to find your way sufficient they cannot get enough staff, client to ring, not all in the community around. rotas are poor and do not consider patient are able to do this. because that is what needs and cannot provide 24hr care which Therefore you are you are expecting. is often needed. I am fortunate at the relying heavily on the Also please consider moment I can drive and have a vehicle but family. Agency's are poor transport links for how long and until its my turn??? only insured up until from these outlying 10.00pm, so what areas. happens between 10pm and 7am.

307 A (Only Holsworthy listed). Any of the other Hospitals 4 More beds in Holsworthy Hospital please. Will there be 24 hour I consider that you N Holsworthy must have suggested are not suitable to nursing at home. do not have a clue beds. I live just out side people in Holsworthy. about getting old and of Holsworthy, we have living in the country. no bus service at all. It is We need our possible to get a lift into Hospital. Have you Town but very difficult to considered cutting get lifts to Barnstaple. It back on your staff to aids recovery having save money. visits from friends &relatives who can easily visit Holsworthy Hospital. 308 A Of the options offered I am not B Completely unacceptable in 4 Maintain and improve the status-quo. Care in the Your consultation N the preferred options are competent the foreseeable future as community is a document clearly first A followed by C, but to there is zero likelihood of wonderful phrase identifies the strong only if one of the comment care in the community and it is attractive to need for local community hospitals is on reaching an acceptable level. management as it is community hospitals Holsworthy. It is Ilfracombe. Not enough beds have been seen to reduce costs. yet your preferred necessary to provide care allocated. Technological option is Option B. where it can benefit advances offer the However the analysis those who need it and possibility of remote clearly states that where visits by family monitoring and this option scored and/or friends is treatment of lowest by a practical. For old and patients. I believe significant margin. frail individuals, that decent You give the reason particularly those unable community care for this as lack of to drive, to get to costs more and information yet seem Barnstaple or Bideford therefore the level of happy to proceed from Holsworthy and community care will with it! surrounding rural areas is never be acceptable difficult if they are able to because it will always drive and virtually be under funded. In impossible on public the rural areas this is transport. The number of particularly true older people is only going because of high to increase, exacerbating travel time/costs for the problem. Holsworthy care staff. To provide is a modern facility with sufficient care in the high quality local staff. community will take Holsworthy already takes money and time. 309 A Preferably Bideford and B Because for those in outlying 4 Yes, the obvious one of keeping the status I understand the I am the treasurer of N Holsworthy or areas the difficulty in visiting quo. intention, but do not the Bideford hospital Ilfracombe. Bideford is patients is overwhelming consider it to be League of Friends. I the largest community especially for those without valid. believe you have a outside of Barnstaple, a car. tremendous resource and Holsworthy is in the local hospitals possibly the most distant. which you tamper I do not consider the with at your peril. option above to be the The population of best situation. It is my North Devon is belief that beds should growing and ageing remain in all community rapidly, and a 10 % hospitals. Presumably the population increase stories in the press about within the next 5/10 bed blocking and patients years is a distinct waiting in corridors for a possibility, and thus bed are not total to reduce bed fabrication, and so with numbers appears patients on the road to bizarre. recovery, but not well enough to be sent home it seems to be common sense to have community beds available as an interim. Care in the community cannot cover the situation as well because care is not 310 A (Only Bideford listed). : N Bideford is well run, and well-respected by local residents and is accessible by public transport for visitors. It is also small enough to be intimate for elderly patients who need the care after time spent in bigger hospitals such as Barnstaple. 311 A4 Holsworthy and South B All beds at NDDH Impractical 4 Barnstaple is one of We were told Y Molton both have for people of this area No the most inaccessible originally during purpose built buildings transport People get better towns for us in consultations that if which are relatively with visitors. Many would Holsworthy due to in-patient beds were modern, only 25yrs old, not have anyone. Young very poor transport closed then the they both have the palliative care patients with links. Care closer to hospital would be capacity for change and young families need visits home works in some made a hub. Why expansion. Holsworthy is from the children Palliative cases, however there can't it be both? We 30miles from Barnstaple, care patients need easy are people whose have inpatients, we 40miles from Derriford access to fresh air. Young homes are not cater for several and 50 miles from Exeter, rehab patients need visits suitable for them to clinics and we do day- therefore to have a from children and family stay in even with lots cases. All of these community care ward in members. of input, or the time could be enhanced Barnstaple would be a taken to bring in and the building disaster for this area. equipment or do could be adapted to There are few transport adaptations is too accommodate more links and taxi costs are long for them to if required. Rurality is extortionate, we are also manage. Sometimes the key here. Where 20 miles from other they are admitted is the patient choice community hospitals i.e because there is no for preferred place of Bideford and care in the death? Palliative care Okehampton. There are a community, even for is not just a few days few private sector emergencies. We it can be weeks. nursing homes but these have not hit winter Would you like to be beds are usually full with pressures yet. stuck on a ward 30 little room for flexibility. miles or more from Holsworthy hospital has home and people not such capacity and the able to visit regularly. 312 A Holsworthy and N/A. B Beds at Barnstaple. Travel to 4 Actually increasing the number of beds, so Yes. Devon is a HUGE N Torrington. Holsworthy is NDDH is costly and that people don't have to trek to county. Many remote and it is over an inadequate, and parking is a Barnstaple. The NHS should be run for the communities are hour to either Barnstaple joke for those who drive benefit of its patients, not bean counters! remote. Not or Exeter for treatment. there. everyone has access Public transport to to a car. NDDH is not Barnstaple is inadequate a convenient and taxis cost a fortune. location. We need a community hospital to serve the large number of patients in this area. 313 A4 These hospitals n/a B Travelling is nearly Not well at all Keeping more beds in Holsworthy hospital Travelling in rural N particularly for patients impossible by bus. Very to enable patients from a large rural area to areas takes time from in the Holsworthy area expensive by taxi or be cared for. Life at home with no near one patient to are very much needed to volunteer drivers scheme. neighbours can be very lonely sometimes another. How many enable them to move And takes at least one hour not seeing anyone for several days. This extra staff can you their care to the purpose (good travelling) to get to cannot improve their health after all the employ? In some built local hospital and NDDH from the Holsworthy good work main hospitals have done. cases it maybe only stop bed blocking at catchment area four patients a day North Devon District can be seen. In a Hospital. Only today it local hospital many has been reported how can be cared for at many patients bed one time. blocked in Devon because of shortage of beds.

314 A Long-term planning and n/a B Centralised care is not Not well at all Reduce bureaucracy and cut managerial No, still don't see My mother received N Holsworthy joined-up thinking needs always good for patients and posts to free up money how your options end of life care at +1 to be used and not simply bigger is not necessarily better existing Helston Community financial criteria. "beautiful". situation. hospital. She was well Holsworthy hospital looked after and all should be saved for the her needs were met. following reasons: The The staff were caring distance to Barnstaple for and helpful to the family and friends is family - much better considerable especially if than dying in a large people have to use public hospital where transport in order to visit nurses are rushed patients; Holsworthy is a and everything is good place for local anonymous. people to recover from illness or operations or to receive palliative care; the location of the Long House and Health Centre next door to the hospital could provide a hub for treatment and care and also provide the possibility for future expansion into a place for rehabilitation to get people home as soon as possible; relocation of 315 A As parking at nddh is n/a B Nddh as the staff are some Quite well Yes N Holsworthy poor so relatives can't times over stretched and +1 park and getting to nddh getting to and from is a struggle for some Barnstaple is difficult, plus people who live far from the stress to find somewhere there to park

316 A4 Ilfracombe cannot meet n/a B Patients are already in a Quite well How much extra N bed criteria and Bideford vulnerable position being ill funding has been is close enough to enough to require guaranteed and are Barnstaple whereas hospitalisation, they will be the staff and training Holsworthy and S Molton greatly distressed nit to already in place? I can meet the needs of receive support by way of think not. their own and other visits from family and friends communities nearer to and I believe this will hinder them than Barnstaple, their recovery. Many people Holsworthy in particular do not have their own being the furthest transport and public distance from Barnstaple transport is not adequate to with very poor public say the least. Care in the transport available is a community is a good idea vital asset to both but insufficient resources patients and their put patients at risk. Last families winter this was highlighted by bed blocking at many hospitals due to patients being kept unnecessarily in hospital due to insufficient care available for them in their own community 317 A - South Elderly patients need to n/a B Not well at all If you can't look after Please think of our Y Molton +1 be close to relatives. patients now what elderly poorly Many relatives need to will be done diffently patients and many catch buses, in rural out in the familiy members. areas this is very commuinty. Its the They have worked difficult.South Molton night times that are hard for us in their cover a large area with going to be concerns. youth and I feel it is very remote areas for Pallitve patients who our place to keep example exmoor. We want to die at home them in an hospital have had many delayed are not haveing their they want to be in. discharges due to care choices and wishes being unavailable in the listened too, the commuinity, we have at hospice is so small present time 5 delayed nursing homes are discharged due to this. nearly always full, My own mother in law this is going to get had to go into a care worse. Patients home via fast track, having to go out of which was excactly what area, to be cared for she didnt want, she and many times fast wanted to be able to die track is used, Would at home... Due to lack of you like to die in a care in the community nursing home, I this was unable to wouldnt, we need to happen, we visited every look after our day, to find her very community hospitals upset. She died within for our future too. weeks, as a family we People who do 318 A1 With the growth of n/a B Too far to get there, Not well at all It appears that you N population in Bideford it especially if you have to rely would be putting a would seem a sensible on public transport. lot of responsibility option to keep Bideford for a patient's care on open, how are you going members family, to accommodate all the which might be ok in patients at NDDH if you the short term, but close the hospital. having looked after Bideford hospital doesn't my husband for quite just cater for Bideford a few years I can residents, it covers rural assure you after a areas as well where there few years of broken isn't a regular bus service nights sleep it gets to to get to Barnstaple for be jolly hard work. appointment, or for visiting patients. Last year my husband spent 5 weeks in NDDH and if I hadn't been able to drive I couldn't have got to see him. Lots of OAP's don't drive. The same arguments apply to Holsworthy hospital. 319 None Since we are frequently n/a Not well at all See 1 above. Having experienced N being told that "bed- the "care at home" blocking" is a major option around which problem in large your vision of the hospitals in the winter future seems to be months ie periods of high based and given your demand, it seems logical failure to attract to use the existing local nursing staff into the hospitals (Bideford, area to fill vacancies Torrington, Holsworthy within "conventional" etc) to use their beds to health services I have release patients into little confidence in these hospitals on their this project. The way back to home. As existing District Nurse per the old idea of provision barely "convalescent homes". provides cover in "Agreed criteria" - agreed rural areas (I failed to by whom? The list of see the same nurse criteria includes No 9 - twice as the "The impact of lost Holsworthy nurses opportunities" etc etc. are drawn from 3 This sentence is practices - bureaucratic Holsworthy, Hartland gobbledygook. I have and Shebbear/Black read it several times and Torrington).When still do not understand it! one is ill at home it is essential that the service is regular, 320 A4 1) the distance invoved , I cannot B theye would not be Not well at all possility of offering private care as you do At the meeting in Staff should have the Y There needs to be a safe answer as I commuity ,Where is the at NDDH Holsworthy we were opportunity to have place for GP to admit a have no ward which you would use . told that you could a "safe" meeting to patient to , for those who knowledge It would be filled with manage the needs of talk and ask cannot manage at home of outlayers from other wards patients with rapid questions . At the , They might have a Ilfracombe and then patients spread response, community public consultations package of care but even around the hospital. There is nurses and care that it is not possible for with increases it is the the distance involved for all is already in place staff to speak out night time needs that and would need to be looked and buying care from without the fear of cause concern, toileting after by a consultant not the local nursing homes. being taken out of at night is a major issue GP. If you offered staff to I know of patients context or fear of for someone who is frail work on the community with cancer who being quoted in the and at risk of falls. ward , they would more that were to be fast press, we also should especially if they also likely be expected to be tracked home but know what the have confusion or moved to other areas where could not get a options are for us dementia Also there you are short staffed. The is package of care, needs to be a place for no community in this option another was unable people to die where they to get a place in a can feel safe . Maybe nursing home in her some want to die at chosen location of home but for others it is where she wanted to a frightenening time both die and had to wait for the patient and the for a bed. In the family . It is in these meeting you spoke of circumtances that we can the need to deliver offer palliative/ terminal safe care. In the care respecting dignity hospital we are one and giving reaasurance trained nurse to eight 321 A4 The best solution so that n/a B One site at NDDH as this is at Quite well N people do not have to least an hours drive from travel too far to a Holsworthy and difficult to community hospital get to on public transport. particularly elderly people who need to attend the hospital or visit 322 A4 With such a fast growing n/a B See answer 2. No beds in Not well at all I cannot believe that this money saving Community nurses If I had to spend any N population in the area I community hospitals would could not have been achieved without are committed, length of time in am certain that be unthinkable and closing all beds in the communities. How generally well trained hospital in Barnstaple community hospital beds unacceptable. about thinning out middle managers and and do a great job. I it would be difficult will become huge assets the salaries of consultants etc., etc. just am not for my wife, who in the future, to both the convinced that there cannot drive, to visit locals and to support the are not enough using public service main hospitals. outside care staff and almost Therefore, I believe we committed to the impossible for my should keep them all. It same level. To a lot of severely partially would seem that, based these staff weekly sighted son apart on your information, that salary is the main from using taxis. from a geographical and reason. There must be many practicality point of view other situations like you are pointing us to this throughout the option A. area.

323 A4 Strength of public n/a B All beds at NDDH - taking Completely Yes, I think we should have beds at; Yes. Y opinion in Holsworthy away all community hospital Holsworthy South Molton Plus a number Travelling distance from inpatient units is too much (8?) "community rehab beds" at NDDH Holsworthy - accessibility of a step change and would which would serve the Ilfracombe/Lynton South Molton's be very unpopular. folk. We could call this the "Ilfracombe geographical location - unit" accessibility Quality of building stock

324 A4 both reasonably new n/a B doesnt allow for care nearer Completely I understand Y buildings so will need less to home upgrade than Bideford or the Tyrell and these 2 sites would offer beds to the population furthest away from Barnstaple 325 A3 This option is the n/a B I would prefer that not only Not well at all While I understand money needs to be I do understand and I feel money has Y prefferable option of the that the 40 beds get opened saved I feel we need to be realistic of the it is a fantastic vision become the driving 3 provided as it covers a at NDDH as well as 2 hopitals patient needs as we are in a area with a but currently there is force on the larger area. There has no in the community. There are very large elderly poulation. no care available in decisions being consideration been given currently on 42 acute the community currently made and to the fact that the medical beds in the hopital. thereby causing the fact that there realatives would need to ASU is only for patients who increase in delays in are patients at the in some cases travel quite have a stroke and Fortescue discharge. There are end of the day who a distance to visit patient. ward is for Dementia and also no placements are going to be rehab patients and need to available in Nursing affected the most are meet a certain criteria or Residential homes not being before they get accepted. As considered.At the a result we have a average of end of the day we 20 to 30 medical outliers on will be failing in our the ward at one given time duty of care towards which I feel is not safe for our patients if we are both the patients and the unable to provide wards. adequate and safe care at all times.

326 A3 There is still an need for n/a Holsw Holsworthy as the distance Not well at all Keep 3 community hosptial at Bideford No Y community hospital as orthy to travel is so great from this south molton and holsworthy as there is a alot of people are waiting side. need for them. Have our own inservice care in hospital for care teams to assist with discharge and getting packages, and to waiting patient home soon and so to free up beds an acute hospital for in the community hospitals. these is not an effective use of a Acute bed. I work out of Bideford Hospital on the Early support discharge team which is a very important service to reduce time in hospital and to see patients in their own homes. I feel holsworthy is too far away for patient's in north devon area and along way for people to travel if they live in Ilfracome or Lynton. As we have already lost beds at Oakwell and such like where are these people supposed to go when they are not ready to return home if we dont 327 A4 I believe it would be n/a B I dont believe this would Quite well Y better for elderly patients meet the needs of the and their families if there elderly population in North were beds at these Devon and surrounding community hospitals. areas. They are modern buildings with nice environments.

328 A4 Holsworthy and South n/a B No transport People get Not well at all Barnstaple is one of We were told Y Molton both have better with visitors. Many the most inaccessible originally during purpose built buildings would not have anyone. towns for us in consultations that if which are relatively Young palliative care Holsworthy due to in-patient beds were modern, only 25yrs old, patients with young families very poor transport closed then the they both have the need visits from the children links. Care closer to hospital would be capacity for change and Palliative care patients need home works in some made a hub. Why expansion. Holsworthy is easy access to fresh air. cases, however there can't it be both? We 30miles from Barnstaple, Young rehab patients need are people whose have inpatients, we 40miles from Derriford visits from children and homes are not cater for several and 50 miles from Exeter, family members suitable for them to clinics and we do day- therefore to have a stay in even with lots cases. All of these community care ward in of input, or the time could be enhanced Barnstaple would be a taken to bring in and the building disaster for this area. equipment or do could be adapted to There are few transport adaptations is too accommodate more links and taxi costs are long for them to if required. Rurality is extortionate, we are also manage. Sometimes the key here. Where 20 miles from other they are admitted is the patient choice community hospitals i.e because there is no for preferred place of Bideford and care in the death? Palliative care Okehampton. There are a community, even for is not just a few days few private sector emergencies. We it can be weeks. nursing homes but these have not hit winter Would you like to be beds are usually full with pressures yet. stuck on a ward 30 little room for flexibilty. miles or more from Holsworthy hospital has home and people not such capacity and the able to visit regularly. 329 A3 We already have an n/a Holsw I would probably leave the Not well at all reviewing our early supported discharge No Y increasing bottleneck in orthy trust if I was based here as teams, increasing staffing and having in ASU and our stroke rehab financially this just would not house carers who can bridge the gap unit/community hospitals be viable as so many patients are rehab/ESD ready however waiting packages of care. Several care/nursing homes have already closed placing more strain on care agencies. They already have no capcity to take our patients and we haven't even hit winter pressures yet. There are many patients who need a bridge between acute and home and we are loosing so many options for this. ESD is an invaluable service which help keep the flow but we cannot do this without the adequate care at home. If we have no care available these patients will continue to 330 A3 Bideford due to the n/a B The whole idea is suddenly Not well at all I believe that NDDH should not have been The concept to look How is the support Y largest population and not Community beds, it will considered at all for "Community Beds". It after patient in being organised after Holsworthy due the be in reality an extention of can only cover Barnstaple and surronding communities is 17.00 and during distance to any other Care of the Elderly Beds, and areas and totally discard a large area of acceptable if the Saturday and hospital. North Devons although cost effective for North Devons rural communities. patient is not Sundays? geographical area is very the trust it will not enhance seriously ill. As far as I large. To have only beds anything for the patients, am aware there is at NDDH will create a lot who will be far away from only support from of problems for relatives their communities and more community hospital to visit. Patients at likely having less visitors staff Monday -Friday community hospitals are which I believe is vital for during office hours. usually over 65. Bus recovering, based on my How is the support routes are cut at an own, and husbands inpatient being organised after alarming rate and car is hospital histories. There are 17.00 and during often the only mode of two things you look forward Saturday and transport. Recovering in as a patient, apart from Sundays? hospital, visits are an being discharged when important part, specially ready, and that is visitors for elderly patients and and food. The criteria seem also for their reltives. to have changed from Even with own transport Patient is the most driving from outlying important person to Safe areas of Holsworthy is a and Effective Care within the considerable distance to Budget. These two oould Barnstaple. To have easily be contradictive. community hospital beds at NDDH, which has always been seen as and 331 A Ilfracombe Ilfracombe and Not sure B Quite well Y +1 surrounding area do not ALL of that, always have the that has opportunities to visit previously those in hospital in been Barnstaple, Ilfracombe is explored much more accessible to the very large community of elderly folks we have here, and would ensure there were no empty bed, also freeing up beds in NDDH. 332 A4 I dont support n/a B I believe it would just Quite well I Think that its the Since I started Y community beds being become another medical intention to provide working within this operated from NDDH as ward with added problems more care at home to trust the number of having worked there for of patients who have social patients, but we do managers has grown 12 years I can say it issues and are unable to be not have the staff, and resources have doesnt have adequate discharged, The distance experience or clear dropped. surely if staffing numbers or alone would generate poor guidelines from any there are cash flow medical support to run as communication between health department problems it would be a community ward. service provision and I think about how we responsible to cut Community wards need it would lead to more prevent patients back on the layers to have closely lengthy admission times. from getting which arent established links to admitted to hospitals detrimemtal to the community services and with chronic and publics lives and to the distance between the social health related stop shifting staff into site and the services eg problems. This is not roles which could be district nursing teams a clear concise plan filled by lower grades and GP surgeries would but a reaction which and not used as not support this working will require much sideways steps to in practise. I think that more funding as keep staff in jobs Holsworthy and South public expectation of which are not Molton would be the 2 care they want is necessary to the viable options as going to create provision of frontline remaining open and another layer of care and which providing the community provision which the should be reviewed beds to the population. NHS cant afford, and and got rid of. Distance and staffing I have concerns that already in existence it will become would be my main points another 333 A4 Traveling time would be n/a B Beds at north Devon as Not well at all Y significant for anyone travel times and cost from from the above areas and the furthest areas possibly prohibative to (Holsworthy and surounding) people in these areas as will be significant, especially no reliable transport links for the elderly exhist. 334 A4 Holsworthy and the B All beds in NDDH as the time 3 N surrounding areas are an needed to travel from rural hour away from NDDH. areas is not manageable for Having all the beds there a lot of the elderly and would proclude a lot therefore the patient would patients from this rural not have contact with their area receiving visitors. friends and family. Providing community care in these areas would not be cost efficient as there is too much distance between house calls - depending where the patients are in the area the carers could maybe only get to 3/4 patients in a day.

335 B Lynton has no C on the basis as noted above. 3 Not that come to mind. I am aware of the Just to reiterate what N community hospital, and (2) intention of building I have written above with the exception of up the stroke unit at (6). Although Lynton Ilfracombe, to which Barnstaple, which and Lynmouth only there is no direct bus link, would mean have a population of the other community extended care and 2,000, there are hospitals would involve physiotherapy could many elderly people, long distance travel, by be offered there as well as young what are often frail or rather than Bideford. families whose elderly relatives. Also, Lynton is three income is quite the amenities for further quarters of an hour limited. Some of the essential health care are drive from parents need to work on hand at the Hospital Barnstaple, and at more than one job, should the need arise. although we have a and travel is costly, splendid new Health whether it be by own Centre, and nurses transport or public who visit at home, I transport, and take understand carers up several hours if are reluctant to come the journey is to a out as far as Lynton community hospital on the basis that beyond Barnstaple. I their travelling time is am a volunteer with not remunerated. the Chaplaincy at Lydiate Lodge has NDDH, primarily in been closed, and ASU, and am aware there is only 1 of some of the remaining care home practical issues that in the town. Lynton face patients. 336 A (Only Holsworthy listed). B as it is simply too far for 4 Keeping all Community hospitals fully open Yes. How will you Holsworthy is a N Holsworthy and its people to travel to NDDH to until there are guaranteed better make it possible to growing town with surrounding villages are visit relatives. There is arrangements for care in community. help people visit new houses, the new in a very remote area. It virtually no meaningful Looking for other ways of reducing the relatives and get to market and other takes well over an hour public transport. There are budget shortfall. and from facilities. To cut to get to Barnstaple and not sufficient facilities to appointments? The hospital beds as this there is insufficient public care for patients at home at journey from stage without there transport to make visiting present. Holsworthy and the being sufficient feasible. surrounding area to facilities for home Barnstaple is an awful care in place seem to one for a fit person be an ill conceived let alone someone move when demand who is elderly and would seem to be unwell. increasing. The North Devon Hospice has specifically built its new Outreach centre in Holsworthy to cater for patients in situ thereby saving them the long uncomfortable journey to their main Hospice site in Barnstaple. It is generally accepted that we are an ageing population with large 337 A I feel that community should not Least favourite is any 4 Yes. It is painfully simple. They all need to Basically you can`t The decision to close N hospitals should be close. closures at all. remain open- even increased due to our look after them. At hospitals is short increasing and not ageing population. present we lack staff, sighted. With an decreasing. " more beds and facilities all increase in patients being cared for around the country. population due to in their own home" The reality will be people living longer translates into no that we attempt to and increased hospital beds available care for ourselves or population due to due to closures. our relatives. All this migration a reduced Therefore nowhere for is a budget busting professional care people to be cared for. exercise. If you can`t system certainly is afford to keep the not the way forward. appropriate premises I truly hope that you operational how on reconsider any earth do you expect closure. We actually to pay for in localised need more. Please care in towns and take into account villages which will that very few people ultimately cost more can cope with a near if it is to be effective. death situation at home. This creates compounded stress which will obviously have a knock on effect needing health care. 338 None. It is absurd to take care Surely C The worst of all worlds - and 4 Finding ways of resourcing community That is going to be This feels entirely N away from the local Ilfracombe only postpones what is by beds. How are GPs going to be able to still difficult if you are not finance driven. There community. Having must be then the inevitable. Most of look after patients in community beds talking to the CCG. is little sense of already seen the impact included. It the community beds have when they are miles away? It is difficult My experience is that community on patients of the closure may not be gone, the assumption for enough at the moment, this will make it people are left on involvement and of of beds at Torrington, I able to Barnstaple has been impossible. their own, and feel service to the do not accept the provide effectively made, and the isolated. Often community. It is a assumption of improved beds in remaining community nurses, etc do not business driven home care. If any 2015/16, hospital could be miles come when they are proposal. The hospitals are to be kept but away. expected. People feel Barnstaple option is open, then the most presumably very vulnerable, woefully inadequate. obvious is Holsworthy. we are especially when Where would the With increasing need looking elderly. beds go? The being identified in all more than involvement of care areas, surely this just 1 year homes seems indicates a greater need ahead. In spurious. Would they for community hospitals, an area the be offering care rather than a reducing size of instead of a hospital? one. Including Ilfracombe If so, at whose consideration of care and with expense? And have homes begs the question the needs they been consulted? of their involvement in and social what is hospital care - deprivation and if they are, how is there, it that funded? would be madness not to have something 339 A3 If community hospitals B 4 How are you going to N are closed relatives of make sure there is patients who are cared adequate staffing on? for there will usually have Facilities to care for to travel further to visit. more people at This is especially home? important as the majority of these patients and their relatives are elderly. Fewer community beds will increase the likelihood of bed blocking in NDDH. 340 A4 Holsworthy is a modern B Easy for administration but I 3 Have you tried N flexible building. Well fear a case of out of sight out travelling from supported by the of mind, for the rest of the Holsworthy to community with a recent area. Barnstaple and back modern built centre and by public transport hospice to cater for its recently? isolated rural community. Excellent staff and a day centre.

341 A1 Broad rural catchments. B Kills other hospitals. Too far 2 Remains to be seen. Should ever there be N Large enough - flexibility from too many folk. money - will the for time of need. Nearer service expand where I live hence selfish again? reason. Projected increasing need.

342 A4 S. Molton high B Beds at NDDH only. Using South Molton has an N retirement area, elderly Community hospitals frees active and financially living alone with family up acute beds. Care services sound league of away. Poor public in these areas give patients friends, funding many transport from S. Molton time and confidence to come items of furniture, to NDDH and none from to terms with possible life furnishings and outlying villages. Purpose changing conditions. Time to expensive built with flexability to set up a good care package, equipment, also paid cope with surge no day including equipment, for a nurse to extend case since closure of part enough carers to visit so her qualifications to 3 who's private nursing preventing re-admission. enable end of help have been waiting list. care to be given, New housing estates funding a small increasing the library also. population. 343 C Option C but really need A Because the expertise put at 3 But relative costs & public transport not Intentions are all very South Molton already N 2 community hospitals. NDDH is lost. well explored. Existing provision for well, but post does all amount of NDDH - South Molton & consultation S Molton just ignored. Why? experience does not consultation Holsworthy. Continuity of seem to bold well for provision which you treatment in specialised the future. No ignore for some units in NDDH with costing's done so it reason when you gradual rehabilitation in may well not be described "hubs" at a the 2 local hospitals. cheaper. previous meeting S Molton was in a strong position - why have you "forgotten" this? I see the outpatients clinics listed for the stakeholder decision making why not for the general public it is very important.

344 A (Only Holsworthy listed). N/A. B Barnstaple is 1.25 hours 4 Retention of all community beds and either No. Both my parents I do not think you N Holsworthy is an isolated away. Patients here would sourcing additional funds on lobbying have had lengthy have properly community. Travel times be isolated from their family central government to provide them. This stays at the researched the needs to the nearest acute and friends. Those at 'end of threat to the community is clearly wrong community hospital of those who use the hospitals are at least one life' would be in unfamiliar and you have not fought it with due vigour and could not have community beds, nor hour by car, far longer by surroundings and looked and publicity. been properly looked have you properly public transport. As far as after by people they do not after at home. My considered the I know Holsworthy meets know. Community hospitals father had CDIF difficulties that all of your criteria, it is a work. It is foolish to contracted at families will low income society and dismantle them, particularly Barnstaple hospital encounter in serves a large rural Holsworthy. and my mother had travelling to and from catchment. The loss of to recover from N. Devon hospital. community beds here broken arm and hip. would have a severe It is not possible to impact. Your decision cope with trips to the making criteria are yours - toilet at home in such not mine. circumstances. 345 A4 Holsworthy & South N/A. B It makes no provision for 3 Yes. No. Y Molton have the greatest care in community hospitals issues in terms of access and makes it exceedingly to NDDH (public difficult for those form transport & car remote communities to ownership). They are also receive appropriate support situated closer to the from families & friends most remote parts of the whilst in hospital. area served by the trust.

346 A Beds will remain in their B Beds at North Devon district 3 Yes. Although it can I do not believe that N community as original hospital. Beds should remain be very stressful for any money will be planned South Molton in community. some families. saved in this exercise! has a modern building in a glowing community.

347 A4 Holsworthy & South B Beds at NDDH because I 3 Yes, but I have If the outcome is that N Molton are isolated with would be concerned that in concerns that you community beds are low car ownership. Their practice the resources would may not be able located at NDDH, fail community hospitals be diverted to acute care. recruit the required safe arrangements offer good flexible Also the environment in calibre and numbers need to be in place to accommodation. NDDH is less conducive to of staff to achieve ensure that the quiet recovery & this. resources, beds and recuperation, especially for staff are not re- the elderly confused. directed to acute care when the pressure is on. 348 A4 These are relatively new N/A. C NDDH does not have the 4 Saving money elsewhere ie management From what I see & Generally the public purpose built hospitals. capacity for a 40 bedded positions, cost of medication, wastage in hear, very little has feel you are not going These communities are community unit. Where is general. been done as yet to to read or listen to furthest from NDDH the sense in building one replace the care anything we have to public transport is when there are a choice of currently provided in say and that infrequent. Taxis are community hospitals already community beds. decisions have ridiculously expensive. up and running. How long Lots of talk little already been made Visiting for families & before it was used as an action. Where are prior to any friends would be overflow for other wards! these people who will consultations. We infrequent difficult provide extra social have no confidence in longwinded & in some care? At least put this your ability to cases for the elderly in place before manage these treacherous. Patients closing beds. changes. Closing would be deprived of Bideford hospital families when they need seems to me an them most. obvious choice. The hospital is old and poorly layed out. It is already acknowledged that recruitment and retention of staff is difficult & that it is closest to NDDH. It would make more sense to redeploy staff Bideford hospital to any of the 349 B It makes great sense to A Whichever 2 hospitals might 2 Re-locating Bideford GP surgery at Bideford Yes. N have full range of care be selected there are extra hospital sight and developing Bideford to under one roof, saving costa ie staff levels - agency take all community beds. This re- transport coast and the nurses, building development might encourage more length of patients stay in improvements or layout permanent staff instead of agency staff hospital overall. issues. This extra expense being needed. should be put into a well- funded facility unit at NDDH.

350 C2 It is relatively easy for Anything but what I have 2 Yes. Why did I receive this N clients in South Molton, expressed at in my opinion on 15th Sept telling Bideford & Ilfracombe to any of the other options me I could attend get to NDDH. Holsworthy would not be economically consultation meeting is a very long way from sound. in the previous NDDH. month? 351 C2 NDDH would give more No as it is South Very near to NDDH. 2 I feel most important options have been Not really: But I am sure you could N beds to every person. not far for Molto considered. Torrington as a town get more help from Holworthy being the patients to n community is very volunteers if made furthest away. be close. History of work easy for them to transported to keep unit available help. I lived in to NDDH you would get more Torrington for 35 and not to help from public if years and I saw how far too you cut out so much. hard locals tried to commute. Stupid red tape and help their unit paper pushers. hospital.

352 A1 Older people living alone. B NDDH - Beds only in one 1 NDDH and 3 community hospitals ie If community hospital N Number of people with corner of large area. Bideford, Holsworthy & South Molton. beds are reduced or cars transport. Very large Difficulties for relatives to axed this will put an area - the need to visit & support patients due even greater load on facilitate the criteria to lack of good public the community above by spreading the transport links & long healthcare nursing provision of hospital beds distances for car owners. teams which are for recovery rather than already over all in one corner of North stretched with Devon. patient number over large catchment areas.

353 A1 Holsworthy total isolation Hop, skip & B Stop centralising - stop 4 Build a new hospital as suggested by The focus here is on Process is rushed, N in all manner of things - jump to isolating communities away Durron in 2006. 'intend' our shambolic, divisive. roads, transport, Barnstaple. from Barnstaple. communities don't deprivations / economy. believe you can do it. Bideford has large population - but again not far from Barnstaple.

354 B It would be easier to get C Because you would have to 2 Yes. N to and wouldn't need employ lots of agency nurses loads of work to obtain and it would have to be 16 this option and I think beds or more. Barnstaple needs a frailty unit. 355 A1 Capacity for sudden B Travelling time to NDDH - 3 Yes. Consideration must N demand expanding traffic congestion - fuel be given to: A. The population. Relieving costs, car parking problems high percentage of road congestion & car & cost - poor public elderly people who parking at NDDH. transport. cannot be left alone Convenience for family & in their own homes friends to visit local eg Dementia community hospitals. sufferers. B. Community beds give must needed respite to carers of elderly relatives.

356 A4 These are the two B Speed at which frailty unit 3 Keep all community hospitals open. Then I understand but how Only that 1. I feel that N furthest from NDDH. could be set up. Distance NDDH is better used for acute patients, can district / everyone should They are the most from both Holsworthy & community hospitals for recuperation / community nurses have access to a local modern of the 4 hospitals South Molton is the furthest. rehabilitation which was probably the excellent job though hospital so much (Holsworthy hospital less Lack of public transport. original idea of them. Easier access for they do, provide the easier for journeys. 2. than 25 years old & was NDDH should be used for patients visiting as community hospitals same 24 hour cover Much more of a purpose built). They are acute cases, community over a local area. then a community family feel about the 2 areas with least car hospitals for rehabilitation & hospital can? community hospitals, ownership making the chronic illness treatment which 3. gives journey difficult due to when necessary. patients a less distance & lack of public stressful time & transport (Holsworthy better opportunity area outside town) has for that short stay in very poor public hospital particularly transport. required by the elderly, between treatment at a major hospital & discharging home. 357 A1 As these are the only B Again transport is a major 4 Perhaps as the Long House has just been If as above I These plans are ill N options available, major concern for patients opened had it not occurred that the understand you thought out people transport for all and their visitors. Plus I have hospital working with it was part of the intend to "look after travelling miles from concerned is a major had experience of the so reason it was built in Holsworthy and again people" in their a lot of areas to all be factor. As is distance to called care in the community to cut down travel time. homes - nothing it a very good NDDH. a disaster. against the carers but hospital (NDDH) but god help us. Having one that often has seen homecare and wards closed and community hospital need beds all the care there is no time again - a comparison - disaster. community hospital care works.

358 C4 This would keep NDDH at C1 Bideford has good access to 2 If Bideford loses its N the centre of a full health NDDH by patients for current stock of beds provision & support. services. Bideofr could then and becomes more South Molton would take on more day care involved with offer provision away services to relieve NDDH. daycare, what from the congested implications will NDDH / Bideford areas there be for moving South Molton seems also aged patients to to have more flexibility NDDH site? for future use.

359 A4 These are the most B People in high places have 4 Keeping beds at Torrington. I can't see how Money could be N isolated & more difficult no idea what it is to be having a nurse going saved on heating in to get to Barnstaple elderly & have to drive or get form one area to main hospital on especially in the winter. transport to Barnstaple how another is cheaper & many visits in can visiting a patient once a better for patients at summer light shave day in own home be better some stage they are been full on giving off than 24 hour care. going to be in the heat & fans having to wrong place, how are be put working. Staff they going to get to running around with isolated areas if there 1 piece of paper is snow on ground surely with the use of patients are going to computers this is not be left to fend for necessary. themselves. 360 B Makes sense to A Beds split between 2 1 The monetary employed on the report Yes. N concentrate all assets at hospitals, waste of probably could have kept 2 beds open in a central point and have resources. one of the hospitals in consideration. peripheral units to treat & see out patients. Thus saving journeys to NDDH providing they are kept open.

361 A1 Barnstaple is a long way N/A. B It’s a very long long to travel 3 Yes. My dad was in N to have to drive or rely from Holsworthy isolating Holsworthy hospital on public transport. patients and their visitors. before he later died Holsworthy is a lovely at home from reasonably new building pancreatic cancer at which is always age of just 54. welcoming and clean. Holsworthy hospital Holsworthy is growing was a much nicer and needs tis own environment for him provision. and cecause it was so close to us it enabled one of us to stay with him 24/7 you just wouldn't get the level of care and attention on a bigger ward in Barnstaple he was able to have his own room at Holsworthy. At one time there wasn't th eprovision for mcmillian hospice carers at the time. The hospital would be a big loss especially to those with transport issues Barnstaple is such a 362 A4 The most modern of the Non starter B Putting all resources in one 4 Public consultation document is biased. 1) How are home The idea of including N four community due to the site leaves no options for patients going to get the aged hospitals at hospitals. South Molton building assistance in times of crisis. attendances at Ilfracombe and and Holsworthy serve age. reasonable times. 2) Bideford is not viable remote populations as How are home nurses due to modernisation well as people living in going to cope with and maintenance the TOWNS. South remote patients. 3) costs. Where there is Molton is able to take 28 What happens when difficulty in attracting patients in times of home nurses cannot and keeping staff is surge. North Devon link attend due to totally due to the road ensures inclement weather . incompetence of accessibility. Eg snow & ice. managers, not individual hospital areas.

363 A Keeping beds in our rural B This option would take away 3 Not only older people living alone BUT ALL You state that there Had my late husband N hospitals is vital for our the chance for rural hospitals PEOPLE ON THEIR OWN. will be care in the been in either NDDH towns & villages with to flourish and grow. community. How do or Exeter hospitals I little or NO transport you propose to pay would NOT have links, especially for all this and will we been able to reach Holsworthy where our be means tested it is him in time when he local hospital gives us an unreliable method died in Holsworthy such great service. of care I think. hospital as the nurse called me at 6:30 in the morning.

364 B Better parking / more A Too messy an option. Too 3 Just look after everyone to the best of your Get your act N general and central. spread out. ability within the budget. together. Train more Better buildings / ENGLISH nurses and equipment etc. doctors. Pay them a decent wage for the job they are doing. My grandson has waited 5 months to get the results of tests done in Bristol hospital. NOT GOOD ENOUGH!! 365 A3 Bideford has a unit for B NDDH Would not necessarily 3 Apparently care in I have worked for 16 N recovering from a stroke benefit South Molton the community has years in South & would cover patients more difficult for not worked well in Molton hospital Holsworthy area. South relatives to visit. Torrington area (albeit being in the Molton reasonably without hospital beds old hospital) & I have modern hospital which in Torrington worked in Chulmleigh does not require any / hospital. / South Molton area little work. S.M. covers a for 8 years as a very large area. district nurse and know there is a need for interim care in a community hospital & care for the terminally ill where it is not possible in the patients own home. (I am now retired).

366 A4 1) Outpatient care is not N/A. B For all reasons cited for 3 This is not just about N always appropriate - question 2. towns but about rural criteria 2,3,4. 2) Public areas where trained transport is inadequate - staff will be spending criteria 2,3,4. 3) If we much of their time in lose community hospitals cars travelling they are a valuable between outpatients' resource gone for good, homes and some increasing reliance on vulnerable people / private provision - criteria groups will be alone 4,5,6,7. for much of the time.

367 A4 More impatient care is B See answer 2. 3 I understand the N important for patient policy but am not groups such as terminally sure it si adequate for sick - public transport in an area where rural this area is poorly infrastructure means provided - if we give up patients are spread existing hospital facilities out and an efficient and buildings are policy will be repurposed we will not challenging to be able to get it back. deliver. Criteria relevant: 2,3,4,6,7. 368 C1 NDDH central for North A Too small and too remote. 2 Yes. Make more use of N of area Bideford has most council care homes & spare capacity with high facilities instead of and increasing closing them down. populations. Holsworthy is too remote and too small.

369 A (Only Bideford listed). 2 Because Bideford offers a good overall service and is the nearest to us.

370 A One site must be N/A. C 4 Listen to local requirements more. Towns are already The NHS needs to be N Bideford. Rural North served better than run more efficiently. Devon has lost too many the rural districts. The staff are terrific hospital beds. If beds are Why do not dave but there is too much not provided at Bideford costs by working waste. Missed considerable hardship smarter & efficiency appointment etc will caused due to the savings rather than should be charged long distance required to closing existing beds? for. travel from Woolsery, Clovelly, Hartland to the nearest proposed alternatives to Bideford.

371 A5 Both are long journeys especiallythis really Holsworthy is notBideford a question forIt both is very topatients askclose a nonto and Barnstaple professional families at so a there person.time whenare However, lesser people4 Theredelays inare any should inunder emergenciessituation bestress a referendum regarding and less funding, so travel that timegoodall households managementI understand have should youa chance intend be toable to consider treat to prioritise more and peoplevote, needs rather Yesat and home, this allocate than is butcompletely a few funds,personally meetings whilst againstN I am whichkeeping what12 miles you localan would eyefrom people on Holsworthyknow good want from working and experienceso feel I practicesfeel they the havewould expense paid not ofinto attract home the asnhsvisits many for. would Therepeople be is more also lotsexpensive of publicity than abouta hospital "bed bed blocking" locally asdue the to hospitalthe lack isof already ability ofcosting the professionals the community to sort to stay out open.care packages Also there soon will enough. be 45 minutes What better or more way travelling to stop thistime than for eacha local visit, hospital which able could to beprovide better convalescent used in the hospital care for a while 372 A1 1. furthest from n/a B we had insufficient 4 How can a consultation such as this be Why are the CCG not N Barnstaple. 2.highest information to discount this creative when you are not working closely involved with this? proportion of people as an option" is an appalling with those directing care in the home Care in the without transport.3. reason to have to expect (CCG)? There is insufficient evidence to community is not good building. 4.well- GP's to be able to care for discount NNDC as an option - not enough well covered because liked hospital locally 5. patients there when they are exploration of this option. Cost of care via there has not been Torrington closed 6. coming from as far as Care homes is not covered- this is the input of CCG. Use Holsworthy covers a Holsworthy, Shebbear and important for local people coping of Care homes does large area with many Black Torrington and Holsworthy Hospital beds to be closed. cannot be an option - elderly folk in need of surrounding areas. how many do not post op care and rehab already have a that cannot happen in waiting list? A friend their homes - many of recently spent the which are remote and her last few days of take up hours of nurses life with cancer at and doctors time to get Holsworthy. She was to. 57. How could she have been cared for in a Nursing Home, and where? 373 A1 The catchment area for n/a B 3 Yes Significant difficulties Y both Hospitals is with recruiting extensive, with a Qualified staff to significant increase in provide Community population currently based services, is occurring and with creating concern extensive planning within the Staff-base. applications for housing The large development within geographical area Torridge. The services and the complexity of offered by both sites are many of the patients, utilised by 9+ GP demands much of surgeries: as far ranging staff, who often work as Bude, Holsworthy, alone in very stressful Shebbear, Hartland, circumstances. The Bideford and Fremington. need to admit to The rurality of the area Community beds creates logistical comes from a MDT difficulties for Elderly and approach/consultatio Disabled clients who are n and is for proven not able to access public reasons, rather than transport, or are unable from and abscence of to travel to NDDH. The in- 'an alternative'. patient services are valuable in reducing the impact on Acute Beds and supporting slower- stream rehabilitation and 374 A4 Holsworthy and South n/a B 4 transportation from outlying areas to NDDH Yes Y Molton are buildings should this be the preferred option. end of which were built recently life care and the relatives involved. and can be developed to make adequate arrangements for end of life care, where family are able to come and stay to be near their relatives when close to the end, this can be for anyone within the northern devon area incuding Barnstaple and Ilfracombe and hospice care is not always available. the sites are serene and peaceful and the care is outstanding according to CQC. people living in these areas are out of area for NDDH and transportation is either not readily available or extremely expesive and a pensioner would not be able to afford to visit regularly this will have a 375 A4 The distance of n/a B Does not provide a 4 No costings provided, no details of how I understand, but feel Holsworthy is an area N Holsworthy to NDDH, 30 community hospital, it is the much money would be saved with each that services are with poor transport miles is too far for district general hospital. Too option, or how much it would cost to already stretched in links, whether private relatives and patients to far to travel from increase care in the community. the community, feel car ownership, taxi or travel. Community beds Holsworthy. The beds would that losing public transport. It is should be in the probably be used by patients community beds the furthest from community in which they in the north of the area ie would be a safety NDDH. The care serve patients. Barnstaple, Braunton, concern for patients provided at Holsworthy has poor in that community. Holsworthy is public transport and very Home is not always exceptional. It poor taxi service, It would the safest or provides excellent be virtually impossible for appropriate place to end of life care that many to attend NDDH. It be cared fore. could not be is a purpose built compared to care Hospital which provides provided in nursing excellent care and homes. It is often services for patients and difficult to get an their families. urgent placement in a home locally. 376 A4 Quality of the buildings, n/a B All beds at NDDH Distance, 4 Many people in this community have not Care closer to home Y both built 26yrs ago, so accessibility. Traffic appalling quite grasped what is potentially going to can work to a point. purpose built. Both serve in summer months, roads happen. Many of the very elderly residents However, if beds are very rural communities. terrible in bad weather of the area are still quite trusting of the to be reduced the Holsworthy 30 miles from Parking, costs and distance system. Not sure what other options to follow-on care needs Barnstaple with poor for elderly people to walk to offer, only that both Holsworthy and South to be in place to transport links Infrequent main building even if they Molton are to me the most obvious choice compensate. This so buses (over an hour have a car or manage to get as both hospital can adapt to change and far is not the case. travelling), poor road a lift, Add to that the cost of able to cope with surge. the capacity is People in hospital are with few route fuel for over 60 mile round there. Staff once recruited tend to stay as it still waiting for options,extortionate taxi trip. There would be a lot of is where they have chosen to work, are part nursing home places fare, but actually no taxis very lonely people stuck on a of a multi-disciplinary team who all work even if they are self- available only private ward for what could be well together for the good of the patient. funding. When Rapid hire. weeks. Cannot offer the intervention are same amenities that unable to find carers community hospital can i.e. in emergencies easy access to outside space. patients are admitted More personal individulaised to community care. Particularly important hospitals. This to young palliative care happens frequently patients, and people with now and we have not dementia. Closer to home even had winter and visitors. Sense of being pressures. I am part of the community. Day concerned that centre is held at holsworthy patients are getting hospital and they welcome less and less choice. anyone from the ward to What happended to attend. 'preferred place of 377 A4 Holsworthy and South n/a B Not easily accessible from 4 Community hospitals Y Molton are the greatest Holsworthy ars just that, for the distance from Barnstaple community. This is especially so in rural areas. Time and time again, it has been shown that care in the community through home visits does not work well. 378 A2 No mention has been The Burrow Don't 3 These people need Having experience of N made of the planning for House care have someone around a close relation hundreds of new homes home, now one. 24/7 sometimes, care needing to go on to a planned to be built in closed, in the community is community hospital Ilfracombe in the coming could have fine for some, but not after leaving NDDH years. It may be viewed been everyone. on two occasions I that the system has considered understand all the worked well whilst the as an reasonings behind hospital has been closed, alternative making these but it has not been easy unit. changes. My relative for family to have to go spent her first respite as far as South Molton to in South Molton, she visit their elderly relatives was very agitated and who need their visits at a unable to have many stressful time for them. visits from family and friends due to the distance involved. Her second respite was in Ilfracombe, close to home, she was able to have a more relaxed time there and as a result was discharged far quicker than she had been in South Molton where she felt lonely and vulnerable. I 379 A3 This leaves Holsworthy n/a Holsw Its too far out on a limb and 3 Torrington Yes I think using N out on a limb, but then so orthy would be better for people community hospitals are Lynton and living on the edge of without beds as Lynmouth. Bideford is Cornwall, ie Bude etc and medical centres for a not too far from too far for people to go from wide range of clinics Ilfracombe area and a the more northern outposts is much better for the better option for people of the area. community and a from Holsworthy than much better use of South Molton. resources. They are after all community hospitals. Extra money needs to be found for scanning and Xray equipment and staff, so the pressure is off NDDH. Years ago in Lynton when I lived there, they bought beds as and when required in the local care home, so patients needing rest and recuperation could be dealt with locally by NHS staff. Does this still apply? If not, why not? In Torrington, 380 A4 BOTH IN RURAL AREAS n/a B ALL BEDS IN NDDH LACK OF 4 COSTING OF EACH OF THE PROPOSALS, NO YES BUT CAN NOT Y BOTH BUILDINGS BUILT TRANSPORT FROM RURAL WHERE HAS BEEN STATED HOW ANY OF SEE HOW IT IS GOING LESS THAN 25 YEARS AREAS WOULDN'T BE THESE CUTS WILL SAVE MONEY ? hOW TO WORK AS AGO CAN INCREASE COMMUNITY BEDS AS IN CAN A DECISION BE MADE WITH OUT PACKAGES OF CARE NUMBER OF BEDS THE SENSE OF HAVING HAVEING COSTINGS THOUGHT THROUGH ARE FEW AND FAR REQUIRED IF NDDH ON THEIR OWN GP'S LOOKING AND PREPARED FIRST !! BETWEEN, PATIENTS RED ALERT WITHOUT AFTER THEM AS IN HAVING TO WAITS ANY DISRUPTION TO COMMUNITY HOSPITALS WEEKS BEFORE A HOSPITALS DISTANCE FOR SUITABLE SPOUSES/FAMILY/FRIENDS OF ELDERLY PATIENTS TO TRAVEL 381 A1 n/a B penalises elderly in rural 4 Spend the NHS budget better and don't yes - the dn and care Would you be happy Y community waste it on 1 obscene amounts of money workers and complex if your elderly/sick on agency nurses - focus on sorting out this care teams are going mother or father alarming situation please. 2 Procurement to be spread very lived in any of the system - its worse than poor, when the thinly! more rural areas for same items can cost different NHS Trusts their local IP Ward to vastly different costs. close? We need to balance the books financially, but this is not the way. Look at the year in, year out spend, on private agency nurses and the bank nurse system, its a dreadful amount of money. What a waste of the taxpayers money. I would far rather you focused on getting this staffing situation sorted out first and spending your budget more efficiently.

382 A4 North Devon has such a n/a A2 These are both close to 3 Yes Y geographically dispersed NDDH and so coverage of population that there the NDHT remit would be should be provision in the poor. extremities of the area, i.e Holsworthy and South Molton. This is essential for visiting families, and for patients to have the opportunity for rehabilitation and care nearer to home. Also, these are the two commnity hospitals with the most up to date building and facilities so are more 'fit for purpose'. 383 A people would rather be n/a Y nearer their own homes, this enables visitors more often which helps with recovery. By putting the beds at NDDH are they going to be discharged quicker (perhaps when not really ready), also by having beds at NDDH how is this going to effect the hospital particularly over the winter months when there are never enough beds anyway.

384 A3 South Molton has been n/a B If any beds go to Barnstaple 3 Leave all the beds as they are! Do not see how Staff moral is at an Y practically full ever since they just will be swallowed anything could help. alltime low and Ilfracombe closed and if up by medical outlyers not shutting these this were to close community patients. hospitals will just relatives would have to make matters worse. travel greater distance to see the patients. Bideford has the stroke unit which offers excellent aftercare and rehabilitation which i dont think you would get anywhere else. 385 A4 This is a rurally deprived n/a Ilfraco Ilfracombe - out on a limb, 3 I don't think there are any ideal options - all Yes - I do feel that the This is a difficult Y area - people find it mbe difficult to access - building options will meet with opposition. slide is slightly mis decision to be made, difficult to travel to major not fit for purpose - difficlt to leading - 900k is we have an hospitals to attend get in/park etc spent for a 16 bed increasingly elderly appointments, visit unit in a year - how population and must relatives etc. Public many nursing staff. cease fire fighting transport is poor and HCA's etc are and plan for the high mileage makes cost employed to staff future. People need of travel unrealistic to that unit in a 12 to be responsibile for many. Placing community months period. You their own health and hospitals fairly have detailed how the NHS needs to geographically across the many staff will be look at ways to county is the only fair required for care at generate income way to approach these home? utilising the staff and imposed cuts in service. fascilities that they already have.

386 A1 Bideford hospital I dont 2 Y currently houses the understand stroke rehab unit - this is how invaluable for long term someone stroke rehab for all pts in with no the north devon area. An business or environment that is less financial clinical and different from planning the acute setting is training/ex fundamental in perience is encouraging functional able to stroke rehab and answer this optimising patients question potential. Holsworthy hospital provides a valuable service for patients on the Devon/Cornwall border who otherwise would need to travel 70 mile round trip to visit relatives 387 A Beds at community B If the Trust close all the 2 As I understand it, lack of funding, lack of Yes, but my concern It is a short sighted Y hospitals to enable community hospitals down, nurses have guided the Trusts Management is if you cannot find decision, and I will be patients decent rehab the reality is we have lost team to this decision; if the intention is to the nurses to staff interested to see how time, and family local to beds over the years, so as an ensure the demise of the NHS this will go a the community this works when you the area to visit. I don't acute hospital we are far long way to ensure that it happens hospitals you will still have closed down all know whether this meets smaller than the original. have the problem. I the community beds. the agreed criteria, but Winter pressures will mean assume you will train It makes me very North Devon is our acute hospital will be HCA's instead, which aware how grateful I predominately a rural under pressure once again, means patients will am that my daughter area, a lot of elderly with waiting lists having to not really be is a staff nurse on patients, who have either be cancelled with all the receiving nursing care ICU, and my nephew never driven, or are now problems that will bring to as such, unless you is a Doctor, because I unable to drive. I the Trust. train them to NVQ think when my time understand that there is level 3 at least. comes for medical a nursing shortage input I will need because of Government someone to fight my short sightedness. But case for decent unfortunately, the people medical care. who will suffer in the long term will be the most vulnerable. The idea of patients being looked after in their own homes to work will still rely on patients having family within the area to help support. Fine if they have family local but 388 A4 These two hospitals are n/a B Not well at all Yes but it will never N many miles from NDDH work efficiently because of distances involved especially in the winter. Flooded rivers, snow, ice etc. 389 C2 Holsworthy is to far from B 3 Leave things as they are, for the safety and You are intending to Rural and agricultural N NDDH for older patients care of the elderly. "beef up" care in the based lives are to reach comfortably and community but completely different safely also this would however good this to towns peoples help the trust to meet its becomes local lives. Relations often budget requirements. hospital beds are work long and essential "pay back" awkward hours so to those who have visiting elderly contributed most relatives a long way through out their away is often very lives. difficult. Local hospital beds are essential for care, safety and general decent human rights.

390 C2 Holsworthy is so isolated B It is not a feasible option for 3 Yes. But I keep No. N and includes a hinterland Holsworthy. hearing stories that even further from doesn't give you Barnstaple. Older friends complete confidence would find it hard to visit in it being delivered. NDDH without help from other younger people. Holsworthy is a modern hospital.

391 A4 South Molton is central in B 4 No I do not What was the pointg N a rural area. With a lot of understand, if you of holding meetings new houses being built. A cut beds in towns with the general lot of older people living where are you going public, when you alone, so where would to send people who would not answer you send them if have no family to any of the questions, Barnstaple hospital is on look after them or you just hedged Black alert, if you send even worse the around them and did them home alone would people who are dying not give us a truthful you get carers to travel who would have answer you only told miles out to the been well looked us what you wanted countryside three times a after in South Molton to tell us. This is all day at great cost. community hospital about money and not where their palliative about people. care for the elderly is second to none in fact excellent. 392 A4 It serves the local B It will complicate health 4 Putting the lives of the elderly at heart as Keep the community N communities and closure care. the other options is not to their best hospitals. will affect the lives of the interests. elderly. 393 A4 The population of these B 4 Why always choose to cut back on those Why are you moving The public meetings N areas are increasing fast. who are vulnerable. Perhaps it is time to the goal posts instead were a farce. The So the travelling will be start at the top instead of the bottom. Look of considering the suggestions and much greater for those closer at the ways to save by looking at people who need comments were not who need instant care. where there's waste. care. South Molton is accepted and no real They deserve to have a a modern building all answers given. Waste hospital near to where on one level easy to of peoples time and they live. maintain and operate NHS (our money in a growing area. wasted) money seems to be more important then people.

394 A4 Due to demographics + Not viable B Already working at full 3 Utilising GP's & health centres as How can you be sure N productivity + quality of or capacity & juggling community hubs + for outpatients clinics / that staff will be both sites in relation to applicable discharges to the services with 'pop up' healthcare services. happy to redeploy + NDDH for the elderly as a 16 bed community. Car parking Using NDDH for acute medical / surgical / not leave nursing? community. Buildings unit. difficult. Hospital needs children / maternity + mental health only We already have newer + fit for purpose. updating & wards too small services. poor retention for South Molton provides for our ageing & obese nurses in the UK, an excellent rehab population. what extra provisions service in a rural area + + equipment + skills has a wide range of & training are going services already in place - to be put in place for could be used as a centre people being of excellences. discharged home instead of going to a community hospital bed?

395 A (Only Holsworthy listed). B Difficulty of access plus 3 This seems to me to If Holsworthy N Access to hospital. distance from a large part of be a question which community hospital Treatment by known the area covered. has not been very is closed what is to doctors ie doctors at well explained. There happen to all the health centre in the case seems to be a gap in ancillary units? Eg of Holsworthy. the thinking. podiatry. Will they also be moved? Again necessitating further travel and expense to the community. 396 A (Only Holsworthy listed). B A round trip of over 60 miles 4 To explore any option which removes beds Yes I do, but feel it North Devon hospice N Holsworthy is an isolated with a poor bus service. from Holsworthy is no option at all. isn't right for people a charity doing an community with poor needing end of life amazing job relieving public transport. Travel care particularly pressure from NHS by bus to other hospitals elderly, living alone hospitals has just in unrealistic & in the and receiving maybe opened the Long case NDDH involves a 3 short care visits a House next to the round trip of over 60 day to be left lonely medical centre and miles. Holsworthy and frightened for hospital in hospital is a modern hours / all night. Holsworthy, site so building meeting the Patients are likely to all can support each needs of older people become "bed other. Itself a non- living alone and removing blockers" at NDDH bedded unit, "bed blockers" from because community intending to work NDDH / Exeter / beds have gone and closely with hospital Plymouth. they cannot cope at staff caring for home. terminally ill patients in the hospitals beds.

397 C2 Holsworthy is the B No town would have beds at 3 Use of mobile carers N furthest site from NDDH their local hospital. Problems is inappropriate in (30 miles) with longest with accessibility for people the Holsworthy and least frequent bus living in Holsworthy area environment owing services. Also the town who do not have a car. to the rural has the lowest Infrequent bus service form population with percentage of people that area. Lowest car many properties with a car. Also it is the ownership and furthest difficult to find and easiest to recruit and away from NDDH. poor roads which are retain staff. Hospital not gritted in winter. there is purpose built Moreover mobile with a flexible layout. telephone signal is extremely poor making communication exceedingly difficult. 398 A Because we both serve a We are very B Not enough beds provided 4 It is all being done to fast without Care in the I feel that we have a N very rural community. sorry that for all the communities it consultations from the public. community does not really good team at Both are relatively new Ilfracombe serves. work properly and is South Molton hospitals built by a lot of hospital is a cause for great hospital and it is funds we worked for. We closed. We concern especially in much closer to have not got any buses would the winter months people in this rural for our outlying prefer it to when people get area. Plus it is a communities and people stay open. sicker. relatively new prefer to be nearer to But we hospital with good home at all times. would facilities. always welcome people from Ilfracombe to our hospital.

399 A4 These are the 2 furthest From your B Barnstaple or Barnstaple / 4 Like everyone else, I think this is a foregone Yes - care in the N distances from description Holsworthy only. How are conclusion & this is merely home. This appears Barnstaple thus enabling Ilfracombe people to get from South windowdressing. A lot of waffle by to be stretched now. easier access for many is too Molton to Holsworthy!!? "managers" how much is being paid in I have seen this in people both patients & ancient a saleries to people putting up this spiel?!! operation with their visitors. Buses do building. elderly relatives. One not run in the evenings has to pay ofr min patients NEED visitors 1/2hr morning & morale boosting. Patients evening & the would either have to pay careworkers whizz in for cars / taxis or take 2 & out in 10 mins 1/2 bus journeys - not on of which is spent on when one is ill. These 2 form filling. People sites would at least allow are left unattended reasonablel access to all. until nearly 10am it is You state staffing is quite obvious that reasonable for both not everyone can be these sites. visited at a "good time" & the more people in care in the home the system will not cope. (The same applies in the evenings of course). If people NEED to be in a hospital they are not fit to be at home usually on their own. 400 A4 Rural location of N/A. B This is a main hospital not 4 Reducing the cost of bureaucracy and Yes but it won't work There are not enough N Holsworthy - lack of community hospital consultation. Cut down on administration in a wide rural area - community beds public transport. Rural transport links from the costs including staffing. More frontline there won't be now. When patients deprivation and access to Holsworthy area are virtually healthcare workers & less managers. We enough hours in the are ready to leave healthcare. Torridge is non-existent even extinct in need all our community beds. Listen to the day & staff will spend our acute hospitals one of most deprived some places. Alternatives locals who know the area better than you!! more time travelling (Exeter/Plymouth/Ba areas in the country. are expensive. Elderly then visiting patients. rnstaple) they Holsworthy has good relatives already under strain Using the resources become bed blockers staff recruitment and a & stress of an ill or disabled already in existence if they cannot move cost effective building. family member do not want in our community to a community The Long House has just to travel for a longer period hospitals is more cost hospital near their opened & will work of time then they will spend effective and home. This then has a closely with Holsworthy with their family member. efficient. knock on effect hospital. South Molton is throughout those also cost effective & hospitals down to would give an option for breaches in the beds in the northern end emergency of the area which do departments and have transport links from cancelled admissions - other places. then more cost to the trusts if they are fined by the government. If beds are closed will you provide transport links (eg minibus) to the new facilities to compensate our loss? 401 A4 Both rural centres a long B Barnstaple is such a long way 4 Please think long & hard before closing our Not entirely - do you My father died at N way from Barnstaple. from St. Giles on the heath. valuable local hospitals. Holsworthy is have enough staff to Holsworthy hospital Difficult for visitors & family remote from any large hospital & so needs cope with all the & the care he to get to. the back-up of a community hospital. home visits that will received there was be necessary? Will excellent. We were doctors be able to able to visit cope with the extra frequently & stay work load. with him at the end. Vulnerable people A better experience could suffer. for the whole family.

402 A4 These two centres are B As it is so far from my home 3 Care in the home N most rural & furthest & on a miserable route. sounds ok but does from Barnstaple. not always work. Holsworthy has an Long periods at home especially tedious road to without any back-up. get to Barnstaple. 403 C2 Distance from N/A. B Distance from Holsworthy. 4 You have let the situation deterate before N Barnstaple, roads, traffic Cost of parking. Over getting peoples opinion. good parking. Holsworthy extended ward. Cost. is there, modern and central to the rural area. The new hospice does not have beds so should not have been included.

404 A4 Bideford is the closest, N/A B Care will not be closer to 4 You should have considered other ways to I understand but You reduce the Y with the best transport building not home if all beds are at save money instead of shutting community where are the extra bandings of admin links. South Molton and serviceable NDDH, especially for the hospitals such as centralising the staff coming from to staff and do not fill Holsworthy were / now remote and rural procurement system, reduction on agency work in the vacancies at the specifically built for the appropriate communities in Devon with staff and the hire of bariatric equipment. community? You lowest levels to save purpose of healthcare for poor transport links. can't recruit to money, BUT! You and being the newest healthcare nursing jobs at NDDH create an additional builds are laid out better needs. as it is. There are not senior management with scope for expansion enough care agencies vacancy instead / extension & surge. either so there is NOT which seems so the care in the unnecessary and not community in place. justified.

405 None Beds at all community N/A. Full of smoke & mirrors. It is not possible to Accept that you are N hospitals. Until you can provide safe care in not doing the job of provide enough carers & our rural areas. C.I.T community nurses it is not safe to properly. promote. Care closer to home as a success story. 406 A4 Both modern building B Access from the very large 3 Retention of local beds & additional Beds would be Your suggestion that N with good facilities both rural area is by public facilities provided locally. removed not reduced the hospice in but especially Holsworthy transport inadequate & by care at home Holsworthy (with no remote from NDDH taxi prohibitively expensive. proposals seem beds) provides an causing considerable Most patients prefer & haphazard, alternative to the hardship to patients & probably recover more inadequate. hospital is puzzling. relatives / friends with quickly in smaller hospitals in The hospice is bus services infrequent & familiar surroundings. designed to provide taxis far too expensive for complementary most. Both have capacity services alongside for "surge". the hospital - it is an additional facility not a competing one. The suggestion that a high number of private care homes provides an alternative is also misleading NHS has no control over these beds & the level of care is potentially far lower. 407 A4 Travel to NDDH. From B Transport from these rural 3 Retain & enlarging Holsworthy hospital to After removal of all The idea that the N both these rural areas is areas is inadequate and cover other areas of healthcare. beds in this area hospice without beds lengthy & expensive. expensive. Patients would homecare proposals at Holsworthy is an Patients would feel prefer and would recover would be expensive alternative to the isolated from their better in small hospitals in & unreliable, hospital is perverse. relatives. Both are good their own area. especially in winter. The hospice is to quality modern buildings provide services not capable of handling available at the additional patients at hospital. There is no busy periods and also overlap of services. It good at retaining was designed to experienced staff. complement the hospital. As to care homes providing an alternative to the hospital, the NHS has no control over these and the level of care is debateable also very expensive.

408 A4 Most remote from B Surely this would restrict I do not have sufficient information or See question 5 N Barnstaple. 1.2.3 space for acute care beds experience to comment. answer: The only and (negative in all counts for and is in any case make it best alternative to above sites) 5 South difficult for those reliant on community hospitals Molton hospital relatively public transport to visit would be well new and well planned & especially in the evening. trained, well paid equiped. 6. 2 private home carers, allowed social care homes South more than the Molton but none public notorious 15 minutes since sad loss of Been per visit. House. 409 A4 These hospitals are B Centralisation is not what is 4 Moving GP surgeries to the hospital Home care!! There is N essential for local people best for the patient & their locations & making them a medical centre / a shortage of good who have no transport & families who many have to hospital. trained carers as it is many also be elderly. travel a considerable & with "care in the Family & friends can visit distance on public transport. community" being easily which lessens the The hospital service needs to the focus, costing's strain of being be person centred & a need to be done to hospitalised & aids budget worked to evaluate such a recovery. South Molton accommodate this. move. People prefer & Holsworthy are to be at home if anything remote areas & possible but need suitable local adequate trained hospitals. professionals need to be employed on decent wages.

410 C2 1-3a-3d-6-7-9 as n/a A3 Bideford Hospital due to its 2 cannot answer as limited local statistical am concerned that Unless the nhs is fully N outlined on page 15 of staffing situation. South information is available to a lay person to the current provision responsible in the consultation Molton Hospital -ditto-. Also use in formulating other options. of community meeting all charges feedback form. both of these have well nursing may not levied when the use served population by both provide a sufficient of Care Homes is public transport and observation required the subject ownership of private cars so time/care ratio for will arise of "means travel to and from the NDDH patients in their own testing" of patients if would be reasonable. homes by reason of they are made to the inevitable meet the cost of non- pressure of workload. medical aspects of This will need their care. In such a constant supervision situation the whole if the service is to run family unit may smoothly. suffer. 411 A The beds in the n/a C As I have said, If the NDDH 4 There is not the Y Holsworthy community hospitals are had beds simply for rehab infrastucture in the a vital part of the patients, these would be the community to community and provide a 1st to be used if there was a manage all patients great interim place for bed shortage, leaving that would have to patient's that need that vulnerable patients going stay at home if the extra bit of support and home before they are commuity hospitals rehabilitation prior to physically ready. were not here. We going home. Many of spent a whole day these people would end looking for care for a up straight back in an lady who lives 10 acute bed if these miles out of both hospitals were not Holworthy and available. If the NDDH Okehampton, she had beds simply for had to be admitted to rehab patients, these Holsworthy hosptial would be the 1st to be for support whilst used if there was a bed care was found - if shortage, leaving Holsworthy wasn't vulnerable patients going here, she would have home before they are taken up an acute physically ready. bed in NDDH for pure social reasons, and with an elderly and frail husband, he would not have been able to visit. 412 A4 Holsworthy and South n/a B These will not provide the 4 keep the beds open until all care agencies Community care is we are all aware of Y Molton are modern fit for community aspect of the are in place to care for the patients. patchy in rural areas, the financial pressure purpose buildings. beds. Will be used as acute there are insufficient our health service is Holsworthy area is over beds when bed pressure is care agencies able to under, however the one hour drive from occurring.The distance cover the existing continual loss of Barnstaple, public families would need to need. community inpatient beds, can transport very poor and it travel, poor public transport, Nursing Teams are not be justified will serve the south of already struggling to unless the the area. south Molton fill vacancies, and community care cover areas of Exmoor morale is at a all time structure is in place and can cover the north low. to enable a high of the area quality of care delivery. 413 A4 I am disabled suffering a B Not sensible to expect one 4 The meeting did not When I had my stroke 14 years ago. My hospital to cover closures in make this very clear, stroke I spent 5 wife is my carer and 4 hospitals worried that care in weeks in NDDH and a driver, she is 73 years. the home will not be further 5 weeks in Barnstaple travelling is fully covered at all Holsworthy. My wife too far and too tiring times was working part time in Holsworthy hospital and travelling to NDDH to visit me. If this had been for 10 weeks, this would have been a trial.

N 414 A4 These hospitals are new, B Beds in CHs are essential. 3 When you say that A nurse looking after N modern buildings. people will have four 20 patients in Holsworthy is the visits a day in their hospital can manage furthest away from own homes, I cannot this far better than Barnstaple see this being viable. calling on 20 pts in We live in a very rural the community. community. Closing community Travelling will not be (hospital) is very easy in the winter. short sighted, the larger hospitals cannot cope

415 A4 These two hospitals have B Where are you going to put quite well keeping them all open and cutting down on We understand what It is easy for you to N the most modern the large number of extra the number of admin staff! Less chiefs and you are telling us but say public transport facilities, they both have beds without much expense more indians! have our doubts that takes this long or that a large catchment area of and without prejudicing the this is and will in long from places like villages which do not present beds available for practice meet the SM/Holsworthy or have easy access to emergency and general needs of many Bideford to get to public transport to either surgery etc. Rehabilitation elderly patients (i.e. NDDH but what Bideford or NDDH. Both beds are better to be nearer end of life situations about people that have many outpatient people's homes especially and in many cases live in the outlying clinics, both have for the elderly (whose people living alone 0 villages and hamlets capacity for surge and relatives are probably elderly they need someone that don't have both have adequate too) and for the end of life there all the time, regaular buses to parking, both would have care where it is more that they can call). connect at the larger no difficulty recruiting personal and homely in a towns. and retaining staff. SM smaller hospital. has the capacity to extend and offer daycare when renal unit goes. 416 A4 transport difficulties of B NDDH should only be used 4 It seems you are only basing clsoures on the Yes, but not all beggars belief that N other options. SM is a for procedures. Population is new system you want to introduce patients will be when bed blocking is new building, has been expanding in ND. suitable rife, that our CHs are greatly supported by the not being used to LoF who have raised alleviate this. SM £000,s over the years for hospital currently equipment used for physio, visiting drs, audiology etc (ambulance paramedics also based there).

417 B it it fairer and reasonably A Very uneven coverage 4 No. What services No information on We need joined up N accessible. It will allow will you offer? service to be care for the long devt of rehabilitation and available under new term. Need free local community care. community care, how transport to local can people get it? services How will you work with social services to provide seamless caer from hospital to home?

418 C2 Holsworthy as it is very A and 2 The closure of N well situated and has the B holsworthy hospital capability to expand if would be of great required. The town itself loss and concern for is growing and we need local people who rely this amazing facility to on its good access for remain as it is. those living in and around the area. It really is a jewel in the crown for Holsworthy

419 A NDDH is central to the n/a B See above 3 no no no N region, so two community hospitals to the north and the south makes easier access for patients in these two areas. 420 C2 Holsworthy is n/a 3 Yes, however, I am Generally I am in N singnifcantly more not convinced you favour of the isolated than other have explained how changes, but how communities and has you will be able to much will it cost to poor public transport deliver/afford the create the fragile links change before local care beds in hospitals are closed. Barnstaple. Will this You say there has reduce saving made been minimal impact across the region. due to the closure of Please consider the Ilfracombe beds (for role of the voluntary the majority), but sector in assisting there is no better care and description of how savings in the services are now affected areas. There delivered in the is likely to be a community. Splitting considerable impact the consultation from thier capacity/ability the CCG consultaion to help, which will does not inspire need funding, confidence that all support and health services cooperation from (comissioners and NDHT. providers) are able to work together to provide long term savings and improved health care across 421 A1 Bideford - 2nd largest Not an B The site is big enough now - 3 Day Centres to aid recovery/combat Yes it looks to me What will the cuts be N population in the area & option due staff and visitor parking is loneliness and O.T's Physios & other health that their stay in next year, and the growing rapidly and to costs. running at full capacity. carers could see people in private rooms hospital will be as year after? We have estimated to grow by Outbreaks of virus's will there instead of them driving around North short as possible, seen cuts year on 81.1 per cent of 85+ age seriously affect the working Devon all day long. Trouble is all the Day they will be sent year for several years band which means a very of one site whereas more Centres have been closed!! home or to a now, where will it large number of elderly. than one site can help take care/residential end? The The government has the strain in times of need. home where the cost government would recently increased the DON'T PUT ALL YOUR EGGS burden will be on the love to see the NHS number of new houses to IN ONE BASKET - YOU'LL END patient. Many will be burden fall to the be built in TDC area. The UP IN A MESS! readmitted very individual & private area has a low capacity of shortly after health insurance & Care Homes to meet discharge or die at the profitable bits will needs. Hospital recently home despite the be hived off to redesigned with Willow care packages put in private companies Unit. Bideford has place. (TTIP). Private capacity to increase bed companies will only space in times of crisis. be interested in profit Holsworthy - newish - cheap unqualified hospital, Holsworthy is staff who will be very far from NDDH with forced to cut corners very poor road & public to meet targets. You transport links just need to look at (compared with South private contracts in Molton). Cornwall to see how they have failed & lies told to meet targets. 422 A6 (Torrington important B As stated in 2. 4 Listen more to local people. Having to visit a Care in the N too!). Local people in all relative in a hospital a long way from home community & 15 the smaller towns need is not easy for elderly spouses etc. minute visits? This care (convalescent) after will not reduce the stays in NDDH. needs of the elderly isolated. 423 A There is an elderly B Many people do not like 4 Yes - why not use beds at nursing homes? Yes. N population in going to hospital and this is In Holsworthy there is deer park NH - this Holsworthy. We are how they would see it. has nurses on duty 24/7. along way by car to NDDH / RD&E we need some inpatient beds. (See 5). 424 A4 Because they are the two Ilfraco Because I understand it 3 Taken a closer look at care in the I understand but A neighbour had N furthest away from mbe needs a lot spent on the community before "thinking" of closing can't see it working. community care NDDH. Transport from building and already beds beds. three times at 1/4hr Holsworthy is not really have been closed there? a day. Apart from this convenient for hospital he sat in a chair & visiting (especially if you was dependant on live in one of the outlying anyone who villages). happened to call in to make him a cup of tea. Luckily for him he died after 3 months. Is this what the elderly have to look forward to? Unless legalised euthanasia comes into force which would solve all your problems!!!

425 A4 Holsworthy furthest from B NDDH very difficult to get to 4 2 community hospitals plus one No - there would be Just a question - how N any of the major for relatives of sick / dying convalescent ward at the NDDH. too many "clients" to much of your budget hospitals in the south family members. Bus be seen on a regular goes to the west. Keep all current network impossible. Hospital basis by too few "managers" who do beds or even increase transport very expensive community matrons not work at the sharp number. Transfer to the considering distance. & district nurses. end? And how much NDDH exceedingly poor - in expenses to come impossible for older to the various members of the consultations? community. 426 C2 By your own admission & If option A Any option which closes 3 Yes. N criteria Holsworthy were to be Holsworthy because from should be featuring in all implemente your own figures it is the the options. Staffing - d the two best option. Also for patients distance to Barnstaple - community to convalesce to save bed car ownership & if hospitals blocking at Barnstaple. Holsworthy were to close would why has a new hospice logically be been built on site. Ilfracombe & Holsworthy but as Ilfracombe is not practical option C featuring Holsworthy is a no brainer.

427 A4 Its very short sighted to B Its problem enough getting 4 Keeping all bed open. What are you going I understand how you Having been involved N be closing any bed in to Barnstaple hospital, don't to close next time, the rest of our beds? hope you will look with 'care in the North Devon. As its going complete by putting all the after people in town community' until I to happen lets have the beds there. but what about retired I do know the beds spread over a wide country in winter? problems of having area. It is to serve old Will the council clear people in their own people in the main. Many ALL country roads? homes in winter you others as well. will face the same problems to look after someone for a week at home as long term. That’s when you'll need a hospital at South Molton. 428 A4 Both areas are very rural B As already stated in section 2 4 You should be leaving community hospitals Far more staff will be Elderly people being N with Holsworthy NDDH care is not always as they are. I fail to understand how extra needed for more released from particularly having had needed which is where the home care is going to save money - infact home visits than hospitals often need public transport links community hospital plays quite the opposite. those working in the continuous help for a form outlying villages & a such an important roll. This community hospitals short time which is high proportion of elderly must be seriously where those needing why the community non drivers. Community considered! help can be given it hospitals are so hospitals must be continuously. important they retained to serve these should not be left areas especially where often on their own in NDDH care is not needed. their own homes for long periods of time + in particular over nights.

429 A South Molton with no B We need community 3 Not all questions were answered - 'we've Working in a South Molton Y preference to either hospitals. Winter pressures got a plan' kept being said. Staffing properly community hospital hospital is so valuable Holsworthy or Bideford. I and Red alert mean South and not relying on so many agency staff will and not always being to both the work at SMCH and know Molton increase their beds. / would immediately cut costs. able to access Devon community and of how valuable it is to the Since Ilfracombe and doctors as they are at course the staff that community. The staff Torrington and Crediton the other end of the work here. We are a here are a team and all have closed we are the only area that they cover. fabulous team. The work well together - we community hospital in the If more people are at surrounding area, fit. The community rely area. home will there be plus patients from on us for continuity of more Devon doctors Braunton, care. They trust us as available. Ilfracombe, we've nursed many of Torrington outlays them or family members. need us too. I really Care in the community is don't think that care NOT for everyone. in the community is good for everyone - people NEED community hospitals. 430 A4 We need beds at B Because of my previous 3 Yes - built a bigger hospital in Holsworthy. Yes and I don't think Yes - you need to N Holsworthy due to this comment. We are in a rural Barnstaple cannot cope with more patients it will work as this keep Holsworthy being a rural area area & have very poor as it is not big enough for all the new area is too rural & it hospital open. We transport is very poor transport. Also too far to housing going up around between will fall on good need it in this area. and making a trip to travel everyday - where Holsworthy & Barnstaple. neighbours to help We are too rural to Barnstaple everyday to Holsworthy is just down the out when someone is take it away & move see someone ill in road. ill at home & not staff all beds to Barnstaple hospital is not possible coming in to deal the road is terrible to but should they be in with & look after drive on & too far to Holsworthy you can visit them. go to Barnstaple. every day.

431 C2 Keep Holsworthy. Poor B 3 Work in partnership with others eg hospice N transport links furthest care, private care sector. from Barnstaple purpose built modern hospital available. Private care home full with waiting lists no respite available.

432 None. N/A. N/A. All of them. See below. 4 Not closing anything! Make cuts at Understand but don't We cannot spend N management level to make the savings. agree. millions on migrants & not look after our own. Charity begins at home!

433 None of the see above Get Social B Might as well move patients 4 see above No. I do not believe England does not N above. The Services out to London. Parking you have the have a capital. community problems, Distance to resources hospitals travel. Patients isolated should from friends and relatives remain open 434 C2 This appears the most n/a B Option B is the worst option Not answered I understand that Are there sufficient N cost-effective balance of all. It covers no care in the District Nurses, that covers those people community hospitals community will Therapists and who live furthest away whatsoever. Staffing at continue to be support workers in from the main hospital. NDDH is already an issue. available. What the community? Also Staff from closed community concerns me greatly there are insufficient hospitals may have great is the availability of nursing home beds difficulty moving to that care. available for Barnstaple. Think this would immediate be a retrograde step. admission/respite? Care and emergency care is almost impossible to find the further from Barnstaple you get. Can we be sure that care will be available when required? The answer to all of these is no. This is our greatest concern. Assumptions have been made about all of them. All of those assumptions are incorrect and misleading for the public. 435 B North Devon District n/a A This would no doubt mean Not answered No. I am not N Hospital is the most that one community or aware/convinced of central site for North another would be the package of Devon so no single disadvantaged in that it services that have community will be would be further to travel to been agreed to be disadvantaged. The than the NDDH. put in place to ensure transport links to the people could be hospital are well looked after safely established and it may and effectively in assist with the issue their homes and around shortage of community. nurses wishing to work in community hospitals. 436 C4 South Molton Hospital is n/a B 4 South Molton is N very well run, and has central compared to always provided first rate Barnstaple, and care for it's patients. For covers a wide the more vulnerable it is catchment area. a safe haven, near home, where elderly visitors can visit easily and this helps aid the recovery of the patients. Patients are always relaxed, and comfortable.

437 A3 Patients that require n/a B Community hospital beds Y further rehab before should remain open, as they discharge home needs are an intragal part of would be best met in a delivering patient care in a local community hospital. rural community. They are A community hosptial an essential link with environment enables community rehab patients to be nearer to teams/Complex care teams, their home and easier for GP surgeries and the Stroke relatives and friends to therapy early supported visit. This is very discharge team. important for their wellbeing, which is essential for recovery and rehab. Complex discharge planning for patients can be better met in a community hospital where access to local services is essentail. In addditon beds at Oakwell intermediate care have been closed therefore patients are unable to benefit from this rehab environment. 438 C1 There is a full range of n/a Holsw Holsworthy - owing to its 2 Yes - no further No N NHS services available at orthy geographical isolation and questions that I can NDDH and (from accessibility problems think of experience) this is far an away the most professional and appealing hospital in the South West. Bideford is within easy access to NDDH and so you will have the best of both worlds!

439 C2 Holsworthy is furthest n/a A2, A5, Any option that includes 3 You intend to care for My major concern is N away from NDDH, has A6 & Ilfracombe because it is the people in their own how you are going to fewest car owners, poor C3 least financially viable and home environments. recruit and retain public transport and a the objective is to save sufficient community flexible hospital money. care nurses. The use environment. In tandem of agency nurses is with NDDH I think this already an issue and would best suit the needs if we have to rely on of local people. such staff, there will be no planned savings and consequently the whole thing will have been a waste of time, resources and money. 440 A3 My preferred options are n/a B North Devon District 4 I am not an expert in these matters so Yes , but to me this N South Molton and Hospital For the same reason cannot comment here. seems more Bideford Hospitals i have given in box 2 above. expensive than although I would prefer having doctors and all the smaller Hospitals nurses on hand when to remain open with needed than having beds.My wife Has to keep calling on received care in both them when needed. these hospitals and the treatment was excellent as was the food,which is essential in the recovery of the patient. The food in North Devon District Hospital Must be some of the worst in the country and at times is virtually uneatable,I would not wish going in there on anyone if they are ill and fragile with age.

441 A But no local hospitals I do not B No community hospitals 4 Not wasting resources - after a brocken Yes I understand, Are you prepared to No community N should be closed. We know should be closed as visits wrist I was given a support for it. Just throw inferior care for pay for buses so Hospital shoul dbe love in an area is spaced Ilfracombe, from friends as well as family it away I was told.Crutches, steps, support patients. relations and friends closed. Particularly out. All the local hospitals but I am is important. The nurses in rails are no longer collected. can visit patients? those a long way need to stay. Patients sure before local hospital is second to from the main need nursing care to previous none. hospital in the area. recover and also visits cut backs We live 1 hour at from friends and family there were least from the main who need to be not far more than hospital. away. 16 beds.

442 A We need to keep n/a C Distances for patients and 2 Yes Very important to N Holsworthy healthcare local as visitors to travel. keep healthcare as & Torrington possible to enable friends local as possible & family to visit. As the taking into account distances involved is to the distances which far for folk to visit and would have to be therefore hasten travelled to only one receovery hospital. 443 A4 Both serve very rural The only B I don't know. The feeling that many people I find it hard to I also think it is N areas. There will always reason I express is that the decisions are and will be understand how morally wrong to be a need, especially for didn't driven by financial restraints and not by sufficient care will be close what local older patients to have a consider what is called 'care in the community'. found for those in communities have 1/2 way house between this option their own homes spent years providing hospital and home. In is that when it is high money for. The last rural Devon many do not Ilfracombe impossible to find straw is the proposed have own cars, cannot is far better carers now. I'm afraid closure of the dialsys access public transport served than the underlying suit paid for by the and therefore loved ones South problem is financial local people. cannot visit. Molton by and these drastic cuts public cannot be maintained transport. in a service industry.

444 A4 To aid recovery patients n/a B Reasons given at question 2. 4 Domicillary care not need contact with friends curently available - and family many of how do you propose whom are elderly to recruit/contact themselves, finding travel additional carers. difficult having to take several buses.

445 A3 I believe that the two n/a Ilfraco As it will cost too much to 2 Yes Y community hospital mbe bring up to standard and we option would be the already have suitable most beneficial option for hospitals which are located the people of North at more accessable sites. Devon. This would cover the Torridge and North Devon area and would allow plenty of space for increased demand at busy times. Bideford being more accessible than Holsworthy for most people. 446 A Bideford So that people can visit B NDDH as it will be difficult 3 You should consider cutting down on No not explained in If there is a shortage Another way to cut N +1 their family and friends for people to visit their loved expenses. Very wasteful when people version 2. of trained nurses why spending is to stop without having to travel one and expensive paying cannot return crutches, walking sticks, not train auxillary chemists giving out far. I do not think you can the parking fees everytime. frames etc. They should all be returned to nurses at NDDH prescriptions get a bus from Bideford With local hospitals a lot of save thousands of pounds. They only need instead of agency automatically. I to NDDH in 45 mins as people can walk to them. wiping off. nurses, much understand that services have been cut. cheaper? people have cupboards full of tablets they never take but still get the tablets. Such a waste of NHS money.

447 C2 Holsworthy is the n/a B This would leave 3 Yes Please do not go back N hospital furthest away communities outside the on assurances given from NDDH and Barnstaple area in relative when Winsford therefore access to isolation. Hospital was closed NDDH is the most i.e community beds difficult - care in the would be transferred community would to Holsworthy! inefficient to operatedue to the geography of the area (poor roads, narrow lanes, inaccessible properties etc) particularly in bad weather - staff spending most of their time travelling between calls. Building stock at Holsworthy in excellent condition. Area to to have a significant increase in population.

448 B It is just a wonderful No cost to 1 N hospital for care, get it would wonderful caring staff. be far too Better hospital than high. There Exeter and Plymouth for is no need care. its only 20mins from NDDH. 449 A1 Bideford's changing n/a B No community in North 4 Reduce management costs at Barnstaple How are staff going You are making a big N demographics i.e 23.7% Devon would have beds at and bank nursing costs. Are there costs to be trained to work mistake if you close increase in population their local community incurred re-admitting elderly patients. in the community? Bideford. and +85yrs band grow by hospital. Elderly would be Barnstaple was on 81.1%. Bideford has unable to visit relatives (car black alert several largest potential bed statistics meaningless0 times last winter - capacity to cope with how will you cope surge. Same reasons for without community Holsworthy but % less. beds? Or will patients just be left or shipped to other parts of the country.

450 A4 Holsworthy is furthest n/a B If there is an outbreak of Flu 3 More thoughts on people living in their own If more people are In South Molton the N west and South Molton is or the hospital is closed due home when they live in an isolated area. looked after in their staff are very good not far from Barnstaple. to infection, the spare ward own home, ones that and devoted to their Both Hospitals are both may be needed. Also it is have no family or work. Patients are modern and in good easier for families to visit neighbours to an eye well looked after condition. patients if they are in on them. How will which they need hospital locally. they manage if they when they are cannot leave a chair recouperating. or bed?

451 A4 Most modern hospitals. n/a B 2 Yes no

452 A4 Both new hospitals and n/a B 4 both have a lot of elderly people in out lieing villages. 453 A4 As many community beds n/a B A) Long way to travel. B) 4 Yes A) cutting down on managers. B) No - care in This venture may N as possible are needed :- Often on red or black alert. Avoiding use of agency staff . C) Cutting community is at best save £11 million in A) relieve acute bed C) High cost of parking. D) down on readmissions by keeping sparce, the worst non- the short term. In the shortages in NDDH. B) High risks of infection. E) Will community hospitals open. existant. There will long term it will be Reduce infection rate. C) in more readmissions. be more more expensive and reduce admission rate. D) readmissions with difficult for patients Community care plans fewer community and carers. Saving are often not sufficient hospitals and more money does not due to staffing and in fact infections and usually result in they are aften just on inconvenience for better care but staff paper. E) Patients are visitors. cuts can be made as often sent home in the they are in the middle of the night to be private sector by cared for by elderly moving staff around carers. from a pool as and when necessary.

454 A4 Sites which are furthest n/a B 3 from NDDH and cover a larger rural area. People do not want to travel too far to hospital. NDDH can't cope now, why have more beds there.

455 I cannot We marched through 4 Central Government funding - increase is this anything to do No wonder the NHS N agree to the London over the closure national insurance. with the creating is running skint. loss of of NHS services during innovation of the community the Thatcher years. This NHS? hospital is a repeat of that period. beds The Government anywhere. 456 A5 The consultation It is also B for the reasons already 3 No .... Option A appears to be the most I think if the option B I would be interested N document highlights the documente highlighted above in section sensible solution if it is truly the Trusts or C are chosen - the to know what part reasons why i favour this d that many of this response. intention to deliver COMMUNITY beds ... Trust will have failed finance will play in option i.e. isolation, public they then need to be in the community - the community it the Trusts decision. deprivation, low car assets held not in Barnstaple. serves. I feel that an For example, is part ownership etc. In by various undue burden will be of the decision addition, these are Governmen placed on the criteria based on the community hospitals and t communities in the amount of capital should not be located in Department more rural areas. If that will be raised by the principal s are Holsworthy is not selling the facilities conurbations surplus to chosen to remain the that are closed. That (Bideford/Barnstaple) requiremen Trust will need to is, Holsworthy is a who already have large ts and are explain how they will new facility and could hospital facilities and set to be deliver quality generate a large should be based in the sold on the services to the reciept for the Trust community. Centralising open community there .... i so there could be a all the beds in the market. The am sceptical about temptation to close it principal towns would Trust the Trusts ability to for that reason alone. disproportionately should do this well. detrimentally effect the work with wider community where the the it is well documented Governmen that public transport links ts Central are very poor and getting Property worse. Unit (i think it is located within the Cabinet 457 A4 Beds should be spread I do not feel B I am totally against having 3 Yes leave everything as it is. At the I fully understand I am not 71 years old N over the whole of North that I can the community beds in the consultation at South Molton it was clearly how you intend to and I am afraid to say Devon. Holsworthy and comment N.D.D.H. At times that stated that reducing the number of look after people that with all these South Molton are both on this hospital is full and if 40 beds community beds may not save any money differently but I changes in my centres of isolated issue as I do were taken from the present at all. In fact looking after patients in their cannot see it opinion "IT IS NOT A communities. Public not live in bed numbers as community own homes could cost you more money. Is working. I think the GOOD TIME TO BE transport from both of Ilfracombe beds, the situation would be it a good time to be embarking on an public will suffer and GETTING OLD." My these centres to made even worse. If a untested new policy just as winter is especially people wife and I who both Barnstaple are very major flu epidemic was to approaching. living on their own. I have health problems spasmodic and it is even occur and you had to do not think D.C.C. look after each other. worse if you live in one of increase the number of beds Social Services are We are lucky as we the villages surrounding (flexing up) you would have geared up for this have a car and I can these two towns. all your eggs in one basket and nor is the CCG. I drive to Barnstaple if Bideford has a much and could not cope. If you think you are pushing necessary to visit the more regular bus service kept South Molton and this through at too NDDH. If I was to to Barnstaple. Both of Holsworthy Hospitals open fast a pace and have pass on are became these hospital are fairly one with 16 beds and one not fully explored the unable to drive we new and more efficent with 24 both have capacity impact. I was a would have great than Bideford and to flex up as I believe both Police Officer for 30 difficulty in getting to Ilfracombe. have a capacity in an years and I was in Barnstaple. My emergency to take 28 charge of the South wife's mother who patients each. Molton Section has now passed away during the winter of was a patient at 1978. I know for a South Molton fact that some Hospital on a few villages were cut off occasions and the by snow drifts for 6- care and treatment 10 days. What she received from the 458 A3 Bideford has a high level n/a B Association with a 2 Yes, but planned changes are often more I appreciate the wide N of deprivation and a multiplicity of acute services impressive in concept than application! Is consultation which significant level of might adversely affect there a plan for the "winning" option to be has been arranged as population growth is patient and carers' attitudes pilotted? well as the anticipated. Serving such to the care offered. Physical unprecedented an area fulfils many of separation from home area financial constraints the agreed criteria. could isolate patients as facing the Trust and much as coping alone at hope that the chosen home with some degree of option will turn out professional support. I doubt to be beneficial to if continuity of contact with patients. staff members with whom patients have bonded would be possible in such a setting. Relatives/friends might find visiting difficult. 459 12 bed unit proper community 12 beds B Taking away any community 4 keeping all community beds open as a I don't think you've The consultation has N at Tyrell nursing care is vital. with 2 beds cheaper, more viable, quality, safer option provided us with any been a confusing, hospital with People who require 24 nurses is details about costing, messy disgrace. 2 nurses. hour nursing care need significantly operation or costing People honestly don't retention of to be cared for in a cheaper of how the 'care understand what beds at all hospital environment. than the closer to home' will they are being asked community Ilfracombe is an isolated option of a work to consult on as the hospitals. community which does rebuild/refu options have not have sufficient rbishment. changed so often. residential or nursing alternatives. A community hospital is vital

460 C3 Because I live in Do not None 4 Keeping all the hospitals open. How are relatives I do not believe that N Ilfracombe know how of the (probably older the reasons given for to answer option spouses) going to the closure of the the this s are manage to travel the Tyrell are true question really long distances to visit what I ? think should be done 461 D 12 bed 4 N unit at the Tyrell hospital. 462 Would A significant numbers of Suggest a B long distance for a lot of 4 working jointly with the CCG and local GPs Yes but the Your consultation N prefer to patients require thorough patients from rural area, in to find a safe solution at the beginning of workforce in process is too rash have 3 community hospital beds consultatio particular patients in the planning process, not at the end. community nursing and it seems it isn't community when their family or they n with the Holsworthy. team needs to be supported by the hospitals in have no family & friends local CCG enhanced prior to the local CCG and your Holsworthy, that can look after them and change. primary care Bideford and safely in their own home. population colleagues. South Often they have complex to come up Molton care and social care with a safe needs and are discharged solution to too early from NDDH the local with insufficient home population support package.

463 Option D Care is needed closer to B Care in local community 4 Community hospitals should be named Care in the N Tyrrell home town and and hospitals is much more community fails in Hospital 12 actually this does cover a personal and very much that it only provides beds wide area. more convenient for very limited basic relatives and visiting.. care. 464 Option D: Care closer to home The cost of B An acute hospital should just 4 12 beds re-opened at the Tyrrell Yes. Don't agree with N All should mean care in a converting provide acute beds. A it - don't feel there community hospital closer to home the Tyrrell community hospital is the are adequate hospital not further away. People for 16 beds place for community beds. resources in place. beds to recover quicker if friends at £1.5m to remain and family can visit £2m far available in easily. outweighs the centre of the cost of their employing communities an extra , including nurse the Tyrrell to be furnished with 12 beds and 2 nurses.

465 Option D: A There has been a B If all beds are at NDDH it 4 12 beds at the Tyrrell Yes. I think that N 12-bedded suggestion that spending becomes a single point of whilst care in the unit at the £1.5m to £2.0m to create failure: a surge in demand home is a desirable Tyrrell a 16-bed unit would could mean losing service for many Hospital, enable Ilfracombe to be community beds; an people, the reality is with 2 considered for infection at the acute that it is a way of nurses community beds - in a hospital could mean closure sneaking in payment employed. couple of years or so. The of the community beds. for NHS services cost of an extra nurse to which were cover the beds would be previously delivered much more cost- at no cost. effective.

466 Option D: All It is better to have the B 4 12 beds at Tyrrell with 2nurses Yes. N community hospital beds available hospital locally: people will get beds to better quicker with remain friends and family close open. Tyrrell by. I don't believe there to open 12 are sufficient resources beds with 2 to support care in the nurses. home for everyone. 467 Option D: Community hospitals Spending B Keep community beds in the 12 beds in the Tyrrell Yes. Yes: listen to the N Keep all the should be close to the £2million community. community! community community they serve. doesn't hospital North Devon being a make sense beds open, rural area means that - it must be including 12 access by public cheaper to beds (with 2 transport is difficult and employ 2 nurses) at inconvenient for nuses for the Tyrrell. hospitals outside the 12 beds. area.

468 A3 Largest population n/a B Beds at NDDH, as 3 1. How much money 1. Will the beds be Y centres community beds should be will be invested in the closed before a full in the community they serve community teams? 2. complement of How many extra community staff is in community staff will place? 2. How will be recruited 3. When money be saved if will these new staff the community be in post. hospitals remain open (so ongoing capital costs) and all the community staff remain employed to deliver care to patients in the community? 3. Do you plan to use community staff to cover inpatient acute beds at NDDH? 469 A3 Patients make a faster B All beds at NDDH as this is 4 Saving money by reducing the number of The theory is clear North Devon is not a N recovery in a small too far for families to travel senior staff and reducing the employment but the practice is demographically hospital with continuity in a rural area with poor of external consultant called on policy. not. All questions are balanced community of care where their public transport. Remembering short-term gain can increase answered by "we but has greater families and friends can long-term costs. have a plan" but numbers of the visit. details are never elderly who suffer given. For example increasing frailty. If we have not been they are discharged told how many too soon from community nurses hospital, their there are and how condition is likely to many carers there worsen and they will are in any locality. need re-admission. These people become prisoners in their own homes suffering from solitary confinement in spite of having committed no crimes. Even if three visits per day could be guaranteed, that can still leave someone frightened and lonely for over 22 hours a day. Is that a kind way to treat 470 A6 I do not believe that the A 12 B North Devon has a high 4 Ilfracombe has lost Burrow House and its I understand the There are insufficient N necessary capacity bedded unit elderly population who associated facilities which could have theory but the private sector currently exists within will be would suffer by not being provided respite care as an alternative practicalities are the services in the health and care services sufficient. close to their friends and without beds at the Tyrrell there are no issue and the Ilfracombe area and in Ilfracombe to allow family and there would be post hospital care / respite solutions for the infrastructure is we do not qualify for closure of further transport issues. elderly in the immediate area. certainly not yet in assisted care. community beds whilst place to support the maintaining safe care for carers who will be our residents. I am sure talking on more that the same situation responsibility (and I exists elsewhere in North include not only Devon. We have the professional carers facilities available in but unpaid family Ilfracombe and they carers such as my should be used to husband and I). support our community. 471 A4 A best of a bad selection B NDDH is already bursting at 4 Keeping all small hospitals open as is and 1) Do you realise we I wonder if you have N you should be aiming to the seams sometimes. Local making economics elsewhere: do not all love in the an adequate group of keep all open. Distance people wish to stay nearer administration and executive costs. towns? 2) Who will your finances that form Barnstaple. their homes, friends and be available to an you have allowed the families. elderly person living trust to be in a deficit on their own, in the situation. middle of the night? 3) Do you realise that some of the nursing homes in this area already have waiting lists?

472 C2 Holsworthy is furthest B It would take so long to 3 All the beds at Holsworthy. Yes, I can see how The staff at N away from NDDH and reach from villages around you intend to look Holsworthy hospital even further for outlying Holsworthy. Even by car the after people but with are very committed villages eg Haliwill. roads are very slow to travel more financial and caring. They live Comparing the 4 on. constraints imposed in and know the community hospitals the it might not be community they are time taken by public possible in the future. working with and transport is not included people in Holsworthy in your assessment. For & the surrounding all the other hospitals villages have this is included it is the confidence in them. most important point. What could be better Therefore these options than being able to are unfairly portrayed. visit your relative frequently locally?

473 A3 The distances involved B Not easy for people not near 2 No. Yes. No. N travelling to NDDH also to NDDH especially travel at the convenience for night. patient visiting.

474 A5 We need local hospitals B This is a large rural area 4 Home care is all very From the meeting at N in the area as Barnstaple served by one major hospital well on paper but Bradford / Cookbury is very inaccessible by and it is essential to have how do you plan to last week it appears public transport. local hospitals which are have enough staff to that the closure of all Holsworthy hospital is nearer the rural cover the area not to local hospitals is fait purpose built and needs communities away from mention vehicles. accompli and all the more facilities to serve Barnstaple. notice of us local the elderly population of people will be totally the area. ignored. 475 A2 Covering geographic Yes security of With dedicated Y north / same area of ongoing resoures? community consular North Devon. New physical involvement. housing coming to Ilfracombe & Bideford areas. 476 A4 As residents in the B All beds at NDDH would 3 Care in the Our experience of N Bradford / Holsworthy mean that all patients & community is all well care in the area, we need to keep their visitors travelling many and good but in these community is that our local hospital beds miles from our rural areas. rural & romote area's patients all need help open. Those are needed Our bus services are poor or how can you ensure at the same time of because we are a long non-existent car parking & patients needs will be day, with so much way from NDDH & we congestion will become met at a time when travelling to do the also need them to intolerable. they need it most? carers won't have support the works at the enough time to new Longhouse project spend with their which has been purpose patients. built along side the Holsworthy hospital.

477 A4 (or C2) Holsworthy is over an N/A. B For everything at NDDH 3 Do not feel you are Very concerned for N hour's drive from people cannot access the considering mental not just inhabitants Barnstaple. There are no facilities there, elderly no health of patients or of Holsworthy but for bus links for visiting cars or bus contact. their visitors large outlying area NDDH. Taxi fares (especially elderly) if which has prohibitively approx £180 they have to travel to Holsworthy as hub. £200 round trip. For NDDH with a with a Why build hospice older relatives visiting 2.5 hour round trip, outreach centre if many difficulties time / no bus connections - there are no hospital cost / effort. One of the everyone stressed at facilities to support poorest communities in the effort. Transport it?!! Torridge has the area. No easy access links from lowest pay in this to any other community Holsworthy are part of UK. Cannot hospital. Waste of a EXCEPTIONALLY afford reliable care, modern will equipped POOR! or taxi fare to NDDH. hospital already there next to health centre. Best place for supervised care. What happens if NDDH closed with epidemic if keep Holsworthy another uncontaminated source of care. 478 B If beds cannot be in A If beds are not possible in 3 I can't think of any. Yes. I have read a letter in N Ilfracombe then travelling Ilfracombe then NDDH is the North Devon to any of the other best for travelling also for Journal which states hospitals is out of the the improved facilities. that some space in question. the Tyrell hospital Ilfracombe is being used by social services if this is true they could be re- located anywhere so freeing up more space.

479 A1 These hospitals are 2 A local hospital is a N nearer to EX39. But lot better to visit if it people living at means travelling a lot Ilfracombe & South and patients need Molton need beds at family to visit as there hospitals. often as they are able to travel costs a lot.

480 A Because we need the 2 Yes. N local hospitals to remain open as we have to Barnstaple hospital a round trip of 55 miles.

481 C2 Good transport links C1 NDDH and Bideford very 1 No. Yes, thankyou. No, everything seems N from remaining options close proximity to each to be covered but poor from other. comprehensively. Holsworthy. 482 A3 Flexibility for period of B Elderly people prefer the 3 N surge at both sites. quietness and friendliness of Accessibility, parking and staff at local hospitals when fairly good public convalescing. transport. South Molton is a modern building. 483 A4 Accessability for people N/A. B NDDH is too far for people to 4 Make more use of all community hospital I understand what Your options do not N in rural areas. travel it is very often on red beds leaving NDDH to care for post - you hope to do but comply with WHO ref or yellow alert and so would operative patients who could then transfer you do not have accessibility etc for not be able to cope. to community hospital once their condition enough staff trained each individual. You was stabilised. to deal with the have not listened to situation and should local people who not rely carers and have more voluntary information to help organisations to do you make informed the work for you. decisions. The NDH trust seems to have been purposefully under hand in advertising the public consultations to ensure that the LEAST number of local people attend and are able to give their opinions.

484 A4 Holsworthy meets the B Distance from Holsworthy, 4 No respect for wishes of community. We do Understand - don't I do not believe it will N criteria's 1, 2, 3a, 3b, 3c, poor transport links, low car not want to die isolated in unfamiliar like. Bed blocking will be possible 365 days 3d, 5, 7, 8. ownership. nursing home. be worse. pa to look after people in their own homes in Holsworthy outskirts. This entire proposal to reduce beds is bonkers with an acknowledged expected increase in the age of the population. Promises were made about the No. of beds at Holsworthy being maintained when Winsford was closed. 485 A4 Each of these community B There is already a bed 4 The opinion of the local community. I feel Yes. Home nursing is not N hospitals are rural areas shortage for emergency the decision has been made thinking only of appropriate for all and the furthest away beds and routine admissions. money and not be people you are meant to elderly people those from NDDH. Patients being moved from be treating and looking after their who live alone one ward to another to wellbeing. recover more quickly make beds available. in hospital where Patients being discharged to constant care and early and having to be re- rehabilitation is admitted. available 24/7. With home care they spend many hours alone.

486 B The only option for those 3 Yes. With the closing of N who live in Lynton. the care home in Lynton the need for relatively local beds is paramount. 487 None. Ilfracombe Tyrrell by Take offices 4 Not at all because your mind was made up You are selling care It's all been a waste closing the Tyrrell best out and before the consultations! Your never closer to home. This of time and money option you are affecting beds in you considered the Tyrrell an option!!! is not what it seems and I would like to over 12000 people. The have people will be left on know how much this Tyrrell is best for betrayed their own for long has all cost, I suspect Ilfracombe people who the people hours! In a hospital enough to keep the live here need the Tyrrell. of you have everyone Tyrrell hospital beds All the excuses made Ilfracombe under same roof for a while and have been absolute lies shame on receiving 24hr care employ nurses to and the ordinary people you!!! by trained staff. tend them!! Who have been hoodwinked. ever dreamt this up All the meetings have has no common been a waste time & sense!! money. 488 NDDH & South Molton & These small Closing any beds in any small 4 Just keep as many open as possible and Community care I found it so N Holsworthy at the very hospitals hospital would be a disaster look again at other ways to save money to locally is not what it depressing to be left least. It is imperative for are more for the future. Would you be finance them. Perhaps a time & motion is cracked up to be. If for long hours on my community hospitals to financially agreeable to be left for long study would be beneficial I have come to this is the only way to own recently. It is be operable with as many viable local hours in your home if you conclusion that many staff at NDDH pick up care for our elderly traumatic to go beds as possible. In view staff are weren't feeling well & a sheet a paper & walk as slowly as who have given so through surgery only of the bed blocking in more prayed for a visitor to call & possible. much to our to be told you must previous years it is available make you a cuppa. neighbourhood over go home the same necessary to have beds making many years when day without anyone available. We do not recruitment illness comes to the to help you get well. know future easier with fore. The loneliness A little TLC is all part requirements and cannot cost of they experience of the healing possible predict illness & living in following a spell in following any medical possible illness in the rural hospital surgery etc is procedure. I just light of population housing indescribable. hope it doesn't increase over time. much less happen for your and relatives to be transport pushed out in future costs down. years. We are not all able to drive or wait for a bus in the cold and rain. Try cutting costs 489 Holsworthy Option A is the least Not enough B Centralise in Barnstaple. No 4 Look at real needs of people. 30 min visit at No. Forget the towns, Barnstaple is a great N possible option. But not information transport, no consideration home does not compare with good 24 hour think about the hospital, I have had the best, keep them all . for time & cost to get there. care in hospital. Also access to physio, hamlets and villages. superb treatment operational & re-open Parking already critical & (hospice now care available in Holsworthy). Do you know the cost there but it should Winsford too. expensive. Care not relevant Occupational therapy etc. of a taxi form not be expected to Holsworthy is the most to local problems. No Holsworthy to cope with long term distant, most viable & knowledge of farm tracks, Barnstaple? Is there a or minor health has hospice back up. You flooded rivers etc. bus from Shebbear, problems that a local say Holsworthy (my Milton Damerel, or GP supervised preferred option) has Thornbury, Black condition would do care home capacity this is Torrington etc? For better. not financially viable for visitors or patients? the majority & is not Do you know? what is supplied by the hospital. Bed blocking is a severe problem. Beds in local areas would relieve this. 490 A4 Both are further away I think it will B Its important to locate 4 Agree a better budget with government. For some patients it I am a young patient N from Barnstaple and if take too patients nearer their home may work but we live compared to the closed you will not be much environment. a different lifestyle majority of patients serving the community. money to and family is no but spent 4 months restore longer close enough in Holsworthy as I Ilfracombe. to help. I think care was bed bound and homes will take more despite having a patients that the support network it trust fails to support. wasn't enough for me to go home Holsworthy was outstanding and should be a flagship for the trust.

491 A4 The trust has an I feel that B It is already difficult to get 4 Reducing repeat prescription orders. Care closer to home I have just recovered N obligation to provide care Ilfracombe there and parking is also an will not work for from two bouts of to the whole community. is closer to issue. everyone. The trust is Pneumonia NDDH Taking beds away from Barnstaple merely passing on its discharged me far community will create and could duty of care to family too quick and in a more isolation to the serve the members in a bid to matter of days I had a people of Holsworthy. community save money. relapse, believing unlike that this second bout Holsworthy was going to finish & South me off I went to Molton Holsworthy hospital which are but their care and further support means I'm away. now fully recovered having had more time to recoup. 492 C2 NDDH makes sense and B Because of the loss of 1 As explained in the N while it would be lovely Holsworthy. survey, Holsworthy is to keep all community a very well-run and hospitals - losing trouble free hospital. Holsworthy would create It is flexible and far more trauma for modern and it is people living 30 and needed because of its more miles from NDDH location in a very than any of the others. inaccessable area a long way from Barnstaple. It has very poor public transport and it is an area where many people do not have cars.

493 A4 My dad had his end of life B Community hospital. If we 3 I understand, BUT we N plan organised. He died have two community need to consider in Holsworthy in April hospitals, at least some those who have end 2015 with his family all people can stay within their of life plans & who together, just as he own area. Making it less don't want to die at wanted it. My mum stressful for everyone home, but in their doesn't drive & was able involved. local community to walk to the hospital hospital. day or night. It’s a modern building which can now work alongside the North Devon hospice long house.

494 A4 1, 2, 3a, 5, 6, 7, 8 both Unfortunat B In theory, convenience of 3 Give local communities option to submit Yes. N sites have sound facilities ely, Tyrrell resources & diagnostics business plans to run their own unit. & room for surge. Both hospital no looks attractive on paper but have strong staff loyalty - longer fit in practice outer rural SMCH only struggled for purpose communities will lose out. after mismanagement as in bed and changes in contracts unit. / terms.

495 A4 Criteria 5. B The beds will simply be lost 1 Fully understand. The proposals will N for intended use due to only work if the care continuing bed shortages in in community is fully NDDH. staffed. 496 A4 Holsworthy & South B It would not serve the needs 4 It is assumed that the nursing homes in the Community nursing is N Molton. Option B should of the people in the North Holsworthy area would be available to take not an option in a not even be considered. Devon area. the slack but did not consider that they rural area. The Holsworthy is the operate on a full basis most of the time. patients are spread furthest from Barnstaple. over a large It has a very poor bus geographical area service and this also often in areas prone serves as the college run to flooding, mobile to Petroc college so gets phone black spots overcrowded with and satellite standing room only. navigation taking you There is also no bus the wrong way. Time service in the evening would be wasted and which would allow the service a very relatives to visit any expensive option. patient staying in You have also not Barnstaple. The taxis are considered the effect very expensive and have that your Option B to be booked in advance would have on the so people have to die to relatives of patients. order. There may well be Visiting hours would a high number of nursing be difficult for people homes in the Holsworthy who are working or area but someone has to have school age die for space to become children. We are all available even for respite having to work longer care. Holsworthy is a gem but you would put for the people in the area more stress on the 497 A3 Holsworthy now has a B I do not feel confident that 4 Are there any other options we could have I understand your I do not feel NDHCT Y hospice service, Bideford NDDH has the capacity to considered? 24/7 rapid response team, intentions but do not provides enough has reasonable transport accommodate 'community access to nursing home beds within the feel you have the support and links. South molton is a beds'. I am gravely community. staffing resources to education for modern hospital facility. concerned about the reports manage this. relatives and carers from patients regarding of patients who are movement within the discharged 'early' hospital at night of patients, into the community. the use of day surgery to Carers are excluded accommodate patients from contact with which places patients at risk hospital doctors as as facilities are overcrowded, ward rounds are washing facilities are undertaken at times inadequate and day time they are not allowed surgery gets cancelled as to visit. Discharge patients cannot be decisions often discharged. appear hasty and rushed. Discharge summaries are often not sent out with patients meaning that interface communication is often so poor discharges are dangerous. Increasing pressure on beds within 498 A It is felt that all beds in B Travelling to and from 4 Where are the N Holsworthy should Barnstaple will be very 'Nurses'? What plans remain as they are. At difficult for elderly people, have been set to the present time there is the inconveneinece and employ the 'Nurses' insufficient evidence that expence is prohibitable to who will be needed the infrustructure for many pensioners, thus for 'Care in the 'Care in the Home' is not making it at times impossible Home'. in being. Thus making life for spouses to visit. very difficult for all concerned. A local community Hospital is the best oprion for 'local' residents who might have difficulty with just having 'beds' in North Devon Hospital. 499 C2 All of Ilfracombe, Transport B I am in favour of localism 3 The consultation document does not When Torrington Co-ordination N Bideford and South links to and subsidiarity wherever present the option of retaining THREE facilities were between medical Molton are within easier Ilfracombe feasible. Ideally all four community hospitals without any presence withdrawn, it was care and social care is reach of Barnstaple (and are community hospitals would at NDDH. This would have merit insofar as stated that patients notoriously a subject NDDH) than is reasonable be retained but given that there are direct links between Ilfracombe could be moved to immensely difficult to Holsworthy - some (every this is not feasible a balance and Bideford (including an evening service Bideford or get "right". nineteen miles even from twenty is required. There is a case on routes 21/21a). Whilst there has been Holsworthy. It would Arrangements for Bideford. Holsworthy has minutes for associating the consultation on the merits of each of the appear that the "discharge" lowest %age of residents during community hospital four towns, the consultation document Bideford option constitute a critical with cars. It is the easiest daytime functions more closely with appears not to have addressed the strategic would be withdrawn point in the process. location to which to plus hourly the District Hospital but this issue of how many community hospitals to if only one Even transfer recruit staff and to retain link via is out-weighed by the retain. This is deficiency - although I would community hospital between wards or them. It is a relatively Muddiford) remoteness of Holsworthy (I withdraw this comment if my own deficient is to be retained. hospitals can present modern hospital and has but suffer go there to visit the Waitrose reading of the documentation has led to my Even if two were to challenges. Thus the some capacity for a from store and so am aware of not seeing something which actually is be retained, the first priority on such "surge". I support the extended how long it takes to get present. second should be occasions must be Holsworthy option journey there) and it would be unfair South Molton (as if it supply of information despite living in Bideford - times on to choose just ONE of were not the to ALL those involved but I admit some route 21 by Bideford and South Molton. Torridge/NorthDevon so that each such prejudice by virtue of traffic balance would be person can be being a resident of delays in unacceptably proactive in doing Torridge district (whereas Braunton. skewed). Thus, the what is necessary to South Molton and This is far questions would be: enhance the patient Ilfracombe are in North better than Will Holsworthy be experience. Devon district). the used to meet the Preliminary to this situation in needs of Torrington must be a collated Holsworthy residents? If so, will (and communicated) with just representations be list of ALL the 500 A 1. Far easier for older This is B It is a round trip of 70 miles 4 We understand what You are dressing-up N people living alone to nonsense to NDDH. you have stated but what is in reality a reach a local hospital and to expect a you do not money saving visit relatives. 2. Getting lay person understand the exercise. to NDDH from this area to offer a problems we face in without private transport solution. the rural areas during would be a major winter when rivers problem for relatives. 3. may be flooded or Holsworthy posesses a roads impassable modern relatively new because of snow. hospital. 4. N problem Providing staff with recruiting staff to four wheel drive Holsworthy hospital. 5. vehicles is a waste of very low car ownership time and money as this area. roads inevitably become blocked by other vehicles. 501 A (Only Holsworthy listed). I am disappointed in N I only know the criteria the number of for patients who live a responses you have long way from Barnstaple received so far and - access to a cottage feel that this form is hospital where loved probably the reason ones can recover and be why. People do react near family and friends. emotionally to issues such as this but that's not to say they don't have a fair point and they need to be listened to. This form in effect denies them that right by making it so off-putting - "say how your preferred option meets the agreed criteria". Really! 502 A6 Keep the South Molton Keep South Ilfraco 4 Yes I understand, but There is so much N Community Hospital and Molton mbe it does not work. more can be done to Ilfracombe also open. bring a better care to Torrington should have patients. The NHS is remained open. The being ruined. To Community hospital is avoid infections and needed to relieve the extra costs use general hospital and uniforms.Do not allow them to get on with allow them to be operations and all worn outside the emergency and medical hospital or allow care. The Community patients to be outside hospital gives the best the wards. Drs always post op and to wear coats as rehabilitation care before, the green because they have plastic gowns do not trained nursing staff and cover their clothes 24hr cover which is not when they are given out in the dealing with those in community and isolation. This will physiotherapy, especially save lives and avoid for those living alone and the costs of those the Elderly. There are getting D&V etc. very few homes for those suffering Alzhiemers and dementia due to closing 97 percent of the N. Devon council homes 503 B This is my preferred A We would be stretching our 1 I hope that patients N option because it will resources too thinly. will not have to wait provide a better service for too long a time for the community. It before being referred means that staffing levels when necessary. I would be better and hope staff training there would not be a mirrors what is problem finding staff for required for these outlying areas. As we are measures. an aging community a better service would be provided in one place. 504 A4 Assessment of the agreed B As given in answer to 2 No. No. Beds are not For many people end- N criteria plus … - The question 2. being reduced in of-life care requires focus at NDDH is these towns. They hospitalisation, achieving a result are being completely especially where (diagnosis, treatment, removed. It is not the location makes a cure/management of a people in these rapid response condition). This creates a towns that will be at impossible. There are culture, staff and risk? You do not NO hospice beds in patients, in which appear to appreciate Holsworthy. patients are being the logistical issues in "processed". For most providing care for patients in a community people in their own hospital the "result" is homes when they are often almost inevitable; miles from villages for some it is recovery and possibly with no after treatment mobile phone elsewhere, for others it is coverage. taxis are in death. For these people some cases the way the hospital unavailable at less makes them "feel" is than 24 hours notice more important than the and there isn't a process. Our community neighbour next door. hospitals are great at If an elderly person is this; the staff are sent to Barnstaple focussed on these from the Holsworthy aspects, patients feel area there is no they, rather than the practical public process, are at the centre transport for their 505 A4 The Bideford building is B It will be detrimental to the 4 You need to look at the bigger picture, the Yes. You say that There is a saving of Y old, and the distance to health and wellbeing of problem needs sorting out properly from patients being nursed 68k if you do not travel to NDDH is the patients and staff. We all the top.I don't think cutting community at home would be appoint a person to least disruptive. know that NDDH has a bed beds is going to solve the problem, maybe placed into nursing oversee changes, also Holsworthy beds need to crisis every so often and the short term but what happens in a few years homes if places at money could be kept open as it is so situation will be made worse time when you need to make yet more NDDH were full probably be saved by far for patients, relatives by the continued building of savings? It would be a bad idea to make any should they need a looking into other and staff to travel to new housing to decisions now if in a few years time you are hospital bed. yes positions that are not NDDH creating more accommodate the growing going to change your minds -that is what there are lots of needed. The use of risks on the road, more population.I worry that wastes the budget. I have worked for the nursing home beds in agency staff is staff sickness etc. patients will be discharged nhs for a long time and I notice that you the holsworthy area expensive! before they are medically make a decision to change things and after but they are all full ready because their beds are spending money, after a few years you most of the time. desperately needed. I change it back again! Also, the nursing believe that this is the homes could charge reason that you want to the nhs whatever close the community they want once the hospitals before the winter nhs has no other pressures hit and the need options. And what of for community beds is the patient who has proved.Also because the carers in twice a day patient's relatives are often who has a collapse at elderly, they would struggle home when no-one is to get to NDDH to visit. The there, where if they elderly driver, if they are were in a community lucky enough to have their hospital if they had own transport, could be a any incidents it would risk on the road if they are be dealt with 506 A1 We are a remote area A3 South Molton would be 1 My husband & I are N with long distances from impossible to reach if you both elderly (over 80 NDDH & other did not have a car. years). My husband community hospitals. We has Parkinson's & have a good modern finds the drive to hospital at Holsworthy Barnstaple & other with excellent staff. distant hospitals difficult. I have a heart complaint & have had two minor strokes also find long distances to drive, very tiring.

507 None. 4 N 508 A4 Holsworthy & South B Because many older people 4 Care in the N Molton the most modern cannot drive so far but can community does not building to cover rural manage to get to the nearer work for many, after areas Bidford nearer to hospital eg Holsworthy. having a opp. It is so Barnstaple so not so helpful to go to the difficult for people to see community hospital there love ones in to recover. Barnstaple hospital.

509 A4 Both sites modern, N/A. B Too centralised. 2 Reduced capacity & Financial support of N equipped & cover large facilities (No. of beds) local facilities could geographic areas. will lead to closures easily be sustained Centralisation in one in the future nationally by place ie Barnstaple is not following more government the best option for the "economic reviews". cancelling some user. "foreign aid" budget to unrequired countries Argentina, China, India.

510 C2 Elderly people have B Hospitals in the community 2 Are there enough I love the NHS and N problems with transport. are also important. district nurses trained realise there are BUT we also need to do home care for financial difficulties. hospitals big enough to very ill people. Health education in maintain specialist schools & to young staffing & expertise. parents could help reduce unnecessary ailments due to overweight / lack of exercise, common sense about food & exercise. 511 C Ilfracombe, South Holsworthy. It is a long 4 Leaving well alone! In the bigger towns The more rural areas N Molton, Bideford. Please arduous drive to NDDH and there is a higher such as Holsworthy KEEP HOLSWORTHY. I the older population find it home care capability. need these have family eligible to use far too difficult to travel to Rural areas struggle community beds. Holsworthy but not care close relatives due to very to employ and retain home suitable that needs poor transport links. care staff which the hospital near home. means hospital to home direct discharges are much harder, community hospitals support these areas.

512 C Ilfracombe, South Holsworthy, long journeys, 3 Doing nothing. But I do think Holsworthy There may be care We are a very rural N Molton, Bideford. Most poor transport links to has a strong position for being retained. homes but I am in area therefore it is importantely for me NDDH, older people have need of hospital / essential to have a Holsworthy. I am in need trouble getting transport. nursing care I am not more central hospital of hospital care & live elderly & infirm as for these areas. With midway between Exeter such but have serious a lot of farming. & NDDH so the journeys health issues. Chance of needing for my family are an hour more beds I would long each way. Please think especially if keep Holsworthy. other community hospitals close. 513 A3 Good transport links to n/a B isolation of all using/ 2 Utilising Oakwell in Barnstaple for surge in Yes, but concerned Important you use N NDDH and each of the 2 needing community hospital patient admissions during peak times and about these patients kidney unit to hospitals. Bideford could support patients being cared for by community staff feeling isolated and support people of support Holsworthy if this was to become their centre (work afraid at a vulnerable north devon in this residents with public base etc) time in their life due exercise. This money transport and South to health issues was raised by the Molton could be people of ND for the supported by public people of ND and as transport for Ilfracombe. the NHS has taken Good transport and road the kidney unit to links to both sites for NHS Barnstaple, this staff. South Molton and makes a prime Bideford have minimum outpatients beds in care homesa to department to support elderly support community population beds in SMCH and free up more space in hosptials for more beds. Keep up your hard work, I know your job is difficult as no one likes change!

514 Okehampto Nearest to my home n/a too far Anything further away than 4 the views of the people How can you look Listen to the people, N n and away to Oke or Torr after patients we pay your wages Torrington consider without any beds? 515 B transport (buses), car n/a A Too costly 1 No No N parking, more efficient, better facilities, cost effective

516 No beds See letter to prime n/a 4 Look at other ways to make cost cutting Homecare is not read my letter to the N closed minister and newspaper always the answer in prime minister. It cuttings the short term, clearly explains my hospital beds are reasons and needed contempt at your decision to close any hospital beds, as also the included letters by more professional persons than myself 517 C2 Geographically option C n/a B I feel this option allows 3 If this exercise is to save money, which I feel Yes I think I do Having been an N would be the best. residents of Bideford and it is, it seems to people like us who have understand how you inpatient at NDDH a Holsworthy is nearly 3x South Molton to be least paid into the NHS almost since its intend to look after few times in recent the distance from NDDH inconvenienced by having to beginning, are being pushed to one side. people and you will years the last in and the other two travel to NDDH. Whereas The NHS is being used for operations for do your best. October 2014 treated hospitals. Holsworthy is residents within a similar which it was never intended. I am sure with Howevber, if you for encephalitic. modern and appears able radius from Holsworthy careful thought money could be saved close the community Following 10 days in to increase bed numbers would be. elsewhere. hospitals or even one NDDH, 5 of them should it be required or two the death rate unconscious, I was is more than likely to transferred to increase. Holsworthy. This reduced my wife's carers round trip from 90 miles to 22. My recovery took a further 10 days in better surroundings, other patients agreed a community hospital aids recovery.

518 A5 Ideally community beds How am I B It is short sighted to close 3 Impossible to say when I don't have any Those refunding and As a graduate I found N should be maintained / meant to be community beds in a figures to help me make feasible monitoring. The the document poorly reinstated at hospitals on able to do hospital such as Holsworthy, suggestions concept of more care written, eg poor the periphery. this with which is modern and well- at home may be good English, use of jargon, Holsworthy is the only a very used. It is recognised that for some patients not inaccuracies etc. This furthest from Barnstaple. pooly patients recover better with for others. Nothing hardly leads to SM and Bideford both worded frequent visits from relatives convinces me that healthy, fair have better road links document and friends. This would there will be enough consultation. than Ilfracombe. Nothing to base my prove very difficult funding for this to suggests that there will reply on? particularly in winter and on make it better for be greater care at home our poorly maintained roads. anyone. This is not surprising since the exercise is budget-led not care-led. 519 A4 Purely because I live in Accept you Closing any CH beds until 4 Give figures for bed costs in all hospitals. No. Where will staff Yes. Why has the Y and N Holsworthy. But real will NDDH can demonstrate that Show evidence of community care. How for 24hour Chief Executive not option is to keep all (temporaril it runs for 95% of the year about getting rid of NDHT and running community care replied to my letter community hospital beds y) need to without bed shortage alerts NDDH from Exeter? come from? Will requesting more open. How about employ meals, toileting etc information? What downgrading NDDH from extra be provided at redundancy plan do a DGH? nurses for home? you have for staff? long-term This form is worded gain in a biased way. Lack of evidence provided.

520 None Beds at NDDH and all B Too much No If you put more N community hospitals. verbage pressure on NDDH With an ageing you will need more population and with the car parking for baby boomer generation visitors. It is more more beds are necessary difficult to find not fewer. parking at all at times

521 A4 Both of these sites best N/A B This facility is already under 1 No Yes It is unacceptable N meet the criteria given, pressure as a result of its that there is specifically they benefit comples healthcare unsufficient budget 2,3 and 5 from the given provision requirements and for all existing NHS list extra beds should be left facilities to remain where they are in the open community.

522 A1 Bideford because there is B AS it is a long dostance + not 2 From bitter Transport to any N an increasing population everybody has a car or can experience I find that hospital is very or 85+s and Holsworthy use public transport most emergencies difficult here. I am because of its isolation occur during out of wheelchair bound hours? One night unable to use public when I phoned 111 transport + medically there was only one unfit to drive - yet I nurse on duty for the am told I am not whole of North disable enough for Devon! patient ambulance service - there are many like me. The cancer care will take me to hospital yet cannot transport my wheelchair. 523 C2 Would give good, B Would leave patients in 2 There needs to be Frail elderly receiving reasonably close facility outlying Torridge area most hospital beds for rehabilitation and for W. Devon. Torridge disadvantaged, difficult for good palliative care terminally ill patients (Holsworthy area) most travel, too far away from when this is not benefit from being as remote from NDDH. Care support in local community possible at home due close as possible to homes do not have the to personal family + friends in medical staff resources circumstances. Most local community. This for satisfactory residential homes can have a valuable rehabilitation or palliarive cannot provide this impact on care. Holsworthy is a specialist care (if this rehabilitation and good modern building. were the case then help terminally ill Holsworthy closure there would be no patients die with the would be an incredible need for hospitces.) dignity and qualit of waste of previous end of lige they invextment. Older people deserve. Recent living alone or with reports have shown elderly spouses need how society neglects period in hospotal during to really help people period s of frailty. Social through the most care in community does important last not give enough soupport journey. Special (and for all cases. often local) units can help to improve the situation.

524 A3 Bideford can cover B Car parking very difficult 2 Keeping all beds open at all hospitals How do people At the smaller N Holsworthy, Heatland, now with more people including Torrington, patients recovering or manages if they pospitals the staff are Torrington, Hatherleigh visiting it would be much dying much prefer being in their own area require or need help more helpful, areas, also N. Cornwall worse, also visiting by bus so people can visit easier. when home carer has cheerful and know eg. Stratton, Kilkhampton not really suitable especially left people can not go their patients better, and Bude. South Molton for older people/none to the toilet to order that way the patients can cover East Devon drivers etc. when the carer is recover quicker and area plus part Exmoor, with them, 20 to 30 so vacate the beds Ilfracombe area. mins 2 or 3 times a quicker for the next day shouldn't be an patient. option. 525 A4 South Molton & B Lack of public transport in 3 Savings could be N Holsworthy meet most of rural areas. More made elsewhere in the criteria required. At expenditure to create a new the NHS. Stop South Molton, the staff ward. No community in foreigners coming are fully commited North Devon would have here especially to provide a wonderful inpatient beds, in their receive our NHS service. The public locality. treatments for free. support is tremendous. Earlier this year, it Why would anyone break was reported a total up something that's so of £62million is owed good? to 100 NHS trusts, by foreign patients.

526 A1 Holsworthy is furthest B Patients need beds closer to 4 No How are all the With increasing N hospital from NDDH. home. For continued care it patients needs going population, Bidford will see is easier for patients/family to be met? Extra community hospitals population increase. for travelling and recovery. room for should remain and be equipment/toilet maintained. They facilities/stairs/made should also benefit cation/personal care. the mental health service problem in the South West area.

527 A1 Bideford, because it is Just a Difficult to judge! Looks like Sorry, couldn't read. N larger & I have comment - alcomprehensive review - gut for some experienced the care, 2-3years to (mee) just too much to wade through & attention given to me as refurbish take in. Sorry. a local resident. Ilfracombe Holsworthy, because of Hosp!!!! its 'remoteness' & That's a hell transport problems of a long time. Plus ??? Refurbish 7 the hosp will prob close any way - 'wot' a waste of dosh

528 A1 Large increase in Ilfraco Too small, not enough beds 1 Yes N populations. More mbe people can access these hospitals with own transport + buses. 529 Don't close All hospital beds are All of See before 4 Cut down on administration and layers of Not answered Listen to GPs, adopt a N any beds valuable and precious them management to reduce costs philosophy of modest and sincered respect for medical, technical staff and GPs. Ge trid of administrators and accountants

530 A4 If staff know hosptial is B Lack of transport, shortage 3 Find 16 beds at Holsworthy and S Molton We understand, but We have 28 beds at N secure then it will be of care home beds, and keep a stroke/frail patient ward at feel that with the SM; the fabric of the easier to recruit and preventing bed blocking NDDH best intentions in the building is good and there will be less agency. world someone it has modern Transport is an issue. would fall through equipment; the staff Many frail elderly people the net, particularly are well-motivated live in villages with poor in rural areas, and always keen to public transport e.g. especially in winter. enhance their villages such as Yeo Mill, We need the safety knowledge. The Anstey, Molland have provided by a senior nurses have one bus a week on a hospital recently taken Thursday. These buses courses on end of life stay in South Molton for care and palliative just 2 hours before care. We are already making the Sutton trip. a hub having at least There are no buses 23 outpatient clinics serving Rose Ash, a week Romansliegh or Normansleigh to name just a few 531 Don't close Just about government All of See notes at end 3 Fight against government cuts Yes but do not agree There is no option N any beds cuts them other than the Government's cuts policy. They are cutting corporation tax from 28% to 18% indeed many other measures beneficial to the super rich so the whole underlying premise on which their policy is based is a false one. They have money and choose to throw it at the people who do not need it. There is no objection to efficiency and keeping people out of hospital when they do not need to be there for treatment, ops and post op rcovery until they are well enough to cope at home. The reality is that they Govt has 532 C2 Distance from NDDH 2 N 533 B I live 10 mins walk from 2 Yes I am 94 with COPD, N NDDH allergic rhinitis and bouts of gout. I am cared for by my wife as well as doctors, CREADO and have an alarm button 534 A4 My preferred choice Ilfraco Distance and would cost too 2 Yes I do understand. I We are informed that N would be Bideford but I mbe much and take to long to have offered my the day centres that have not chosen that due bring up to standard opinion from have been closed to the appalling parking experience and have cost council situation broadened my views thousands to stop them deteriorating. These centres would be the obvious choice to be used as "convalescent" homes. This was an excellent system and prevented bed blocking. My views were printed nationally and received an overwhelmingly positive response

535 C1 Best transport facilities A Least facilities, not viable 4 Fight against government cuts No Looking after sick CHs are the way N people, in their own forward with homes, running adequate finance around in cars by ands staff, which nurses and doctors leave hospitals for and inadequately- serious treatments trained helpers on and technology time limits is advances. This madness. Open the country has the door and leave finance to provide this and it will be viable in the long termq 536 C Ability to retain staff. A Possible staff problems, 2 As an OAP aged 94 N Rapid move into beds at Transport of patients to after a hernia NDDH if required NDDH may be delayed if operation I was required transferred to the CH at South Molton where I received excellent care, including good meals, for 9 days 537 A4 Long house hospice, B Distance to travel from 1 Yes Holsworthy is a very N medical centre and CH Holsworthy to Barnstaple well run situated side by side is establishment in a ideal combination serving relatively new remotest part of N building, a godsend Devon. Holsworthy and to people recovering SM have most modern from acute condition buildings

538 C4 South Molton has the N option to be used for other things as well. Also not too far away from NDDH 539 C1 Bideford has good bus Ilfraco Ilfracombe: bus transport 4 The budget is not being spent on the right Consultation could N route, parking facilities mbe or and 2 years to refurb. facilities. Money could be moade by other have been advertised on route through to Holsw Holsworthy: bus transport means e.g. car park money, self-inflicted more through the NDDH. Populations to orthy which could stop at any time injury e.g. drink and drugs, car insurance Journal or Gazette so expand increasing. through lack of use from accidents more people would Ambulance station in have been up to date. Bideford, medics quick Too much money response. Easy access to being spent on NDDH, more space to agencies and nursing expand as population agencies and other increases sub-contractors. If kept in house, the budget would be there. Computers were brought to cut down paper work and middle management. Too many people walking about looking busy. 540 A4 South Molton provides B Because it would lead to the 4 Cost/figures? These questions could not be "Providing more Have you stopped to N excellent care in a closure of our community answered! prominent therapy consider the impact relatively new building hospital beds! resource to support that this will have on with capacity for surge. re-ablement" - what the elderly and As the renal services will does this jargon unwell? Wil the care be moving to Barnstaple mean?! Will an they expect and in 2016 the vacant ageing member of should receive in building could be used to the rural community their own homes fill gaps in service get all the care they have been trialled provision. need in their own and fully functional? home if the local community hospital has no beds?

541 A2 Ilfracombe is a big town Ilfracombe B There is a bed blocking crisis 4 Yes, have faith in these smaller hospitals as Not really, if it is a Why was the Tyrrell N with villages around it, it needs to at NDDH parts of the year, think they could not have been build just to day centre it is silly is Hospital let to get needs the Tyrrell hospital have staff so keeping the Tyrrell close and give up the care they offer. North should be full care were there was not for patients to feel as who know Hospital open on full Devon is growing and people are living and 24 hour hospital enough staff to run it they are not being put how capacity would give more longer. not part time. to the full capacity as out of reach of family and important is people more urgent medical instead of agency friends. Recovery is much for a full help. nurse's treat staff better for them and the recovery or who have trained for Tyrrell hospital has the comfort at years and still train right environment for this the end of on the job with more to happen. life. There care and the NHS will are plenty grow not shrink. of staff who would have to work at the Tyrrell and if run properly finance should be found and if wards were not turn into offices the Tyrrell would work as a very efficient 542 A B Because there is the serious 2 Improve home care Our family N risk of blocking beds for service capacity. At experience of service more urgent cases, its total present this seems to and care at NDDH capacity should be for a be fairly sparse, has always been trauma hospital, surgery and members need to be excellent, also our GP medical. increased, standards practice at revised which Abbotsham Road in probably requires a Bideford. better level of pay and training.

543 C1 Community hospital 2 N could free up beds in NDDH 544 C2 Holsworthy is most C1 Bideford is more easily 3 Looking after patients N isolated, with poor accessible to NDDH. The at home in towns is transport links and less building is older and less quite possible - private transport. flexible. however many of our Holsworthy is a relatively population live in modern, flexible building. isolated rural areas, where community care can be very difficult - especially during winter months.

545 B I have had friends 2 North Devon Hospital N transferred from is vital to the area. Barnstaple to Bideford at We have a great the end of their lives and many people moving then taken back to into the local towns Barnstaple to die. I feel and villages. I fear this causes unnecessary that in the future stress to elderly patients. more and more services will be moved to Exeter and Plymouth. Alison Diamond has an uneviable task. 546 Holsworthy The best of a bad job. B NDDH sadly has failed a 3 Making more use of community hospitals Yes, and as a vetinary The bottom line - if N & all the Losing community number of people whom I which for 9/10 patients are able to provide surgeon I know the you were other hospitals will harm care know. Care of the elderly better "care". In 2005 my mother was dying relative efficiency of old/frail/dying - community and not save money. should be just that, care of cancer - she was "processed" in NDDH. use of manpower would you want your hospitals Community hospitals are which does not equate to She was cared for in Holsworthy Hospital between managing nearest/dearest to often the place that cares the number of diagnostic and allowed to die at home. She hated cases at home with have at least 3 hours for the elderly/dying that tests/interventions, but to being in NDDH. visits verses in a travelling time and will be you sometime. surroundings, visitors and an hospital setting. associated costs to District general hospitals acceptance that death There is no way that visit (excluding time can specialise in comes to us all. you will save money spent with you). diagnostics/interventions without seriously Perhaps to arrive at a but are not the place for damaging patient time when you have paliative care. This needs care. just drifted off. To to be accessible to close beds in friends/family. Holsworthy will mean this and worse for its growing aging population. Public transport is negligible, care at home often no longer viable and very expensive to provide given the geography .

547 Holsworthy I think holsworthy should Bidefo It has many private homes 4 Less nurses and more care assistants at the In our smallhousing This is an area of N and one be one of these chosen - rd who could make beds hospital - helping to feed wash patients - so development (13 ageing population other a. A purpose built available - many within the families do not need to check if their loved home) at certain many moving here to building with room for immediate catchment area. ones are helped with feeding and not times - 12 visits (per retire - please make expansion b. Poor Closer to Barnstaple. having to attend mealtimes to check! day) from carers, 2 every effort to view transport, low car nurses, a doctor, Holsworthy a life owners. A. 5 estates and physiotherapist, saver and comfort to many private homes in other special needs many. last 10 years. B. Serving people. How can this many villages with new pay? When the same housing. C. Meets elderly people could help requirements for visiting those 7 people families as the the bedded together to transport to Barnstaple recover from leaves everyone cut off 'strokes' etc for from recovering parents perhaps a short time. etc. 548 A1 Holsworthy is distant Would like B Barnstaple has many 2 Yes I am really sad that N from NDDH. Bideford has Ilfracombe facilities already and I feel some beds cannot be large population. to be given locating elderly people from provided in beds but outlying areas in NDDH Ilfracombe but realise feel it is not would cause distress in many it is not feasible at viable at cases. present. the moment

549 A4 One hospital in each N/A. B The dual purpose of 3 More consideration on Care Closer to Home I would like better The consultation was N North Devon and hospitals - such as South most definitely ought to have been answers on the not as valid as all the Torridge. South Molton is Molton - NHS hub and in- included. Hearing about the work of the trust's views on the CCG meetings - in linked to other parts of patients' beds meets the community workers in NDHT was not future use of the those the audience North Devon by virtue of needs of the local effective, and did little to assuage the renal unit in South felt their views were the link road - and an A community. Focussing all concerns and worries of the attendees at Molton. really being sought. road to Ilfracombe. South services in the NDDH is a the consultations. It seems absurd to have At NDDH's we felt Molton is not well linked much more centralised included Ilfracombe in the consultation. The that there was an to Barnstaple - or towns service - and not tailored to task you have set responders is well nigh agenda - which would beyond- by public local inhabitants. Having impossible - unrealistic in the extreme! be delivered, come transport. Holsworthy is beds centralised in hell or high water! far away from other Barnstaple would aggravate The idea of round towns - yet relatively transport concerns for all table discussion and close to Bideford. Both inhabitants of North Devon. feedback is ideal - but towns have relatively This would also be a less very disappointing, new hospitals - which can friendly and intimate even frustrating, "flex up" in times of environment for many when it is badly need. Both towns serve service users, who benefit managed and doesn't large rural hinterlands. from a smaller service. happen. Staff at South Molton are getting skilled up in areas of medicine , which suit local needs - e.g. end of life care.

550 A Feel it would be more No community beds. 2 Yes. It will be the older N helpful for a wider group patient group that of patients. will suffer most from no local beds. 551 A4 1.This gives a hospital B Least preferred due to travel 2 I'm not well enough qualified in my I think so. I attended I am very concerned N and each end of the area costs and time of same, knowledge of the whole subject to suggest a local well attended that you have only a ie north and south. parking space issues and any others. meeting at Bradford very short time 2.Relatively modern cost of parking and a when Dr A Diamond between closing the buildings with flexible perceived view that NDDH is went through the consultation process layouts. 3.Lower costs for not the preferred hospital issues. I am (today) and the local people cf travel to over RDE Exeter. concerned if more decision early next NDDH or another care was given at month. This does not community hospital 4.In home, how well you seem adequate in the case of Holsworthy, would cope in bad view of the good links with N Devon weather and some of importance of the hospice service, our local roads are issue across your especially with new Long very bad. whole area. I well House facility recently recognise that you coming on stream. In the have a hard job in limited time I've been balancing your able to spend on the reduced budget and whole subject of pleasing the majority healthcare and your new of people. financial constraints, I feel this option fits the criteria the best.

552 A4 We agree with all the B 2 Yes. No. N decision-making criteria for Option A outlined in your document, with the exception of the last item criteria with reference to hospice and care home. We do not feel that this criteria should have been included as a hospice or care home are not a hospital. 553 A4 Holsworthy is crucial as it B The area is too rural and 2 How do you propose Please save N is not only the town but Barnstaple too difficult to dealing with rural Holsworthy hospital. the surrounding areas get to. roads, with no salt which can be extremely spread on them in remote with no means of winter and public transport. The new vulnerable people Hospice does not have stranded in their overnight beds and was homes with no cares always intended to work able to reach them. in conjunction with the Also, there is a knock hospital. South Molton is on effect to relatives the next rural option. having to travel to Barnstaple to visit relatives in NDDH.

554 A4 a) Bideford is closer to My understanding is Last year the Health NDDH which means for that NDDH does not Authority made a the people living in the have the capacity complete shambles Bideford area, it is a to house a 40 bedded of 'the investigation' relatively short, community unit, and at Holsworthy straightforward journey if they did manage to Hospital and wasted to their nearest hospital conjure up some a ridiculous amount for patients and their space, how long of money on it, visitors. b) When it would it be before it admitting that the comes to redeploying was used in an situation (not to staff, they could travel outreach capacity for mention the staff either to NDDH, South the other wards, concerned) had Molton or Holsworthy. thereby losing even been badly dealt Whereas people who more community with. My fear, and work in Holsworthy but beds! that of many other live either in Bude or people, is that you towards Okehampton could make another would have much further misjudgement in the to travel, should they be closing of community redeployed to NDDH or beds. I would find it South Molton or more reassuring if Bideford. c) As stated in you at least waited the consultation until more staff were document Bideford is working in the somewhat old and community, or there outdated, and has was more funds problems recruiting and available in Social retaining staff. Services before 555 A4 Both these community N/A. B NDDH is an acute hospital 4 Given that the CQC have rated the standard No. This has never NDHT appear to have N hospitals serve a wide and the type of nursing and of community care offered by NDHT as been properly totally ignored the rural catchment area and care that is offered is good I fail to understand why the objective articulated and it is work done by the have poor public completely different to that appears to close all the beds in all the quite clear that the CCG consultation trsnsport links to needed for the type of community hospitals. My preferred option general public, as team and has Barnstaple and Bideford. patients that should be in a would be to retain 56 beds and three well as the CCG, have repeated some of the Both these hospitals are community unit. An acute community hospitals - Holsworthy, South grave doubts about former's initial relatively modern and all hospital is unsuited to either Molton and Bideford. This probably more the ability of NDHT to mistakes. That is to the facilities are on the 'step down' care or 'step up' properly reflects the actual need for deliver adequate care say no account same level. Both have the care. In addition does NDDH community hospital beds. if the community appears to have been ability to 'flex up' to a actually have enough hospital beds are taken of local plans certain degree. capacity to sustain 40 closed. The currently being 'community' beds alongside 'consultation' process developed by its acute requirements? seemed to answer Torridge and North this question by Devon Councils and saying that 'we do the understanding of very well now and public transport in we'll do very in the Northern Devon is future as well'. This lamentable to say the despite the fact that least. This type of the NDHT exercise is 'consultation' form is purely about saving a bit of a nonsense as money, and says it pushes nothing about respondents down a redirecting any particular route. Your savings from question about Town community hospital name/post code bed closures into saying that this is 556 A4 These are the towns B Apart from the transport 4 Are there any other options we could have I do not find it easy to N furthest from Barnstaple difficulties NDDH struggles considered? Greater consideration of the follow the logic of and with the limited to get people home now. impact on individuals and families when such provision. public transport. More beds there will be affected by illness or accident. The use of under pressure from acute the community hospitals to provide services and planned recovery care to make more acute beds operations so the "bed available in NDDH. blocking" issues become exacerbated. The community hospitals make sense of "Care Closer To Home" as rehabilitation can take place with the support of family and friends. The time and cost to local people, many of whom are not financially comfortable, for travelling is considerable. 557 A (Only Holsworthy listed). B Community beds should be 4 There is lack of care Y Community beds should in the community and where available in the be in the community. in nddh will these beds be community with Holsworthy long way ??? Long way from community hospitals from nddh or another holsworthy and lack public so what will happen community hospital, transport.not ideal to these patiients.the public transport not environment for the elderly care is not out there available regularly and who prefer smaller units and vulnerable not all households have close to home where family people will suffer. ccg cars. Patients are can easily visit. patients has withdrawn admitted to a community refuse to go to nddh but will support -i wonder hospital because they are agree to be cared for in why. unable to be cared for in community hospital. their own home or residential home. They do not need an acute bed in an acute setting they need to be cared for close to home. Holsworthy hospital is able to recruit and retain ward staff. The building is relatively new and can be easily maintained. Although there are care homes in area people block hospital beds because there are no 558 1. Holsworthy is a long way from NDDH. When patients are discharged from NDDH, but are not well enough to go home, they have been transferred to Holsworthy. This " unblocks" beds in NDDH and makes it easier for family members to visit. When my husband was dying of oesophagial cancer, I was able to visit more frequently and was comforted knowing he was receiving excellent care locally. It was also comforting to him to know I could visit easily and quickly.....which was so necessary at the end. 2. Prior to his 559 A3 When I read in the Y paper that the CCG wanted to reduce the number of community beds to 40 across the district with the reason that patients would rather be treated in their own homes, I was already sceptical. My experience from the clinicians perspective is the time lapse when organising packages of care for patients at home can end up keeping the patient in hospital, or sending them home without the right support at the right time in terms of intensity, appropriate services, and potential patient outcome. There is a huge differential between hospital 24/7 care and visits by community staff to 560 C1 Maximum number of 2 Whilst I understand I'd like to voice my N beds. that people think opinion on the they would prefer to closing the beds in go home some find the 4 local hospitals, the transition harder for one thing I don't then they thought. I think there's enough today visited a man qualified people to with terminal cancer care for patients in sitting at home their homes also its waiting to die. His difficult from out care from the NHS is here in the country to good, but he lives get to Barnstaple to alone and is lonely. visit and people He belongs to Torbay without cars can not but I'm sure he is not offord to hire an isolated example. transport to visit. The companionship Hopefully this will be of the small units is a thought thru and valuable part of care, these sm hospitals particularly for old can be kept open. people living alone.

561 C3 Living in Ilfracombe I feel B Beds are needed at 2 It will mean we have It feels sometimes N a hospital is needed. A community hospitals. to travel to like Ilfracombe is the large area is covered by Barnstaple for end of nowhere. We the hospital. It helps near hospital treatment. need a hospital. by towns as well. It feels that it gave a good service.

562 C1 Mainly because largest A Allows smallest number of 3 Holsworthy to link with Stratton? Yes. N population areas. beds. Therefore more likely to require amenities.

563 C Plus Bideford more Holsworthy would be central. inconvenient for anyone living on the Ilfracombe coastline and Bideford seems much easier to access than South Molton, whether by car or bus. 564 C I agree with NDDH and Ilfracombe Exeter 1 Yes I do. PS please let me I have had two major N one community hospital know what the operations at NDDH in case NDDH is full, no outcome of what spent all told 3 beds. happen good luck. months with you I love my hospital they looked after me well very good indeed.

565 My wife & I live in the 3 N NDDH catchment area. It does not seem to us to be right that we should vote, since we are unlikely to use either options A & C, option B is being greedy?

566 A1 It is too far to Barnstaple, Ilfracombe A We need local beds for 2 Will you provide free Were at Milton N if someone is dying it is is nearer to people who need to be in transport for the Dameral live 24 miles too far if called in they Barnstaple. hospital but do not need elderly who visit from Barnstaple. It is would be dead! specialised treatment family & are not up too far for the elderly Bideford because central & to driving in bad to drive to visit easy finding Holsworthy traffic at Barnstaple? spouses & family because of isolation. Holsworthy is a kind friendly & caring hospital with all that is needed & wonderful staff!

567 A4 A large majority of the N/A. Ilfracombe plus option B. At 4 How do you intend to Perhaps if you spent N population of South the present time NDDH is recruit & retain more resources on Molton and Holsworthy unable to cope with the suitably trained staff? recruiting and rely on public transport. demands of the patients. retaining local people Therefore a local hospital you wouldn't have to is very important. In pay to send a nurse addition South Molton from London that hospital is a modern, was recruited by an purpose built unit, plus agency! How can this South Molton has a be right!? growing elderly population. 568 A4 Bideford is nearer to N/A. Ifracombe plus option B 4 Yes I understand but I don't agree with N Barnstaple with good because NDDH unable to recruiting & retaining cutting people from public transport. cope adequately as it is. staff isn't feasible. family & friends Holsworthy & South despite the promises Molton are poorly of care closer to serviced by public home, to be safe this transport (South Molton needs to be in especially in the evenings community hospitals. and weekends therefore preventing visiting for family & friends who don't have a car. South Molton hospital ideal & has extra potential space from the renal unit.

569 C See No.7 See No.7 See No.7 2 See No.7 See No.7 We think one of the main ways to deliver safe and effective care within the budget is to reduce the overspend on staff payment: 1) 3- way swap by doctors should be abolished with immediate effect. Doctors are currently allowed to move a weekday clinic to Saturday clinic for enhanced payment by doing an extra session in their 'free' time during weekday. This caused lots of inconvenience to patients especially the appointment is moved in a short notice which had happened. 2) Follow Exeter Hospitals by giving a flat rate for doctors whether they 570 The beds at the Tyrrell Providing B 4 Why when my N hospital should be essential mother in law was reinstated and the wards and discharged from fully staffed. Withe adequate NDDH for continuing reference to the above rehab in rehab before coming options, there are no community home, were there beds at NDDH for this, hospitals none of the so called they are virtual. I linked with 9 beds in the presume you're community residential sector expecting the patients to teams will available? If she had be virtual as well. keep been discharged to patients out the Tyrrell for of the acute dynamic rehab I,m hospital sure she would not therefore now be languishing in saving residential care with money in no prospect of her the long ever returning home. term.

571 None. Retain 12 beds at I appreciate B Pulling everything into 4 Refurbing and keeping Ilfracombe! Home care, or trips I understand that N Ilfracombe. that mine is Barnstaple. Whatever to Barnstaple. See care will be offered at a very funding there is at the below. home. I have recent annoying moment will vanish. experience of 'home answer, but care' during my I think father's last days and you've while it was (mostly) perhaps provided with been given kindness and the best a set of of intentions and rules that suited his desire to enforce die at home, it was short-term almost always too thinking little too late. Until 24- rather than hour care was put in planning for place during the last people's 2 weeks of his life, long-term the whole process needs. We was frankly need our something of a community nightmare: the beds. IN the system was communitie fragmented, s. confusing and worrying, and there seemed to be no one person who could explain it (or indeed 572 A4 Whilst under pressure to n/a C NDH plus one other local 4 The Main OPTION of course - All local Yes Their is only one N accept an option from hospital. WHY, it is obvious hospitals to remain open, staffed other choice, For those offered and having that in the time of sufficiently with the correct personnel for those in the "Over made the journey to NDH emergency, those beds such a aging population in this area. When I 70's" age group that Barnstable to see friends would be used for additional started work as an apprentice on the 4th cannot "pay for their as well as for emergency beds. January 1952, working for 53 years, both nursing" the issue of treatment/operations parties supported NHS, stating by paying just "one pill" will myself, with NO Public the NHS Insurance rate (which would likely assist in decreasing transport that connects be adjusted as the years go on), this would the NHS Costs as well in time and directness, ensure everyone paying into the scheme as the countries. my now home town that NO problems would beset our life and Having just been (Holsworthy) since 2004, in particular, OUR LAST DAY's - A promise lucky on at least 2 is rather distant from that governments, particularly have found occasions to not be NDH and a rather difficult reason to forget, plus their inability to judge killed in the German drive, assuming you have the extended lifespan. This is directed to bombings (I was born a car and the money to NHS also, as it is them who failed to warn at Northfleet Kent, cover the running costs. each Chancellor of the Exchequer! All which was the As I, like everyone, gets because of the Political Damage it would bombing run for older you need to know cause to their Party and their chance to London, only kept that access for your Rule!! out of this Country by family and friends is the "Few" in 1940 direct in both time and and of course costs! South Moulton Winston Churchill, seems to be the most who together with likely second local the King and Queen, hospital to offer kept our moral up rehabilitation to the East, when it was most whilst Holsworthy is too needed! NOW I FEAR 573 A4 Distance from NDDH n/a B This would not actually 4 Staffing numbers to N Difficulty of transport represent a "community" cover home visits in from Holsworthy let Hospital rural isolated areas alone from any of the out Can this be covered laying Villages that are by existing staffing serviced by Holsworthy levels? If more staffing required, what plans for recruiting and how long should this take? what danger is there of having to rely on agency nurses and what is the estimated additional cost? What contingency is in place for home visits during periods of adverse weather? 574 A4 Holsworthy and South n/a B Because the hospital is not 4 How will elderly or N Molton would give more very accessible to many less able family and patients the chance of older or less able people and friends be helped to staying reasonably close their families. visit and support to their own localities. If those who are not there could also be beds hospitalized locally? at NDDH that would be even better. Travel to and from NDDH from Holsworthy is difficult for those unable to drive themselves. The taxi fare is high (£80-£100)and buses not easy to use or direct to the hospital. A local hospital would allow patients recuperating or those in an end of life situation the opportunity to feel happy amongst people they know and family / friends who can visit. It is incredibly difficult, if not impossible, for an elderly, frail individual to visit their spouse in NDDH. This puts additional strain 574 A1 Holsworthy is relatively n/a Any of As I believe other 3 Not sure if there are any other options that I understand how you N remote in relation to the combinations would be could have been considered - given that this say you are going to NDDH and other above grossly unfair to the whole consultation has taken place over a look after people Community Hospitals. option population of Torridge. very short period, there doesn't appear to differently, however I Transport links are not s that have been much time devoted to thinking am still unclear how great. Bideford and all does through what other options might be this will actually work the surrounding districts not available. on the ground for have a large elderly includ frail elderly people. A population, likely to e visit once, twice, increase because of the Bidefo three or however new housing rd, as I many times a day, developments planned. believe will never be the Public transport to other same as having a Barnstaple is fine if you combi friendly face there for actually live in Bideford nation your entire stay in but if you live in s hospital. Isolation is surrounding areas - would a very important Abbotsham, Clovelly, be factor for many Hartland, Monkleigh - grossly elderly people and if they are not great at all unfair they are unwell and and it can take an hour to to the therefore by an hour and a half to get popula definition less able to to Barnstaple. There is tion of get out and about, I poor care home provision Torrid can only see them in the area. ge. becoming more isolated in their own homes, waiting for the next time 575 A4 North Devon is a very n/a B Please see the above 4 Yes - making a good reasoned case for more I understand but do N large area. The public comments in answer 2 finance so that "Care closer to home" could not like the options. transport links - mean just that!There is no "one size fits all" particularly from the solution to this problem. The situation in Holsworthy area to other big towns and cities which have good centres are poor. Travel transport links is very different from that in from the area served by a predominantly rural area. The sheer cost Holsworthy and NDDH is of travel from outlying areas - whether by often not possible using car (with parking to be taken into account public transport, and too) or by public transport where this is even by car not even possible - is a consideration in an area particularly easy. If where a high propotion of earners do ot people recovering but even earn the living wage, and coupled with not in need of acute care the time such travel takes is daunting are occupying beds at where a hospital stay is of more than one or NDDH, then these beds two days are not avalable for acute cases. It makes sense to move people in need of care but not in need of acute care closer to their home areas so that (a) beds at NDDH are fred for acute cases and (b) allow easier access for visitors. This is particularly true when the patients and/or 576 A Holsworthy hospital is a n/a 4 Holsworthy vital lifeline for +1 Holsworthy and surrounding parishes. Having a local hospital is hugely benefitial to families that have sick, injured or dying relatives. I recently visited a poorly relative in NDDH three times in six days. I am a young Mum of three and am active and able to drive. The journey to and from Barnstaple is a slow, winding and very draining route in a car when you are visiting the hospital. It takes up several hours by the time you travel, visit your relative and return home. Even I found this tiring, so I have no idea what it would be like for older people who are not so able to do this on a regular basis. There are 577 A1 However, I think See above. B I think this is the worst 3 In the consultation document foreword, it I understand the I think the concept of N Ilfracombe needs to be solution. I fully support the says "To enable us to continue delivering process, but am not a Frailty Unit should considered in the longer concept, as outlined in the high quality care within our budget we convinced that be progressed term, due to its high consultation document, of need to shift our resources from hospital enough community regardless of the deprivation index and the development of a "Frailty beds to the care surrounding the patients in services and outcome of this distance from NDDH by Unit", which includes earlier their own homes" . It then says, "This resources are yet in Consultation, as it public transport. The senior clinical input and consultation is how we decide the location place to facilitate the could improve consultation document rapid access to diagnostics of fewer community hospital beds in closure of beds. At assessment, states that Ilfracombe is and a more joined up Northern Devon whilst giving people the the consultation diagnosis, treatment "Not safe at fewer than approach which would reassurance as to the care they can expect there was a and care pathway, 16 beds", and that "safer provide better, safer, patient in their own homes". I think that whilst the document with a resulting in a more staffing was not possible care, with a reduced number direction of travel in health care may be to scenario which joined up approach in a 10 bed patient unit of transfer of care. This shift some resources from hospital beds to included the for patients and a due to lone working". approach would improve care at home, it is a process, which I don't possibility of placing potentially quicker, This is not necessarily care for patients and makes think can be facilitated until there are a patient in a safer discharge. It's a true, as staffing could sound clinical sense. adequate and safe services in the residential or nursing win/win approach. I have been increased to However, I do not feel this is community to facilitate that shift and the home bed, if don't think any ensure adequate staffing, the same as having closure of beds. To close beds without appropriate. This community hospital without lone workers. "community beds" at NDDH. "giving people reassurance as to the care may be appropriate, beds should be This is unlikely to be the Hopefully, the process they can expect in their homes" is but there is little closed, prior to an most cost-effective outlines in Option B, may potentially leading to unsafe care. Listening evidence that an absolute assurance staffing, but it would be mean less patients require to what I heard at the consultation and appropriate bed that there are possible, and should not transfer to another hospital, from other conversations with people, I do would necessarily be adequate community necessarily be ruled out, and may be able to be not think people are reassured that there is available, given resources to ensure as the brief of the discharged home directly, adequate care available to people at home. recent closures of safe and effective consultation is to provide with appropriate and Some of people's concerns are, of course, homes and an care in the "safe and effective care" - adequate home care. based on anecdotes. However, there are a already limited community - patient within the budget, yes, However, I think there will significant number of anecdotes and number of beds safety has to be 578 A4 Both these hospitals are n/a B From Holsworthy this is 4 Not shutting beds or units at all. Yes with visiting Holsworthy hospital N furthest away from approximately 50+ mile health staff, which is was a purpose built Barnstaple and makes round trip, on a windy road, fine if you live in hospital, and has sense to keep them and can take more than an town where excellent facilities. open, will save on hour each way. This is properties are easily What is going to travelling time and costs. unacceptable for anyone found and people happen to this Will allow family and who does not drive, using around to ask building if the beds friends to visit patients in public transport would take directions. We live in are closed? We live in hospital. upto 2 hrs to get to a very rural area, sat a area with many Barnstaple and the cost of a nav does not always elderly people and a taxi would be too costly to take you to the right high proportion of many people, especially the property, and there people do not drive, elderly and those on low are not people having to rely on ever incomes. This would not around to be able to diminishing public allow patients to return to a ask directions. transport, and rising hospital nearer to their Mobile phone fuel costs make using home, before they are reception is patchy to a taxi a costly actually fit and able to return say the least. This experience. to their own home. problem would be made much worse during periods of bad weather, snow and ice makes many roads impassable, heavy rain means that rivers flood and bridges close, again making navigation 579 Ilfracombe ilfracombe local Unneccessa B All the communities need 4 Yes. Allow all community hospitals to Yes. But an essential It is widely believed N community needs beds in ry expense their local Community function at a lower level than that required element is missing if that this whole the local area for is being Hospital. Surely community at a critical care hospital. community hospitals consultation process recuperation. This will quoted to beds are an essential part of are closed. Some is a waste of time as help with the issue of bed refurbish "Care in the Community". people can not be the result has been blocking in Barnstaple. the suitably cared for at pre-determined. The Beds in other community Ilfracombe home but do not refurbishment of hospitals are too remote hospital to need the level of care Ilfracombe Hospital is for vulnerable patients to critical care provided by a critical only being receive visits from friends standards care hospital. These considered to critical and family. when all people will either be care standards that is inadequately cared ensuring that the needed in for at home or block cost is high and the Ilfracombe a bed in a critical care option for keeping are unit. Visits by friends the hospital open is recuperatio and family are an untenable. More n wards. A essential part of such innovative thinking 16 bedded people's recovery. should have unit would determined more be possible viable options for if a lesser Ilfracombe beds. standard of bed criteria was accepted. 580 A Bideford & Bideford Hospital is a n/a B It feels like NDDH is losing all 4 1. Improved resources within the no. 1. How do you intend Y one other, large community hospital it specialist areas to community services to keep people at to look after people Taw side. serving a big community Derriford, Taunton & Exeter home. 2. Trust owned care agency to differently in towns with an assigned large GP and Barnstaple will just improve discharge planning & reduce where beds may be practice, which offers the become a rehabilitation length of stay. 3. If it is a pure financial reduced? With a opportunity for patients hospital; which is a sad reason to close community beds, other shortfall in care who are in crisis in the prospect. inefficiencies within the NHS should be homes and care in community to have rapid looked into. the community? responses with the community rehab teams and the availability to admit people into community beds rather than into the acute system. It is a well staffed hospital (with exception of the current nursing crisis)and I believe it would be more difficult to recruit into posts in more rural location such as Holsworthy. It has specialist services such as the stroke rehabilitation unit; which patients feedback that moving away from the acute hospital is a big 581 A1 Holsworthy - remoteness n/a B Main hospital ideal for 2 I have no medical N from all main hospitals. urgent medical care but knowledge at all. My Care currently very good. cottage hospital answers are all based Bideford - accessability environment ideal for elderly on the welfare and good whilst retaining and recovery patients closer wellbeing of the 'cottage hospital' to relatives and friends for patient. TLC of vital environment and staff visiting. importance so recruitment and adequate staffing permanent retention both paid and very important. TLC vital voluntary paramount and healthy food to aid (eg Elderly and recovery. disabled given help at meal times). 582 I feel as Older people should not n/a I feel this exercise is N many have to travel further largely time wasting community than is necessary to visit. for most of those hospitals as who only will be possible ….(illegible) should be kept open. 583 A1, A4 or A5 1. Historically the N recruitment and retention of staff at Holsworthy Hospital has not been a concern. 2. There are more elderly people living in Holsworthy area, partly because people are living longer, partly because more houses are being built. People are retiring to the west country from other parts of England - often dependent on the support of a partner and, if this is lost, or a period of rest is needed, a problem arises. 3. Access to NDDH or indeed another community hospital from Holsworthy is not easy. Holsworthy is a low socio-economic are a with a significantly low car-owing population. The roads northwards are tortuous - and there 584 C1 The number of n/a 3 Yes No N houses/devlopments being built around Bideford/Northam/West ward ho! 585 A3 Expected population B Too great a concentration on 2 Costings? N growth, surge flexibility. one site. Meets needs for future adaptations. 586 A4 These hospitals are the n/a B 3 N furthest distance from Barnstaple with no credible bus services especially from the out lying villages.

587 C1 Acessability by public n/a A4 No direct access to public 3 Yes I wonder in an Would cost prevent transport. Bideford as transport isolated community elderly getting back up has a good like enough quality care stroke unit. Lynton/Lynmouth, at home because of whether enough the short time many carers could be carers spend with employed. clients. NDDC recently closed Lydiate Lodge. A 16 bed care home which leaves these neighbouring communities with just 1 private care home.

588 A4 or A3 If the jobs/careers were n/a B People in rural communities 3 Moving services from NDDH to community a) Your evidence is The whole NHS Ex secure due to assurances (local people) would have hospitals which would thrive and be thin and not robust structure structure that community hospital the most to lose!! Transport welcomed by the local vulnerable section in as you attempt to and management is positions were needed being main problem and deprived county. push your will against at fault so we can (keeping 2 hospital sites isolation from loved ones. the community. B) hardly blame open for definite) the More expensive for them in where is the secure individuals. However recruitment to those taxis to access OPD's. evidence that you when consultations hospitals would be can deliver "better are just a paper easier. You make it health outcomes"? C) exercise the whole impossible to recruit to surely recruitment to community sees it - jobs when the future of community posts is that much is hospital is insecure. languishing - no transparent. Quality of facilities is mention of this?? Dishonesty rules better at Holsworthy and when money is tight. South South Molton. If all This is not your purse community beds are - it is the comunity's. closed the people without transport would not be able to visit relatives, increasing inequalities and stress to those deprived individuals. 589 A4 3. Access/travel for the n/a B Already an overcrowded site. 4 A major factor is the current governments There is no guarentee Recruitment/retentio N elderly and relatives. 9. Expensive parking. Without radical reduction in funding for of a community care n of nursing staff is Sites provide vital service community hospitals as a health/social care in real terms. Obsession substitute due to not an argument for as community based saefty valve bed blocking with 'targets and times' wastes time, effort central government closure of community hubs. 7. Currently will result as at other South and money. This makes proper reform of slashing health/social hospitals. This also provide flexibility in West Hospitals. Poor trained services an impossible remit and certainly a budgets. Poorly paid applies at NDDH - surge periods (winter staffing levels are already an very poor compromise for service users. carers cannot afford indeed nationally due pressures). 5. Relatively issue so quality of care to run their own to previous cuts in new buildings, lower cannot be guarenteed. vehicles and make a training numbers. maintenance. living. 15 minute Allied to poor visits are a cynical working conditions - substitute for under valuing staff vulnerable patients has compounded the care needs. There is problem. poor health/social care co-operation and private care is for the rich only.

590 A4 + NDDH I believe NDDH will be n/a B I feel that the areas further 2 Not with the constraints that are being I understand the N able to serve the closest from NDDH are, and will still placed upon the whole health care system. intentions, but unless communities and be in need of beds (a) all the parties that Holsworthy and South because of poor transport are involved in caring, Molton are better able (b) road networks (c ) aging pool their resources support the more remote population. and work together, I areas. As well as being forsee a lot of newer. problems arising.

591 A4 Spreads beds available n/a B Distance from outlying 2 Not really Are there enough N furthest from NDDH. homes. Can NDDH provide staff? Both buildings are fairly space for all the extra beds new and adaptable - will required? cost less to convert. Regarding staff - especially at South Molton - would require a recruiting drive and could the nurses be helped with local people without full qualifications. 592 None of the Each community needs Given the B Where would they be 4 Retaining the smaller hospitals. Incentives No Will patients be Sadly yes - in view of above. its own hospital "care" in closure of located? No space exists at to retain staff? (financial? - probably visited in their own the "consultation" such a rural region, with the x-ray present; this would need a cheaper than agency staff) homes by one nurse carried out in East staff travelling from department new building (not possible in or two (as required devon and the patient to patient is , there is 2015/16) at what cost? by "safer staffing")? closure of beds at unrealistic and extremely space How will necessary Axminster contrary to expensive in staff time within the clinical services be the community's and travel costs, plus the building to provided? wishes, I suspect that limited accessibility of accommod (equipment not easily decisions about some homes in winter. ate the moved or shared) North Devon have How is this more beds who will pay for staff already been made economically viable or needed. travel costs? How will and the safe for patients than Otherwise, the NHS provided "consultation" is care in a properly an empty sufficient staff, if simply a PR exercise. equipped hospital? hotel could recruitment is be rented in already a problem? the short - Staff are less likely to term - want to travel than to plenty in St work in one properly Brannocks equipped building. Road. Many may have ensuite facilities, some may have lifts. Possibly reopen a 593 A1 7 plus noted the n/a B Would this take beds from 3 not convinced that N projected increase in other sections of the hospital the 'care at home' population of Bideford or would these be all would always be and distance of additional beds? Where sufficient and Holsworthy from NDDH. would these beds be appropriate and 2nd choice C1 situated? would result in more hospital admissions.

594 Ilfracombe 12 bedded 4 12 bedded unit at Ilfracombe - we accept We do not believe No support from CCG unit with 2 that two nurses should be duty at all time that the necessary - We are alarmed and nurses and acknowledge your assertion that there capacity currently concerned that the should bea minimum nurse:patient ratio of exists within health & Trust is effectively 1:8. Having 2 nurses caring for 12 patients social care services in setting a strategic (1:6) could, taking a simplistic view, be ilfracombe to allow direction that is not slightly more expensive, but additional closure of further supported by the duties such as home patient and family community beds at CCG because of its liaison, could be combined with the nurses' the rate you propose ambition to cut costs. inpatient roles. whilst maintaining care for our residents. 595 A3 A HUGE AMOUNT OF n/a B NDDH ALREADY TOO BUSY, 4 I DONT THINK IT IS N NEW HOUSES BEING DIFFICULT FOR PEOPLE TO VIABLE TO RE-OPEN BUILT IN SOUTH GET THERE BY PUBLIC ILFRACOMBE MOLTON (1200) A TRANSPORT. GENERALLY IT HOSPITAL. WE, AS A MODERN HOSPITAL IS OLDER PEOPLE NEEDING PARISH COUNCIL ALREADY EXISTS, IT THE HOSPTIALS. THEY WANT JUST WANT YOU TO PROVIDES WHAT THE HEALTHCARE LOCALLY. CONSIDER ALL THE COMMUNITY WANTS OLDER PEOPLE AND AND IN AN ACCESSIBLE THOSE THAT DONT LOCATION. OUR DRIVE THAT LIVE IN RESPONSE IS TO KEEP THE RURAL VILLAGES. HOSPITALS ON THE PLEASE REMEMBER EASTERN AND WESTERN THERE IS VERY FRINGES WITH BOTH LIMITED PUBLIC HAVE GOOD ROAD TRANSPORT IN THESE ACCESS. VILLAGES.

596 No beds We unanimously feel B where will these physically What will happen to NICE guidelines Y closed very strongly that the be located? If it means a the Elizabeth ward published today are closure of ANY beds will reduction in acute beds it beds if the recommending a have a very detrimental will put even more pressure community beds at minimum of 30 effect on the lives of the on the hospital especially in Bideford close? There minutes per visit for most vulnerable people the winter months. We are is no mention of this care in peoples own in North Devon for the already struggling for beds in the consultation homes. Obviously reasons given below. and winter hasn’t begun. paper. These beds this will put Care agencies are There have been several provide expert care enormous pressure struggling to cover the days this month when we to stroke patients on the services demand on them to have had 40+ medical out- and are vital for our already stretched to provide home care, liers and day surgery has community. • The breaking point. especially in more been utilised to cope with option of keeping remote areas. • There is pressures. Also, how will Holsworthy- a long waiting list for these beds be staffed? Holsworthy is community therapy in all Therapy rehab posts have isolated areas. There are not been frozen and there is geographically. GP’s enough community difficulty recruiting to those have to accept care therapists to “pull” we have. The consultation of patients for them patients out of hospital paper states that “The first to be able to go there or to support patients at aspect would see us and there are home. There are already establishing a Frailty Unit at frequently insufficient residential NDDH” This would need to difficulties’ in getting and nursing home well established before the GP’s to do this, as vacancies in the area. community beds were a consequence they There are insufficient reduced. The location of this often have empty care managers to cope unit and how it will be beds. If Holsworthy is with the number of staffed is not mentioned. A one of only 2 597 C4 Advantages of n/a A Specialist services at NDDH 3 Yes No N centralization and should be an integral part of continuity of care plus provision retention of a modern, strategically situated community hospital