Agenda item

This report identifies the background to the decision to close Archways Intermediate Care unit and to reinvest the resources into an expanded range of community services.

Members received a report which identified the background to the decision to close the Archways Intermediate Care Unit and reinvest resources into an expanded range of community services. It provided an update on the success of measures planned and implemented.

Mike Proctor, Deputy Chief Executive of York Teaching Hospital NHS Foundation Trust and Steve Reed, Head of Strategy for Out of Hospital Services were in attendance to present the report and answer Members questions.

Members were given some background on the community services that were being provided following the closure of Archways. These included a Community Response Team (CRT), Community Discharge Liaison Team (CDLT), Advanced Clinical Practitioners and Outreach Pharmacists. Staff from the Archways Unit were either redeployed into other units and additional staff were recruited to work in the CRT.

They informed Members that as a result of the work of the CDLT, and the closure of Archways they had been able to support an additional 129 patients than in the previous year. They had planned that the expanded CRT team from January- March 2017 would be able to support 430 people as opposed to 360 people previously supported at home. 422 people had been admitted into inpatient beds, but this was 40 fewer admissions than previously and showed that those people who went to Archways were now going to other units. In addition more people were receiving care at home.

Further information was given on the how the Community Response Team would work alongside other teams such as voluntary sector services, Reablement and Physiotherapy services from York Hospital. It was noted that the CRT would be based in the Archways building, which would allow for an integrated space to deal with referrals.

The Deputy Chief Executive admitted that the Hospital had not carried out consultation on the closure of the Unit to the best of its ability.

In response to a Member’s question it was confirmed that patients who had been discharged from Archways into the Community Response Team would be monitored on the outcomes of their care and if they would recommend the service to others. It was noted that the rehabilitation period between community units and home based care was different and that rehabilitation was quicker at home.

The resilience of the system was brought up by a Member as the measures were introduced in winter time when travel to other units out of the area could be difficult due to the weather. It was also highlighted that with home based care, staff could have difficulty with travel.

The Deputy Chief Executive felt that although it there had been mild weather, it had been the toughest winter for the NHS. He felt that the hospital were in a better position for no longer having Archways and that more work could be undertaken to expand community services to prevent hospital admissions.

Further discussion took place over regarding financing the community services contract. Members were informed that it cost £1.5m to run Archways and that £1.2m had been spent on the community services contract.  This meant 20% of the money available for community services had been spent elsewhere by the CCG.

However, it was acknowledged by the Deputy Chief Executive that it was the decision of the Clinical Commissioning Group to divide this portion of the money and given their financial difficulties he was unsure as to whether £300,000 of funding would go into the Community Contract.

Members expressed their disappointment that they had previously been provided with different information.

One Member questioned whether it was up to the commissioner of community services (NHS Vale of York CCG) to provide a 20% cut in services, particularly given that they had previously informed the Committee that the money from the sale of Archways would be reinvested and the provider (York Hospital NHS Foundation Trust) was unaware of the location of the money.

Members asked that a request for an answer to this question be made to NHS Vale of York CCG.

Members also requested an email update on figures in the community service provision. It was confirmed that an emailed report could be produced in six months time.

Resolved: (i) That the report be received and noted.

                 (ii) That a letter be written to NHS Vale of York Clinical Commissioning Group (CCG) to explain where they had invested their share of the Community Contract money.

               (iii) That an email update report including figures on community services provision be circulated to Members in six months’ time.¹

Reason:   To keep Members updated on the progress of actions taken following the closure of Archways Intermediate Care Unit.