Letter: Fears for Shropshire's hospitals

In particular in Ludlow, where, at a meeting with Philip Dunne MP and David Evans, accountable officer for Shropshire Clinical Commissioning Group the Friends of Ludlow Hospital were assured that it was safe.

I was at the CCG meeting at Shirehall on August 10 at which they were discussing the decommissioning (cutting) and disinvestment (handing over to for profit providers or the voluntary sector) of a whole tranche of services. The public were allowed copies of the agenda, which only served to confirm our fears that our hospital was not safe from closure.

An "SSCG Decommissioning/Disinvestment tool" was used to assess appropriate actions, from which I will quote.

Of particular interest vis a vis community hospitals, was the possible cuts to the four Pathway2 rehabilitation beds currently paid for in the privately run Lady Forrester Nursing Home in Much Wenlock.

Regarding the question: "Does the service deliver value for money". The answer is yes, in comparison to the cost of a community hospital bed the cost is £2,450. The beds are able to offer the same level of rehabilitation at a considerable lower rate. In terms of the long term direction and decisions of the CCG a "shift" in activity from community hospitals is a potential cost saving for the future and by maintaining the care home beds this will provide an evidence base that rehabilitation can successfully be delivered in an alternative setting to a community hospital.'

Ludlow Community Hospital for example is now almost entirely rehabilitation beds and over the past two years has suffered cuts to almost half of those beds. Overheads for the hospital of course remain the same, so cost per bed increases incrementally.

Answering the question of possible unintended consequences of cutting these beds. Five possible consequences were listed, the fifth of which says:

'If we apply the three month termination of contract with immediate effect the beds will then close at the start of winter pressures, this could impact on the system.'

Suggested decision whether to cut:

'In an ideal world the recommendation would be to actually disinvest from the more costly community hospital resource. The reality is however that in the interests of expediency to release money in year the removal of the four independent beds from the system is the only option to rapidly release finances.'

What could be a clearer indication that the CCG has little interest in the clinical consequences of this decision under winter pressure, and that NHS England has its sights on getting rid of NHS run community hospitals and privatising post acute hospital rehabilitation care.

The CCG told the media that these discussions were in the early stages, and that it was aimed at improving services, clearly "with immediate effect" refutes that. I believe the above is equivocal proof that this whole thing is about money, a cynical cost cutting exercise aimed at making our NHS un-workable and ripe for privatisation.

David Evans was present at the meeting, his pronouncements to the Friends of Ludlow Hospital that their hospital was safe are exposed as empty promises.

Marilyn Gaunt, Ludlow

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