Along with many residents I am appalled by the process of “consultation”. In effect the key decision, to close Prestatyn Community Hospital, has already been taken. It is hardly surprising therefore that there is a great deal of anger within Prestatyn and considerable anxiety in the rest of Denbighshire about how decisions are being made by the Local Health Board.
There is growing evidence to suggest that a sense of community and of “belonging “ is essential to peoples long term physical and mental health. A key element in fostering a communal sense of “well being” is to maintain continuity between modern services and what has been delivered in the past. The failure of the Local Health Board to understand this and its inability to propose an “option” which takes this into account is disturbing.
The four options as presented all have very considerable flaws. Not least is that three of them involve very substantial capital outlay and yet may still require some patients to use hospital services. I believe that the only cost effective and practical use of the available capital expenditure is to improve existing buildings rather than build on new, unidentified, sites.
Option one –Extra Care Housing requires a site to be found and housing to be built incurring substantial capital costs. The provision of services is similar to those provided currently in the hospital. I am baffled as how it will be cost effective to provide in house catering services in the sheltered housing when it has not proved possible in the hospital. Unless a site has already been identified this is not a “real” option. Residents could select this as their preference and then see it dismissed due to the lack of a suitable, affordable site.
Option two a Care Home raises similar problems. Has a site been identified? What are the capital costs involved? What happens if the home is built, becomes operational and then fails to meet the standards set out by Care Standards Inspectorate? The only advantage for the patient is that they will have a private room. Will the NHS funded beds be restricted for use by Prestatyn residents only or will they be available to other residents of Denbighshire?
I cannot believe that the fourth option is serious. There are no advantages to residents and nobody is going to support a proposal to provide the same level of service but in a distant, unspecified, location.
After extensive discussion with Health Care professionals in different parts of the UK I am convinced that there is a huge opportunity to provide high quality services, at sensible costs on the current site in Prestatyn. The only practical option open to the LHB is to develop the Primary Care Resource Centre on the existing site whilst maintaining the current hospital provision.
Experience of Primary Care Centres in other parts of the UK show that the range of services that can be provided is extensive (far greater than that indicated in Your Voice in Your Future.) With other services on site the costs of running the building overall will be reduced. As three of the four options involve substantial capital outlay I assume it will be possible to extend the existing building if need be. With a substantial increase in staff and possibly out patients using the building (depending on services provided), it should be possible to provide catering facilities on site.
The current rate of two hundred patients per year using the site could be increased by allowing residents from outside the area to use the facility, although Prestatyn residents would receive priority. I assume this would require an amendment to a GP’s contract, however given that the LHB has made provision for sending some patients to an NHS hospital elsewhere this might actually represent a saving in costs.
Here is an opportunity to do something very exciting for the community of Prestatyn providing a high quality Primary Care Centre whilst maintaining and even enhancing the existing service. This debate is taking place in many communities across the UK with Community Hospitals threatened by the current NHS orthodoxy which is driven by Governments in Cardiff and London who demonstrate little interest in communities such as Prestatyn.
The Local Health Board now needs to make a leap in imagination and look at ways of providing services that suit the needs of Prestatyn rather than simply follow the current orthodoxy in the NHS. This will require levels of leadership and courage that have been sadly lacking to date. However this proposal will generate substantial public support, and I urge you to combine the development of a Primary Care Centre with the existing services at Prestatyn Community Hospital.