Under-funding, staffing issues and growing demand on service could potentially lead to a crisis in the island’s community health services.
That’s the conclusion of the latest annual report by the Health Services Consultative Committee.
The HSCC was established in 2004, under the National Health Service Act 2001, with the remit to provide independent scrutiny of the island’s health services.
It reports, which outlines the work of the committee between April 1 2015 and March 31 2016, includes reports on 12 key areas – such as quality improvement and patient voice – as well as a list of 17 recommendations.
The report says: ‘Community Health Services have been subjected to numerous challenges and constraints, whether financial, staffing issues or the seismic shift in the nature of healthcare. This coupled with the increase in volume in complex cases, general underfunding of the area and increased demand on services could potentially lead to crisis and run contrary to the current DHSC strategy.’
Chairman Sue Gowing said the committee welcomed a new stability which is permeating the department since a new management structure was brought in and it is clear that ‘real progress is starting to be made’.
But despite the new five year plan, new strategy for mental health and new emphasis on integrated care there is ‘little evidence that a genuine two way conversation between the department and its staff, the public and patients.’
Pursuing value for money is laudable, but it is unlikely to resolve the issue that our current model of health is unsustainable in the longer term, the report notes.
One HSCC member reported that it is ‘questionable’ as to whether the move to an integrated care hub strategy is happening in a consistent and timely manner. ‘Service transfer between areas appears haphazard, inadequately funded with roles and accountability “blurred”,’ she said.
She noted that the MEDS service was reaching a ‘crisis point, becoming increasingly difficult to staff, particularly overnight and weekends, proving a costly service’.
Recruitment and retention issues remain issues and there is too much focus on operational issues to the detriment of strategic thinking, the report notes.
‘A pervading feeling remains that necessary fundamental changes are still stuck in the pipeline, with consequences of continued low morale, disenfranchised, poorly motivated staff and high staff absence,’ it adds.
The HSCC lists no fewer than 17 recommendations.
This includes a call for the department to decide what community health services can be prioritised and afforded and this must be articulated to the public. The notion of ‘spend to save’ needs to be qualified with a full explanation of what it is designed to achieve. ‘The prioritisation of services and associated funding has to be clearly mapped out,’ the report says.
Solutions need to be found for patient flow, bed management and delayed discharges at Noble’s Hospital, it says. This should include reviewing the provision of nursing homes.
Health and Social Care Minister Howard Quayle MHK said: ‘The annual report recognises that the “green shoots” of real change are emerging, but that challenges remain in a number of areas.’