The Integrated Care Organisation within Torbay is being extended to provide "Integrated" Care to the rest of the area covered by the CCG.
They have one imperative, which is to make millions of pounds of cuts to the money being spent so that they don't go over budget.(which they will do)
Integrated Care is a means by which patients; instead of being admitted to a hospital bed, are looked after in their own home by a multidisciplinary team. The ambition of the ICO is that they can reduce admissions and therefore be able to cut costs by cutting the number of hospital beds. Their website shows this. Evidence elsewhere though has failed to show any cost savings at all.
They have had a "consultation exercise" across our South Devon area with the purpose of shutting the community hospital beds; which they will do.
They haven't yet got a structure to replace them with community care. Negotiations so far with GPs to provide the medical cover for these patients have failed as the GPs bidding to provide the doctors recon it will cost a whole lot more than the ICO do. TUPE seems to be in the way as well - as there are already GPs with contracts to provide medical cover to the community hospitals, they either need to be made redundant now or paid off by whichever organisation takes over the provision.
One of these GPs is the wife of the medical director of the ICO. I notice she hasn't resigned her position altruistically.
Our "Moor to Sea" part of the CCG (in blue on the map) covers an area from Moretonhampstead down to the coast.
They must know this though:
Just imagine being an Occupational Therapist tucked in a valley on the moor seeing a patient, then having to visit the next one in, lets say, East Prawle or East Portlemouth. Our geography makes covering that area incredibly difficult. (An hour and a half travel from one end of the CCG patch to the other! In that time you could get from the CCG headquarters in Torbay all the way to Wales!)
The ICO intends forming ICO "Hubs" based in Totnes and Ashburton from which the workers will emanate.
There is no money to make the buildings in Ashburton suitable to be kept as a hospital, but there is apparently money to transform them into a "hub".
After a morning multi-disciplinary team meeting each day Physios and OTs will jaunt round the countryside making care recommendations for these frail, ill old people stuck in their own beds. I'm presuming part of the plan is that "carers" will come in to support these people too. The local care companies struggle to provide even a basic quality of care and really struggle to recruit and retain care staff. Mears Care in Torbay recently got a wholly inadequate rating from the CQC. Another one of the care companies with a contract to provide care in Ivybridge handed its contract back a couple of years ago due to the difficulty of finding carers to do the work.
I'm concerned too about the relationship between the CCG and the ICO.
As I understand it the CCG gets the money to provide health care in Torbay and South Devon. Their 2015-16 accounts show an expenditure of £400 million. As the CCG effectively "merges" or partners with the ICO then who is offering the scrutiny of what is going on? It seems they hand over the money to the Hospital with little guidance on what it should be spent on, or scrutiny of how it is indeed spent.
At the moment everyone seems to be swept along with this unworkable plan to upset all the local populations by shutting their beloved community hospital beds.
To save how much exactly?
How much they predict to save and how much in the end might actually be saved appear to me to be likely to be very different. I think with the combination of our geography and the limited saving to be made, combined with a procession of ICO managers all wearing their Emperors new clothes that it is about time a small boy pointed at the naked procession and laughed in their faces.
In my view they should tear up their plans entirely, keep the community hospital beds open and start again working, from the start, WITH general practice.
It is so odd that they have made all these plans so far over the last couple of years and at the point in time they want to implement them only then speak to GPs about the medical provision. Daft.
