By Graham Smith
Cornwall’s health chiefs are planning to close and sell more than a dozen health visitor bases, moving staff into council offices. The strategy is to cut down on home-visits, and to make patients travel further, by prior appointment, to clinics.
A confidential “Questions and Answer” document, detailing the Cornwall Partnership NHS Foundation Trust plan, has been passed to Cornwall Reports.
The document is intended to brief managers about the lines to take when communicating with health visitors and school nurses. It explicitly tells NHS managers that the proposal in relation to the CPFT estate is secret, and “is happening behind the scenes.”
The paper runs directly counter to the claim often repeated by NHS bosses that “no decisions have been made” and that their approach to cost-cutting is transparent, and will involve public consultation.
The CPFT chief executive, Phil Confue, even took to BBC Radio Cornwall on Wednesday to deny that Cornwall’s Minor Injury Units were under threat of closure – flatly contradicting the chief executive of the NHS Kernow Clinical Commissioning Group, Jackie Pendleton, who has spoken of the NHS’s “commitment” to close them.
Pressure to rationalise the NHS estate stems from last year’s government-commissioned Naylor Report. More than a dozen of Cornwall’s “drop in” clinics are now at risk.
The CPFT documents make it clear that plans to dispose of health visitor bases are at an advanced stage, and have been under discussion for several months. “The Family Health Plus Teams are likely to move into council offices, to promote joint working with the council,” says one answer. The “FH+” nursing teams specialise in dealing with patients with more challenging or complex needs.
More than 100 health visitors across the whole of Cornwall, who often work with children and other vulnerable groups, are likely to be affected. There is no suggestion in any of the documents that patients will ever be consulted. “We need to bring clients into clinics,” says another answer.
“There is an Estates Strategy to try and free up clinical delivery space. There are currently unused CFT buildings. This is happening behind the scenes.”
The document says the nursing teams are passionate about their work, but must expect to offer a reduced service in future. “It isn’t possible to do everything,” it says, “resulting in difficult decisions going forward. Need to reduce commissioned services to meet delivery ability….need to reduce areas of duplication. Continue to work with the council within a limited budget to achieve contract changes.”
Next week Cornwall Council’s cabinet is due to endorse County Hall’s ambition to further develop its role in providing community health services.
One of the options, favoured by officials, is to set up a new “arm’s length” company which would take over many of the services currently provided by CPFT, whose contract with the council is due to expire next year.
Cornwall Reports asked CPFT for a statement which addressed the “behind the scenes” rationalisation of its estate and to justify previous claims of transparency and public consultation. CPFT did respond with a statement, but it made no comment about the “behind the scenes” aspect of the Estates Strategy.
The statement, in full, says: “The vision of the Cornwall Partnership NHS Foundation Trust is to deliver high quality care; our aim is to ensure that, individuals receive the right care, at the right time, from the right person with the right skills.
“The property portfolio of the Trust is therefore required to align and support the workforce to achieve these aspirations. To do this it needs to be safe and suitable and in the right location.
“To ensure that financial resources are directed wherever possible into front line care to support the overall vision, aims and values of the Trust the operating cost of properties and building support services are required to offer best value, business resilience and sustainability.
“Therefore the strategic aims are that the Trust will provide estates, facilities and services that are; safe and suitable and in the right location for services and users to enable the Trust to offer best value, business resilience and sustainability.
“There are a number of examples where Cornwall Foundation Trust staff have co-located with Cornwall Council staff at a number of locations. These are not for clinical use but office space for teams; our patients continue to receive their care in the appropriate facilities.”
The Estates Strategy is not discussed in public and neither staff nor patients know what is happening