Via http://www.hayletowncouncil.net/15May2014HTCMinutes.docx

Eileen Lewis, Treasurer of Friends of St Michael’s Hospital, asked to speak to the representatives of Royal Cornwall Hospitals Trust (RCHT) who were attending the meeting.  She said that she had heard news that St Michael’s might be closed and asked whether RCHT had thought differently or laterally how hospitals could work more efficiently together, for example with the Royal Cornwall Hospital at Treliske transferring its patients, who would otherwise have to stay at Treliske, despite specialist care no longer being required, to St Michael’s to be nursed back to health after the specialist treatment they required had been delivered.  Eileen Lewis also asked if RCHT had assessed the impact loss of jobs on the local community would have if St Michael’s closed.  Jo Gibbs, RCHT’s Chief Operating Officer answered that they were considering ideas for St Michael’s and its relationship with Treliske.  She said that funding for hospitals was agreed at the national level and that there was a definite squeeze on Cornwall, although the trust was now in a relatively good financial position.  She said that health and social care teams had to work together and added that she would cover the trust’s plans for St Michael’s Hospital in her presentation later in the meeting.

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6    GUEST SPEAKERS – LEZLI BOSWELL, CHIEF EXECUTIVE, AND HER COLLEAGUE ETHNA MCCARTHY, DIRECTOR OF STRATEGY AND BUSINESS PLANNING, ROYAL CORNWALL HOSPITALS TRUST, TO PROVIDE AN UPDATE ON THEIR PLANS FOR THE FUTURE FOR HOSPITALS IN WEST CORNWALL GENERALLY AND ST MICHAEL’S HOSPITAL IN PARTICULAR

The Mayor invited representatives of RCHT to give their presentation.

Jo Gibbs, Chief Operating Officer, introduced her colleagues Richard Schofield, Company Secretary, and Garth Weaver, Acting Director of Estates, and apologised for the absence of Lezli Boswell and Ethna McCarthy, who had had to attend an urgent meeting out of county that day.

She then gave her Presentation on St Michael’s & West Cornwall Hospitals (see Appendix B).

In presenting her report and in answer to questions from Council the following details were given:

• Only planned orthopaedic surgery takes place at St Michael’s and patients must be fit enough to go to St Michael’s.  There is a possibility that they might look at stepping down some younger, fitter orthopaedic trauma patients to Hayle, but these patients must not have infections or be at risk of falls or dementia as the hospital’s security is not suitable.  For these reasons, and the lack of a high dependency unit, complex anaesthesia and out of hours consultant care at St Michael’s, free beds cannot be offered there when there is bed pressure at Treliske.
  
  
• 99% of patients in Cornwall who need breast surgery come to St Michael’s.
  
  
• There is a lot competition, especially for orthopaedic surgery, from Duchy Hospital, which is able to provide free parking, single rooms, better food and is more centrally located for patients from the east of the county.
  
  
• It was claimed that one consultant prefers to work at Duchy and patients choosing that consultant must have their surgery at Duchy.   Jo Gibbs said that there were no data available on the proportion of consultants who do not want to work at St Michael’s, but that all surgeons who do hip, knee, foot and shoulder surgery do sessions at St Michael’s. Only complex revision and emergency surgery are not carried out there.  She added that all consultants are required to sign a job plan and declare any private work that they do.  If any consultants were compromising patient choice she would like to know so that it could be dealt with as it was not looked upon favourably.
  
  
• The NHS is more bound by waiting times (patients must be seen within 18 weeks) and Duchy is able to be more flexible.   It was explained that Duchy Hospital is able to provide a ‘hotel-like service’ as this is a relatively small proportion of the full cost of care and it does not have the considerable costs that RCHT has in providing a full range of care for local people and visitors (for example emergency and elderly care).
  
  
• In response to a question regarding the difficulty of travelling to Treliske for hospital appointments, Jo Gibbs answered that she accepted it was a challenge, but that there was no money allocated for transport costs for patients.
  
  
• The recent capital investment in upgrading facilities and proposed investment in single room provision are NOT precursors to a rumoured sale of St Michael’s to Duchy (Ramsay Healthcare), but exist because of the need to update outdated facilities (eg to digital x-ray) and the availability of single en-suite rooms will attract patients and result in improved infection control.   Jo Gibbs said that there had been no plans or discussions at Board level regarding the sale of any local hospital to Ramsay Healthcare (RH) and that RCHT had not been approached by RH regarding this issue.
  
  
• Jo Gibbs admitted that the £5m capital investment identified as being necessary for St Michael’s would only be spent if the business plan for the site proved it to be financially viable and she agreed that the Board had had conversations about closing hospitals (including St Michael’s) and units, but that there were no current plans for closures, although the hospitals would have to win back their market share from Duchy and other private healthcare providers to ensure that closures did not happen.  She and her colleagues were working to reduce waiting times; working with GPs to kill myths and to get them to encourage patients to choose St Michael’s; and working with staff in St Michael’s and with clinicians to get them to encourage more patients to choose St Michael’s.  She also admitted that there were no plans to invest in St Michael’s to enable the removal of the restrictions on taking certain types of patient.
  
  
• It was reported that RCHT’s debt to the national NHS now stood at £20m.  It was added that they were now in final negotiations to agree re-profiling the loan to maximise the term and minimise the percentage interest.
  
  
• Ms Gibbs said that she took her responsibilities very seriously and in response to the question how Councillors and the people of Hayle could help St Michael’s win back its market share, she replied that there was nothing better than personal recommendation and asked everyone to recommend St Michael’s and to ask GPs and practice managers to contact RCHT for information regarding what was on offer to patients.  Councillors and members of the public provided anecdotal evidence of not being encouraged to or even being informed that they could choose their local hospital for treatment/follow up treatment.  Jo Gibbs said that she was surprised at the high number of incidents recalled and that she would deal with this issue.  She also agreed that it was important that GPs were aware of what could not be done at a patient’s local hospital so that time was not wasted trying for the impossible.
  
  
• Jo Gibbs was informed that she needed to take action now to make best and full use of Hayle’s excellent hospital, which has received top reviews from the Care Quality Commission and patients.  Councillors were in agreement that if RCHT decided to close St Michael’s it could be expected that 20,000 people would take to the streets again in protest. 
  

The Mayor thanked Jo Gibbs and her colleagues for attending the meeting and giving the presentation.