I have now finally received the report from the Independent Reconfiguration Panel (IRP) following the referral of the decision to close Teignmouth Hospital to it by the Secretary of State. That followed a formal referral to the Secretary of State by Devon Health and Care Scrutiny Committee. The decision is not one I welcome. The panel has determined that the consultation was compliant with the rules the Clinical Commissioning Group (CCG) are required to follow, and that it was adequate to enable the decision to be made to close Teignmouth Hospital. I remain very concerned that this decision is not in the best interests of Teignmouth residents given the lack of evidence that, following Covid, our local health system will have the capacity it needs, and lack of any evidence as to the adequacy of home-based care which it is argued satisfactorily replaces it.
The IRP did however find the consultation was not of the standard it might have been, both as regards communication with the public and the openness and transparency of financial information. It has recommended a joint review be undertaken by Devon Health and Care Scrutiny Committee and the CCG to consider how any future consultation might be undertaken should any further change to service provision be proposed in the area. However, with regard to the future of health and care provision in the Teignmouth community the IRP has made a number of helpful recommendations to ensure the community is fully involved in the future of the Teignmouth Hospital site. For me that has to mean full consideration is given to options of including the site in some form in the ongoing provision of care in the Teignmouth community.
The key recommendations are:
- The NHS must engage the local community and interested parties, such as the local authority, in a programme to determine the future of the Teignmouth Community Hospital site. It is for Devon County Council Scrutiny Committee and NHS bodies to discuss how best to do this.
- A specific time-limited standing group of stakeholders, including patient representatives, transport providers, and planning authorities, should be established to scope out the work for a proper travel plan for residents to access the reconfigured services in Dawlish, Newton Abbot and the District General Hospitals in Exeter and Torbay.
- The NHS must continue to scenario plan and regularly review the impact on beds and workforce following Covid.
- Options should be explored to ensure mental health provision is included and properly provided for in the new model of care.
While there is one more avenue of appeal - a judicial review of the process undertaken by the IRP in the High Court - that is eye wateringly costly and without a good case to show that the IRP process was flawed, could not succeed.
My priority now must be not only to ensure the recommendations proposed are taken up but to hold the CCG to account for what it says it can and will deliver to the residents of Teignmouth and I will be asking Healthwatch and Devon County Council to undertake full scrutiny of the quality and adequacy of home-based care. It is simply not enough to rely on the level of readmission rates being acceptably low. That could be for all sorts of reasons and is not a valid proxy measure of the adequacy of health care provision. Our CCG is currently subject to the highest level of scrutiny by regional and national health bodies in the country and any evidence of shortcomings will be listened to – and acted upon.
Having been involved with this campaign since 2014, I commend the tireless determination of the local Teignmouth community, the League of Friends of Teignmouth Hospital and the many other groups who have lobbied hard in our fight to save the hospital and ensure the provision of excellent healthcare in Teignmouth and more widely in Teignbridge. I would also praise Devon County Council Health and Care Scrutiny Committee for calling this in to the Secretary of State and recognising the deficiencies in the process. I have little doubt but that they will work with the Teignmouth Community and the NHS to ensure these recommendations are implemented in full.
The full report from the IRP can be found here: Teignmouth_IRP_advice_letter.pdf (publishing.service.gov.uk)