NHS Board hears why shutting down first rate service for cancer patients is a good thing.

On April 26th, I sat through a couple of the longest hours of my life, and heard the words "quality" and "going forward" droned more times than I would have thought possible.  Yes, I went to the first part of the NHS Nottingham Board Meeting (open to the public).

Even though I couldn't spot it on the agenda, Hayward House was discussed quite early in the meeting - "in view of the media attention it had been receiving".  So we've achieved something!  Dawn Smith, Director of Delivery and Performance, delivered a fine performance.  She explained to the Board (who did not seem to know very much about it) that it was not a closure, but a "transfer" of services.

Dawn Smith explained to the Board that Hayward House patients were not going to lose their service; it was just going to be transferred "into the community" and "specialist services will continue to be available to all
patients".  She was concerned about maintaining a "drop-in".  (What drop-in??)  The new centres in the community (she mentioned Notts Hospice on Woodborogh Rd, and Treetops, which is nearly in Derbyshire) would provide complementary therapies, nursing support and some medical support.  Existing patients could continue to receive specialist care at Hayward House, but daycare will be provided elsewhere.  This is not about decreasing investment, but changes are driven by the need to extend the range of specialist services to a wider group of patients.

The Board swallowed this wholesale.

This is not a "transfer", it is a cut made by outsourcing.  Patients will not receive the same service:

* There is nowhere else within reach that can supply the same services that Hayward House daycare now does.  At Hayward House, patients receive a total care package – their physical, personal, emotional and social needs are treated.  But mainly, there is an expert team of highly experienced palliative care doctors and nurses to treat daycare patients on the spot.  This will not be available in any other centre.  People will be in pain for longer as they have to make travelling arrangements to get help elsewhere.  "Medical support" at Notts Hospice is not equivalent to the expert palliative care team who are currently looking after patients.

* Hayward House is in the grounds of the City Hospital, which means that it’s easy for daycare patients to attend appointments in other departments.  Again, this will be lost if daycare takes place elsewhere.

* Daycare patients are very sick and often frail.  They need all their services in one place.  They do not have the energy to travel about to separate appointments.  If they lose Hayward House Daycare, they will have to drag themselves from one location to another.

*  Inpatients also benefit from Daycare being in the same building, as they can use these resources too when they are well enough to get out of bed.  Moving Daycare will be a loss to inpatients too.

* As Hayward House has units for both daycare and inpatients, people needing hospital admission – perhaps for a few days, or perhaps as their lives end – can be admitted into a familiar environment.  This is a great help at a tremendously difficult time.  Of course, this will be lost if daycare takes place elsewhere.

* The deep distress and the adverse effect on their health caused by the announcement to close on current patients has not been considered.  The PCT don't seem to grasp that human suffering is being caused to those near the end of their lives.

I would not doubt that more wards are needed for patients with other terminal illnesses, (which is what Dawn Smith claims the space is needed for).  The Hayward House model works so well for cancer patients; instead of destroying it, why not create more sanctuaries on the same lines in new buildings or closed-down wards?

Perhaps it is time that individual directors and Patient Representative Dennis Bancroft (no voting rights) received plenty of individual letters pointing out that it is a cut not a transfer, that the new daycare services won't be equivalent in the most fundamental way to what Hayward House currently provides, and that patients' health, emotional well-being and lives will be put at risk.  Board members' names and the PCT address (Standard Court, Park Row) can all be downloaded from the Save Hayward House Daycare website.

(One other comment from a different part of the meeting that I recorded is:"The voluntary sector is a very cost-effective method of delivering services."  Is there any connection, we wonder?)