The Royal College of Nursing (RCN) is the world’s largest professional union of nurses, representing over 400,000 nurses, midwives, health visitors and nursing students, including over 24,000 members in Wales.
It has just made its official response to the Betsi Cadwaladr Health Board’s reconfiguration plan, "Healthcare in North Wales is Changing”, which in Llangollen has sparked a major backlash to plans to close the town’s Cottage Hospital and replace it with a new £5.5 million health centre, possibly on the site of the derelict River Lodge just down the road.
A copy of the response document has been sent to llanblogger by Keep Llangollen Health Services, the campaign group set up recently to ensure that services currently provided by the hospital continue to be available locally in the gap between it closing and the new facility being built, which it fears could run to a number of years.
In its response to the BCUHB proposals concerning Llangollen, the RCN says: “The general thrust of the document is in keeping with government policy to increase the volume of care delivered in the community by providing care at or closer to home and the plan indicates that the Health Board ‘will carry on looking at other services that can move from hospitals into local communities. We will need to release money from hospitals and other buildings to do this. We will monitor and discuss our progress with the Community Health Council.’
“There is however no indication that there has been a robust assessment of the financial impact of the overall proposed changes of shifting care into the community.
“The Health Board is operating under financial constraints and the proposed changes have cost implications.
“A number of the proposals in the Health Board pan are dependent on successful bids to the Welsh Government e.g. Llangollen Community Hospital (£5.5m), new NHS community hospital through redevelopment of the current Royal Alexandra Hospital site (£21m) Llandudno Hospital (£40m) and Flint primary care resource centre (£4m).
“In addition to the capital build costs the creation of new primary care resource centres and the development of enhanced care at home services will require education and training of staff for new roles in these new services and centres and this will require financial and human resources.”
The RC asks: “Have the proposed changes been costed?”
And it queries: “Is there evidence that the proposed community model is more cost effective (as well as clinically effective) than the current model?”
In a separate report, the Community Hospitals Association (CHA) has also criticised BCUHB's decision to close Llangollen Hospital.
And it says: “It is extremely disappointing that rather than addressing the development needs of the service in North Wales Betsi Cadwaladr Health Board has chosen to ignore the clear clinical preference and put forward a proposal to simply outsource all longer term neonatal intensive care to Arrowe Park Hospital on the Wirral.
The CHA claims that if implemented the changes set out by the health board “will have a devastating effect on healthcare services in North Wales”.
It adds: "The proposals reduce access to local health care services and reduce community capacity. The implications of this will be an increased reliance on specialist acute services, which is contrary to the policy of providing care close to where people live.”
Mabon ap Gwynfor, of Keep Llangollen Health Services, said: “The health board have argued all along that these changes are clinically led and supported by health practitioners.
"It is clear that that is not the case, and highly respected health organisations are severely critical of these proposed changes.
"The health board have also argued that these changes are needed in order to save money, but again it is clear that these changes will not save any money, and serious questions are being asked about the robustness of their financial plans.
“We want to see our health services improved, but the health board provided us with two options only: maintain the status quo or adopt the health board’s downgrading proposals.
"The Community Hospital Association sets out clearly that there is an alternative, and that is to invest in community health services and work with local communities.
“While the official consultation period is now over, the battle to save our health services is far from over. We are encouraging people to contact the Community Health Council reiterating their opposition to these proposed changes.
* The RCN's response also deals with the controversial subject of how neonatal care will be provided in North Wales in the future.
“The Royal College of Nursing is firmly opposed to this proposal which we do not believe is the option that will provide the best care.”
The RCN also criticises the system used by the health board to brief the public on the proposed changes at a series of local public meetings.
These meetings, says the union, were “fraught with unnecessary difficulty which has undoubtedly caused public and professional anxieties to increase.”
It adds: “Our members have informed us that the audience in each meeting was restricted to 30 people resulting in many people being refused entry.
“The number and frequency of meetings was not sufficient to balance this policy of small group meetings.”
· The Betsi Cadwaladr University Health Board does not reply to communications from llanblogger, so we are unable to gain a response to this story for readers.
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