Rancour at Knapdale Ward consultation
Health bosses were consulting this week on plans for the future of dementia services in Argyll and Bute.
These include the closure of Knapdale dementia unit in Mid Argyll Hospital as part of a move to dementia care in the community using specialist teams.
On Tuesday health bosses faced the public at a consultation meeting in Lochgilphead. The current plan would see people requiring intensive dementia care moved to the Greater Glasgow and Clyde NHS area.
Many people voiced concerns – not only about the community care model but about the way in which health bosses have developed the dementia care model with little consultation with staff, carers or families of dementia patients.
In the face of widespread opposition to its plans to close the region’s only specialist dementia unit, health bosses faced the public at a lively consultation meeting in Lochgilphead.
A final decision is due to be made on the future of dementia care in Argyll and Bute – including the proposed closure of Knapdale Ward within Mid Argyll Hospital – at the next meeting of the board governing the region’s health and social care services on Wednesday March 25.
The governing body, known as Argyll and Bute Integration Joint Board (IJB), will have in front of it that day a report based on the findings of the consultation.
A series of consultation meetings have been held across Argyll, with the Lochgilphead event held at the Baptist Church Hall on Tuesday March 10.
Senior staff from the region’s Health and Social Care Partnership (HSCP) gave a presentation on the plans for dementia care, followed by a question and answer session.
Four options have been considered by a dementia services review group commissioned by the HSCP, with the preferred option being to move to a community care model, with inpatient services provided ‘out of area’. Knapdale ward would be closed. Three community dementia teams would operate – one each in Mid Argyll, Kintyre and the Islands; Cowal and Bute; and Lorn and the Isles.
Speaking at the meeting, HSCP chief officer Joanna MacDonald said the planned changes were ‘not about saving money’, adding the money currently used to run Knapdale Ward would be diverted to enhanced community teams.
According to papers presented in January to the IJB, the ‘re-design’ would save an estimated £200,000 within Argyll and Bute – but if 10 patients per annum require inpatient care, the additional payment to NHS Greater Glasgow and Clyde would potentially be £196,000.
Options
Trade union UNISON, with the support of dementia patients’ relatives and NHS staff, has spearheaded calls for another of the options considered by the dementia services review group to be taken forward.
This alternative model – known as Option Four – would develop Knapdale ward to provide inpatient assessment/respite/day care/ outpatients/information hub and a community team base along with the development of enhanced community teams.
Option four would include the installation of dementia-friendly flooring; fitting out of a sensory room and resources to fund an improved activities programme; dementia appropriate toilet fittings; a proper sitting room with soft and period furnishings; more homely decor throughout; the filling of 3.5 RMN vacancies and the re-opening of the ward.
At the consultation meeting, a current Knapdale ward nurse said: ‘We take people in crisis dementia settings who might have violent tendencies or perhaps suffer from delusions. What is going to happen to these dementia patients? Care homes won’t look at them.’
Another member of the public, a former nurse, added: ‘You need support services for these community teams. You can’t have three teams working in isolation. Don’t throw the baby out with the bath water here.’
Amid the frustration being expressed by the public, Ardrishaig minister David Carruthers addressed the assembled senior HSCP managers: ‘You are talking here about engaging with the community,’ he said. ‘It’s a shame that did not happen before the recommendation went to the IJB in January.
Part of what people are objecting to is the way this has been handled. There is no real discussion.’
The HSCP’s head of service for older adults and community hospitals, Caroline Cherry, was a leading member of the dementia services review group. As the consultation meeting closed she remarked: ‘What I’m hearing here today is that we haven’t really sold this decision.’
David Carruthers made a final appeal, posing the question: ‘Does the IJB have to make a decision at its next meeting?
‘The evidence from this meeting is that the decision must be postponed.’