Facilities could shut
care home beds; and a community health services hub.
In 2022, the hospital faced water quality issues on-site, leading to the temporary transfer of all residents and Belhaven inpatients to the hospital in Haddington.
While care home residents returned to the site in January last year, the NHS in-patient beds at Belhaven continue to be accommodated within East Lothian Community Hospital (ward six).
Fiona Wilson, chief officer and joint director of East Lothian Health and Social Care Partnership (ELHSCP) – responsible for health and social care services in the county – described the financial pressures facing the IJB as “unprecedented”.
She said: “There are no easy solutions, but it is important that we act now to secure our current services and reduce the impact on people in years to come.
“We are fully aware every decision impacts on service provision and have ensured we have mitigated against the risks of these proposals.”
About £6 million of savings have already been identified, says ELHSCP, by applying tighter controls on spending and “exploring the most costeffective ways of providing services through improved internal processes”.
But it says “difficult decisions” have to be made on a series of proposals in order to set a balanced budget.
On Belhaven, the report reads: “Belhaven is facing challenges due to its outdated infrastructure, which does not fully meet care home and inpatient standards.
“The ongoing maintenance costs for the facility are increasing steadily and are anticipated to rise further.
“Additional occurrences related to security and fire hazards within the community garden are being reported, posing risks to both staff and residents on the premises, particularly during non-operating hours.
“This has escalated further in recent weeks following an unannounced Scottish Fire and Rescue Service inspection which highlighted significant evacuation risks in the event of an emergency.
“This resulted in the immediate transfer of Blossom House residents to East Lothian Community Hospital to ensure their safety.
“It is proposed that Belhaven’s care home and inpatient beds are closed on a permanent basis, due to the associated risk of fire hazards, security and lone working.
“As part of this proposal, the community health services operating from this site would be relocated.”
The Abbey could also close on a permanent basis.
The North Berwick care home has 30 care home beds – 28 single rooms and a double room. But only 16 of the rooms feature an en-suite toilet and hand basin, while there is only one shower and two baths within the home.
The report noted “inadequate provision of showering/bathing facilities for the number of residents and does not fully comply with infection protection and control protocols”.
The report goes on: “While significant work has been taken to maintain the building, The Abbey care home is no longer fit for the longerterm delivery of safe and effective care. Extensive work will be required to fully meet current and future care and safety standards.
“However, this level of refurbishment is not financially viable, especially as no capital funding is available.
“ELHSCP was in a similar position in December 2022, when the Care Inspectorate issued an enforcement notice to Eskgreen care home [in Musselburgh], citing significant concerns about the condition of the building and the refurbishment upgrades required. It is likely The Abbey care home may find itself in a similar position.
“ELHSCP’S priority remains safety and wellbeing of care home residents. A planned approach needs considered before building conditions deteriorate further.
“It is proposed that The Abbey care home is closed on a permanent basis due to the building’s infrastructure being unable to fully meet current and future care and safety standards.”
It has been said that “without agreement to these proposals, the IJB will be unable to move forward with a balanced budget, preventing the delivery of much-needed services”.
Mrs Wilson added: “We continue to prioritise the wellbeing of our patients and service users now and into the future. ELHSCP has undertaken numerous community engagement projects over the last few months and years specifically relating to the provision of older peoples’ services. This engagement has proven invaluable and has been carefully considered when preparing these savings proposals.
“As part of this process, it is important that we are transparent with our thinking.
“We want our staff and communities to be part of this very difficult process.
“We want to clearly express why these proposals are being considered, and the impact these proposals may have. Our focus is on providing high-quality and sustainable services.
“While these are incredibly difficult decisions, the proposals enable us to maintain the wider delivery of the best possible integrated health and social care services.
“This includes the ability to provide community-based services that ensure the provision of care closer to home and allow individuals to live independently in their local communities.
“This process will be about making the best decisions for the people of East Lothian in an extremely challenging financial climate.”
If the plans are approved, health chiefs say the Edington site will continue to offer community health services including CTACS (Community Treatment and Care Service), vaccinations, the MSK (musculoskeletal) service and North Berwick GP practice. Community health services operating from the Belhaven Hospital site would be relocated.