£40m plan will give Arran 21st century health care
Memorial hospital will close in shake-up
A £40 million blueprint which will see the biggest changes in health care on Arran for 100 years has been given the go ahead.
A new super-hub will combine all the health and social care services on the island in one place. But it means the end for the much-loved Arran War Memorial Hospital, which opened in 1922, but is now considered not fit for purpose.
The plans have some way to go yet and it will be at least four years before they reach fruition. But the first real progress was made this week when the Arran integrated island services initial agreement was approved by the NHS Ayrshire and Arran board. The next stage is submission to the Scottish government for consideration for inclusion in its capital projects.
Central to the proposed development is a new ‘hub’ concept that would provide a central primary delivery point and include all health and social care beds on the island from a new hospital.
Also included would be GP surgeries, community nursing, social work and administration to enable all services of the North Ayrshire Health and Social Care Partnership to be served from one place.
It is expected this would be in Brodick or Lamlash, with the new Montrose House site a possibility. Early costs vary but it could cost anything up to £40 million plus but, subject to approvals, construction could start in June 2022 and be completed by June 2024/25.
As well as the closure of the memorial hospital, Brodick Health Centre, Lamlash Medical Centre and the Lochranza Surgery would all shut, but Shiskine and Whiting Bay surgeries would continue to provide local service delivery on an outreach basis.
The proposal would see Arran lead the way in Scotland, if not the whole of the UK, in terms of health care integration.
North Ayrshire Council leader Joe Cullinane said: ‘This is an exciting proposal which would deliver a truly integrated, 21st century model of health and social care service for Arran and its residents.
‘Having had numerous discussions with groups on the island in recent months I know there’s been a good level of engagement with the community and that’s demonstrated support for the model. I was therefore happy to support the proposal going to the next stage at the NHS board meeting.
‘The next step is gaining Scottish government support, particularly financial support, for the proposal and I am confident that it will see the benefits it will bring to the island and provide the investment needed to make it a reality.’
The review, drawn up Ruth Betley, senior manager Arran Services, states: ‘By providing flexible and multi-functional space, all partners would have the ability to work together, including staff and consultants from the mainland who visit the island regularly. Making maximum use of the estate resource and protecting future service model requirements will allow models of care to
evolve and develop in a facility that will serve the population and visitors to the island for many years to come.
‘It is envisaged that Scottish Ambulance Service will also be part of this hub, with the potential for staff to become integrated into the proposed model of care, to enhance the robustness and the sustainability of 24-hour care on the island.’
Talks have also taken place with the police and fire services.
The review continues: ‘By providing flexibility and innovation in health care delivery through integrated and multi-disciplinary teams, significant improvement in the delivery of Health and Social Care could be achieved.
‘The historical separation of hospital and care home places has placed especially severe pressure on the island’s ability to provide appropriate numbers of the required staff in both settings – particularly as these areas represent the balance of 24-hour care services on the island.
‘This is particularly challenging in the face of unpredictable, urgent, unscheduled care presentations and daunting in the face of a shrinking island workforce and growing demand.
‘The Arran review confirmed that “the time is right” and change is required now – the services, communities, and the Arran Economic Group, are all committed to change and an extensive consultation supports this view. The key estate facilities are ageing and not fit for the delivery of modern health care and the opportunities to build on recent investment are very real,’ reports the review, adding: ‘The challenge has never been greater, and the way forward must lie through integration of the delivery partners on and off the island to support the new model of care.
‘The Arran War Memorial Hospital has long since exceeded its lifespan and – based on national estates planning tools and guidance – requires complete replacement as soon as possible. The existing facility, whilst reasonably maintained for its age, has very poor clinical functionality – particularly in relation to the in-patient accommodation, outpatient functionality and urgent unscheduled care facilities.’
Stephen Brown, director of North Ayrshire Health and Social Care Partnership said: ‘The approval of the amended initial agreement by Ayrshire and Arran NHS Board is a positive step forward for Arran services. The initial agreement sets out our preferred way forward for island health and social care services and was subject to a series of island engagement events in 2018 and 2019.
‘The next step is the development of an outline business case and a full business case which will take more than 12 months to complete, and will be subject to further community engagement.
‘The plans will be submitted to the Scottish government for consideration and approval. Our aim is to make Arran an exemplar for integrated health and social care services, ensuring sustainable services for many years to come.
‘Our initial timescale for these plans has been impacted by the response to Covid-19 but throughout this time we have continued to progress and refine the proposals.
‘Our local management of the global Covid-19 pandemic has reinforced our commitment to integrate and create a single health and social care team and an island hub to deliver those services from.’