Recommendation to invest in community beds and alternatives to keep people well across south Warwickshire

South Warwickshire University NHS Foundation Trust (SWFT) has undertaken a review of community inpatient facilities within the south Warwickshire area. This has included the bedded ward at Ellen Badger Hospital in Shipston on Stour and the ward at Stratford Hospital.

The purpose of this review is to ensure the services we are providing best enable ‘All elderly or frail patients to be supported home to continue their recovery following an admission to acute hospital’.

This vision is in line with the Government’s national health and social care Home First approach, which states that people should be able to live independently and well in their own home, with appropriate adaptations equipment and technology to enable them to do so.

It is expected that there will be a 15-20% projected increase in the number of people over 70 in Warwick and Stratford districts in 2025. Therefore, if services continue to be delivered in the same way, then demand will outstrip supply. Alternative approaches to providing appropriate care and support need to be considered to ensure sustainable services are available.

The review has considered lots of elements including feedback from the public, clinicians, and professional partners. This has then been combined with key data on patient safety, accessibility, and workforce considerations.

Findings show that a significant number of patients using community hospital inpatient beds could have been supported via an alternative community-based pathway, but there is also a recognition that these beds do offer vital rehabilitation support predominately for frail, elderly patients.

With input from senior clinical and operational teams, the review considers several options for the future of community beds in the area and identifies a preferred option from South Warwickshire University NHS Foundation Trust. This recommendation would:

• Increase the number of Community Hospital beds (from 35 to 41 beds – this will provide more beds than what is currently needed so will support future needs for south Warwickshire) and change the location of delivery to Stratford Hospital and Leamington Spa Hospital
• Invest in community alternatives

These recommendations would mean permanently relocating the community hospital beds from Ellen Badger Hospital to Leamington Spa Hospital, retaining the community hospital beds at the Nicol Unit at Stratford Hospital and developing community alternatives to help support patients in the best place to improve their outcomes.

It is proven that recovery and rehabilitation can be enhanced within an individuals’ home environment, so investing in community alternatives will offer significant long-term benefits.

The community alternatives may include:

• Home Based Therapy which supports patients in their home after a stay in a main hospital.
• Home-based overnight care to support patients with delirium and/or cognitive impairment.
• Increasing capacity within the Community Response Team, which provides urgent support, seven days a week with the aim of preventing unnecessary hospital admissions.
• We will also be working with hospices with the aim of improving the pathways to support patients at the end of life to die at home with the support of hospice at home services or within a hospice.

Relocating from Ellen Badger Hospital to Leamington Spa Hospital means that the ward is co-located with other inpatient services. This provides a range of benefits for people across south Warwickshire including clinical cover, access to dedicated therapy areas which help promote rehabilitation and recovery and independence.

Post code analysis of previous patients has highlighted that many patients were having to travel significant distances for the inpatient facilities in Shipston on Stour and Stratford. With both units located in the Stratford upon Avon district of south Warwickshire, there were inequities for our populations located centrally and further north of the county. Leamington Spa Hospital is centrally located and closer to a much higher proportion of the users of community hospital inpatient services.

These recommendations have been put forward in line with NHS strategic direction and driven by the best clinical outcomes for patients.

Following SWFT’s internal governance process, the review will next be considered by the Board of NHS Coventry and Warwickshire Integrated Care Board (the organisation with responsibility for planning and paying for NHS services in the local area) at their next meeting in July.

Work to develop the Ellen Badger Hospital site continues and you can read more about that project here: https://www.swft.nhs.uk/our-hospitals/ellen-badger-hospital

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