First-person article from Dr Joe Mays, GP at Newcombes Surgery and Executive GP for Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG):

MANY people will be aware that we have been looking at the development of a health and social care hub at Crediton Hospital. Local people may also be aware that, as an organisation, the CCG is reviewing the use of community hospital beds across the whole of Devon. I wanted to write something about how these two separate issues are related. What is a health hub? A health and social care hub is a physical space in which providers and organisers of health care, social care and voluntary services are co-located. The co-location of these services has a number of benefits, including: • ease of access for patients to a wider variety of services in one place • better joint working between people working within different disciplines who serve the same patient Could this exist at Crediton Hospital? The good news is that it already does. The services already based at the hospital include: • District Nursing • Community Domiciliary Therapy Teams i.e. physio, occupational therapy • Community Social Work Teams • Physiotherapy teams treating injuries and arthritis with gym facilities • Outpatient clinics for rheumatology and older peoples medicine • Voluntary sector older peoples services provided by Upstream • Older peoples community mental health services including consultant outpatient clinics • Dental Services How could hub services be expanded at Crediton Hospital? We are looking at the possibility of bringing more outpatient services, mental health services and voluntary sector services onto the site. We would also like to explore the option of private sector organisations renting space at the hospital, for example a dentist. We are open minded about other health, voluntary and social care providers using space on the site, so long as their services fit into the overall vision of how healthcare services will be provided locally in the future. At present there is some room for the expansion of hub services within the space available, but it is limited. How does this relate to the provision of inpatient services at the hospital? Inpatient services at the hospital face a challenge because it is difficult for small units such as Crediton Hospital to guarantee clinical safety, efficiency and the flexibility. It is also difficult for them to be resilient in the event of staff sickness or absence during periods of increased demand. It may be that the inpatient unit will have no option but to close, especially if a decision is made to transfer stroke services to a central site in Exeter. The development of hub services is largely separate from the inpatient services. However, if the inpatient services do close then a large amount of space will become available at the site, which could be used to facilitate further expansion of the hub. This would potentially allow other services to be developed, including day hospital services such as blood transfusion or infusion and other outpatient clinics. What next? We need to continue to work to develop the hub as much as we can, seeking interest from local health and social care providers. We will be reviewing the design of the building and planning what services could potentially be housed at the Hospital. We will be collecting local views about what people would like to be able to access at the Hospital. We will also be working with voluntary sector groups to assess what services they may be able to provide from the hospital, and what other requirements will need to be addressed in order to support this, for example, community transport services. We intend to develop the capacity and skills of our community nursing, therapy and care teams over the next 12 months. This will allow patients who currently require community bed based care to be looked after at home or in other care settings. We are also planning a series of drop-in sessions and public meetings in the Crediton area and surrounding villages, where local people will have the opportunity to be part of the discussions about the future development of local health services. Crediton Public Meeting Wednesday, October 1 – 6pm - 8pm Boniface Centre, Church Lane, Crediton EX17 2AH