Winter fear raised over hospital bed closure plan

Up to two wards are set to permanently close at a hospital as part of plans to provide more care closer to patients' homes.

The 48 beds in Royal Lancaster Infirmary's Castle View unit will be phased out, but only when NHS leaders are satisfied alternative community services can safely meet demand.

Health chiefs said no beds would close until out-of-hospital care and patient discharge arrangements had the capacity to cope.

But some councillors raised concerns about reducing bed numbers during the winter period, when hospitals often face their greatest pressures.

While no firm timetable has been agreed, Lancashire County Council's health and adult services scrutiny committee heard the aim was to decommission one of the two 24-bed wards by the end of the year.

The committee voted that the proposal did not amount to a "substantial variation" in services, meaning the NHS will not be required to carry out a formal public consultation.

NHS leaders said they would continue with what they described as "more meaningful" engagement with patients, staff and local communities.

Castle View's wards provide rehabilitation and therapy for patients, helping them regain independence and return home after illness or injury.

A recent review found most patients on the wards did not meet the criteria for requiring a hospital bed. Similar findings showed about a quarter of patients across the Royal Lancaster were occupying beds despite no longer needing acute hospital care.

The committee heard the changes reflected a wider NHS drive to provide care closer to home.

Andy Curran, co-medical director of the Lancashire and South Cumbria Integrated Care Board, said: "What we are not doing is closing beds and kicking patients out – that would be entirely inappropriate.

"It's putting in place an alternative to inpatient care to enable those beds to close, not the other way round."

He said services such as rapid community response teams and virtual wards were already helping more people receive treatment and support at home.

But committee member, Margaret France, a retired GP and Chorley councillor, questioned whether reducing bed numbers during winter was the right move.

"I think this will sit very badly with the public when you're talking about closing 24 beds towards the end of this year," she said.

"It seems to me that it would make more sense to have those as a resource for A&E departments, which are absolutely strapped at this time of year."

She suggested moving services into the community could be successful, but argued a more gradual approach may be needed.

Anna Telfer, chief nursing officer at University Hospitals of Morecambe Bay NHS Foundation Trust, said patient safety would be the key factor in determining when any closures took place.

"Patient safety, quality of care and access remain our priorities," she told councillors.

Telfer said plans were already under way to create nine additional bed spaces in the emergency department, while efforts to reduce hospital stays would also help tackle so-called corridor care.

The committee heard that £7m had recently been invested in enhanced GP services across North Lancashire, increasing the total budget for the programme to about £10m.

Committee chairman Graham Dalton also sought assurances that the plan would not simply transfer pressures from the NHS to Lancashire County Council's adult social care services.

Despite concerns from some members, a majority of county councillors on the scrutiny committee backed the proposals.

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