This news article is from The Shipston Medical Centre issued 31st January 2025 and appeared in their patient newsletter. The direct link is here

Statement in response to the South Warwickshire Community Hospital Rehabilitation Bed consultation

The partners at Shipston Medical Centre are mindful of the ongoing South Warwickshire community beds review and are aware of the strength of feeling locally as well as pressure on the wider NHS to provide an equitable service that delivers value for money. 

Successive governments have recognised in principle the value of a more integrated NHS based in the community and in that spirit we feel that the outcome of the review should reflect what is truly needed for patients in the area regardless of which NHS body provides the funding. 

Any assessment of community beds should consider the needs of the local population as well as current provision which is considerably higher than the 35 beds stated in the consultation and has been for many years; failure to recognise this reality would distort any cost/benefit analysis of the options provided. Given the inequality of access to care that rural populations face we are in favour of local service provision to support the needs of our community, especially given the relative size of our elderly population and the paucity of transport links in the area. 

We support the inclusion of local beds if used wisely and in ways that could help reduce acute admissions to secondary care and keep vulnerable patients closer to home and their support networks. For example by taking admissions from the community for acute illnesses that can’t be managed at home but don’t require secondary care, stepdown care from secondary care for rehabilitation and palliative care when required. This way, patients could be cared for by local GPs who have an intimate knowledge of their patient’s needs and personal circumstances potentially enabling a quicker rehabilitation and discharge. 

However, the subject of community beds and their location is a complex one and should not be considered in isolation from the wider health landscape. Economic, social and medical factors are often interwoven and all merit consideration in order to provide high quality, efficient and effective care to patients. It would be crucial for any beds to be supported by other local services including district nursing, rehabilitation and social support in an integrated manner to enable efficient transfer of care back to the patient’s home as well as avoidance of admissions whenever safe and practical. 

It is widely recognised that many of the major determinants of health such as physical and social isolation, access to transport services, poor housing and lower than average earnings impact disproportionally on rural communities. Although general mental illness may well have a lower prevalence in rural populations as compared to those in urban areas, with an ageing population the number of people with dementia in rural areas is increasing. These challenges are exacerbated for those living in rural areas when it comes to geographical access to services; Shipston-on-Stour is no exception to this and the distance from regional healthcare centres poses a challenge to those delivering as well as accessing services. 

The key priority for our community is to address this ‘rural inequality of care’ and the new Ellen Badger site has an opportunity to try to achieve this. This should also include a wide range of other services to help address the challenges discussed above – these might include consultant out-patient clinics, physiotherapy, outpatient midwifery, hearing services and medical devices to name a few which would very much be welcomed. Many such services may well be able to integrate with local primary care; one example could be a frailty unit utilising the expertise of specialist consultant on an outpatient basis and integrating with the frailty team at Shipston Medical Centre, helping our most vulnerable and complex patients to avoid unnecessary admissions. Bringing services together in one place in a local setting not only reduces inequality of access but would offer the kind of joined-up, effective community care that we should strive to provide.