Health officials have backed the permanent closure of the Ronas Ward rehabilitation unit at the Gilbert Bain Hospital – but not without concern being voiced by one health board member.
It follows a decision in February to mothball the six-bed unit as it redeployed workers to address a staffing shortage within the hospital.
NHS Shetland members this morning agreed to push ahead with the permanent closure following the presentation of a report by director of nursing and acute services, Kathleen Carolan.
She highlighted interim measures implemented over a three month period to address the staffing problems.
Ms Carolan’s findings stated that moving staff to cover nursing vacancies had maintained safe staffing levels across the hospital and community settings.
It added the health authority had “successfully provided non-acute rehabilitation and reablement in the community as an alternative to the hospital based model.”
Addressing board members, she said: “I’d ask the board to support the decision to close the rehabilitation unit at the Gilbert Bain Hospital.”
Her proposal gained backing from the vast majority of members, who regarded the plans as an “evolution of the service” – as referred to by chief executive Ralph Roberts – as it moves to provide more community-based care. Her report says the move will save £475,000 a year.
But Tom Morton was less than convinced it represented a good idea.
“First, there is the degree of concern there is around the closure of Ronas Ward.
“I think we have to look at this boldly and honestly as driven by a need to save money and a need to enact, or a perceived need to enact, Scottish government policy.
“I personally don’t believe in an ideal world that Ronas Ward would have been closed.
“I do wonder whether this report takes account of medical viewpoints and whether you have sufficiently consulted with consultants because I don’t see any points there expressed from them.”
He challenged Ms Carolan to give “an assurance” there was not, what he called, “medical unease”.
“Yes,” was Ms Carolan’s immediate reply.
“Consultants have not said this model was not safe,” she added.
“Nobody has said to me they fundamentally oppose this as a change.”
Simon Bokor-Ingram said staff in community services “fully supported” the moves being proposed.
Mr Roberts was keen to discuss the issues raised by Mr Morton.
“Resources is an issue. I have no problem with that because it’s about us making the best use of the resources we’ve got. I don’t think we should shy away from that. I have no problem saying this is the right thing to do. You’re right to say this is a national policy. But it’s national policy for a good reason.”
Mr Roberts also focused on hospital occupancy rates, which he said had been at 60 per cent over the last two years. Prior to that, he said, it had been less than 50 per cent.
“I couldn’t sit here, as chief executive of NHS Shetland, and say we’re going to continue to run Gilbert Bain Hospital at less than 50 per cent occupancy.”
However, Mr Morton said it was not a fair comparison to list the Gilbert Bain alongside other “urban” hospitals.
Chairman Ian Kinniburgh, speaking via video-link from Orkney, considered a rather different picture from a few years ago when the hospital was full with no capacity in the community.
“People were living in the hospital and dying in the hospital.”
He added: “We’re continuing to keep people in hospital where it’s clinically appropriate to do that. It may not be the Ronas Ward setting, but we have capacity in the system.”
Members approved the proposal, however Mr Morton noted his “certain uneasiness”.
Speaking after the meeting, isles MP Alistair Carmichael said: “This is bound to be a decision that will cause a lot of concern to the affected families. Some wider consultation, rather than landing this out of the clear blue sky, would have been sensible.”