CCG bosses were also accused of not knowing how to measure the effectiveness of the shift of hospital services into the community in reducing A&E attendance and unplanned hospital bed days.
In a sometimes testy meeting of the Calderdale and Kirklees Joint Health Scrutiny Committee yesterday, Carol McKenna, chief officer of NHS Kirklees Clinical Commissioning Group, said £62m had been invested in community services across Kirklees and Calderdale over a three-year period.
That got short shrift from Calderdale councillor Colin Hutchinson (Lab, Skircoat), who sought specifics on where the money was being spent and how it impacted on additional hospital beds across the trust.
He said there was “no mention” of district nurses in the report despite their high workload during the pandemic.
He said: “I don’t understand why we’re able to produce accounts that specify how much has been spent on this service or that service and yet we’re unable to tell what benefit has occurred from that spending – why financial accounts are treated with such reverence and yet the human benefit from that spending remains obscure.”
He said figures quoted in the report were “extremely selective” and added: “I would have hoped to have seen a lot more detail.”
Ms Basford said the £63m paid for staff and helped mitigate the impact of demographic growth, reducing unplanned admissions in people aged over 90, and reducing length of stay in hospital, which she described as “really important”.
She added: “Being able to demonstrate that we are able to get people out of hospital at an optimum time is actually really important from a patient perspective.
“I would counsel against thinking about community services in the form of beds
“Increasingly it’s much more about delivering care in people’s own homes – not having community-based hospitals with beds in them.”
In two deputations to the committee Rosemary Hedges of campaign group 999 Call for the NHS said health bosses had “obfuscated” over modelling used to create a hospital capacity monitoring report.
She said CCGs in Calderdale and Greater Huddersfield had been guilty of “a cop-out” by not being able to present statistics that demonstrated a robust causal link between the increased and redesigned capacity in the community, and changes in secondary care demand.
She added: “The CCGs haven’t known how to measure the effectiveness of the shift of hospital services into the ‘community’ in reducing A&E attendance and unplanned hospital bed days.”
The meeting also heard senior health professionals outline how plans for Huddersfield Royal Infirmary (HRI) and Calderdale Royal Hospital (CRH) were expected to move forward.
The plans include a brand new A&E building and an essential works programme of upgrading wards and theatres at HRI and an extension of hospital buildings with an A&E, Paediatrics A&E, enhanced Intensive Care Unit and theatres at CRH, as well as a patient and staff car park.
Anna Basford from Calderdale and Huddersfield NHS Foundation Trust said a planning application for the new A&E department at HRI had been submitted in mid-June and that a business case for the project would be completed by November.
She said the trust was looking for a decision on the project “before the end of the calendar year” to enable building work to get underway by December 2021/January 2022. The new A&E is envisaged to open in 2023.
But there were concerns from the committee that the window to discuss the details was “very tight” and that the process was “too fast”.
Councillors complained that they were not being given sufficient data and that key information was missing from the report.
There were further concerns about the robustness of an engagement with local people living around the hospitals as only 309 people had responded: 167 from Huddersfield and 142 from Calderdale.
That was described as “quite limited” although the trust defended its “robust and detailed” engagement, saying the community was “broadly supportive” of its proposals.