SHORTAGE of staff at Alton Community Hospital is to result in the closure of beds in order to maintain a good safe clinical quality of care. So critical has the staffing level become, that the decision has been taken to reduce the number of beds further, rather than continue to employ agency staff who are expensive and do not provide the continuity of care patients need and expect. Alton Community Hospital, which is run by North Hampshire Primary Care Trust (NHPCT), has the capacity for 48 beds, 12 of them GP funded, and the rest used by medical and nursing consultants. It is currently maintaining 36 of those beds and this number is likely to be reduced. At the same time, services will be reviewed in order to develop modern approaches to care. "The PCT is currently providing services in the two wards at the hospital across 36 beds," said Jane Duncan, director of nursing services for North Hampshire PCT. "We have relied on agency and other temporary staff for some time to keep all the beds within the hospital open. However, we do not believe this supports good clinical care due to lack of continuity of staff for the patients. It also presents an issue of patient safety, and decisions have therefore been made to reduce bed numbers and to consolidate permanent staff across these beds. "We do not believe it would be possible for our already hard-working permanent staff to maintain and safeguard clinical and quality standards at the hospital if we were to try and open more than 36 beds." Staffing levels have been an issue in Alton for some time. Last October the PCT ran a recruitment campaign to try and attract more health care assistants and the problem hasn't gone away. The national pay scale, the fact that the Alton area enjoys a high level of employment, and that service providers are all competing for a small pool of people makes it difficult to attract staff. Mrs Duncan confirmed that, as a result of staff shortages, the PCT would be working urgently with the hospital matron, ward sister and others to establish how they can provide an effective service at Alton using the permanent staffing structure available to them. But, she stressed, it had become clear that, while "absolutely crucial to future service delivery", the community services currently offered at the hospital were not necessarily of the right shape to meet current and future demand. "We know for example that patients at Alton Community Hospital have, in the past, had a very long length of stay in comparison to many other community hospitals. This doesn't make sense for either the patient, or the PCT, when we are under so much pressure to make sure that every penny of taxpayers money is spent wisely." According to Mrs Duncan, the average length of stay for patients in Alton Community Hospital is 53 days. "It could be for a number of reasons – they may be waiting for a nursing home placement or for things to be put in place so that they can return home," said the director of nursing services. She said she believes there is need for more research into community support packages which enable people – particularly the elderly – to retain their independence but afford extra support if they stay in their own homes. "I have yet to meet an elderly person who would prefer to be in hospital," said Mrs Duncan. "We have got to get the balance of resources right - do we need 48 beds at Alton Community Hospital or should we be putting some into the community." Mrs Duncan said that the PCT would be looking at ways of developing services at the hospital that would allow the more effective use of beds, give patients better assessment and quicker access to the most appropriate care, delivered as locally as possible.
