Plans to close West Lothian’s two community hospitals and create a new purpose built centre in Livingston have been agreed.
The proposals will see Tippethill Hospital in Armadale and St Michael’s in Linlithgow, which has been shuttered for two years, close as community hospitals offering elderly care beds and dementia care.
These will now be concentrated around a single campus, including existing facilities at Maple Villa and a redesigned Craigmair care home site in Livingston.
Councillors who had voted to delay the decision accepted the proposed option to provide complex dementia care on one site through the co-location of Rosebery Ward with Maple Villa on the Craigshill Care Campus. It will also provide frail elderly community hospital provision on the same site as Maple Villa in the Craigmair building, a care home which will be converted.
The move comes as the Integration Joint Board (IJB) has to make savings of more than £13m in the next three years.
Councillors on the IJB, which oversees social care services provided by NHS Lothian and West Lothian Council, voted against approval of the proposals in June.
They were concerned that they did not have enough information on future provision to agree the closure of two community hospital facilities – fearing a growing elderly population would see a resurgence of demand.
Health officials produced statistics to show that changes based around a Home First care of the elderly model showed that hospital beds were needed on fewer occasions and that, in most cases, care of the elderly can be managed within the home setting.
The number of elderly people occupying community hospital beds had been dropping even before the onset of Covid-19, as fewer and fewer referrals were made.
Staffing problems caused by the pandemic had prompted the temporary closure of St Michael’s to concentrate beds and resources at Tippethill near Armadale.
Campaigners against the closure have argued that patients and families were discouraged or not told about the potential care beds at the hospitals and this generated the dropping numbers, but health professionals argue that the Home First care proposals were a more effective way of delivering cost effective community care.
Alison White Chief Officer said: “We have invested heavily and significantly in the Home First programme delivering that care and support in their own homes or in a homely setting and that increased capacity has seen a reduction in the number of people requiring hospital based care.”
In her report Mrs White said the preferred option was “all community hospital provision in West Lothian on a single campus in Livingston and the creation of more modern service than currently exists. This option would see dementia care for both male and female patients provided in Maple Villa and frail elderly provision offered on the same campus in the Craigmair Interim Care Facility building.”
A single site would reduce operating costs, be easier to staff, and provide other services within a short distance to St John’s Hospital. The report added the single site would provide the “ability to meet current demand and flexibility for longer term future bed expansion if required – 30 beds available in Craigmair compared with 24 currently provided at Baillie – improved accommodation and facilities for patients, families and carers, including ensuite showers in all rooms.”
The proposals were an opportunity to create: “a centre of excellence and enhanced care quality through a collaborative approach involving easier access to multi-disciplinary teams and expertise.”
The report added: “As well as delivering improved facilities, identified, financial savings would be achieved in full through this option – £750,000 for dementia care and £800,000 for frail elderly beds.”
Mrs White said that if no decision was taken savings of £1.5m would have to be found in other health care areas. The money is the equivalent to 35% of the district nursing budget or 27 whole time equivalent staff for West Lothian.
Mrs White said: “I must highlight that’s not a proposal we are putting to you but we are wanting to put into context what alternatives might look like.”
Capital costs for work at the Craigmair site have yet to be determined but the IJB would have no say in this element, which would be funded by the NHS Trust and West Lothian Council.
Mrs White pointed out that closure of Tippethill would make considerable savings for NHS Lothian in PFI payments. In backing the plan the IJB will allow capital costs to be explored.
By Stuart Sommerville, Local Democracy Reporter
The Local Democracy Reporting Service (LDRS) is a public service news agency. It is funded by the BBC, provided by the local news sector (in Edinburgh that is Reach plc (the publisher behind Edinburgh Live and The Daily Record) and used by many qualifying partners. Local Democracy Reporters cover news about top-tier local authorities and other public service organisations.
The Local Democracy Reporting Service (LDRS) is a public service news agency. It is funded by the BBC, provided by the local news sector (in Edinburgh that is Reach plc (the publisher behind Edinburgh Live and The Daily Record) and used by many qualifying partners. Local Democracy Reporters cover news about top-tier local authorities and other public service organisations.
