A GP has said three out of five people who died at home from cancer since the closure of an East Lothian community hospital ward would have benefited from its support.
Dr Claire Doldon, GP partner at North Berwick Group Practice, said the closure of the Edington Hospital's ward had left people without the extra support it offered as they came to the end of their life.
And she said claims by health bosses that only two people from the town had been referred for palliative care to East Lothian Community Hospital (ELCH), in Haddington, since the Edington closed were misleading as people were reluctant to travel to the alternative facility.
She said: "East Lothian Health and Social Care Partnership reported at our meeting in January that only two patients had been referred for end-of-life care at the ELCH.
"This figure gives a false picture of the state of palliative care locally; as a practice we have 20 active patients on our palliative care register all being managed at home.
"We are experiencing a reluctance from patients and families to be admitted to the ELCH, whereas many of these families would have requested or accepted care in the Edington in the past.
"Since the closure we have had eight cancer-related deaths, five of which took place at home and, of those, three were prolonged and difficult and would have been better managed with the back-up of the Edington."
Staff at the Edington were temporarily transferred to the Haddington hospital last September in a bid to tackle shortages caused by sick leave and absences in the county.
Health bosses have insisted the hospital itself is not closed with non-emergency services still being offered however Dr Doldon said the minor injuries unit previously based there was a 24/7 service, which has also gone.
She said: "Since its closure there has been no emergency service at the Edington Hospital.
"There has been a sign on the door of the hospital since September that states ‘no A&E or Minor Injuries’, the Monday to Friday daytime CTAC service, which is now run from there, is only for prescheduled non emergency nurse appointments.
“In addition, the purely numerical assessment of in patient bed requirements belies the true state of patient care locally and does not give a clear picture of the importance of the Edington Hospital to our community."
Health chiefs said that a review by NHS Lothian's Gold Command last Thursday had ruled staff shortages and high demand for healthcare services across East Lothian meant it was not yet possible to reopen inpatient beds at Edington Hospital.
Alison MacDonald, Chief Officer of ELHSCP said the staffing challenge has not diminished.
Responding to Dr Doldon's comments about end of life patients who could have been supported by the Edington, Mrs MacDonald said: "We continue to work closely with our colleagues on this matter and the chief nurse is reviewing any areas of concern that are raised."
She said: "We strive to provide the highest quality palliative care in East Lothian, both in hospital settings and in the community.
"Many people prefer to stay at home which we will always try to support and accommodate, working closely with the patient and their family.”
Health bosses said staff shortages in East Lothian meant grouping staff at the Haddington hospital had kept more beds open.
Mrs MacDonald said nearly half of registered nursing staff in East Lothian had left their posts since September to work in other roles in the NHS and there are currently 27 vacancies to fill.
She added: “Transferring the staff means we can keep more beds open overall and look after more people while preserving safe staffing levels.
"We have been able to open 16 beds at the East Lothian Community Hospital in Haddington, a net increase of 10 beds. We can only do that by having more staff in one place. It allows greater flexibility in how staff are deployed day to day.”
Murray Duncanson, chair of the Friends of the Edington, which has been campaiging for the reopening of the ward, said it is disappointing the decision to keep it closed was being made on bed supply and staffing rather than the impact on the local community.
He said: "The Edington was fully staffed when it was forced closed; questions need to be asked as to why they are failing to recruit and retain vital nursing staff and relying on the nursing bank and clinical support staff to keep wards open at ELCH.
"If they reopened the Edington tomorrow, the nurses would be back in a heartbeat."
“The Edington closure was a category one response to pressures brought about by the pandemic and we have asked for clarification that they’re basing their assessment on pre-pandemic median values.
"We have also asked for, and have yet to receive, clarification on how the criteria apply in real terms to the reopening of the Edington so that we have a better understanding of what needs to happen to get us to that end point.
"What we don’t want, and are seeking a guarantee on, is for the goalposts to now shift because the NHS faces a huge backlog of patients awaiting treatment.”
