A community hospital's only ward remains closed a year after a temporary shut down despite claims by a local GP that dying residents have missed out on extra care.
Campaigners continue to battle to reopen the Edington Hospital ward in North Berwick, East Lothian, more than 12 months after staff were moved to a central location to help with shortages blamed on the pandemic.
But despite reassurances the ward remains 'under review' and the closure is temporary NHS bosses have said they are no closer to reopening it.
And discussions are now underway to find alternative local provision for end of life care in the coastal area.
Staff at the Edington were temporarily transferred to East Lothian Community Hospital (ELCH), Haddington, 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 the only ward, which offered palliative care, and a minor injuries unit, were closed.
Campaigners held a series of protests against the decision amid fears that the ward would not return and the hospital would be closed by "the back door" after the decision to move staff was made by an NHS Gold Command set up during the pandemic.
Last March, six months after the ward closed, local GP Dr Claire Doldon warned people in need of end of life care were missing out on support without it.
She said three out of five people who died at home from cancer during those months would have benefited from its support.
And she said claims by health bosses that only two people were referred for palliative care to ELCH in the months after the Edington ward closure were misleading.
She said, at the time: "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."
In April last year hundreds of local residents took to the streets of North Berwick demanding the return of the ward staff and services at the hospital.
A number of reviews have been carried out by health bosses but nothing has changed.
Murray Duncanson, chair of the Friends of the Edington, said the campaign continues and there is frustration at the way the ward was closed without public consultation and remains shut.
He said: "The concern is that it was closed under emergency powers through Gold Command with no public consultation and now that the emergency powers have been lifted there is still no sign of the ward reopening.
"We do not want to see the Edington closed using a back door without any consultation with the local community and are continuing to call for it to be reinstated."
East Lothian MSP Paul McLennan has been involved in community forum meetings between campaigners , local residents and NHS bosses.
He said talks about the future of the service were continuing adding: "discussions about possible alternative local services are ongoing and any future decisions will be brought forward for public consultation."
It is understood a paper on possible alternative sites for additional end of life beds in the area will be brought forward by health bosses in the next few weeks.
Fiona Wilson, Chief Officer of East Lothian Health & Social Care Partnership, said: “At present, ongoing staffing pressures and system demands mean the in-patient beds at Edington Cottage Hospital remain relocated to East Lothian Community Hospital (ELCH).
“The location of the in-patient beds at Edington’s Hospital remains under constant review, however the provision of this service is intrinsically linked to the availability of sufficient staff to provide the care required.
"Regrettably, despite sustained efforts, there continues to be ongoing pressures being felt across ELHSCP, the NHS and the wider network with regards to the recruitment and provision of staff. We appreciate the community’s understanding at this time.”
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