St Michael’s Hospital in Linlithgow faces long term closure as a community hospital almost a year after being temporarily shut during the Covid pandemic.
A report to West Lothian’s Integrated Joint Board yesterday, which oversees council and NHS health care provision in the county, agreed to proposals for public consultation ahead of plans for a wider reconstruction of long-stay hospital care.
Greater emphasis is being placed on care in the home, and a move away from long stay geriatric wards such as at St Michael’s and Baillie ward at Tippethill Hospital for what is known as Hospital Based Complex Continuing Care (HBCCC).
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But Linlithgow's Labour councillor Tom Conn warned the IJB would struggle to win public support for the plan, suggesting local people see St Michael’s as their community hospital, and basic errors in the report to the IJB would encourage people in Linlithgow to think it “ill-informed.”
He cited the report’s assertion that the hospital was poorly served by public transport. There is a bus service, between Edinburgh and Stirling, which stops near the hospital.
Councillor Conn told the meeting: “ It may not be the most frequent and it may not serve the rest of the county but, from a local perspective there’s a bus there.
“If you can't get that right, the question will be are you getting the bigger picture right?”
He also pointed out that when the Secretary of State and the Health Board proposed closure of St Michael’s in 1990 there was a petition raised, based on the fact that the hospital served the local community.
“That’s part of the sentiment in the community,” he added.
Councillor Conn, newly appointed to the IJB, also suggested that the perception from the report was that the hospital was to be closed as part of a wider closure programme and added: “The question locally will be why are we losing this hospital. "
St Michael’s was first shut in August 2021, in response to acute staffing pressures created by the Covid-19 pandemic. The Chief Officer of the local HSCP exercised emergency powers to close St Michael’s Hospital temporarily and transfer patients to Baillie Ward in Tippethill Hospital in Whitburn.
At the time of the closure there was only one patient in the hospital from Linlithgow. The other beds were occupied by residents from around the county.
The report said the transfer ensured that patients could be cared for safely at a time when there were significant staffing pressures in the health and social care system and allowed staff from St Michael’s to be redeployed to assist in other healthcare settings.
St Michael’s had 18 beds available, Tippethill's Baillie Ward is the other community hospital in West Lothian, managed by Care UK, and offers 24 beds for frail people over 65.
A report to the IJB said: “At the time of closure, the occupancy levels across the two community hospitals (St Michael’s and Tippethill) were around 50 per cent, which had been the case for the previous six to 12 months. The falling occupancy levels occurred as a result of the introduction of new ways of working which focused on supporting people at home wherever possible. The reduced occupancy levels meant that there was capacity in the system to transfer patients, and some staff, to one site and redeploy other staff to assist with pressures in more critical local areas such as St John’s Hospital during the pandemic.”
There is a wider review ongoing into the future of long term hospital stays for the elderly. A new Home First policy promotes care provision in a residential setting whether the patient’s own home or in a care home.
The report added: “It is recognised that short term priorities, such as a decision on St Michael’s Hospital, cannot wait until a bed- based review is concluded. Similarly, the lease for the building on the Tippethill Hospital site is due to expire in 2025 making it critical that decisions are reached as quickly as possible about future use. It is also essential, however, that long term decisions are not rushed because of short term priorities or are made in isolation of the Home First programme.”
The IJB agreed three main recommendations: To acknowledge the Home First transformation programme and the ongoing work to determine bed based and community models of care; that St Michael’s Hospital remain closed, and approved consultation with the IJB’s Strategic Planning Group and community stakeholders including, service users, carers, and community groups, on the future requirement for beds in St Michael’s Hospital.
IJB Chair Bill McQueen told Alison White, Joint Director of West Lothian Health and Social Care Partnership (HSCP): “Tom’s right. Getting the history and context right will be vital in securing the outcome you want at the end of the consultation.”
Mrs White responded to councillor Conn’s concerns and said the report had wanted to give the IJB as full a picture as possible of the current context for the ongoing closure of St Michaels' , as well as its long term future.
She added: “ Local context is really helpful. At the point we are doing consultation around St Michael's we may need to give a bit of a broader context about how this fits into the overall strategic direction for the health and social care partnership but take on board we need to get our facts right about St Michael's and be much more specific about what this means for Linlithgow. That’s very helpful feedback as we move forward.”
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