November 2003

Editorial - November 2003

It is good to be able to report some further positive developments.

The various initiatives described in this issue are all of interest. The Health Park seems to be developing well. It is much used by the local population. Eyebrows may be raised at the significant component of complementary therapies. The absence of an evidence base for these therapies has been overwhelmed by the, perhaps surprising, public demand for services such as aromatherapy and acupuncture.

The projects to free-up hospital beds is clearly of much potential economic importance. However, it is less clear what patients really think of this service. Have they been asked? The various developments have occurred in close collaboration between the Primary Care Trust and Social Services. This liaison is to be much welcomed. A rudimentary grouping of community services in the south Bristol area is evolving and this process is likely to continue for somewhile with increased cooperation, and eventual probable partial amalgamation, of the teams involved. Lastly, there is a clear requirement for academic input for the independent analysis of data, the critical analysis of results, the collection of epidemiological data related to the needs of the population etcetc. Here indeed is a real research opportunity.

An important principle underlying the reconfiguration project is that intermediate care would be largely provided outside the acute hospitals. Such a principle appears to be widely accepted (although we are not aware of any careful analysis of the needs of the patients involved.)

Community hospitals are perceived as being an important component of intermediate care. It has been proposed that there should be a number of community hospitals situated around Bristol providing locally-based intermediate care as well as other low-tech services. A detailed report on possible community hospital provision in Bristol was produced but has not been made available to the public or indeed to the professions. We ask why not? Public money has been spent both on the community hospital Sigma report and on the Finnamore Report, which dealt with service reconfiguration particularly in relation to hospitals. Neither report has seen the general light of day. We are not in favour of secrecy. The quality of public debate would be enhanced by publication. We invite the SHA to authorise the publication of both reports together with the important and comprehensive supporting documents.

It seems self-evident that a South Bristol Community Hospital should be established. Anyone who doubts this should take an afternoon off and drive around Knowle West, with its miles of council houses, whose residents must travel to the City centre if they have anything significantly wrong with them. The SHA should now declare that they support the development in principle. Once this has been agreed hopefully a timetable can be established.

It is understood that a business plan for a South Bristol Hospital has been presented to the SHA. It is now being actively considered by them, and a decision is due to be made toward the end of November 2003.

The editor is grateful to Linda Prosser, Assistant Director of Primary Care with the Bristol South and West Primary Care Trust. Linda Prosser provided much useful factual information on the various developments that have occurred in the South Bristol area. However, she is not responsible for the opinions expressed in the editorial

R Langton Hewer (Joint Editor)