Day hospital at Montfield formally closed as home care proves successful

The formal decision to close the intermim placement unit and associated day hospital at Lerwick’s Montfield Hospital was taken at a board meeting of NHS Shetland today.

This follows a public consultation on the proposed closure of the units, and reflects the trend to provide care in the community in partnership with the council.

The board agreed community care resources should be reviewed at some time in the future to best respond to changing demographics. It also agreed that both health and care services should continue to align more closely to support people to live as independently as possible, at home or in supported accommo­dation. The closure of the interim placement unit (IPU) comes after it has been empty for more than a year.

Chairman of the board Ian Kinniburgh said: “It’s a success story. Over the last 12 months we have been more effective in de­livering care to vulnerable people. It’s a complete philosophy shift, helping people to lead as normal a life as possible. It proves the NHS and SIC can work together to deliver services. The joint approach removes duplication.”

The IPU was originally set up in 2005 to accommodate people whose discharge had been delayed due to lack of capacity in the community to support them at home or lack of residential care places. The unit originally had 10 beds; this was later increase to 18. Montfield also housed four beds for young disabled patients which have not been used for many years, thanks to care in the community. Over time the number of delayed discharges and the use of the day hospital diminished, in spite of an ageing population, due to changes in the way care was provided. This included greater use of technology as well as the NHS working with the council and voluntary sector.

In 2007, NHS Shetland board agreed plans to convert some of the ground floor in Montfield into a temporary care home, to be managed by the council. This 17-bed unit opened last year with the emphasis on “re-ablement”, which provides intensive input to short-stay patients with a view to their being able to live in their own homes again. This care centre will remain in Montfield and was not the subject of the public consultation. The board will now look at the use for the unused part of the Montfield building, which is owned by NHS Shetland.

In 2009 a joint SIC and NHS project titled “Shifting the Balance of Care” was developed with the aim of reducing the number of delayed discharges from hospital, thus ceasing reliance on the IPU. But the project asked that any decision about the unit could only be taken after it had been proved that Shetland could manage without the IPU during one winter period. This was demonstrated in the winter of 2010/11.

All staff have been given permanent re-deployment with the exception of one, who agreed a temporary option.

The aim of reducing the time people spend in hospital also applies to day case surgery, where advances in technology and use of drugs means people do not need to stay in hospital overnight.