Decision deferred on closure of rehab ward in Lerwick’s Gilbert Bain Hospital

Plans to close the Ronas Ward at the Gilbert Bain Hospital and redeploy staff have been put on hold.

According to NHS officials, closing the Ronas Ward would free up resources to provide more effective care in the community but councillors argued for deferring a decision until more information on the health board’s endgame could be provided.

Both councillors present at the integration joint board meeting yesterday raised concerns with the plans, in particular, questioning how the closure of the Ronas Ward would impact patients from Shetland’s outlying communities.

Director of community health and social care Simon Bokor-Ingram said that the proposed closure of the Gilbert Bain’s rehabilitation unit was part of an ongoing “journey around shifting the balance of care.”

Instead of being admitted to the Ronas Ward patients in need of rehabilitation would be admitted to Montfield, where they would receive non-acute care.

In a hypothetical situation presented to the committee this patient would then be discharged home, where they would complete their “reablement” with support from an intermediate care team.

It is to these intermediate care teams which the health board hopes to re-direct resources by closing the rehabilitation unit at the Gilbert Bain.

Mr Bokor-Ingram said that Shetland was at a “tipping point” because of “demographic pressures” and “diminishing resources.”

Factors such as an ageing population and tight budgets meant that the joint board had to start looking at ways to care for people in a “community setting.”

During the initial phase of the plans put to the board patients in Lerwick and surrounding areas such as Gulberwick and Scalloway would be looked after in their homes by an intermediate care team.

Patients from Shetland’s outlying communities would be admitted to Montfield to receive non-acute care after being treated as normal at the Gilbert Bain when they are acutely unwell.

It saddens me that this is about money. If money was no object I don’t think we’d be looking to shut down the rehab unit. BILLY FOX

Eventually the plan is for everyone in Shetland to have access to an intermediate care team.

North Isles councillor Gary Cleaver said he had concerns for outlying communities, and felt the impact the move would have on patients from those areas in the interim was not fleshed out in the document presented to the board.

Councillor Billy Fox also questioned whether the scheme could ever be rolled out to cover all outlying communities, saying that he felt at least four intermediate care teams would be required to cover the whole of Shetland yet currently they were struggling to staff just one team.

Mr Fox added that he was “extremely uncomfortable” about the proposals and feared that there was “no safety net” should the plans backfire.

He added: “It saddens me that this is about money. If money was no object I don’t think we’d be looking to shut down the rehab unit.”

The discussions concluded with Mr Cleaver tabling a motion which suggested any decision on Ronas Ward should be deferred until NHS representatives can come back with a more detailed plan including information about the potential impact on outlying communities and timescales for rolling out intermediate care teams across Shetland.

More in this Friday’s Shetland Times.