Future of hospitals and care homes in East Lothian in doubt

A three-month consultation exercise has been launched to examine the future of Dunbar’s Belhaven Community Hospital; Musselburgh’s Eskgreen care home; and North Berwick’s Edington Community Hospital and the town’s The Abbey care home.

All services currently offered at these facilities could potentially be provided elsewhere.

The future of North Berwick Medical Practice, which is part of the Edington site, is also under scrutiny.

The Edington, North Berwick. Image Google Maps

According to the draft proposals, NHS community beds, nursing home care, residential care and residential respite would all be included within ‘extra care’ housing.

The report adds that this could take many different forms, including very sheltered housing, housing with care, retirement communities or ‘villages’.

Consideration would also be given as to whether day treatments could be provided in the new East Lothian Community Hospital being built in Haddington, while a separate review will consider the future of the minor injuries service which is included within the Edington.

It is proposed that in the three towns affected – Dunbar, North Berwick and Musselburgh – there would be ‘extra care’ housing developments of 60 to 70 units.

These would allow for “re-provision” of the existing facilities, plus a contribution to the additional 300 extra care units planned over the next five years in the local housing strategy.

There are 104 beds in the four facilities combined. This will reduce to 93 when ward two at Belhaven Hospital closes.

Belhaven Hospital

The papers were approved for public consultation by East Lothian Integration Joint Board (IJB) – which governs East Lothian Health and Social Care Partnership, which is made up of councillors and NHS professionals.

The report stated: “All the current facilities have physical challenges and are either no longer fit for purpose or require significant upgrade.

“The accommodation is inadequate [and] there is little or limited scope for flexibility in use or for refurbishment.”

It added: “The sites at Abbey, Eskgreen and Edington are very constrained and have no opportunity for redevelopment. The site at Belhaven has some adjacent land owned by NHS Lothian which could offer scope for redevelopment. The council also owns the Wireworks site in Musselburgh which could offer scope for development, but is constrained.

“Since the Edington site also houses North Berwick Medical Practice, which is also not fit for purpose, plans for North Berwick will have to include the future location of the medical practice.”

Eskgreen care home

The report’s breakdown of its proposals for the future of services currently provided at the four facilities is as follows:

• NHS community beds – to be reprovided in extra care housing;
• Day treatments – consider whether this should be provided in East Lothian Community Hospital;
• Minor injuries – commission a separate review of this service;
• Nursing home care – to be reprovided in extra care housing;
• Residential care – to be reprovided in extra care housing;
• Residential respite – to be reprovided in extra care housing.

Councillor Stuart Currie, SNP Group Leader, was worried that the move to extra care housing would cast the long-proposed care home for the former Tesco site in Musselburgh into doubt.

He said: “It is just not acceptable for the largest town in East Lothian not to have a residential care home operated by the council.

“To have no council-run care in our town will mean all our eggs being in the one basket with the private sector and it will not end well.”

New facilities are unlikely to be created in the immediate future.

If the proposals are met with approval this summer following the public consultation, a business case will be drawn up.

That would need to be approved, with indications suggesting that could be in summer 2019, with new builds then being created within the next three to five years.

Last month’s IJB meeting heard that consultations had already taken place with the health and community care forums in the three towns and the proposals had been “received positively”.

There was an argument at the meeting from Alison MacDonald, a nurse, that there would always be a requirement for round-the-clock care for some patients with more complex needs.

She said: “I do feel that we will always have people that need 24/7 care, whether that is through dementia or end-of-life care.”

After a lengthy discussion on the proposals, IJB members unanimously agreed that a consultation period would take place before the final proposals were discussed.

The consultation runs until June, after which the final proposals will be presented.

Jacquie Bell, secretary of Dunbar Community Council, felt it was a positive step.

She highlighted that there were already similar facilities in the Borders and Midlothian but wanted assurances that the level of care at Belhaven Hospital would remain in place until any new facility opened.

Meanwhile, Tommy Todd, chairman of North Berwick Community Council, admitted he knew nothing of the proposed changes, adding: “If [closing the Edington and The Abbey] happens, it would not be very good for the town.”

Dr Deborah Ritchie, who co-chairs North Berwick Health and Wellbeing Association, said: “We are open to the consultation process and at this stage feel that it is important for North Berwick to focus on retaining the services offered, rather than focus solely on buildings.

“We would also stress the need for the health centre to be included in the review.”

She added that the idea of a health ‘campus’ including the Edington, Abbey and a new health centre was “very appealing”.

A spokeswoman for the IJB said: “Re-provisioning isn’t about closure – it’s about taking existing community assets and seeing how we can use them to best meet the needs of our growing older population. It’s also about moving services into modern assets.

“We have already done a lot of research that indicates that people are interested in seeing a shift in the balance of care; that is, being cared for at home or in a community setting.

"The next stage of this project is to work with people across individual communities to see how we can take this forward at a local level.”

On whether the buildings themselves would close, she added: “That would only become clear as the process unfolds.”