Decision to close Eastbourne walk-in health centre backed by scrutiny committee

On Thursday (December 10), the East Sussex Health Overview and Scrutiny Committee (HOSC) confirmed it would not call in an NHS decision to close the Eastbourne Station Health Centre, as long as “alternative services” are put in place beforehand.

These alternative services would include the soon-to-open Victoria Medical Centre establishing a branch surgery in the town centre and the commissioning of drop-in clinics for rough sleeping and homeless patients.

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Cllr Peter Pragnell (Con, Hastings Ashdown and Conquest) said: “There is a temptation to obsess about buildings rather than the services that are provided and where they are provided. 

“As long as the services are provided in the town centre, which is what we are told is going to happen, and as long as the current service is not closed until the replacement is fully in place, I remain happy to move the motion [to support the decision].”

The day before (Wednesday, December 9) the proposals had been approved by the East Sussex Clinical Commissioning Group (CCG) governing board, with HOSC members meeting to consider whether to call in the decision to the Secretary of State for Health.

While the decision was ultimately not called in, there was significant opposition to the proposals from several committee members, including Eastbourne councillor Alan Shuttleworth (Lib Dem).

Cllr Shuttleworth said: “The mitigations which have come forward as a result of this process, some of them almost kicking and screaming   are simply not enough for those groups the walk-in provision is there to support.

“I do not accept that there is a continuing level of care at the same level or, as I would like to have seen, an improved level of care. I think there will be a diminished level of care for certain groups.”

Cllr Shuttleworth went on to argue the full proposals should not go ahead as it was “not the right time”, given uncertainty around the coronavirus pandemic and recent changes to the NHS 111 service.

He also argued the proposals would have a disproportionate impact on the town’s homeless and rough sleeping community, due to the centre’s ease of use and central location.

This view was challenged by the CCG’s managing director Jessica Britton, however, who argued homeless people were not the centre’s main users.

She said: “In terms of people currently using the walk-in centre, as has been previously reported and further reviewed, it is predominantly and historically working age adults who use the centre and parents with young children. 

“It is used by some of our more vulnerable communities, but no more so than other services I think particularly.

“That is why we are wanting to understand about that and hence the reason for the proposals around the rough sleeping and homeless population.”

The proposal referred to by Ms Britton would see the CGG commission drop-in clinics in the town centre – taking place at least once a week – to meet the medical and nursing needs of rough sleeping and homeless patients.

But the effectiveness of these clinics was disputed by Cllr Amanda Morris, another Eastbourne Liberal Democrat councillor who opposed the proposals.

She said: “For us to have a clinic that is only open one day a week, then you are expecting homeless people to keep an appointment that is one day.

“If they wake up on a Saturday and they feel ill at the moment they can go straight to the walk-in centre and be seen [and] I think it is 75 per cent of patients who are dealt with on site. 

“They are going to have to wait six days possibly before there is a clinic open. The hospital is a 50 minute walk away. How is one day effectual? I think there needs to be more for that.”

In response, Ms Britton said the proposals for the drop-in clinics had come from professionals working with homeless people in the town and would see further work  take place before commissioning.

This could include extra clinic days, councillors heard.

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The meeting also saw discussion around the loss of walk-in appointments from the town centre and whether the NHS 111 service could effectively replace them. 

Nationwide NHS 111 has recently undergone some significant changes, with the service beginning to  book GP appointments and making referrals to pharmacies for the first time.

As part of this the service has begun using a new Clinical Assessment Service (CAS), which is intended to simplify the process and allow the service to become a single point of access for urgent, but not emergency, healthcare.

Labour councillor Mike Turner took issue with how this connected to the closure of the walk-in centre, however.

Cllr Turner said: “It seems to me that all of this is very premature. You are gambling with people’s lives. 

“111 can’t be relied on [and] that is one of your central components. Everything revolves around 111, well 111 could have cost people their lives.

“Until you get 111 in place and until you are able to get everything up and running, I think it is very premature and the wrong time to be bringing it about.”

HOSC chairman Colin Belsey took another view, however.

Cllr Belsey said: “It is so easy to knock things that have only just been set up and running.”

He added: “I think we have asked for enough assurances from Jessica and the [CCG governing] board and others. 

“We are in the position still where, if this isn’t fully in place when they come to close that centre, we can put our oar in and make things very difficult.” 

Following further discussion, HOSC voted seven to five in support of the decision to close the walk-in centre.