Best foot forward?

Feature on Bispham Nurse Led Unit, which on April 1st leaves the control of the NHS trust to become a social enterprise with the unit owned and operated by its staff.'Staff in reception. PIC BY ROB LOCK'29-3-2011
Feature on Bispham Nurse Led Unit, which on April 1st leaves the control of the NHS trust to become a social enterprise with the unit owned and operated by its staff.'Staff in reception. PIC BY ROB LOCK'29-3-2011
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Norah Byrne, 77, doesn’t mind who owns or runs a 40-bed rehabilitation hospital at Bispham which helps patients of all ages get therapy to get them back on their feet – so long as it stays open for NHS patients.

And it will, stress bosses-in-waiting, on the verge of an historic transfer of business interests from Blackpool Teaching Hospitals NHS Foundation Trust to a new community interest company, meaning nurses and other staff will actually co-own the hospital they currently run.

It secures the future of a crucial community hospital at a time when there’s a call for an inquiry into a controversial decision by hospital bosses to close Wesham Hospital – a rehabilitation unit – in January.

Spiral Health Community Interest Company, off Kincraig Road, is what used to be known as the nurse-led therapy unit. It helps patients of all ages, from youngsters getting over accidents, to older people recovering from falls, or regaining mobility after surgery, hip and knee operations, amputations, heart bypass surgery and more.

It’s an halfway house between acute care – the kind delivered in Blackpool Victoria – and going it alone back home. Referrals enable hospital beds to be freed faster – or prevent patients ending up in them in the first place.

Norah’s been there a couple of weeks to nurse her second replacement knee through post-operative therapy – although patients can stay for up to six weeks.

She rates the quality of care received from senior therapy leader Anne Brodie as “second to none.” She’s stayed in the intermediate therapy unit a couple of times, having gone there after complications with her first knee replacement. Patients are usually referred after treatment as an hospital inpatient – or directly by a GP or community matron. It helps ease bed blocking, that awful term to describe those occupying hospital beds when there’s a real risk they could be readmitted if they went straight home.

Norah reckons it’s a lifesaver. “The staff are lovely and want to toughten you up a bit,” she explains. “It helps keep you independent and that’s what I want. I’m moving in with my daughter, but I’m not going to be under her feet as I’m getting a granny flat.”

Norah has just taken part in an official launch of the unit, cutting the tape to declare Spiral open as a community interest concern, a social enterprise, run independently of the NHS Foundation Trust.

The event was attended by 22 partner agencies. It was actually registered as a social enterprise last year. The business transfer is now being finalised, the unit running as a “shadow company,” ahead of its national launch in September, when Cabinet minister Francis Maude, spearheading David Cameron’s Big Society, may come to see it for himself.

Whether VIPs include Health Secretary Andrew Lansley, who received such an humiliating “no confidence” vote from the Royal College of Nursing, regarding legislation allowing GPs to take over the £60 billion budget to commission services, remains to be seen.

There’s been an hiatus in pressing on with NHS reforms in order to allow for more consultations, although it hasn’t stopped Dame Barbara Hakin, the Department of Health’s key commissioner of development, urging GPs setting up “pathfinder” consortiums to buy health services to “keep up the momentum.”

Locally, the clinically-led Bispham unit will rely on GPs and others directly sourcing intermediate rehabilitation care to keep patients independent and healthy, reducing acute inpatient length of stay, and preventing unnecessary admissions to acute hospital care.

The only difference, says Jayne Mottershead, the new boss-in-waiting, is that the unit will be co-owned and run by nurses and other staff.

The team’s already bidding for other contracts, one of which has been secured, without going through the bureaucracy involved in NHS administration.

But is it privatisation through the front – let alone – back door?

Not so, says Jayne, operations director of Spiral Health. She admits: “I think, if anything, it has secured our future. It’s the shape of things to come. It’s been a long challenging journey, but we can now look to the future with optimism and determination to continuously improve quality of care and services we deliver to the patients of the Fylde coast and beyond.”

It comes at a time when campaigners have called for an inquiry into a claim that local hospital chiefs sought legal advice as to whether they should close Wesham Hospital on “purely financial considerations” rather than clinical evidence. Services were transferred to Fairhaven’s Clifton Hospital.

The Bispham unit appears to face a brighter future. Government health mandarins call it a first for the NHS and one of the brightest “Second Wave Pathway” projects, the buzz term used to describe workers now running London borough Havering’s youth and library services, lecturers taking charge of Stockport further education college and others handling projects formerly run by local or central government or public sector, often through charitably minded community concerns.

Jayne’s team was guided through the process by the employee-run social enterprise, BAXI Partnership. “It’s one of the best,” she adds. “NHS patients will notice very little difference other than we will be able to go for more contracts and offer a greater range of services under this roof with profits ploughed back into the concern, not for personal gain. We will still take NHS patients, from acute ranks (hospitals) and directly from GPs from the Fylde and further afield. We will have greater autonomy as a totally independent and registered company, be able to reduce bureaucracy, and respond faster to needs.

“I believe in, and cherish, the NHS, nothing will detract from its ethos, not on my watch. We may moan, but our free at point of delivery health care system is the envy of the world.”

The transfer is backed by Aidan Kehoe, chief executive of Blackpool Teaching Hospitals NHS Foundation Trust, who says: “The trust believes in employee engagement, and there is no better way of achieving this than through social enterprise.”

And the last word goes to Norah: “As far as I’m concerned it’s best foot forward – for us all!”