Two years ago, the NHS Great Yarmouth and Waveney Clinical Commissioning Group (Health East) announced fundamental change in the care of patients (mainly but not exclusively elderly) who would previously have been admitted either to an acute hospital or to Southwold Community Hospital.

Named as 'The Shape of the System' in future the focus will be on care in the patient's own home wherever possible, obviating the need for a hospital stay, with the deployment of new "Out of Hospital Teams" (OHTs) backed up with local "Beds with Care" based in our "Hub" surgery in Reydon.

In our area in Southwold and Reydon the set up was:

   ·    An Out of Hospital Team based at the Sole Bay Health Centre (SBHC) hub

   ·    NHS funded "beds with care" to replace the closed Southwold hospital beds

   ·    Converting Beccles Hospital into "intermediate care beds"

The OHT team to support the in-home care changes but typically was made up of:

   ·    A team leader

   ·    Community nurses

   ·    Social workers

   ·    Physiotherapists

   ·    Occupational therapists

   ·    Health care assistants

   ·    Administrative support

Up to now this has been very successful:

   ·    Patient satisfaction (postal satisfaction questionnaire), patient access, the number of patients seen, picking up acute and chronic conditions and patient safety through good clinical leadership and clear and robust procedures have all improved,

   ·    Through better use of the available staff skill mix and the IT system it has been possible to optimise the hours available for both doctors and nurses, the demand being driven by the patients stating their needs,

   ·    SBHC has the best figures for keeping admissions to James Paget as low as possible (the population of S&R for 65+ years, is twice national average).


As of January 1 2018 however the CCG has appointed the East Coast Community Health Care to take over the running of the OHTs directly for all five doctors' practices in the South Waveney area.

Given the success of how the SBHC ran the system we are concerned about the outcome of this but will maintain a close watch and keep members informed.

The other area of concern is that the SBHC is taking over the running of Bungay Medical Practice (BMP). The CCG told us that the BMP was not performing well and we hope that the SBHC team can bring it up to their standards without diluting the good service in our area.