Strategy is no Excuse for In-Year Budget Cuts

Much has been made about the Strategy of the LCFT to reduce the number of inpatient beds while increasing the input from the community teams.

In our meeting yesterday, we strongly challenged the closure of the 22 beds in Burnley as it was clear that decision had gone ahead with full acknowledgement that the loss of those beds was unmanageable, thus resulting in The Orchard being closed to women.

Mr. Dibble referred back to their strategy to reduce the number of inpatient beds and their major planning process of 2006 that had involved wide consultation and full due process.  This was quoted that as a reason behind the closure of Ward 18 as it was part of the strategic plan.

We disagreed that you could refer back to an 8 year old plan to explain the closure of a ward to women in 2014.  Mr. Dibble disagreed with us, as in his experience plans involving PFI, for example can take many years. 

Our issue with this is that Strategy lays out the long term goals of an organisation, however, Strategy should not result in a failure to deliver required services. 

We are not talking about the long term strategic plan, we are talking about a short term measure to deliver savings to the in-year budget knowing that it was not sustainable operationally and therefore resulted in the Trust being unable to deliver its services as required.

Blaming strategic plans for operational failures does not make business sense.

To summarise:-

• The Trust will have had to make cost savings within year.  This is part of the yearly budget plan, not the Strategic Capital Investment plan.
• The 22 beds were closed as part of the yearly budget plan, not the Strategic Capital Investment plan.
• It is not the overall LCFT patient care strategy that caused the closure of The Orchard to women, it was the financial pressures and required budget savings within this financial year
• A decision was made to reduce services knowing there wasn't capacity to manage that change.  This is not a strategic issue.  That is financial and operational. 

It is still clear that the women of North Lancashire are paying the price for the decision to reduce bed capacity to deliver short-term savings knowing that it was not manageable.

This is not acceptable.

Dancing with Aunt Sally and the Strawman at Beds in the Orchard.

At Beds in the Orchard it feels like we've been doing a dance with Aunt Sally and the Straw Man when it comes to our complaints.

For anyone who doesn't know what a Straw Man or Aunt Sally argument is, it's explained on Wikipedia but the basic idea is that a debate or argument is knowingly and deliberately skewed to lead the debate or argument in a different direction.

So how are we in an Aunty Sally situation here?

Closing a unit only to women and sending them away for inpatient care is discriminatory.

Some women are better treated at home.

We don't deny that, but closing a unit only to women and sending them away for inpatient care is discriminatory.

Not every clinical presentation is suitable for treatment at the Orchard.

We don't deny that, but closing a unit only to women and sending them away for inpatient care is discriminatory.

We provide beds on a pan-Lancashire basis.

We don't deny that, but closing a unit to ALL women in ONE locality so ALL women are treated away from home is discriminatory.

The Trust's inpatient facilities are able to flex with demand.

We don't deny that, but the Trust has NEVER closed a whole unit to just one sex before and closing a unit only to women and sending them away for inpatient care is discriminatory.

The thing is; if this wasn't at all discriminatory, we'd have had a response outlining how that was the case, rather than these Aunty Sally arguments about clinical presentation, home treatment and flexing.

And yet the dance with the straw man continues...