Tackling health debt

But the region's counselling service could still be cut - despite South Worcestershire Primary Care Trust receiving a petition containing more than 1,300 signatures objecting to the move.

The trust decided to review its services at the end of last year after amassing debts of £5.5m.

Under the latest proposals, practice-attached social workers should keep their jobs, and occupational therapy services and the day rehabilitation service in Evesham could be retained.

The PCT and Worcestershire County Council's social services department intend to pool their budgets to make more funding available for these provisions.

The services had looked doomed when the PCT initially proposed to transfer their funding to social services - a suggestion that provoked an angry response from the county council.

However, the pooling of resources would result in more interest being accrued, providing extra funds.

The pulmonary rehabilitation service for those with lung disorders - another provision that had been set to end - is also now likely to be retained and expanded due to public demand.

But there is bad news for other services following the consultation process held in the wake of the cash-strapped PCT's review.

The trust wants to reduce the number of top-level district nurses, effectively from 41 to 28, and introduce more lower grade nurses. This would save more than £55,000.

Pershore Dental Clinic will also be scrapped, saving £8,300.

The trust received a total of 110 responses from the public, councillors and MPs during the consultation period.

Trust chief executive Mike Ridley admitted the majority of responses indicated "regret and opposition to any reduction in services".

He said people who attended public meetings were frustrated and confused by the proposed changes.

"I recognise and understand the enormous concern that has been generated and reflected in the responses," he said.

But he said the trust would be in a better position to take advantage of the planned additional resources being made available in the next few years if the recommendations were accepted.

"We should also be able to allocate more of our scarce management time to reviewing services," said Mr Ridley.

The Latest Recommendations

Counselling:

Initial recommendation: Abolition of service.

New recommendation: Not changed.

District nursing:

Initial recommendation: Reduction in number of top grade G nurses to achieve better mix of nursing grades. Aimed at saving £55,487.

New recommendation: Not changed.

Health visiting:

Initial recommendation: Basic service to be provided for both children and elderly, with loss of jobs in both areas.

New recommendation: Not changed for children's service, but more consideration to be given to elderly service. No current service for the elderly to be stopped without detailed discussions between health and social care.

School nursing:

Initial recommendation: Scrapping of health promotion sessions, work with children with mental health problems and parent drop-ins. Loss of one part-time nursing job.

New recommendation: Not changed.

Occupational therapy:

Initial recommendation: Negotiated transfer of 75 per cent of funding responsibility to social services.

New recommendation: Pooled budget arrangement with social services to provide funding.

Physiotherapy:

Initial recommendation: Service reductions to ensure general practices have only their "fair share" of physiotherapy, to save £79,800.

New recommendation: Not changed.

Podiatry:

Initial recommendation: Two jobs (currently vacant) to be scrapped, saving more than £19,000.

New recommendation: Not changed.

Pulmonary rehabilitation, for those with breathing difficulties:

Initial recommendation: Removal of single post, saving £28,000.

New recommendation: Service should continue across South Worcestershire.

Community hospitals:

Initial recommendation: Abolition of day rehabilitation unit.

New recommendation: Joint funding of unit with social services, with pooled budgets.

Community dental services:

Initial recommendation: Closure of dental health clinic at Pershore Health Centre.

New recommendation: Not changed.

Sexual health:

Initial recommendation: Closure of four satellite clinics.

New recommendation: Further discussion to take place with Redditch and Bromsgrove PCT.

Palliative care services:

Initial recommendation: Cost of appointing new business manager to be picked up by Macmillan for the next two years.

New recommendation: Not changed.

Practice-attached social workers:

Initial recommendation: Transfer of funding to social services or abolition.

New recommendation: Service to continue with funding from pooled budgets.

Petition of 1,343 may not be enough to save counselling

A COUNSELLOR described the South Worcestershire health service review as a "fait accompli" after learning the region's counselling service is set to be axed.

Plans to scrap the provision were first revealed in March, as the South Worcestershire Primary Care Trust searched for ways of reducing its £5.5m debt.

During the public consultation period that followed, huge support for counselling emerged.

The trust received a petition containing 1,343 signatures in support of the service, as well as 77 individual letters condemning the move.

However, the trust's professional executive committee is still recommending that the counselling service be abolished.

Worcester counsellor Mike Parmenter said he had not expected the trust to change its mind.

"It's a fait accompli," he said. "We're very disappointed that the representations we have made haven't been listened to.

"It doesn't appear that the consultation process has stood for very much. We have a lot of evidence to support our view that counselling is very important for patients, but it doesn't appear to have been taken into account."

The abolition of counselling, which uses the services of 17 counsellors, would save the trust £246,000. However, the prescribing of anti-depressants could increase as a result.

David Moon, the PCT's deputy chief executive, said a new and complete mental health service would soon be developed.

"The service would be led by a psychologist supported by graduate mental health workers, counsellors and support staff, and would serve the whole of South Worcestershire, not just part of it," he said.

The possible reprieve for the pulmonary rehabilitation service was met with delight by Mo Davidson, an emphysema sufferer who has been campaigning to save the provision.

The 62-year-old, from Malvern, believes the help she received from the specialist pulmonary nurse saved her life and helped her live with her illness.

"I think it's absolutely fabulous," she said. "There are so many people who benefit from the service and need it.

"I'm so grateful to everyone who has supported our fight."

The £28,000-a-year service was set to be scrapped, but trust chiefs have rethought their plans after more than 60 people wrote letters objecting to the proposal.

The PCT board will consider the recommendations at its public meeting on Wednesday, June 4, at 9.30am at County Hall, Worcester.