Health Services

Geographical & social background

Edenbridge is on the west boundary of both Kent and West Kent Primary Care Trust (PCT).

Formerly a small market town, it became an Expanded Town after the 1947 Planning Act, when two high density low rise settlements were added to its north. It now has a population of approximately 10,000. Although the town has high levels of poverty with both elderly and young families, it is surrounded with small attractive prosperous villages.

The “Review of Health Needs in Edenbridge” in January 2003 described the town as one of the most deprived areas within the PCT, isolated, with poor access to services. The impact of access difficulties, which affect the elderly and young families most, is significant. Changes in the town’s social structure point to the need for increasing local services. These changes are:-

(a) The Population of over 65s will increase from 16% to 23% between 2006 and 2030, and that of 75 year olds is set to increase by 19% over next 10 years.

(b) The increase in social housing

(d) The increase in psychogeriatric population

(e) Possible future changes which include:-

Possible 200 houses on the old secondary school site.

NHS Local Organisation

Edenbridge Hospital is one of six Community Hospitals in the West Kent PCT. There is one local GP service- The Edenbridge Medical Practice located in Station Road.

The services at Edenbridge Hospital were severely affected by the recent debts of the PCT, but services are now returning to normal.

Impact on Community Hospitals of changes in medical treatments

Changes in approach or techniques mean fewer and shorter stays in hospital for treatment with more out patient and day case procedures. This reduces the number of hospital beds needed, is more cost effective and usually better for the patient.

Medical treatment does not however prevent ageing, dying and death. As large hospitals get better at treating people faster, it is arguable that they become worse at treating people with “slow” problems. Rehabilitation and in particular, respite, palliative and terminal care are often better provided in other settings: often this setting can be the patient’s home, but in many cases this is not appropriate and there remains a need for units such as community hospitals which specialise in such care. The importance of Community Hospitals were highlighted in the recent Government White Paper: “Our Health, our Care, our Say” in January 2006.

Day care services especially for the elderly and elderly with mental health problems (classically dementia) help to maintain people in their own homes and are likely to be increasingly needed: they are obviously best supplied within the patient’s community.

Changes in medical treatments and information technology, and the increasing tendency for both assessment and review clinics to be nurse and physiotherapist led increase the opportunities for care to be delivered closer to communities.

X-ray facilities: modern image transmission techniques mean that X-rays taken can be viewed and reported remotely and increase access by appropriate consultants.

Relief on pressure points in the system e.g. x-rays for review appointments, and. at fracture clinic at the acute hospital, can be taken locally.

Consultant Clinics

A very important function of many Community Hospitals including Edenbridge is the availability of Out Patient clinics where Consultants in many branches of medicine bring their skills out into the community. Apart from the proximity of this service to the patients home, one great advantage of such a service is that patients will mostly be seen and followed up by the same Consultant. See under “Layout and Departments” the range of clinics available, the names of the Consultants and the times of clinics.

Rheumatology: review appointments are often with the nurse specialists: some nurses perform joint aspiration and injections. We are purusing the re-instatement of these clinics at Edenbridge Hospital.

Musculo skeletal services: back pain and lower limb problems are increasingly assessed or treated by specialist physio–led teams, with the authority to arrange scans where appropriate.

Chemotherapy: many chemotherapy regimes involve relatively short (eg one hour) infusion times. These are already administered by specialist nurses in hospitals and patients do not routinely see a doctor on these treatments sessions.

The tendency for increasing specialisation may present a problem for some Community Hospitals’ outpatient services: e.g. whereas once an orthopaedic surgeon would see all the orthopaedic cases, now there are consultants who are general orthopaedic surgeons but who specialise in knees or hands or hips etc and the GP (or the patient) might choose the appropriate sub specialist to refer to and there would not be the volume of work for every subspecialty to be represented at each Community Hospital.

Health Needs

In 2003 A Review of Health Needs in Edenbridge was an important and very detailed report carried out by the PCT and local focus groups.

Significant recent changes in the town’s social structure point to the need for increasing local health services. The main needs relating particularly to Edenbridge Hospital were:

Existing services currently based at Edenbridge Hospital will be developed and out dated areas refurbished and updated. This has been done.

Edenbridge Hospital’s wards and equipment to be updated. This has been done.

Enhanced Day Care facilities for frail and elderly.

Relocation of Social Services to the Hospital site to maximise joint working. This has been done.

Develop the Minor Injuries Unit at Edenbridge Hospital in order to maximise potential, reduce under utilisation and respond to identified needs. This has been done.

Reduce the number of those needing to travel out of Edenbridge for appointments.

Greater integration of Health and Social care provision.