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Local health bosses want to shut £800K per year specialist rehab centre

Community leaders have been asked to share their views on plans to close a specialist rehabilitation centre in Cambridgeshire.
hospital ward

Under plans drawn up by the Cambridgeshire and Peterborough Clinical Commissioning Group (CCG), the £800,000-per-year Oliver Zangwill Centre (OZC) based at the Princess of Wales Hospital in Ely would stop operating.

Health chiefs say the number of patients treated at the facility has been dropping year-on-year. Stats show 25 patients used the facility in 2017/18 dropping to 11 between 2020/21 and just six in 2021/22.

Now Matthew Smith, senior response officer for urgent and emergency care at Cambridgeshire and Peterborough Clinical Commissioning Group, addressed Peterborough City Council's Adults and Health Scrutiny Committee.

Mr Smith said: “The OZC offers what is probably a unique community-based NHS neuro-psychological rehabilitation service in the UK.

“While there is evidence of effectiveness in terms of outcomes, the type of care offered, and the conditions treated are arguably at the boundary of health and social care.

“In the context of delivering the right healthcare services for our local population within the budget available, we must question the extent to which the local NHS can prioritise funding for this service.

“There is a wide range of alternative options available across the area who have the capacity and resources to support anyone who would previously have been referred to the centre.

“The OZC provides neuro-psychological assessment and rehabilitation for adults with acquired brain injury.

“It is an incredibly specialist service, and the only one of its kind currently commissioned by any part of the NHS.

“However, referrals from the NHS and private providers to the service have been dwindling, decreasing over a number of years, but with a sharp reduction over the last two years.

“The service costs around £800,000 a year to provide, and with reducing referrals and several other services that patients can be referred into, the system cannot continue to operate a specialised service in this way.

“In this financial year, six patients have been assessed as appropriate for the holistic rehabilitation programme, but these clients have chosen to postpone their treatment for a range of reasons.

“A clinically led pathway review of the whole neuro-rehabilitation pathway in 2019, including the OZC, combined with further reducing patient referrals to this service has resulted in the development of a joint proposal from the CCG to cease the provision of neuropsychological rehabilitation at the OZC.

“In advance of this decision, other avenues to increase referrals were explored, including out-of-area referrals and insurance funded patients, but despite best efforts the service has continued to see a drop in referrals indicating the service is no longer receiving sufficient referrals to remain viable.

“In the current financial year six patients have been assessed as appropriate for the holistic rehabilitation programme work, but the clients have chosen to postpone their treatment for several reasons. While 15 further patients continue to receive bespoke care and one patient is on the holistic rehabilitation pathway.

“As a block funded contract, the service continues to cost the NHS £800,000 per annum despite the lower number of patients cared for.ent

“In summary, the OZC offers a service which whilst valued by those who receive it, is a relatively high-cost model 

“We have to assess every NHS pound is well spent, and the £800,000 currently being spent on the OZC service is becoming harder and harder to justify."

Cllr Simon Barkham, ward councillor for Paston and Walton, asked why referrals had dropped.

Mr Smith replied: “In 2017-18 we had 25 referrals to the OZC, in 2018/19 and 2019/20 there were 14 referrals, in 2020/21 that had reduced to 11 and in the current year 2021/22 that had reduced again to just six.

“The reasons why the numbers are falling are because we do have a range of alternative services available. For example, the Cambridge and Peterborough Foundation NHS Trust (CPFT) Neuro-Rehab Team takes a large number of referrals."

Cllr Ansar Ali commented: “It concerns greatly to hear those private services are being favoured over services provided through the NHS.

“We should be competitive enough to offer a service, especially one that as you say has a wonderful reputation both here and abroad, so that the insurance companies would consider them instead of going to private companies outside of the NHS.”

A clinically led pathway review of Community Services that took place in 2019 identified further analysis of the whole neuro-rehabilitation pathway, including the OZC was needed.

That further analysis was undertaken in 2020 and concluded the cost per course of treatment at the OZC which, at the time, was relatively high at an average £16,000 to £18,000 per patient.

The current consultation to determine if the services provided by the OZC will cease began on January 11 and will run for six weeks.

The next meeting of Peterborough City Council Adults and Health Scrutiny Committee is on March 15, 2022.