NHS Borders confirmed this week that, due to “financial pressures”, it is reviewing the region’s four community hospitals in Kelso, Hawick, Peebles and Duns.
Between them, they offer nearly 100 beds for local patients, including those referred by GPs or following discharge from the BGH.
Terminal care and convalescent care is also provided, and the majority of current patients are elderly.
Apart from the 23-bed Hay Lodge at Peebles, the other facilities also have day hospital provision of more than 30 places for those who require physical and emotional support short of admission.
A statement from the health authority on Tuesday conceded: “NHS Borders faces significant financial challenges.”
And it confirmed: “In order to maintain the quality and coverage that we provide, we are currently reviewing the way we deliver all our services including, but not exclusively, looking at how care is provided from our four community hospitals.”
The statement spoke of the opportunity to “transform traditional models of delivery by exploring new models of care” and it gave the example of an initiative called Hospital@Home, which had been piloted in other areas and enabled patients to be cared for in their own homes, thus avoiding “unnecessary hospital admissions”.
“Any major service changes will be subject to employee and public consultation,” concluded the statement.
The blue touch paper of concern over the future of the community hospitals had been ignited by NHS Borders medical director Dr Sheena MacDonald in an interview with the BBC on the need to redesign local health services
While conceding any changes would have to be made for “absolutely the right reasons” and only after full public engagement, Dr MacDonald said: “If we can reduce our spending on buildings and overheads for heating and lighting, this will allow us to use the same amount of resource for a much larger group of people by investing in more staff.”
She cited successful examples of local services, such as dementia, being reshaped “to provide better care for more people”.
Local politicians have voiced their concerns about the possible outcome of the review.
“We have already seen the closure of hospitals in Jedburgh and Coldstream, and any further removal of these important facilities would be deeply unwelcome and unpopular,” said Conservative MSP John Lamont.
South of Scotland Lib Dem MSP Jim Hume told us: “Communities will be rightly concerned any review could lead to the closure of these hospitals, which have become a valuable and much-loved health resource.”
Meanwhile, the implications of the review will be high on the agenda of next week’s meetings of the community councils in Kelso and Peebles.
Councillor Catriona Bhatia, chair of the joint Health and Social Care Integration Shadow Board, which is due to take over responsibility for community hospitals in 2016, said yesterday that she had asked for NHS Borders’ review proposals to be discussed at the board’s scheduled meeting on Tuesday.