A REVIEW of Somerset's 13 community hospitals - including Minehead and Williton - could result in changes to the number of beds and care provided.

Somerset Clinical Commissioning Group - the GP-led organisation responsible for the planning and funding of local health services - this week backed the introduction of a new model aimed at preventing unnecessary admission to hospital, particularly for the county's frail elderly and people with long-term conditions, through providing more care and support in their own homes.

Over the next five years, care provision at the community hospitals could include:

l 'Step-up' beds providing care to people admitted from home who require 24-hour nursing care with medical review or medical treatment.

l 'Step-down' beds providing care for people who have been discharged from a district hospital but who still need hospital-based rehabilitation and nursing care.

l Health and well-being centres where a community hospital would offer a wider range of clinics and services but would not have inpatient beds.

The CCG's review does not identify which community hospitals might adopt these different models of service but suggests that only a few of the 13 would have step-up beds, with the majority continuing to have step-down beds.

Although health and well-being services are expected to be available at all of the sites, a small number could focus on those services alone, with no inpatient beds.

The proposals, which will go out to public consultation from July to October next year, before a final decision in November, follow an audit of community hospital beds carried out by the CCG almost a year ago.

It found that just under a quarter - 23 per cent - of the county's 312 beds were being occupied by patients who could have been cared for at home.

Only 74 per cent - 232 - of the beds were in use at that time and 22 per cent of patients could have been better supported in an alternative residential facility.

The CCG says it is developing community services aimed at supporting and caring for patients in their own homes which will reduce demand on inpatient beds.

Somerset CCG chairman Dr Matthew Dolman said: "The model of community health care we are proposing to be developed over the next five years needs to support the growing numbers of elderly and long-term ill so they can live well in their own home for as long as possible - which is what patients say they want.

"Such a model of service must be sustainable and depends upon close collaboration between family doctors, district and community hospitals, social care services and the voluntary sector."

Dr Dolman said that, while a significant percentage of patients currently using hospital beds in Somerset could be better supported in their own homes or communities, the right services needed to be in place for this to happen.

"That is why this community service review is clear that a general strengthening of community based health care needs to be implemented in parallel with any new model of community hospitals," he added.

Consideration of how the proposed model could be implemented in individual areas will take place between December and July next year, leading to the preparation of a business case and implementation plan.

The proposals come as the NHS faces a predicted £30 billion pound funding shortfall within the next five years.

Somerset CCG's share of this national funding gap equates to finding £40 million of efficiency savings each year for the next five years.