The Cranford Hospice review is a bruising document for staff and patients. It comes after a sorry period of accusations and counter-accusations from within Cranford, which made it abundantly clear that management and staff were at loggerheads. We did not need the audit team set up for this review to tell usthat the Cranford operation had become dysfunctional, as this was obvious even before a formal complaint by former medical director Libby Smales. Curiously, there was a brief attempt from some involved with Cranford to pass off the emerging reports of internal problems at the hospice as a media beat-up. They weren't and the result of the Smales complaint was the review set up by the Hawke's Bay District Health Board, which has determined that it will "intervene" in the hospice and take over inpatient care at Hawke's Bay Hospital from May 17 for at least six months. Cranford will continue to offer support for users of the hospice other than inpatients while a restructure gets under way. Some in the community are horrified at the outcome and this is understandable as a welcoming and intimate hospice is a far more pleasant prospect than a public hospital in which to spend your final weeks. Others accept that Cranford has deep-seated management issues and that it has failed to adequately address questions around staff training and performance. This is, perhaps, the most important aspect of the review. A new broom is needed to save a grand old dame and this will take the form of a restructure. Redundancies are likely. No one is saying that staff at Cranford do not care for their charges as best they can but there are clearly questions over whether the right people are in the right roles from top down. The importance of the review is to draw a line under problems of the past and to set up this much-loved Bay hospice facility for the future. If this is done well, there is every reason to expect that the people of Hawke's Bay will continue to support Cranford.
