Campaigners and local councillors vented their anger and frustration at trust board members as United Lincolnshire Hospital Trust decided this morning (Friday) to follow NHS Improvement advice not to reopen Grantham Hospital’s A&E unit at nights
There were tears and angry accusations of “You have blood on your hands” directed at board members after their decision during their meeting at The Reservation in Sleaford.
Chairing the meeting, outgoing chairman Dean Fathers, summarised discussions after NHS Improvement had requested an independent review of A&E cover in Lincolnshire by a panel of experts known as the East of England Clinical Senate, despite ULHT announcing that it had recruited enough doctors, albeit some agency and locum staff, to reopen the Grantham unit at nights.
He said they were required to take heed of the recommendation by the review, endorsed by NHS Improvement, that there is no change to the opening hours of Grantham A&E, which has remained closed at nights since August last year due to staff shortages across all A&Es in the county. Mr Fathers said it is an appropriate decision in light of those reflections.
However he said they were “immensely aware” that further decisions had to be made and local politicians including the county council’s Health and Scrutiny Committee should be consulted on future thinking.
They also accpeted the review’s advice that they shift to having a single A&E team across the three hospital sites in Lincoln, Grantham and Boston to make sure there is the best supervision and the best outcomes for people in Linclnshire. This was after it was pointed out that skills, training and experience varied from doctor to doctor on the team and there needed to be a standard of care.
He added: “Most significantly we urge the Clinical Commissioning Groups to actually move at pace to expedite the review of patient services across Lincolnshire so people do not continue to have that debate and get the best possible care as soon as possible.”
This referred to the senate’s recommendation that the ongoing work on the longer term Sustainability and Transformation Plan for a modern system of patient services in the county should conclude its plans for urgent and emergency care across Lincolnshire. This is being led by Lincolnshire’s Clinical Commissioning Groups, which represent groups of GPs who commission hospital and care services.
ULHT Medical Director Dr Neill Hepburn had added: “Essentially we are part of the NHS systen and have to abide by those recommendations from that system.
“NHS Improvement strongly advises that the trust board follow the recommendations in the report.”
It was also pointed out to the board that A&Es at Lincoln and Boston were already under pressure from the level of demand. By not reopening Grantham at nights, they would not be getting any worse and knew the workforce they currently had was not enough ot meet the level of demand.
Dr Hepburn said: “We have a lot of locum staff in positions at all levels of A&E. While it is safe as it is, it is not a good service. we are working towards that.”
He said: “There is a concern it is not sufficiently resilient. We could end up where we are short of staff.”
On the conclusion of business a member of the public accused the board of treating patients using Grantham Hospital as second class citizens.
Lincolnshire County Council’s Health and Scrutiny Committee will be looking at the decision when it meets on January 20.
In tears, Fighting for Life Lincolnshire campaigner Melissa Darcy angrily branded the board “a disgrace” saying that they were “passing the buck” by calling for the STP to hurry up.
She told The Standard: “We offered them a compromise, to defer until next month for the Health and Scrutiny Committee to look properly at the review - they have a responsibility to do that. But now they have left us with nothing.”
She said: “I am scared. They (the board) are part of the STP.”
But she said it was not the end of the story, saying: “We will work with the Health and Scrutiny Committee in January, compiling a huge argument against it all - the closure and future plans.”
She believed they have a legal case against what she saw as an eventual downgrading of Grantham Hospital from a level 1 to a level 3 service.
Speaking after the meeting, Dr Hepburn said he could understand people’s frustration, but said this was an issue that had gone on for a long time and there was still no satisfactory conclusion. He said: “We need to support the CCGs in their processes in what they want provided. They can only do it safely and appropriately, but it has to be realistic.
On the matter of the review by the Clinical Senate, he said: “We made a commitment to look at reopening Grantham A&E if it had a number of staff back in 2016. the problem that we have is that the A&E departments in Pilgrim and Lincoln are busy but we regardded as a minimal number of staff has struggled to meet targets. We have reviewed what staffing we need and increasd staffing levels and even today we cannot meet the national targets in A&E sites across the county, so we have not achieved a good service.”
He continued: “The world has moved on. We were much nearer achieving targets then (2016) than we are now. The demand on A&E departments is greater, particularly with regard to complexity.”
He insisted that they were still “totally committed” to Grantham Hospital and that the STP would make sure each hospital was viable and working as safely as possible, but provision of services was likely to change as some services became more specialised by parcelling them together to make them more viable.
As for future housing and busines growth projected in the coming 20 years in the surrounding area, Mr Hepburn said they constantly reviewed demand.
The campaign to reopen Grantham A&E has been backed by Sleaford and North Hykeham MP Dr Caroline Johnson, alongside Grantham and Stamford MP Nick Boles.
She commented: “I am very disappointed with the decision made but I understand the position that the board was placed in by NHS Improvement’s report.
“I met with East Midlands Ambulance Service yesterday (Thursday) to talk to them about improving the emergency care in this area. They are going to be recruiting more people for overnight ambulances by April at the latest and reducing the number of ambulance cars to increase the number of ambulances and more paramedic crews as opposed to technician crews to help support people if they are very unwell by offering access to an on-site ambulance.
“I am meeting with NHS Improvement further and it has been raised at the highest level this week by Nick Boles with the Prime Minister.
“We are doing all we can to get the very best service for Grantham area.”
Dr Johnson added that according to EMAS, hand over delays at Lincolnshire A&Es were much greater than many other hospitals, meaning ambulances stuck for up to four hours.
She saw the shift to one A&E team as a positive move.