A&E to continue overnight closure following review

Grantham Hospital’s A&E department is unlikely to be restored to a 24 hour service following a review of staffing levels at the trust which runs it. United Lincolnshire Hospitals NHS Trust (ULHT) is being urged by ‘independent’ experts to consider the department becoming an Urgent Care Centre instead. ULHT will consider the unit’s fate on Friday.

This latest twist follows health bosses deciding to restore 24-hour A&E services last month after a staff recruitment campaign. The overnight service was withdrawn from the centre in Manthorpe Road due to staff shortages in 2016. ULHT bosses recently backed a return to a 24-hour service pending the review of staffing levels.

But a report by the Independent Clinical Senate says: “The unanimous view of the panel was that it was not in the interests of short-term or longer term patient safety to re-open the Emergency Department on Grantham Hospital Site on a 24/7 basis at this time. “It was also the unanimous view that any changes to service provision on the Grantham site should, if at all possible, be linked to longer term plans for urgent and emergency care across the Trust and these plans should be developed with appropriate stakeholders and public consultation as soon as possible.” At present, the department opens daily 8am to 6.30pm, with campaigners seeking to restore a 24-hour service also fearing for the future of hospital services.

Medical Director at ULHT, Dr Neill Hepburn, confirmed the review had taken place and said it recognised the volatility of staff numbers due to the trust’s extensive use of short-term agency doctors. “Whilst they commended our innovative approach to recruitment and the great strides we have made in attracting additional doctors, they have recommended that it would not be safe to re-open the department overnight at present.

“The quality and safety of care is always our top priority, and so our board will consider the full range of recommendations made by the Clinical Senate to ensure that we do the best for our patients. “We understand this is a frustrating time for our staff and patients in the Grantham area, and we do remain committed to Grantham hospital, but we will only provide services that are safe.”

Jeff Worrall, Delivery and Improvement Director at NHS Improvement, said: “We commissioned this report to ensure that any decision made by the Trust is grounded in expert views on patient safety, which remains our top priority in terms of Lincolnshire’s A&E services. We are confident that the Trust’s leadership are now in a stronger position to make an informed decision in the best interest of patients.

“We will continue to work closely with the Trust, commissioners and other key partners to progress a new model of urgent care for the county, as recommended in the clinical senate report.” John Turner, Accountable Officer, South and South West Lincolnshire clinical commissioning Groups, and senior responsible officer for Lincolnshire STP, said: “We are working with all of our partners to implement the senate’s recommendations. We are also continuing to develop options for the future of A&E services, and are fully committed to consulting with the public about this as early as possible in the New Year.”

Local councillors and campaigners have voiced their anger and disappointment at this latest development. I said this would happen from the start so I am not at all surprised. They do not want to reopen Grantham and they seem to spending more time and effort in trying to downgrade the service than actually save it which is disgraceful considering people’s lives are at risk here. Every minute that A&E is shut is a potential life lost in our community.

“The clinical Senate for Lincolnshire was originally East Midlands and they were aware of the geographical issues that come with providing healthcare in rural Lincolnshire. It is essential that we have three fully functioning A&Es in this county. Without three – lives will be lost. The fact that the east of England Senate is in a completely different area of the country is extremely concerning, they do not understand the impact that the closure has had on our community and the ULHT have consistently been conservative with the truth about the true impact since their decision to close overnight!

“Yet again we will be left with no emergency healthcare over Christmas during the night and as a single mother of 3 children, who does not drive, this terrifies the life out of me. “The clinical Senate recommendations seem to suggest that to Grantham should be nothing more than an urgent care centre, as did the response from the IRP – is it just me or has every organisation got it in for Grantham A&E? “Grantham will most likely be downgraded to an “Urgent Treatment Centre” (to fit in line with the national changes mentioned in the report) by the end of next year if we do not stand up and fight this head on.”

Ward councillor Ray Wootten, who has campaigned for a return to a full 24 hour A&E service, said: “I am angry and disappointed that the goal posts have been moved since the overnight closure started in August 2016. Once again the voice of local representatives, campaign groups and the residents of South Kesteven have been ignored. To expect the trust to recruit 38 middle grade doctors from the target of 21 seems an impossible task and I believe in my heart that it will not be achieved.”

Grantham district and county councillor Linda Wootten said: “Grantham Hospital is considered the lowest denominator within ULHT, an easy target therefore they took our staff away with no public consultation. No doubt the chief executive genuinely wanted to pacify us all by saying he wanted the A&E opened as soon as possible but, the cynic in me always felt in my heart, it wouldn’t happen!” “It’s a disgrace that so many are not listened to. Our nearest A&E is over 25 miles away and combined with limited ambulances, people could die. “Grantham Hospital is a clean efficient and well run hospital an example to many and, I’m saddened by this latest decision.”

Charmaine Morgan, chair of SOS Grantham Hospital, said: “Given the evidence that has been presented to the ULHT board from campaigners when their own hospital records clearly show patients needing critical care are attending Grantham A&E 24 hours a day. Therefore any decision which means these patients will not get the treatment they need puts them at life-threatening risk.

“We know there are issues outside the control of ULHT regarding funding and staffing. However, it’s unacceptable if they continue the night closure because they have, in effect, backed moves by this government to downgrade the A&E network. We would expect ULHT to be prepared to stand up for the people they are serving and reopen our A&E unit.” Campaigner Jody Clark, of Fighting 4 Grantham Hospital, told the Journal: “Our whole community of Grantham and District have stood together to fight for the return of our overnight A&E, since it started on August 17 2016. We were told it was temporary and that when United Lincolnshire Hospitals Trust had recruited enough doctors (21 middle grades – that’s 10 more than when we closed) we would have our services reinstated as it was.

“We have gone to great lengths to show the opposition from our community and all affected services (EMAS, LIVES, Lincolnshire Police, Military, businesses and supporting hospitals). We need our joint concerns heard and acted upon as originally agreed. “At the November Board meeting, the trust unanimously agreed to reopen our overnight service as they had reached 22 middle grades. This should not have changed! “We pay the same contributions as everyone else and do not deserve a postcode lottery in healthcare! “Our large rural county needs the three A&E departments we have and already many have to travel far for emergency care. It makes no sense to reduce our vital services.

“Fighting 4 Grantham Hospital will be at the next board meeting as we have been present at nearly all this year and will be pushing for a minimum extension of hours so our residents can access local services for longer. The fight is not over.”

Article originally appeared on Grantham Journal

The Institute cannot confirm the accuracy of this story or confirm that it presents a balanced view. If you feel this is inaccurate we would welcome your perspective and evidence that this is the case.

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