'Sad day' as Grantham Hospital A&E unit to become 24-hour urgent treatment centre
Grantham Hospital's A&E department will become an urgent treatment centre after the change was approved by Lincolnshire health bosses.
The plans for the A&E department to become a 24/7 UTC were approved today at a meeting of the Lincolnshire Clinical Commissioning Group, as well as other changes to orthopaedic, stroke and acute services in the county.
The public consultation on these changes ran from September to December last year, with 51 per cent of respondents living closest to Grantham Hospital disagreeing with the proposal for an urgent treatment centre in the town.
Half of the consultees that answered the survey lived closest to Grantham Hospital, indicating the strong level of local concern over the plans, with fears over downgrading of emergency services in Grantham voiced.
Concerns were acknowledged in the meeting over additional travel times for ambulances, causing risk to life, and increased travel times for those attending A&E impacting those without access to private transport, those in rural areas, and those with disabilities.
One concern voiced by campaigners for Grantham Hospital was the difference between the services offered by an urgent treatment centre compared to services offered by an A&E.
Peter Burnett, planning director for NHS Lincolnshire, said that "the vast majority" of people who would attend Grantham A&E would be able to be treated by the urgent treatment centre, with an average of two patients a day needing to travel elsewhere in the county, as their needs would not be met by the centre.
He said: "Care would be received at an alternative site with the right facilities and expertise to ensure better clinical care outcomes."
It was confirmed that part of the implementation of the plans would include a comprehensive communication plan to make sure that local residents are made fully aware of what services the urgent treatment can provide.
Mr Burnett said: "The concerns raised by the public during the consultation in relation to the conditions that would be treated at a 24/7 urgent treatment centre and that Grantham and District Hospital should have a full type 1 A&E department and supporting hospital service provision area are acknowledged.
“These have been considered and reviewed by urgent and emergency care service leads, as well as the wider system clinical leads."
Mr Burnett explained that, following a thorough review of national guidelines and standards, independent clinical advice, current service provision, and population growth, clinicians reaffirmed that a number of combining factors led to the conclusions that a Type 1 A&E department at Grantham Hospital is "not feasible".
Jody Clark, of Fighting 4 Grantham Hospital, asked how long it could take to implement the 24 hour urgent treatment centre at Grantham Hospital, with the response broadly estimating a period of around 12 to 18 months, but that this could be refined in the next stage of the process.
Dr David Baker, clinical lead for south west at Lincolnshire CCG, lives and works locally to Grantham. He said: “This is where the work starts. We’ll put a working group together to actually work out the details of how we can move from our current model to a UTC and realistically that’s going to take some time.
“We want to get this right. It’s got to be right on day one, because it’s important for the public that we do that, so we want to take our time, do the detailed work and when we launch, it’s going to be hopefully exactly as we want it to be.
Jody said: "It is disappointing that the sustained opposition to the continued downgrading of our Grantham Hospital has not impacted on the end result of us getting a 24 hour urgent treatment centre.
"The Clinical Commissioning Group highlighted the travel issues but again we have no solution. They spoke about the continued pressure on the existing urgent and emergency care services previously in the meeting but don't see the need to increase this capacity, when they agree to reduce ours.
"They said that us having a level 1, 24/7 A&E with back up services, is not viable for at least the next 20 years!
"But when they answered my question, the only one submitted, they said the changes to our current services will take 12 to 18 months! That will be seven years from the "temporary" overnight closure!
"Still feeling like our concerns are being ignored but we will keep pushing for improvements."
Dr Baker continued: “I absolutely understand what the public feels. When you get a change in name from A&E to UTC it’s inevitable that people will see it as a downgrading. I don’t, actually. I also work in the hospital on a Friday, so I do understand the type of patients that come into Grantham.
“Some may disagree, we haven’t had what I would regard as an A&E department in Grantham for 15/20 years and the reason for that is we haven’t got the backup services we need for an A&E.
“An A&E should be able to take unselected patients. They should be able to take whatever comes through the door.
“I know the public will say, ‘well we should have all of those services’, but the reality is that things have changed in medicine over 20 years and it’s actually just not possible to provide those services at Grantham."
Dr Baker explained that public feedback had been "crystal clear" and that "people want to be able to walk into that department seven days a week, 24 hours a day, which they can’t at the minute. This model provides that 24/7 access".
“Many more people will get local access to services that they’ve not had for five years, for me that’s the real plus in these proposals.”
Dr Baker added that he was "very satisfied" with the consultation process, with Charley Blyth, director of communications and engagement, explained that the CCG had worked with an organisation called Consultation Institute, who confirmed that they were happy with the process and that the consultation was an example of good practice.
Dr Baker said: “I’m really pleased that we’ve made a decision, and I think it’s the right decision as well. We’ve had difficult and fragile services for many years and what we’ve done with these proposals is I hope and I believe that we’ve solved some of the problems in terms of the fragility of services.
Charley added: “We must not forget our staff. While a progessive and transitional phase of anything is always difficult and leads to some level of uncertainty.
"What our staff, particularly in the acute hospital in Grantham, have been dealing with is uncertainty for many many years, so that knowledge of the future, and the ambition and progression that we’ve seen commitment to today in the longer term is going to be incredibly helpful and we are really pleased for our staff on that level."
District Councillor Charmaine Morgan, chair of SOS Grantham Hospital, said: "The news that on May 25 Lincolnshire CCG supported proposals to the permanent downgrade of Grantham A&E to an urgent treatment centre is both unsurprising yet shocking.
"The changes planned by the CCG will transform our once excellent District Hospital into little more than a cottage hospital with minimal acute care and a focus mainly on elective surgery.
"This is despite our town's increasing population and further development plans which could attract millions of people each year to our area should they go ahead.
"We have been campaigning to save our local A&E for over 15 years. The first attempt to downgrade it came when the Primary Care Trust consulted about the future A&E and Maternity unit.
"We submitted a petition to Downing Street of over 25,000 signatures. The PCT consisted of both NHS staff and local councillors. They listened to us. Both units were saved.
"However, since the loss of PCTs and replacement of these bodies with CCGs, there is no longer any meaningful public representation at the decision making table."
Melissa Darcey, of Fighting 4 Life Lincolnshire, said: "It is a sad day for Lincolnshire but in particular Grantham, today. Six years fighting and, for some, many more than that and today Lincolnshire CCG approve the closure of our A&E.
"At F4LL we always said that this would be the outcome. It has been written in plans and spoken about in meetings for decades but that doesn't take away from the fact that this decision is completely wrong and will have a detrimental impact on our lives in Grantham and surrounding areas.
"To those who have been complicit in the downgrading and removal of our health services - you have and will continue to have blood on your hands.
"Farewell to Grantham A&E and the future of Grantham Hospital as a whole - sorry we couldn't save you."
As well as approving a UTC for Grantham, the board of Lincolnshire CCG also approved the establishment of a ‘centre of excellence’ in Lincolnshire for planned orthopaedic surgery at Grantham and District Hospital, and a dedicated day case centre at County Hospital, Louth.
Also approved was the implementation of integrated community/acute medical beds at Grantham and District Hospital, in place of the current acute medical beds.
The establishment of a ‘centre of excellence’ for hyper-acute and acute stroke services at Lincoln County Hospital was also approved, supported by an increase in the capacity and capability of the community stroke rehabilitation service. Hyper-acute and acute stroke services will be consolidated at Lincoln County Hospital and no longer provided from Pilgrim Hospital, Boston.
John Turner, Chief Executive of NHS Lincolnshire CCG said: "The review of these four services, and consideration of the public feedback received through the consultation, has been led by the senior clinicians who work in and with these four services. They have consistently recommended this set of proposals in order to deliver improvements in quality and the best possible outcomes for their patients.
“Through the public consultation, we were able to engage with the people of Lincolnshire about the full background of our thinking, the challenges that we face and the recommendations which we believe will best serve our population.
“We are extremely grateful to all of those who gave their open and honest opinions via the consultation questionnaire and face-to-face and virtual events across the twelve-week consultation, helping us to shape the future of these county services.”
