ULHT have presented plans for Grantham Hospital which they argue are a temporary measure, to be regularly reviewed. Due to the Covid 19 situation their plans can be legally implemented without public consultation. Whilst they reflect a national crisis building as Hospital Trusts across the country face an increasing backlog in elective surgery including Cancer treatment due to Covid 19 the plans will result in the biggest changes Grantham Hospital has seen.

ULHT are proposing to make Grantham a ‘green site’ which would see an increase in planned or elective surgery at the site. This would include cancer treatment. The use of the 4 theatres, currently unused, is welcome although patients across the county would be treated here increasing the need for patients and visitors to undertake long journeys. The Trust anticipate 2335 patients from Lincoln & Pilgrim Hospitals will join 1223 patients from Grantham. An additional 1932 Chemotherapy Day Cases will move from Lincoln and Boston to Grantham joining 80 Grantham patients.

Under ULHT plans however the increase in elective surgery comes at a staggering cost to the local critical care wards and emergency care provided now at Grantham & District Hospital (GDH) A&E serving our community. The report states ‘Grantham Hospital would not admit any medical emergency or elective medical patients, there would be no medical inpatients on the Grantham site’. It is estimated that 4611 A&E patients will be displaced out of 24, 617 visitors to Grantham A&E. ULHT anticipate nearly 3000 patients will have to travel as far as Peterborough with over 1000 going to Lincoln. This is little consolation considering the pre Covid 19 wait times were staggeringly high at both hospitals. 

ULHT are proposing to replace the A&E unit, which (though open only in the Day and early evening now) currently provides life saving urgent care. Foi evidence shows the site, (despite former claims by ULHT board members) , has the ability to handle nearly every type of medical emergency, and crucially, where time is of the essence, life saving patient stabilisation and resuscitation. 

GDH is at least 45 minutes blue light ambulance journey away from the next nearest A&E unit. Furthermore, the Trusts own Equality Impact Analysis high lights the negative impact the loss of local A&E care will have on the most vulnerable in the 120,000 strong community living in and around Grantham. 

The loss of the Medical Wards, mainly supporting the most vulnerable elderly residents with complex conditions,that require specialist care is a further bitter blow. Over 1100 patients will be relocated to Lincoln. This will cause significant issues for visitors, especially those without access to transport or on a low income. Winter travel between Grantham and Lincoln can be treacherous with ice, snow and fog on poor roads with poor visibility from 4pm.

The most vulnerable people will be required to transfer to other hospitals. An estimated further 847 patients will be affected. Already 854 patients were transferred last year. Furthermore there will be long term ramifications around staff. 
The report indicates there are already issues with staffing at Boston and Lincoln. We know, from previous work, Grantham has a number of consultants who are agency staff. Whilst ULHT report it is keen to reduce its reliance on agency staff we could be losing valuable skills. Once key staff have been forced to relocate to Lincoln or Boston as planned there is no guarantee they will stay with ULHT, or that they will return to Grantham. Although ULHT state the situation will be reviewed quarterly, nationally NHS representatives are stating it could take years to catch up on elective surgery backlog. 

Cllr. Charmaine Morgan, Chair SoS Grantham Hospital said:

“During a recent public consultation over 25,000 online signatures were presented by SOS Grantham Hospital to local health authorities. The report included personal accounts of how Grantham A&E has saved local lives. The 24/7 Urgent Treatment Centre they are offering does not replace an A&E unit.

It is with bitter irony I read ULHTs latest proposals. Having only recently drafted a motion to full council calling for the Trust to restore the services which they have removed over the last decade. Instead, they appear to be using Covid 19 as an excuse to fulfill the plans former medical directors laid out 5 years ago. Further more ULHT was under pressure from NHSI to reduce the number of A&E units in our county.

These proposals also include losing our important antenatal clinic and scanning facilities, putting mums and babies further at risk, having already lost our maternity unit.

We have to ask if the retention of the agency consultants would have meant both elective surgery and critical care could be provided at GDH as was once the case.

There is reference to a review of inpatient transport to support plans. I called for a regular 24/7 inter-hospital service when the Trust closed our A&E at night. We didn’t get it.

They said the night closure was a temporary measure. Nearly 4 years later it is still closed and the Trust reneged on an opportunity to reopen it when they had the chance.

We called for a restoration of a 24/7 A&E unit. Latest proposals are for a 24/7 Urgent Treatment Centre. At least we gained longer opening hours though the most sick patients will be at more risk 24/7 when these plans go ahead. 

Outpatients will also be required to travel elsewhere for example for diabetes, cardiology, endocrinology, fracture follow up, family health, community paediatrics (Kingfisher Unit), Therapies and Rehab.

Local campaigners must be forgiven if we are cynical about the latest proposals. The need for more elective surgery is widely recognised but it seems we are robbing Peter to pay Paul. Staff, patients and their visitors will be travelling back and forth on some of the worst routes in the country. 

This represents one of the biggest changes our hospital has seen.  As ever it feels like we have been robbed again. 

Whilst these changes are not set in concrete the Trust have virtually total autonomy over what services they provide. As I told Gareth Davis MP when we met, unless Jeremy Hunt’s 2012 Health & Care Act is repealed, that will remain the case. 

When we consider the significant numbers of patients, and severity of their conditions, who will be required to move across the county and outside the county for treatment from GDH to accommodate the ULHT plans, we have to ask if there is an overall gain from all this change?

We must also ask if irreversible damage will be done to the highly skilled consultant staffing team at GDH. What impact will that have on the future of our hospital?”

The full report can be viewed here:
https://www.ulh.nhs.uk/about/board-meetings/thursday-11-june-2020/

District Councillor Charmaine Morgan, Chair SOS Grantham Hospital, Mobile 07398 156296