Grantham & District Hospital faces its biggest ever threat as the Clinical Commissioning Group plan to remove all acute services affecting the A&E, Acute Care Unit, Consultants and chronically ill in-patients. They plan to use the hospital - 45 minutes at least from the nearest alternative A&E for elective/planned low level surgery turning it into a cottage hospital. We strongly oppose these plans. They will cost lives.
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We have until 23 December 2021 to save our District Hospital.
Open letter to Lincolnshire CCG in response to Acute Service Review (2021) Public Consultation
Rural Grantham & District Hospital is located in the heart of England at the crossroads between the North and South, East and West on both rail and busy A1/A52 routes. The area attracts visitors from across the country and overseas many visiting the large out of town retail park. It is a Growth Town with plans for 7000 more homes at least, new business parks and new retail developments. Grantham is approximately 45 minutes car journey from the next nearest A&E Department. Significant and potentially irreversible downgrade of acute care services at Grantham & District Hospital will put lives at risk, and cause undue pain, suffering and stress to patients and/or their visitors. The proposals do not amount to an improvement in service and will not generally improve patient care nor make it safer as the CCG suggest. Grantham area patients will not have parity with those in Lincoln or Boston areas. The changes will not make services more safe but less so. Local patient resuscitation, intubation and stabilisation will be undermined. We call upon Lincolnshire Clinical Commissioning Group (CCG) to review their Acute Service Review (ASR) plans published: https://lincolnshireccg.nhs.uk/ currently in Public Consultation due to end 23 December 2021.
If the plans go ahead Grantham & District Hospital will become little more than a cottage hospital unable to handle emergency patients and non-planned surgery nor care for acutely ill elderly patients in their local area. Of particular concern are the low income, elderly and disabled residents likely to be most affected. The changes will not make services safer but less so.
The Lincolnshire CCG Acute Service Review includes a review of:-
Orthopaedics (elective and non-elective) county wide
Lincolnshire CCG are proposing to remove all emergencu/non elective fracture surgery from Grantham & District Hospital.
We appreciate complex fractures require urgent specialist treatment however those with less serious fractures will be required to travel to other hospitals potentially incurring further injury en route cross country on poor roads and in pain. We believe that simple fractures should be treated at Grantham & District Hospital and that the majority of patients requiring surgery would prefer th to be completed locally with the exception of complex cases.
Stroke services county wide
Lincolnshire CCG have totally ignored Grantham & District residents in their emergency stroke plans despite the significant distance to any other alternative hospital A&E/emergency stroke site. They only refer to the needs of Boston residents in their emergency stroke plans.
Grantham residents experiencing a stroke have the same concerns and needs as Boston residents being a similar distance to the next nearest emergency stroke unit. A clear plan indicating how Grantham emergency stroke patients will be stabilised in the absence of a local A&E unit and without an emergency stroke unit or ACU is required.
Urgent and emergency care at Grantham Hospital
Lincolnshire CCG propose to downgrade Grantham & District Hospital Accident and Emergency Unit currently available during the day and replaced with a UTC and drop In GP service at night with a 24/7 Urgent Treatment Centre. Lincolnshire CCG also state at Grantham & District Hospital there were 'limited range of presenting conditions dealt with by A&E department since 2007/8.(pg 20)'
Local people have persistently called for the restoration of a 24/7 A&E department after the service was closed at night on a temporary basis by United Lincolnshire Hospital Trust in August 2016.Lincolnshire CCG plans will result in 120,000 residents in the Grantham Hospital catchment area, currently relying on Grantham & District Hospital A&E, in an acute emergency, being forced to travel between 15-45 miles to their next alternative A&E units at Lincoln, Peterborough and Nottingham QMC. The plan puts lives at risk and the number of patients affected estimated by the CCG to be 700 a year is not 'a few'. The CCG have underestimated the impact on emergency patients. Prior to night closure 4400 patients were admitted via A&E. We know 1574 emergency patients were admitted from the Grantham area between 1 July 2020 - 1 September 2021 at Lincoln & Boston Hospitals alone. We must assume the remainder were forced to travel elsewhere. Not all Emergency patients with potentially life threatening time critical conditions require admission e.g. severe allergy, some heart conditions and breathing difficulties. A&E departments elsewhere are too busy now. East Midlands Ambulance crews are forced to wait hours outside these hospitals on a regular basis. Note: Tragically on 6 October 2021 a local young man died whilst waiting to be seen outside Lincoln County. Grantham patients going elsewhere affect those hospitals too.
Contrary to misleading CCG comments, Grantham & District A&E staff had the skills and equipment supported by consultants in the ACU to be able to handle a wide range of acute medical conditions up to the highest severity as evidenced by ULHT responses to SOSGH Freedom of Information requests in 2018. Only recently repeatedly resuscitating a local woman and saving her life after a 2hr wait for an ambulance.
Acute Medicine at Grantham Hospital
Lincolnshire CCG propose not to replace the Acute Service Unit which provided vital medical expertise to critically ill patients and included beds commissioned by the East Midlands Critical Care network.
The CCG propose to leave a minimum number of 'integrated community/acute medical beds' shared with other non medical departments. This will result in fewer patients being admitted into Grantham Hospital.
The CCG proposes to place elderly patients with complex needs out of a secure hospital environment supported by specialist consultants and either move them to alternative hospital sites requiring considerable journeys with associated risks, or, place them into community care which is known to be fragmented and where monitoring patient progress and outcomes will become much more challenging. They will not receive the level of medical care they would get in hospital until they make a recovery and will be at greater risk of non recovery.
Consultant training and staff
Lincolnshire CCG omit reference to Grantham & District Hospital as a training hospital in their new plans
Grantham & District Hospital was popular among doctors training as specialist consultants. Elderly patients with chronic complex conditions were supported locally by respiratory, cardio and gastro specialists who provided training support for new Consultants. The site also had training equipment available. Lincolnshire CCG & ULHT the consultants should work mainly between Lincoln and Boston. Dissatisfied staff and consultants will make the future of hospital services across the county less sustainable.
In view of the concerns raised I do NOT support the recommendations in the Lincolnshire Clinical Commissioning Group Acute Service Review 2021. I call for a full restoration of acute services at Grantham & District Hospital and consider if the changes are implemented that the CCG will not have fully reflected my concerns in their Public Consultation. I would also consider what is left of our District Hospital to be little more than a cottage hospital and that future development plans for the area should take this into consideration.
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