Recently we have all been made aware of the utterly disgraceful decision United Lincolnshire Hospital Trust, that starting on a pilot/trial basis Grantham accident and emergency department, will be forced to close its doors throughout the night for a period of 3 months due to staff shortages.
This would force residents of Grantham from the early evening onwards to travel either an hour to Boston Pilgrim Hospital or to Lincoln County Hospital should they need to visit an A&E department. In my personal opinion that is completely unacceptable, especially as a lot of Grantham’s residents do not have access to their own forms of transport and are reliant on locally provided bus services.
Dr Suneil Kapadia, medical director at ULHT, said: "We have not made this decision lightly, but we've made it for the right reasons – to maintain patient safety in all three A&Es.
Currently the stance from ULHT is that Grantham’s A&E department will fully reopen once they have reached the safe staffing level of 15 consultants and 28 registrar of middle grade doctors, currently the staffing ratio is, 14 consultants – 10 which are locums and only 12 middle grade doctors.
However they have provided no time frame as to when this will be.
They have outlined that there is an issue with recruitment and retainment of trained medical staff.
Whilst I can see what Dr Suneil Kapadia is saying that staffing levels need to be maintained across all 3 sites, I personally believe that this decision has not been thoroughly thought through when you consider the demographics, geographic location and current economic climate.
Grantham’s population is currently estimated to be around 43,117, excluding external villages of Great Gonerby and Barrowby, and is predicted to rise by conservative estimates by an additional 16,000 over the next decade.
So with this planned increase in population there is a definite lack of coordinated planning and foresight in infrastructure management between the Council and ULHT.
Currently 21% of Grantham’s population are aged 18 and under, that's 9055 of the population, that's potentially 9055 that do not have their own form of transport to travel the 30 miles to Boston or the 34 miles to Lincoln, and as we are all aware, parents are already having to take their children to Lincoln, due to the children's ward being closed, I myself have had to do this and it is not an enjoyable experience.
26% of Grantham’s population are aged 60-85, that's 11210 people that by the nature of the age and health, may not even be in the position to get themselves to either Boston or Lincoln. This would leave them either reliant on friends or family or having to fork out £35 to get there in a taxi and then £51 to get back. Now when you consider the state pension is £155.65 a week, that does not leave our pensioners with a great deal of income after one trip to A&E during the evening. I believe it has also been confirmed by ULHT that there will be no remuneration for the cost of travel during the length of the closure.
Now if we look at where Grantham is located, geographically namely on top of the two busiest transport links in the area, the A1 and the East Coast Mainline, both of which are high speed transport links and both of which have the capacity for a serious incident. Would it not make sense for Grantham Hospital to be fully operational at all times? The closure of the A&E department, to me looks like a massive oversight by ULHT in infrastructure and management, for if there was ever a need to declare a “Serious incident”, within the locale of Grantham, should there by say a high speed derailment for instance.
Now as we aware Grantham Hospitals operational capability has been getting gradually scaled back since 1991, with closures of wards such as the children's ward and the maternity ward.
Now we face possibly the most detrimental closure of all in the A&E department, it is said that there is a golden hour when it comes to life threatening emergencies in receiving the treatment that is going to preserve life, and that is fine providing you're able to get an ambulance within that hour and if you do fantastic, as modern ambulances are very much mobile hospitals and the paramedics are fantastically trained and brilliant at their jobs however, due to the rural nature of Lincolnshire and it's terrible transport links between Grantham and Boston, and Grantham and Lincoln, odds are you may well be waiting for longer than an hour for that ambulance.
Only recently I had to help the Police direct traffic around a woman who had been hit by a car on the zebra crossing outside the White Lion pub, a woman who lay there for two and half hours waiting for an ambulance. So much for that golden hour.
ULHT have denied that the closure of Grantham A&E department will likely increase the risk of death to patients, I argue the absolute opposite, I argue that ULHT are playing fast and loose with people's lives, the lives of children especially. I personally believe that now that we are inside of this closure, it will be used in the not so distance future to say there is no longer a need for a full A&E department and that the residents of Grantham need nothing more than a minor injuries unit, forcing Grantham’s population into having to travel to Boston or Lincoln no matter what time of day it is, and eventually we will find that we have a cottage hospital. I believe that is an entirely politically and financially motivated decision as opposed to that of patient safety.
A Junior Doctors starting salary is currently, £22,636. Now ULHT have said that they have a staffing level problem, which is fine, however why are they not advertising for these vacancies as for all my job searching there is only 3 jobs I can see for A&E department one is a flow coordinator with a salary of £41,373 per year that wage nearly pays for two junior doctors and two A&E speciality Doctors, however these are all based at Lincoln and not Grantham. Surely if there is an issue of lack of Doctors at Grantham, that is where the priority should lie in terms of recruitment and employment.
The reason I say I believe these decisions to be politically and financially motivated, is because of the ongoing situation between the Department of Health and the British Medical Association with regards to the Junior Doctors contract, please bear with me I am not trying to move away from the A&E closure, as the two situations are intrinsically linked.
The statement from ULHT as quoted earlier,
“We have not made this decision lightly, but we've made it for the right reasons – to maintain patient safety in all three A&Es.”, ok I'm fine with that, patient safety should always be paramount. However an ideology is being enacted throughout the NHS at the moment at the hands the DOH, whereby the current government wants a 7 day elective service, now we already have a 24/7 emergency service. However in the case of Grantham, if ULHT, are unable to operate a 24/7 emergency service, how on earth are we to believe the government's claims they could run a 24/7 elective service?
When there isn’t the adequate staffing levels across the hospital to run an A&E department across normal operating conditions. For me the idea is unmanageable.
There is an ideology currently in Whitehall, that we can stretch an already underfunded and understaffed 5 day service over 7 days, without increasing the levels of Doctors, nurses, radiographers, porters, surgeons, anaesthetists, physiotherapists and many many more.
All of the above staff are needed for a 7 day elective service not just Doctors.
So if I come back to Grantham hospital, this Whitehall ideology seems to be in place already, as we all know the hospital is lacking in staff and funding and as a direct result has had to close its emergency doors, and unless we carry on mobilising and fighting the injustice that is being inflicted upon Doctors with the reckless attempts by Jeremy Hunt to enact his ideological war on the NHS, you will soon find Hospitals up and down the country, forced into closing their doors for good due to a lack of staff, and the result will be super-hub hospitals in geographical strategic locations, which will have a direct correlation on patient mortality rates.
Although for the residents of Grantham and the surrounding area, the closure of our A&E department is unacceptable to us and I will stand alongside you every step of the way in this fight. It is one cog of a much larger machine moving towards the wholesale privatisation of the NHS, and for those of you that say “it won't happen”, please believe me when I tell you it has been for last 20 years at the very least, what with dentistry, ophthalmics, PFIs and now companies like Virgin health buying up entire areas of the healthcare industry contracts worth £700 million just in one county.
It has been reported to me from someone on the inside at ULHT that Grantham hospital was never short of Doctors, and in fact the shortage was actually at Lincoln and Boston(this would tie in to Doctor vacancies being advertised for Lincoln) so the Doctors were pulled from Grantham, to supplement Lincoln, and as a result, ULHT released a statement stating the shortage at Grantham and closed the A&E due to not having emergency surgery or ICT (as they already closed those).
The very same whistleblower informed me that Grantham Hospital is structurally unsound and it is ULHT’s responsibility to repair the structure as parts of the estates are listed. Unless of course the endgame is to close it.
But that's secondary to reinstating the A&E.
ULHT have attempted to distort the facts by stating that Grantham is a category 3 A&E, meaning it only manages less urgent care cases but over the last 12 months there was 4000, 999 emergencies and over 4000 walk in emergencies that needed stays in hospital – all treated at Grantham Hospital, clearly making it a category 2 A&E.
Given the above inside information, I would say that there is very much a concerted effort by managers in offices, at ULHT in line with the Health and Social Care Act 2012, and Jeremy Hunts ideology of the eventual privatisation of the NHS, to attempt to close Grantham hospital by the back door, thus leaving 43,117 people having to travel to either Lincoln or Boston on a permanent basis whenever they require hospital treatment, is this a situation you wish to find yourself in, in the future?
So if we want to save Grantham Hospital A&E then we also need to save Grantham Hospital because once the A&E is closed, the hospital will not be far behind.
I stand in solidarity with all of you fighting for our A&E and our NHS.