Paul Lewis, formerly the senior nurse in charge of Grantham A&E, has gone public with leaked news that, together with Professor Briggs (President of the British Orthopoedics Association and National Director for Clinical Quality and Efficiency), United Lincolnshire Hospitals Trust has announced the decision to withdraw Orthopaedic Trauma from Grantham Hospital.
Alerted to this news, campaigners found that the announcement was made on 21st March, at an internal ULHT meeting with staff.
Withdrawing Orthopoedic Trauma from Grantham Hospital would mean that anyone with broken bones that require surgery will have to go to Lincoln County Hospital.
Without Orthodaedic Trauma, the A&E Department couldn’t function or remain open
In his open letter, Paul Lewis says,
“The repercussions to the Accident and Emergency Department, and the people of Grantham, will be devastating…
“We must act immediately as we have such little time.”
Without Paul Lewis’s open letter, the public would still be in the dark.
Fighting for Life Lincolnshire has called two public meetings to decide on an action plan
- Friday 6th April 6pm at Grantham Railway Club
- Sunday 8th April at 3.30pm in Grantham Museum for anyone who cannot attend the Friday meeting.
Children are welcome and there will be colouring packs for them.
The public message from the medical director of ULHT, Dr Neil Hepburn, to Fighting4GranthamHospital downplays the news:
“We are looking at options – as we do all the time and no decisions made.”
He admits that ULHT are “exploring” how they could move all elective orthopoedic inpatient treatment ( ie joint replacements) to Grantham Hospital and that if they did, “this might mean the orthopoedic trauma surgery goes to Lincoln/Pilgrim.”
As this would be a significant service change and so require public consultation, ULHT have to say they’ve not made a decision, since otherwise this would mean they had predetermined the consultation. This would be unlawful.
Slash Trash and Privatise
The 2016-2021 Lincolnshire Sustainability and Transformation Plan
is intended to cut and change the NHS in the county so that it can make do with a predicted £60m/year underfunding for Lincolnshire’s hospitals – which amounts to a £300m funding shortfall by 2021.
Since 2016, the financial situation seems to have got worse. The December 2017 Minutes of Lincs STP stakeholders board meeting say that:
“in order to achieve a £70m deficit control total, the Lincolnshire system needs to make a £127m worth of savings this year alone. This will not be achieved and the prediction is a £98m deficit. …there is a developing system wide financial recovery plan…”
The Sustainability and Transformation Plan says that the funding shortfall means a smaller acute hospital sector. The Sustainability and Transformation Plan case for change (now unavailable on the Sustainability and Transformation Plan website) said they were considering which hospital services to centralise in “centres of excellence”, and where these would be.
It also said that Grantham, Boston and Lincoln hospital will not all provide the current range of services, and:
“This may mean some patients having to travel further when they do have to visit hospital.”
The Department of Health has calculated savings to be made by making various hospital specialities more “efficient.” Trauma and Orthopoedics offer the 3rd highest potential “saving” (ie cuts): £286m, with Professor Briggs in charge of this.
This is a vital, urgent matter for both South Kesteven and Lincolnshire Scrutiny Committees
Both South Kesteven District Council Combined Scrutiny Committee and Lincolnshire Health and Social Care Scrutiny Committee must get ULHT and the Sustainability and Transformation Partnership to attend their upcoming meetings and explain:
- what they are doing with Orthopoedic Trauma and elective orthopoedic inpatient treatment at Grantham Hospital and across Lincolnshire, and
- exactly what they told the ULHT staff at the 21st March meeting.
Loads of people need to contact the Scrutiny Committees about this and also write to their Councillors – both on the Scrutiny Committees, and their Ward Councillors.
18 April Lincolnshire Health Scrutiny Committee meeting
This is at 10am in Committee Room One, County Offices, Newland, Lincoln LN1 1YL.
To make a deputation statement, tell the Scrutiny Committee in advance by emailing firstname.lastname@example.org or phoning 01522 552104.
In order to make sure that Councillors are clued up enough to ask the right questions, it’s REALLY important that campaigners make deputation statements at the scrutiny meetings, to spell out exactly what questions ULHT and the Sustainability and Transformation Partnership must answer, and why.
The agenda for the 18th April Meeting will be online a week before the meeting.
It will include an update on Lincolnshire Sustainability and Transformation Partnership’s Acute Services Review, according to the HSC work programme in the Minutes of the 21st February HSC Meeting.
Some other questions ULHT needs to answer
1. What is the CLINICAL justification for any proposal to remove orthopoedic trauma? (there isn’t one – since as Paul Lewis points out, the clinical audit of trauma outcomes, particularly relating to the fractured neck of femur surgery, has established much better outcomes at Grantham, compared to Lincoln and Boston hospitals)
2. What possible other justification could there be for ULHT’s decision/proposal? ULHT need to explain how their proposal to remove orthopoedic trauma fits with the Sustainability and Transformation Plan and its cuts agenda. Given the clinical audit, as Paul Lewis writes in his open letter,
“The decision to withdraw orthopaedic trauma must therefore be based purely on finance and the desperate need to consolidate services and save money in a failing organisation.”
3. ULHT and the Lincs Sustainability and Transformation Partnership BOTH need to tell the Scrutiny Committees why the acute services review is so lacking in transparency. At the Lincs STP stakeholders board meeting on 10 Jan there was a verbal report on the acute services review. No paper trail, no public access to documents. And the minutes of that AND the February 2018 meetings are not online. That is very slack.
4. Is ULHT’s announcement about moving orthopoedic trauma out of Grantham Hospital and the related idea of turning Grantham Hospital into a “centre of excellence” for planned orthopoedic care the result of a new STP priority announced at the December 2017 Lincs STP Stakeholders Board: optimum configuration of acute care services? Because:
“[T]he STP does not address all hospital services and in particular has no granular detail on planned care.
Any future work will need to be cognisant of the ULHT Clinical Strategy for 2021 which is aligned to current thinking in the STP.”
5. ULHT and the Sustainability and Transformation Partnership need to explain what it means that that the CCGs and the system are on a:
“journey…into a new accountable structure.”
(From the same December Minutes)
ULHT must stop playing silly beggars with our elected councillors
Comments on social media by Cllr Carl Macey, Chair of Lincolnshire HSC, bear out the need for questions about ULHT’s and Lincs STP’s lack of transparency:
“Currently the constant push back is, they cannot share any further detailed plans until the outcome of the acute service review, we asked for the future plans for Grantham at our last meeting, only to end up with a completely different document with Grantham taken completely out of scope, which the whole committee berated the commissioners of ULHT on…”
Cllr Macey added that he has no information about the Acute Services Review but after meetings on Wednesday, hopes to know when it is likely to be released.
However Lincs Local Medical Committee seem to have heard about the Acute Services Review, so maybe they should come to the Scrutiny Committee meeting too.
South Kesteven District Council has a Combined Overview and Scrutiny meeting 9 April at 10am
The Support Officer is Anita Eckersley
Tel : 01476 406517
The only agenda item is the Council’s Corporate Strategy, about how to survive by “developing a commercial approach to create new income streams and cut spending”, when Central government cuts all its revenue support grant by 2020. This is pretty desperate stuff. And no doubt relates to this
But members of the public can suggest additional agenda items by e-mailing email@example.com.
And there is also “Any other business, which the Chairman, by reasons of special circumstances, decides is urgent.”