Grantham A&E at risk as Councillors and Department of Health appear to have lost the plot

The future of Grantham A&E is at risk because both Lincolnshire Health Scrutiny Committee and the Department of Health seem unable to do their jobs.

Between them, they are supposed to make sure that big NHS cuts and changes are only carried out after consultation, and are in the interests of the public and the local NHS.

This has not happened.

For 9 months, the Department of Health has ignored Lincolnshire Health Scrutiny Committee’s request to the Health Secretary, for advice from the Independent Reconfiguration Panel about the hospitals Trust’s decision last December to make permanent the temporary closure of Grantham A&E at night.

The Trust made this decision without consulting the Health Scrutiny Committee, and despite having recruited enough doctors to meet the threshold to safely reopen Grantham A&E at night.

As a result, on 7 September the Chief Operating Officer, Mark Brassington, told the United Lincolnshire Hospitals Trust Board meeting, that Grantham A&E should not look to reopen 24/7. He quoted the East of England Clinical Senate’s view that it was unsafe to do so.

After the meeting, Lincolnshire Health Scrutiny Chair, Councillor Carl Macey, confirmed on facebook that:

“There would be no plan to reopen it overnight, as it will form part of the acute service review & STP which wouldn’t come out until next year when they would have finalised there [sic] plans for Grantham & consultation will begin”

Melissa presentation_10.9.18_lores
Melissa Darcey speaking at House of Commons meeting about failures in the Scrutiny and Referral process

Fighting 4 Life Lincolnshire chair Melissa Darcey said,

“The whole situation is unacceptable. We have been let down.”

Department of Health has breached its own protocol

Campaigners have been told by the Independent Reconfiguration Panel that the Department of Health has failed to notify them of any referral this year from Lincolnshire Health Scrutiny Committee.

But the Department of Health is supposed to do this,  whenever a Health Scrutiny Committee refers a local NHS organisation’s decision to the Health Secretary.

The last notification the Independent Reconfiguration Panel received was the request from Lincolnshire Health Scrutiny Committee in December 2016, to investigate the initial “temporary” closure of Grantham A&E at night.

Questioned about this by Fighting 4 Life Lincolnshire, Councillor Carl Macey knew nothing about it.

Health Scrutiny Committee has lost the plot

All Councillor Macey could say was that – following his lengthy correspondence with the Department of Health –  Lincolnshire Health Scrutiny Committee’s final submission to the Health Secretary was sent on 15 March, after being signed off by the Council’s legal team.

Lincolnshire Health Scrutiny Committee has clearly let matters slide since then.

A few days ago, Councillor Macey admitted to Fighting 4 Life Lincolnshire that neither he nor the Scrutiny Officer knew what the Department of Health had done with the Health Scrutiny Committee’s referral to the Health Secretary.  But they were trying to find out.

On 10th September, the Scrutiny Officer reminded Councillor Macey in an email that:

“The correspondence  with the civil servant [Neil Townley] indicated that there was some unwillingness to progress this referral.”

Health Minister’s letter is a total travesty

Then at the 12th September Health Scrutiny Committee meeting, Councillor Carl Macey produced an undated letter from the Health Minister, Steven Barclay which apparently the Scrutiny Officer had received the previous week.

In the letter,  Steven Barclay says he has asked SW Lincs Clinical Commissioning Group and United Lincolnshire Hospitals Trust to report to him by December, with a timetable, about how they have carried out, or plan to carry out, the consultation envisaged in the August 2017 Independent Reconfiguration Panel advice on the temporary closure of Grantham A&E.

This advice is completely out of date!

There is no longer any possibility of consulting on the temporary closure of Grantham A&E – because last December the Trust made the closure permanent, with no consultation!

The Health Minister, Steven Barclay MP, seems oblivious to two key facts.

First,  that by last autumn, the hospitals trust had recruited enough staff to meet the  threshold required to reopen Grantham A&E at night, and was talking publicly about their intention of doing this. Until the hospitals regulator NHS Improvement put its foot down and the Trust made the temporary closure permanent – without consulting the Health Scrutiny Committee.

Second, that nine months ago, Lincolnshire Health Scrutiny Committee asked  the Health Secretary to seek the Independent Reconfiguration Panel’s advice about this permanent closure without consultation.


Instead, Steven Barclay’s letter evasively suggests that the Clinical Commissioning Group and hospitals Trust:

“may also know that the Health Scrutiny Committee for Lincolnshire has expressed further concern recently about progress with implementing the IRP’s advice (my emphasis) that “…as the staffing threshold currently required to restore the service at Grantham is unlikely to be achieved in a sustainable way, CCGs and local commissioners must work with local providers and the HSC to engage and consult the public on future services.”

Who is Steven Barclay MP trying to fool?

If it is the Health Scrutiny Committee, they seem only too willing – their meeting did not discuss the Health Minister’s letter.

But now, pressured by public complaints, Councillor Carl Macey is writing back to Steven Barclay for “clarification”, according to Councillor Ray Wootten.

Sarah Stock, co-chair of Fighting 4 Life Lincolnshire, said

“Due process hasn’t been followed, from all ends, including the Department of Health.  Frustrations over the past two years relating to our “local issues” are coming to a head.”

This is only the half of Lincolnshire Health Scrutiny Panel’s ineffectiveness

The Health Scrutiny Committee has also failed to hold the hospitals Trust and Sustainability and Transformation Partnership to account, regarding progress with the Lincolnshire Sustainability and Transformation Plan Acute Services Review.

As a  result, any consultation on the permanent closure of Grantham A&E will happen well after the event, as part of the consultation on the Sustainability and Transformation Plan’s wider hospital cuts proposals.

Slashing £182m Lincolnshire NHS spending by 2020/21

The Lincolnshire Sustainability and Transformation Plan aims to slash NHS services in because of  a funding shortfall of £182m by 2020/21.

Like the other 43 Sustainability and Transformation , it  based on NHS England’s instructions in the 5 Year Forward View 2015/16 -2020/1.

A key feature of the 5 Year Forward View is cutting hospital services and transferring them into primary and community services run by integrated care systems (formerly called Accountable Care Systems).

Integrated Care Providers (formerly called Accountable Care Organisations) will be paid on the basis of a contentious form of contract used by the USA’s Medicare/Medicaid limited state-funded health insurance system.

This introduces financial considerations into the question of treating patients – abandoning the core principle that the NHS is a comprehensive service for all who have a clinical need for treatment.


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