The medical director of the trust which runs Grantham hospital says the A&E department cannot reopen fully until it can guarantee a safe service.
Dr Suneil Kapadia, medical director at United Lincolnshire Hospitals NHS Trust was speaking following a meeting of the trust board which agreed to a proposal to extend Grantham A&E opening hours by 60 minutes from March 27.
This will be reviewed again in early March to make sure staffing levels are enough to provide the extra hour. The unit is currently open from 9am to 6.30pm but the proposal means it will open from 8am to 6.30pm.
Dr Kapadia said: “I recognise people want Grantham A&E to reopen 24/7 and will be disappointed with our decision, but before we can reopen the A&E overnight, we need to be confident that we can staff the doctors’ rotas consistently for at least eight weeks in the future.
“To ensure we provide a safe service for Grantham people and those throughout Lincolnshire, it’s important we aren’t in a situation where we reopen A&E one day and then need to close again the next week due to doctors leaving. We need services to be safe and sustainable. ULHT remains committed to fully reopening Grantham A&E but only when safe to do so.
“We are making steady progress in recruiting doctors. We now have three more middle grade doctors working regularly for us than in August - one at Lincoln and two at Pilgrim – and have secured the commitment of another five doctors, who we hope will be with us for three months.
“We currently have 17.6 middle grades for all our A&Es at Lincoln, Pilgrim and Grantham. Although the numbers are higher than in August, they are still below the required number of 21 to have all three departments open 24/7. Even if we had 21 doctors, this is still below our ideal number of 28. The numbers of senior medical staff can vary from month to month and we already know that two doctors will be leaving the Trust in the near future”.
ULHT says its own data shows that the healthcare system is still coping with the overnight closure of Grantham A&E and that on the whole the impact has been small in the number of attendances and admissions at other A&Es. This is disputed by hospital support groups who say that the trust does not take into account figures from the full catchment area of the hospital and that more patients are being taken to other hospitals in Nottingham and Peterborough.
It says its clinical management board (the committee made up of our most senior doctors from across the Trust) supports this decision. They recommend that A&E remains closed overnight but to extend opening hours to cover 8am to 9am if safe to do so. It says its commissioners also support the continued overnight closure of A&E.
A spokesman for ULHT said: “While we are working hard to recruit doctors to work longer contracts, the reality is agency staff have the pick of places to work and often can leave a placement at short notice. We agreed on the threshold of having a minimum of 21 middle grade doctors before we reopen Grantham A&E with our commissioners and our regulators, as the level required for us to staff three A&E rotas 24/7 consistently and safely.
“Our recruitment drive will continue. We are still advertising in the UK and abroad and are working with UK and international recruitment agencies to ensure we recruit enough doctors. We will review the opening hours in three months, at our Board meeting in May.”