A single A&E department which serves the whole of Lincolnshire could become a reality as major health and social care providers conjure up a new ‘model of care’.
A blueprint presented to county councillors on Friday by the executive director of Public Health Tony Hill brings the closure of Grantham’s A&E department a step closer.
At the full Lincolnshire County Council meeting, councillors heard about the “urgent need” to reduce high mortality rates and improve a poor quality of service in the county’s hospitals. This “radical” review is across the entire spectrum of health and social care services.
Dr Hill told councillors: “It’s probably the most fundamental review of health and social services that we shall undertake in Lincolnshire in our lifetimes, and it will also be a really radical change in the way we do things.
“The reasons for that largely focus on the quality of services that are delivered to the people who live in Lincolnshire.”
Dr Hill referred to the investigation by Sir Bruce Keogh, England’s NHS medical director, into 14 trusts with higher than expected death rates in its hospitals. This placed the United Lincolnshire Hospitals NHS Trust (ULHT), which runs Grantham Hospital, into ‘special measures’.
Dr Hill said mortality rates are now decreasing, taking the county from an “extremely high level” of a few years ago to what is still above what is acceptable.
But he added: “Figures show we have a big issue there and we know that there are really significant numbers of people who are dying unnecessarily in hospitals because of the quality of care they receive.”
The aims of the new ‘model of care’ is to bring together all healthcare organisations and those involved include ULHT, East Midlands Ambulance Service, HealthWatch Lincolnshire, the various clinical commissioning groups and local authorities.
By sharing the load, it is hoped that they will avoid the current £20.6 million healthcare deficit spiralling to an estimated £105 million in just five years’ time. It is also hoped that a higher calibre of doctors and other health professionals can be persuaded to come to Lincolnshire, which has historically stuggled to recruit a high quality workforce.
The new model would see one major A&E department, community hospitals run by GPs and nurses, and neighbourhood teams of GPs, nurses, therapists, social and care workers, mental health specialists and people from the voluntary sector.
In place of A&E departments would be urgent care centres fronted by GPs. Dr Hill said this is sensible as 90 per cent of cases that come through A&E doors could have been dealt with by GPs.
Meanwhile, neighbourhood teams, which would be “at the very centre” of healthcare, would be responsible for populations of 20,000-40,000 people and would be tasked with keeping patients out of hospitals by delivering care in the home.
Present at Friday’s meeting was Councillor Charmaine Morgan, who chairs campaigning group SOS Grantham Hospital.
Although she welcomed the integration of health and social care to improve services, she voiced concerns about the cost of a new model and the downgrading of A&E departments.
She said: “The financial climate in which the review is taking place risks proposals likely to be focussed more on saving money than delivering the services that people need.
“There is a proposal to reduce A&E provision with centralised A&E services. There will be an increased dependency on GPs replacing most existing A&E facilities as most local hospitals become more like cottage hospitals. More detail is needed about how this will work.
“Given the size of our county, poor public transport and high number of residents on a low income or unable to drive this will result in local people being unable to access A&E services directly and increased pressure on ambulance services. The risk to patients being forced to travel will increase.”
Various medical boards have already approved the blueprint, including the Lincolnshire Health and Wellbeing Board, and phase two, which will put more detail into the plan, will begin after Christmas.
Dr Hill said the final plan would be implemented over a number of years.
He added: “There’s a real urgency about getting this sorted out and the timetable is very speedy indeed.”
Public consultation will not begin until the summer. But Coun Morgan in her role with SOS Grantham Hospital is keen to gauge public opinion now. She can be contacted on 01476 574748 or firstname.lastname@example.org
** What do you think to the new ‘model of care’? Will the plan work? Are you concerned about losing Grantham’s A&E? E-mail: email@example.com