A group representing staff at Grantham Hospital has passed a vote of no confidence in the health trust’s medical director over the decision to close A&E at night.
Members of Grantham Hospital Medical Advisory Committee were unanimous in their vote of no confidence in Dr Suneil Kapadia.
The committee says there has been a lack of transparency and cooperation with staff over the decision to close the A&E department between the hours of 6.30pm and 9am since August 17. The temporary closure is for three months but there have been no guarantees from United Lincolnshire Hospitals NHS Trust (ULHT) that it will reopen after that period.
In a letter to the chairman of ULHT, Prof Dean Fathers, the chairman of the medical advisory committee Miss Aarti Varma says: “Our Medical Director does not display the levels of engagement or transparency that we would expect of a senior member of the Executive Committee.”
Miss Varma continues: “I am formally notifying you and the Board that a vote of no confidence in Dr Suneil Kapadia was held and passed unanimously. There were also serious concerns raised about the levels of engagement of and transparency of the Chief Executive and the Chief Operating Officer as we are clear that he has not acted in isolation but has their tacit backing.”
ULHT says the decision to close A&E was taken so that staff could be transferred to Lincoln and Boston where there was a staffing crisis. Miss Varma says in the letter that the committee was understanding of the situation at Lincoln A&E and it suggested ways in which Grantham could support it.
Miss Varma said in the letter: “Our suggestions to see extra patients at Grantham A&E and ambulatory areas to offload the pressure at Lincoln were summarily dismissed by Dr Kapadia stating that it was not acceptable for patients to travel to Grantham. Yet his next statement was to state that by closing our A&E department to new patients after 6.30pm, it would be acceptable for patients of south west Lincolnshire to have to travel to Lincoln, raising questions of why they should be regarded differently to the patients of Lincoln and its surrounds.”
The letter to Mr Fathers criticises the trust for not getting round the table with staff for an “engaged and constructive dialogue” over plans to close A&E. Miss Varma says the proposal was circulated for comment by Grantham clinicians at 5.53pm on August 16 with a view to being implemented at 10am the next day. “Clearly this is unacceptable practice,” she adds.
Asked for her response to the accusations of the committee, the chair of campaign group SOS Grantham Hospital Coun Charmaine Morgan said: “To see the letter from the chairman of the medical advisory committee to ULHT raising concerns over the decision made on A&E gives significant weight to the concerns flagged by the public over the closure of A&E at night. In particular, the lack of consultation has meant there was no formal opportunity for the voice of the public or medical staff at Grantham to be heard and considered as this may have influenced the decision. It’s hugely concerning as it appears to have been disregarded.”
The hospital is in the ward of Coun Ray Wootten who said: “This vote of no confidence in the medical director is a damning indictment of the board of ULHT by its workforce.”
Chair of ULHT Dean Fathers responded: “I am surprised the consultants at Grantham have shared this letter with the media before showing me respect by talking to me first.
“Along with the CEO I have offered to meet Miss Varma face to face to discuss the issues she has raised, and to agree a plan to address the concerns that our consultant staff have raised and that enables us to engage them more effectively.
“The trust board has total confidence in the executive team, including Dr Kapadia, and I know they work closely with our medical workforce as well as other clinicians throughout the trust. Our most senior doctors, known as clinical directors, are part of our decision making in the organisation and meet regularly with executive directors. We also hold regular Clinical Executive Meetings made up of senior doctors, nurses and other clinicians and this along with a range of other mechanisms help us to ensure that clinical based decision making is at the heart of our decisions.
“Due to a severe shortage of doctors, we had to make the difficult decision to close Grantham A&E quickly in the interests of the safety of our patients. Once the need for a decision had been supported at the necessary levels, we involved our staff, NHS partners and other stakeholders as quickly as possible. This involved meeting with the staff personally involved and most of the senior doctors before final decisions were made. We are still engaging actively with those involved and have adjusted our working arrangements to take account of their feedback.
“This wasn’t an easy decision to make and as we said at the time, was the safest option available to us. It was made to protect patients and maintain safe services for the population of Lincolnshire. ULHT Trust Board remains fully supportive of the decision and the actions taken by the executive team to implement it.
“We are always keen to learn lessons from implementing difficult decisions so that we can learn from experience and improve for the future and we know that this decision has affected the working practices for some staff.
“No final decisions have been made on the future of services at Grantham Hospital or at any of our hospitals. We are committed to engaging our staff and the public in our long term plans and decisions. I am committed to ensuring that we understand the concerns expressed by Miss Varma and to ensure we continue to improve how we manage change led by clinicians and with patients at the centre of everything that we do.”