During the development of the Lincolnshire Sustainability and Transformation Plan (STP), by Lincolnshire Health and Care (LHAC), the long-term future of Grantham Hospital’s accident and emergency unit is to be decided.
A key target of the national STP programme set by NHS England and the current government is the reduction in use of accident and emergency services.
The draft Lincolnshire STP, currently our only indication of local plans, shows that they are trying to make ‘savings’ by cutting the number of visits to A&E by almost a third.
The ‘temporary’ night closure of Grantham Hospital’s A&E has lead to local people campaigning for vital services. The recent provision of one additional opening hour of our A&E from 8am to 9am has been hard fought for and disgracefully short of a restoration of the evening and night services we have lost.
Whilst Jeremy Hunt, Minister for Health, pontificates on whether or not to re-open our A&E unit at night, some of us have reached the conclusion that the decision will be so late it will overlap with the timeframe for implementing the Lincolnshire STP.
In view of this, I contacted Alan Kitt, chair of LHAC, and asked if there is any further indication of what the long-term plans are for our A&E unit. It is encouraging that he responded stating that a 24-hour service will potentially be restored. There is a recognition we need this.
The unit may even retain the name of accident and emergency. However, what A&E departments across our country will look like in the future is less clear.
In what can only be a cynical move it appears there are plans to change the definition of services at our A&E units. They may look far more like the smaller urgent care centres that we have objected to, while the services we are used to thinking of as A&E will be centralised in Lincoln.
It is vital we retain the life-saving resuscitation and patient stabilisation service at our local hospital site. Without this, the hour journey elsewhere means some local people will die.
To deliver this for a wide range of scenarios, including heart failure, sepsis, allergic reaction, breathing problems and substance abuse, the unit must have appropriately skilled staff available.
If there is one key message that came from the recent series of SOS Grantham Hospital workshops, it is that members of the public are not medical experts. Whether the Government likes it or not we are not qualified to identify if a headache is just a headache, or, a symptom of something far more serious such as meningitis. There will be times when we go to A&E and it is not necessary but far better we do that than fail to go, or fail to take our children, and find out too late we have made a mistake.
Recent decisions in Lincolnshire County Council (LCC) are also affecting us. The Labour group opposed the switching off of streets lights at night for a number of reasons. Here in Grantham there has been a spate of burglaries. The combination of poor or non-existent street lighting and poor paving has created hazardous conditions for pedestrians, especially in the streets left with no lighting at all.
In an ironic twist, we are now told that East Midlands Ambulance Service crews are struggling to find the homes of emergency patients at night time because they cannot see the house numbers, leading to delays.
The decision to turn off our street lights is due to LCC’s decision to set aside over £20 million from this year’s budget to soften the blow of future budget cuts coming our way from the Government.
A House of Lords select committee is challenging the viability of the Government’s future funding plans for local authorities. Within three years, councils will become reliant on income from council tax to fund future services. There is a significant risk that this is not adequate.
On the bright side, the Labour group at South Kesteven District Council are delighted that our proposals in this year’s budget were approved. They include the provision of a business waste collection service, the consideration of weekly bin collections for people forced to live with domestic waste because they have no outdoor storage, and improving the gateways into our market towns, such as Grantham, to make them attractive places to visit and help grow our economy.