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Judge's hospital downgrade decision 'a real vindication' of concerns of Grantham people says campaigner

Campaigners said they have been vindicated after a High Court judge ruled that United Lincolnshire Hospitals NHS Trust (ULHT) did not consult properly when it downgraded Grantham Hospital into a Covid-free site.

As the Journal reported on Friday, following a review in March, Mr Justice Linden ruled that the trust breached its legal duty to consult people on the changes, and said the decision taken in June 2020, which saw a number of services transferred out of the hospital and the creation of an urgent treatment centre, had been unlawful.

ULHT has apologised following the result and said it will not appeal the decision.

Grantham Hospital (45153305)
Grantham Hospital (45153305)

Here are the top lines from the Dawson v ULHT judgment (final), in which Mr Justice Linden said:

  • There had been “a total failure” of the trust to comply with the National Health Service Act and consult with residents;
  • The less than three-day consultation period was not enough to be meaningful or fair;
  • The legal duty to involve service users could not “be sacrificed” without clear evidence;
  • The reason for the approach the trust took appeared to have been led by a concern about “messaging” and the “reaction of service users”;
  • The evidence for a lack of resources and need for urgency was “thin” and “weak on facts”;
  • A decision on the proposed green site had been made by May 12 at the latest and “steps could and should have been taken to involve service users in the development and consideration of the proposal”;
  • There was “no good reason” why publicity could not have been taken at that stage;
  • That media interviews had not been enough to enable service users to understand the proposal or a fair opportunity to respond;
  • That the board limited feedback to be written questions at a subsequent board meeting and did not answer all;
  • That publicising the decision after it had been taken did not amount to meaningful involvement in the making of the decision.

Justice Linden said: “The perspective and concerns of the consumer of the services will lead to better informed decisions and will increase the likelihood that the human impact and implications of plans, proposals and decisions are taken into account.

“The present case illustrates how failure to involve service users in decision making will foster a sense of injustice or, worse still, undermine confidence in the good faith of the decision maker.”

He did, however, add that the quarterly reviews carried out after were meaningful, proportionate and fair. He rejected a contention whether there was sufficient reasons for why the decision was to last for “at least nine months”.

Justice Linden also noted “numerous patients” had welcomed the changes and that the decision itself was “perfectly rational and was taken in good faith and for proper purposes”.

Coun Charmaine Morgan. (5040482)
Coun Charmaine Morgan. (5040482)

SOS Grantham Hospital chairman Charmaine Morgan said: “It’s a real vindication of all the concern of the people in the Grantham area. We knew it was wrong, our main concern now is getting the services fully restored.

“It’s a huge relief to hear the trust are not planning to appeal the decision. It was a strong judgement and I feel that would be the best course of action for them to take.

“I hope they will take in the message that they must properly consult in the future.”

She added: "The judgement was clear, that under no circumstances, even a pandemic, is it legal to make key decisions about health services without proper consultion. Whilst the judge believes action was taken in good faith, neither adequate time nor sufficient information were provided by ULHT to the community.

"Nor were we given an opportunity to influence the decision to turn Grantham into a 'green' site in the first place. This decision had a huge impact on 120,000 people.

"Inpatients and outpatients from the Grantham and District Hospital catchment area, which includes Sleaford, Newark, Melton Mowbray and villages in between, found the doors to the hospital closed virtually overnight. Thousands were displaced and forced to travel to other sites including Nottingham and Peterborough for care.

"This judgement should make all hospital trusts sit up and listen."

She said campaigners would continue to watch ULHT, particularly around a follow-up decision earlier this year which agreed to restore some services — but not all — and which opponents say also did not give enough consultation time.

Of particular concern, she said, were the acute care unit, long stay medical wards and “full-training” facilities.

The case was brought by Jayne Dawson, who was represented by Irwin Mitchell. She said: “I am pleased the court’s decision is so clear. ULHT should have involved local people before the changes were made.

“While I understand the need for specialist care for those affected by the pandemic, local patients like me were put at risk of increased transmission of Covid-19 travelling out of the area for treatment.

“It was difficult for disabled and elderly people to travel, as I personally experienced. Covid cases in Lincolnshire were lower than other places, and yet the action taken was more drastic.

“I hope that ULHT will now restore the services to Grantham in full and make sure people are involved properly in plans for the future of Grantham Hospital.”

Chief executive of ULHT Andrew Morgan (28592996)
Chief executive of ULHT Andrew Morgan (28592996)

Andrew Morgan, the CEO of ULHT, said the trust regrets it “didn’t involve service users sufficiently whilst making temporary changes to our services to protect the health and well-being of our patients during the Covid-19 pandemic”.

He added: “We apologise to anyone who would have liked to have been more involved in the development of our plans. We accept the ruling and will not be appealing.

“We note that the issue in this case was the process by which the decision to create a Grantham green site was reached, rather than the merits of the decision itself.

“We are pleased that the judge has rejected the claim that the decision itself was unsound, and makes clear that the decision was perfectly rational and was taken in good faith and for proper purposes.

“The judge also commented that there is evidence that numerous patients welcomed the changes and that this is unsurprising given that the decision itself had a great deal to commend it and appears to have been beneficial to many members of the community in Lincolnshire.

“We will reflect on the judge’s ruling and amend and improve our public involvement processes for the futures."

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