From Monday 27 March 2017, United Lincolnshire Hospitals NHS Trust will be extending the opening hours of Grantham A&E to 8am to 6.30pm, 7 days a week.
In August 2016, ULHT made the difficult decision to temporarily change the opening hours at Grantham A&E due to a severe shortage of middle grade doctors at Lincoln and Boston A&Es. Since 17 August 2016, Grantham A&E has been open from 9am to 6.30pm 7 days a week.
There is a national shortage of A&E doctors, and ULHT is very much affected by this. We are overly reliant on short and long term agency doctors to fill staff rotas. Reducing the opening hours of Grantham A&E has allowed us to provide better patient care in Lincoln – where the most serious cases from across the county go to. Though not ideal, this was the safest option for the provision of emergency care for the people of Lincolnshire including those who live in the Grantham and district area.
Dr Suneil Kapadia, medical director at ULHT says: “We understand that Grantham people want A&E to be open 24/7 but we are unable to do this until we are confident that we can safely staff all of our A&Es at least eight weeks into the future. We remain committed to getting A&E open 24/7 but only when it is safe to do so.
We are making progress with recruitment. 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 3 departments open 24/7. 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. Even if we had 21 doctors, this is still below our ideal number of 28.”
ULHT reviewed the opening hours of Grantham A&E at its board meeting in February and considered the views of the most senior consultants, A&E medical and nursing staff, stakeholders and the public in extending the hours. Our 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.
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 at our Board meeting in May.
Hospital emergency departments are staffed by a combination of consultants, middle grade doctors (or registrars), doctors in training, A&E nurses and emergency care practitioners.
ULHT runs three A&Es – at Lincoln County Hospital, Pilgrim Hospital, Boston, and Grantham and District Hospital.
A&E at GDH provides unrestricted access to A&E services 24/7 (8am to 6.30pm since 27.3.17). However, because of the limited range of services provided at the hospital, it is restricted in its ability to support a full range of emergencies that normally would be expected to be treated in an A&E. It cannot receive patients by air ambulance.
The health community (East Midlands Ambulance Service and local general practitioners) are aware that patients with certain medical conditions should not be taken or sent GDH.
Patients who require treatment and management beyond that available at GDH are transferred to Lincoln, Pilgrim or Nottingham University Hospitals.
Two consultants provide on-site presence in A&E from 09:00 to 17:00 during the week only. At weekends and at other times they provide on call cover off site but are available to attend the hospital for emergencies. The department is funded for six middle grades specialising in emergency care.