Grantham A&E opening hours to remain 8am to 6.30pm

United Lincolnshire Hospitals NHS Trust board has announced that the opening hours of Grantham A&E will remain 8am to 6.30pm, seven days a week.

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Despite almost doubling the number of permanent middle grade doctors at Lincoln A&E and appointing a new consultant for the department, staffing levels are still not where they need to be to safely open Grantham A&E.

In August 2016, ULHT made the difficult decision to 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, seven days a week and 8am to 6.30pm since March 2017. This will be reviewed again in three months’ time.

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. 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. 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 Neill Hepburn, Medical Director at ULHT says: “When the decision was taken last  August to reduce the opening hours of Grantham A&E, a threshold of a minimum of 21 middle grade doctors is required to safely staff the three A&E departments at Lincoln, Pilgrim and Grantham. Even if we had 21 doctors, this is still below our ideal number of 28.

“Although the recruitment drive has led to a gradually improving picture in medical staffing, we are currently at 18.6 and have not reached the minimum threshold to open 24/7. The provision of emergency services, particularly at Lincoln County Hospital, continues to remain fragile and requires the support of A&E medical staff, from Grantham District Hospital, on grounds of patient safety. The change to the taxation rules has had an additional deleterious and previously unforeseen effect on A&E staffing.

“We understand the frustrations and concerns of Grantham people and that they want A&E to be open 24/7 but we will only do this once we can safely staff all our A&Es at least eight weeks into the future. We are fully committed to opening A&E but only when it is safe to do so.”

When the decision was made to reduce the opening hours last August, there were 2.6 substantive middle grade doctors based at Lincoln, there are now 4.6 (with one more expected to join in September). At Boston Pilgrim there were 4 middle grades and are now 6. A new consultant for Lincoln A&E is due to start tomorrow (Wednesday 2 August).

To stand out from the crowd and to attract middle grade doctors the trust has offered a ‘certificate of eligibility for specialist registration’ (CESR) training post with a financial incentive after each of 2 years – this gives them the opportunity to work on secondments to become a emergency medicine consultant.

ULHT reviewed the opening hours of Grantham A&E at its recent board meeting in August and considered the views of the most senior  consultants, A&E medical and nursing staff, stakeholders and the public. 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.

Before the next review in November ULHT will work with CCGs to explore an interim service model for a 24 hour emergency/out of hours service.