In June 2020, United Lincolnshire Hospitals NHS Trust Board agreed to put in place temporary service changes to make Grantham and District Hospital a ‘Green site’ in response to the COVID-19 pandemic. This has enabled the Trust to continue to deliver essential cancer and urgent surgery to the people of Lincolnshire during the pandemic in an environment protected from COVID-19.
The Trust has now called an extraordinary Board meeting on Tuesday 16 March at 2pm, where Board members will consider the restoration of services to the site. Prior to this meeting the Trust is asking for feedback from members of the public about the restoration of services to help inform the proposed plans that will go to the Board alongside clinical advice, performance and information.
The Trust has sought an independent review of the emerging evidence on the pandemic and the changes in practice and science over the last nine months, to guide them on the pace of restoration. This includes consideration not just of the likely course of the pandemic, but also the evidence on the impact of the COVID-19 vaccination programme and improvements in testing.
The Trust has put the patient services it intends to strengthen and restore into four groups. Together these form the full operating model which existed at Grantham and District Hospital prior to the changes in June 2020:
1. Existing services on the Grantham site will remain. In the case of patient operations, the Trust has added two theatres so there will be more surgery performed. The Trust will also keep some chemotherapy day services on the site. Day case cancer services such as chemotherapy have been temporarily suspended at Lincoln and Boston and relocated to Grantham, for safety reasons, but the Trust are keen to restore these soon to those sites.
2. Several different services run by NHS Trusts in the county on the Grantham site will return and can be run, as required, almost independently of the core hospital services. These will include sexual health services, some outpatient and community mental health services, children’s and women’s outpatients and dental services. The site is set up in such a way that there can be separate access to these areas.
3. Outpatient, diagnostic (eg X-ray), and therapy services will return in the same part of the hospital with very limited need for any interaction with the other patient services on site. The Trust will also be able to restore a dedicated medical and surgical rehabilitation ward for the local population, which will include a faster local step down from specialist services in Lincoln and Boston as well as serving the inpatients at Grantham. There are a small number of services where, specifically due to scale, there may need to be either a short (couple of months) delay in restoration to site or a continuation, to permit social distancing, or provision at another site in Grantham. The Trust will work through the safety and logic of these before the Trust Board meeting.
4. Emergency care services will incorporate a daytime (previously 8am to 6.30pm) A&E, a same day emergency care unit, an emergency admissions unit/ward, access to all relevant diagnostic services and integrated support from the community teams to help people with services to support them if they can manage at home. This will be supported also by an enhanced out of hours primary care service at the front of the hospital, which will include walk-in services until 10pm and a booked service through the night.
The Trust believe they can make the first three groups happen quickly. However, there are two challenges that need to be considered by the Board for the fourth group. The first challenge relates to the pandemic itself and the level of risk that still exists, even though numbers are reducing. The surgical facilities at Grantham have been very successful in providing essential care to thousands of patients over the last nine months without a single case of COVID-19 for patients and this must continue.
The second challenge is ensuring safe staffing for the emergency care service. This relates particularly to the 24/7 medical cover for the inpatient services. The pandemic has stretched all medical services across the Trust, and prior to the changes in June 2020 there was a reliance on locum doctors to cover gaps in the rotas. Rebuilding these rotas will rely on additional support, bolstered by recruitment, in a difficult market with most other hospitals facing similar challenges.
The Trust are asking the public to answer the following question and email it to Grantham.Restore@ulh.nhs.uk
What impact do you think the restoration of these services might have on you?
· Don’t know.
Please explain your reasons to the answer above, indicating which services you are referring to. Please also include any further views you may have on the restoration plans.
Any feedback received after 12noon on Tuesday 9 March will not be incorporated as part of the paper to the Trust Board due to the publication date being Wednesday 10 March, however it will be considered by the Board at the meeting and also as part of the wider plans when looking at the implementation of the Board’s decision. In addition, the Trust continues to collect feedback on patient views so please share your experiences at Grantham and District Hospital via the patient experience survey: https://www.ulh.nhs.uk/about/support-your-hospital/sharing-your-views/