Temporary changes to the opening hours of Grantham A&E from Wednesday 17 August.
Today ULHT announces that from Wednesday 17 August, Grantham A&E will be open from 9am to 6:30 pm, 7 days a week. This is to boost the number of doctors in Lincoln and Pilgrim A&Es.
The decision has been to temporarily change the opening hours due to a reduction in the availability of doctors in Lincoln and Boston together with an increase in the demand for emergency care services. We do not have enough doctors to safely staff all three of our A&Es 24 hours a day, 7 days week. This plan will help maintain safe services across Lincolnshire.
In order to concentrate our limited medical resource and support our busiest departments at Lincoln and Pilgrim, unfortunately we have had to reduce the opening hours at Grantham A&E. This means we can redeploy the medical staff shift by shift, to where they are most needed and deliver safe services.
ULHT is not alone. There is a shortage of emergency care doctors in the UK. The Royal College of Emergency Medicine says there are around 600 consultant vacancies nationally. Fewer than half of ULHT’s emergency care doctors are permanent members of staff.
The Trust’s three A&Es normally work based on having 15 consultants and 28 registrar or middle grade doctors. At present, we are now down to 14 consultants, of whom 10 are locums, and just 12 middle grades. This crisis point means we have to act.
We are struggling to recruit locums and agency doctors to provide a standard of care expected by all and it has become unsustainable for our consultant doctors to fill the gaps by doing extra shifts. This is placing enormous pressures on nursing and medical staff.
Dr Suneil Kapadia, medical director at ULHT says, “Our doctors have agreed to support our plans in the best interests of patients and work shifts in Lincoln and Pilgrim A&Es. This hasn’t been easy on the staff at Grantham and we are very grateful for their help.
“We haven’t made this decision lightly, but we’ve made it for the right reasons – to maintain patient safety in all three A&Es. We know this will be an unpopular decision but reducing the opening hours of Grantham A&E is the safest option for Lincolnshire. Despite significant actions taken by the Trust, we don’t have enough doctors to safely staff all three of our A&Es 24 hours a day, 7 days a week.
“As well as our doctors, we have the support of Lincolnshire Community Health Services NHS Trust, Lincolnshire Partnership NHS Foundation Trust, South West Lincolnshire CCG and East Midlands Ambulance Service (EMAS) in taking this action. After 6.30 pm, we have put services in place with EMAS, the out of hours service and our emergency assessment unit to maximise the number of patients who can still be treated at Grantham hospital. However, patients will not be able to walk in to the out of hours service without an appointment accessed via NHS 111. In a real emergency, people should call 999.
“We will be working hard to recruit more doctors over the next few weeks and months, and continue to pay premium rates to attract doctors to the county. ULHT are committed to fully reopening A&E as soon as we have enough doctors. But we won’t compromise on safety to deliver convenient services”.
Currently patients with life threatening conditions and children are sent by ambulance to Lincoln, Pilgrim or Nottingham University Hospitals. On average we expect, between 6:30pm and 9am, 25 patients to attend alternative services. Most of these will be discharged back to their GP with little or no treatment required. We also expect that three patients will need to be transferred to alternative A&Es by ambulance”.
Said Dr Vindi Bhandal, GP and Chair of South West Lincolnshire CCG:
“We continue to work closely with ULHT on the provision of urgent care services to those patients in Grantham following the difficult decision to reduce the hours for Grantham A&E department overnight.
“Once the department is closed, and to reassure our patients, the out of hours service will take over and provide a service for urgent care. Patients will only be able to access this service through a pre-booked appointment which will be made by calling the NHS 111 service. Patients who call NHS 111 will be directed to their nearest facility for emergencies, urgent care or minor injuries.
“Clearly we all recognise that there are times when attending A&E is the right course of action, however we need to educate our patients not to think of A&E first but rather to make use of the wide range of alternatives that are available including GP practices during working hours, minor injuries units, urgent care centres, pharmacies and the NHS 111 service.”
“As a health community in Lincolnshire we remain committed to ensuring that our local NHS continues to provide high quality, appropriate care for our patients, their families and carers”.
We would always urge everyone to think twice before they go to A&E – if it’s not serious or life threatening, you shouldn’t be there. Many illnesses can be better treated by visiting your local pharmacy, calling 111, visiting your local GP, GP out of hours services, or attending a walk in centre or a minor injuries unit. During the hours of 6:30pm to 9am, if you are concerned and need medical advice please contact NHS 111.
For further information contact:
The communications team on 01522 573986.
United Lincolnshire Hospitals Trust runs three A&Es in Lincolnshire based at Lincoln County Hospital, Pilgrim Hospital, Boston, and at Grantham and District Hospital. They are different types of A&Es:
Lincoln and Pilgrim A&Es are “level 1” departments.
· Type 1 A&E department = A consultant led 24 hour service with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients.
Grantham A&E is a “level 3” department.
· Type 3 A&E department . A type 3 department may be doctor led or nurse led. It may be co-located with a major A&E or sited in the community. A defining characteristic of a service qualifying as a type 3 department is that it treats at least minor injuries and illnesses (sprains for example) and can be routinely accessed without appointment.
A&E departments are staffed by consultants, registrars, or middle grades, doctors in training, nurse practitioners and nurses.
Middle grades are experienced A&E doctors that can work unsupervised for many clinical conditions.
See Royal College of Emergency Medicine’s campaign calling for action to address the significant challenges facing A&Es http://rcem.ac.uk/Shop-Floor/Policy/Campaigns/STEP%20Campaign/