One year on: Grantham A&E overnight closure extended for at least another three months

The controversial overnight closure of the Grantham Accident and Emergency department will continue for at least another three months, trust bosses agreed this morning.

The closure, still deemed ‘temporary’ by United Lincolnshire Hospitals Trust (ULHT), has been in place since August 2016 due to severe staffing shortages.

Executives heard at a board meeting on Tuesday, August 1 that, at present, emergency care departments in Lincoln, Boston and Grantham still do not have adequate staffing levels to operate a full A&E service.

Grantham & District Hospital. Photo: United Lincolnshire Hospitals NHS Trust

Trust board members agreed to continue with the current opening hours of 8am to 6.30pm (just over 10 hours a day) for at least another three months, when the closure will be reviewed again.

A report presented to the board on the status of emergency departments notes that significant recruitment activity has been underway at the trust, however staffing number are still below minimum thresholds.

In summary, the trust also said there had been very little change in emergency admissions in the year since the reduced opening hours were implemented.

The report summary also states: “Since the last reported to the Board (February 2017), a formal assessment of the quality impact in terms of length of stay, mortality, serious incidents and complaints has not been made because of insufficient data. However, there is no suggestion of any adverse events as a direct consequence of the overnight closure.”

Dr Neill Hepburn, Medical Director at ULHT said: “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 four middle grades and are now six. A new consultant for Lincoln A&E is due to start tomorrow.

The partial closure has been met with objection from a number of local residents over the last year: