Chorley A&E proposals: more detail demanded on staffing

County Cllr John Fillis
County Cllr John Fillis

NHS bosses considering the future shape of emergency care services across Central Lancashire will have to set out more detail about the staffing levels underpinning their options.

Lancashire County Council’s health scrutiny committee also requseted more analysis of the knock-on effects which any changes to A&E in the region might have on neighbouring areas.

Karen Partington, chief executive of Lancashire Teaching Hospitals

Karen Partington, chief executive of Lancashire Teaching Hospitals

READ MORE >>> These are the options for the future of Chorley A&E...
...and this is what was decided about them
Last month, Central Lancashire’s two clinical commissioning groups (CCGs) voted to keep on the table a total of 13 different configurations of services to be provided by Chorley and South Ribble Hospital. These are now being assessed by medics before being whittled down to a shortlist of options for public consultation.

But members of the health scrutiny committee will have to give final approval to the suggestions before they can be put to residents. The broad list of options includes maintaining Chorley’s A&E in part-time form or increasing it – deemed “clinically unviable” by a group of clinicians – or replacing it with one of two versions of an urgent care centre.

County Coun John Fillis, deputy leader of the Labour opposition group on the authority, claimed that the current proposals do not show how they would address the issues used to justify change – including staff shortages and problems with the flow of patients through the hospital system.

“All [the document] does is say: ‘We’re going to change things’ – but not for the better.

Campaigner Jenny Hurley

Campaigner Jenny Hurley

“Unless there is a major overhaul of the system, where we put [more] staff in and actually increase our services, this will get worse and worse. When we move on to the next A&E and say that one can’t cope any more, what happens then?” County Coun Fillis asked.

Karen Partington, chief executive of the Lancashire Teaching Hospitals trust, said that the organisation had always tried to recruit the necessary number of staff – but was now being forced to “think differently” about how to deliver services.

“At the moment, maybe doctors do things that some of our nurses can do and nurses do things that some of our healthcare support workers can do – and maybe there are things that we do in hospital that we can do in the community.

“At the heart of everything we do is [the desire] to provide safe and quality care for our patients – and as it stands at the moment…we’re not able to provide that level of care for our patients.

“It’s difficult to transfer patients through our organisation when we don’t have the right resources in the right places – and that’s what we are trying to [achieve] together,” Ms. Partington said.

The meeting heard that more details on the individual options – including finances, hospital flow and effects on other areas – would be presented as part of a business case before any consultation is finalised.

A group known as the "NHS clinical senate" - made up of medics from other parts of the country - visited Central Lancashire earlier this month to carry out an assessment of the process so far. Their full report is due in early November, but Denis Gizzi, chief officer of the Greater Preston and Chorley and South Ribble CCGs, said that initial feedback had reassured local NHS leaders that they were "considering the right range and breadth of options".

However, the chief executive of Wigan, Wrightington and Leigh NHS trust recently voiced concerns that the closure of Chorley A&E would see patients heading over the Greater Manchester border for treatment.

Meanwhile, committee member and Preston city councillor David Borrow warned that the effects of any changes would also be felt much closer to home.

“I live a mile away from Preston Hospital and [many] times I look out of my window and traffic is at a standstill.

“If the Royal Preston ever becomes the only A&E in Central Lancashire, [then on a] number of occasions it would be physically impossible for an ambulance to get to the hospital – it is in the wrong place [to serve] the Central Lancashire conurbation,” Coun Borrow said.

CAMPAIGNERS CALL FOR CLARITY

More than half a dozen members of the campaign group Protect Chorley Hospital from Cuts and Privatisation attended the health scrutiny meeting to lead a deputation outlining their concerns over the plans currently under consideration.

Given five minutes to address the committee, group member Jenny Hurley said that much more detail was needed about the options being proposed, “so that they are comparable and fully transparent – and can be accepted or challenged as the case may be”.

“They have got to demonstrate, beyond a doubt, that these pathways do not restrict access to healthcare – before the reductions, changes, closures and downgrading of services are implemented. Let’s not put the cart before the horse,” she said.

“[The plans must] include details of all the services provided by each hospital over the last five years – including staffing levels and the population covered in each instance – and show all equality and risk assessments [about the effects of] any downgrading, or location or service change.

“[They should] show a record of waiting times for each service over the last five years – and demonstrate the proven effectiveness of programmes to reduce attendance at hospitals and GP surgeries,” Ms Hurley added.

The group continues to hold demonstrations outside Chorley and South Ribble Hospital every Saturday, having done so since its A&E was temporarily closed in April 2016, before reopening on a part-time basis nine months later.