THE GREAT NHS GAMBLE: Lancashire's hospitals are on '˜at risk' list

In our second day examining the five-year plans to plug the gap in funding for the NHS with a major shake-up of services, we look at the threats to A&E services across the county.

Wednesday, 15th February 2017, 7:53 am
Updated Wednesday, 1st March 2017, 9:35 am
Chorley & South Ribble District General Hospital

Chorley’s A&E unit has been flagged as ‘at risk’ of being closed or downgraded in major overhaul of urgent care services.

Chorley and South Ribble Hospital has been included on a list drawn up by Health Service Journal of 24 A&Es it judges as being at risk of either being downgraded or closed altogether.

Bosses at Lancashire Teaching Hospitals trust said: “Currently there is no proposal to reduce either the number of hospitals or emergency departments in this area.”

Chorley, along with Southport and Formby Hospital, is on the list of A&Es that Health Service Journal has judged at risk after an anlysis of documents drawn up to remodel the health service in England. Both Lancashire hospitals are graded as an ‘amber’ risk.

Chorley’s A&E was closed from April 2016 and although it reopened last month, it still only operates for 12 hours a day.

NHS bosses who have drawn up the changes as part of efforts to plug a £22bn hole in the health service budget by 2021, insist that concentration of specialist urgent services could save lives and there are no plans for a “significant” reduction in the existing number of 175 emergency units across the UK.

But one senior emergency doctor has warned the plans amount to proposals to “make the River Nile run backwards” by planning for a reduction in demand for A&E services at a time when Britain has a growing and ageing population.

Research by the Johnston Press Investigation Unit based on 44 regional blueprints reveals that managers are planning to cater for up to 30 per cent fewer A&E visits and plans have already been advanced to downgrade units to urgent care centres with fewer specialist or consultant-grade staff.

Dr Chris Moulton, vice president of the Royal College of Emergency Medicine said: “A&E units are already desperately short of capacity and hospitals have almost 100 per cent bed occupancy.

“The suggestion that you can close A&E departments and then somehow fewer people will become ill is clearly ridiculous.

“And anyway, it is not people with minor illnesses but elderly patients with serious conditions who are the ones lying on A&E trolleys waiting for beds and then languishing on the wards awaiting social care.

“We have a rapidly growing and ageing population and therefore the idea that the health service won’t have to deal with even higher numbers of people requiring emergency care and hospital admission in the future is like hoping that the River Nile will run backwards.”

Deborah Harrington, who is on the national executive committee for the National Health Action Party, which campaigns for improvements in health service funding and staffing said: “According to the STPs, to make the NHS affordable and sustainable, we the public must get used to longer ambulance journeys for emergency care, longer waiting times for treatment.

“There is a shortage of doctors and nurses. Our A&Es no longer have a mid-winter crisis, they have a year-round crisis.

“But apparently a ‘magic wand’ will make us all so healthy that we will no longer need services or hospital beds.”

An NHS England spokesman said: “The number of people seeking urgent care is on the rise so overall we expect the range of services available to them to expand over coming years.

“Within that overall expansion, it may be possible to improve care and save lives with some concentration of specialist urgent services.

“This approach has increased the chances of surviving a major trauma in this country by 50 per cent, and only today the Stroke Association have called for more concentration of stroke units to improve outcomes.

“However we do not expect significant numbers of A&E changes in the years ahead, and many schemes were in fact decided on many years ago so this is a rehash of old news.”

NHS England also pointed out that The Royal College of Emergency Medicine have said that the threat to A&E departments from local transformation plans is “overstated”.

NHS England has been clear that every STP area must fully discuss their plans with the communities they serve.

Around £1.8 billion of funding in the Sustainability and Transformation Fund has been provided to support providers improving performance, particularly in A&E, and balancing the books as they plan for the future.“The document that we have created does not make any specific proposals for how services may change as there has not been the level of engagement and involvement with staff, clinicians or members of the public that this would require.

“We are committed however, to make sure that widespread involvement with stakeholders takes place over the coming weeks and months to help shape our thinking. We are working to develop an easy-read version of the Sustainability and Transformation Plan and a suite of materials, which has been tested with members of the public to make sure these are easy to understand.” and free from jargon and technical information.”