Further to considerable Public Consultation SW Lincs Clinical Commissioning Group have published the result of their Healthy Conversation Public Engagement exercise, which has lasted more than 2 years.
While we might agree with some of the comments made, such as our admiration and respect for staff in the NHS, other comments made are hugely concerning.
In the summary of their report we are told that local people:
· Have respect and admiration for staff in the NHS
· Believe that prevention is better than cure
· Would like more education on healthier lifestyles and prevention
· Want support to manage their own health conditions proactively
· Want help to look after themselves better
· Recognise that NHS staff and skills are precious and we should use them sensibly
· Acknowledge that seeing a doctor is not always the best option
· Are enthusiastic about engaging with us through digital means as much as possible
· Want joined up care
· Are genuinely concerned about how the NHS can help people living in deprived areas
We heard that people in the Grantham area:
· Want 24/7 ‘walk in’ access to urgent care services at Grantham Hospital
· Support a centre of excellence for elective care at Grantham Hospital
We heard that people in the Boston area:
· Want to keep maternity, neonatal and paediatric services at Pilgrim Hospital (with only one option going into the ASR public consultation)
· Are concerned about travel time for people with symptoms of a suspected stroke if the service is no longer at Pilgrim Hospital
We heard that people across Lincolnshire as a whole:
· Are concerned that Lincoln Hospital is not big enough to have more services moved there
· Are concerned that some patients, families and those from deprived backgrounds will have difficulty travelling to Lincoln Hospital, exacerbated by general issues with road networks and public transport in the county
· Are worried about current difficulties getting a GP appointment, and believe GPs and other services could be better linked
· Are concerned about the recruitment challenges faced by the NHS locally and nationally
SOSGH chairman Coun Charmain Morgan said: “Local people in Grantham did NOT call for a 24/7 walk in Urgent Care centre.
“Local people in Grantham called for the retention of and restoration of a 24/7 walk in Consultant led Accident and Emergency Unit.
“There is a real concern that an ‘Urgent Care Centre’ equates to a ‘downgrading of emergency service provision’ in Grantham and is likely to result in the most seriously ill people being sent elsewhere. Thousands of petition signatures and hundreds of comments were sent to the Healthy Conversation team repeating this message.
“Given Grantham & District Hospital serves an overall population of over 120k people and is in a Growth Town, at least 23 miles from the next nearest A&E unit, there is no justification for the loss of this vital service nor continued closure of our A&E unit. On the contrary, development plans should trigger improvements to local NHS services, not reductions. The Planning process allows NHS services for increased population to be costed but we have to wonder if the NHS managers locally are seeking the level of funding they require to maintain our A&E unit.
“Furthermore, in view of the distance and time it will take to reach an alternative site, residents in Grantham have persistently called for emergency stroke treatment to also be available in Grantham & District Hospital. The report only refers to the provision of stroke treatment at Boston and Lincoln.
“Requests for the provision of transport between the hospitals in the form of an inter hospital bus service/transport appear to have been ignored despite promises they would be considered. This should have been delivered as a priority when Grantham A&E closed at night. Instead the CCG have been happy to leave local people stranded in outlying A&E units or facing extraordinarily high taxi bills.
“The statement that people welcome the use of communications through digital means masks the concerns of those unable to access digital services, or unable to use digital services. Conventional methods of communication must be retained with provision for those with special needs such as those with hearing or sight problems.”
Cllr Charmaine Morgan sent a Freedom of Information Request to SW Lincs CCG raising concerns that there had been no formal consultation with members of the public with protected characteristics i.e those most vulnerable and most dependent upon key services.
She said: “The failure to fully engage with these important groups brings into question the validity of the outcome of the exercise.”
“The Healthy Conversation discussed a narrow range of subjects. In addition to failing to capture our need for emergency stroke care, when Grantham Hospital lost our Maternity Unit a thousand mums to be and their babies were left at risk. We were not asked our views on Maternity Services.
“There was an assumption that the services we currently have, other than A&E, are acceptable. We note that the comments made around the provision of maternity services at Boston completely fail to include the reliance Grantham residents now have on Boston Maternity and neo natal units, in addition to Lincoln.
“It is as if we no longer exist when it comes to maternity and neo natal care, even though a previous CCG report indicated that nearly as many babies are born in our area each year as Lincoln. And, as this report indicates, we know Lincoln is struggling to cope.
“The statement that we want a centre of excellence for elective care is potentially misleading. Of course we need excellent ‘elective care’, but we also need access to acute illness/emergency ‘non-elective care’.
“Another statement that is loaded is the comment that ‘NHS staff and skills are precious and we should use them sensibly’.
“This implies that local people are not using NHS services ‘sensibly’. When SOS Grantham Hospital undertook an exercise to identify what our needs were one of the most important issues we identified is that patients are not medical experts but increasingly NHS managers are designing services to promote self-diagnosis and make it harder to access emergency treatment or GP services.
“Most members of the public are not in a position to ‘self-diagnose’. Even on-line ‘digital’ solutions may require good reading skills. A significant number of people do not have high literacy skills, or are unable to access online services. We require the intervention of a medical expert to diagnose us.
“It is dangerous to discourage people with potentially life threatening illnesses, such as sepsis, to avoid seeking medical help because they don’t want to bother their doctor or A&E unit. Or someone with meningitis, or someone with a potentially severe allergic reaction or pain in their chest.
“All of which have symptoms that could also be down to common non severe ailments such as the flu or a heavy cold or even indigestion. The NHS message should be, ‘if in doubt seek help’. Especially if a condition could be time critical. That is the advice of NHS medical professionals – rather than NHS managers. It is all the more important should you fall ill in Grantham at night now.
“As mentioned in the report, many local Grantham residents are deeply concerned at the difficulty accessing GP services in a timely manner. Some have to wait weeks for an appointment and this puts more pressure on A&E services.
“This is not the fault of patients but rather a managerial and political failure to train and plan for the need for more GPs. There have also been cuts to Public Health services which have an impact on the wellbeing and general health of the community. For the first time in decades those on lower incomes face shortened life span.
“It is right to address these issues but more resources overall are needed or we rob Peter to pay Paul.
“Looking in isolation at the conclusions for Grantham there is a danger the next Consultation phase will be for little more than a cottage hospital offering only ‘elective care’ that has an ill-defined ‘urgent care’ unit 24/7.
“Rather than reflect the services local people want or need the conclusions reflect what the CCG and ULHT want to provide us based on an ever reducing choice of services. The statements used in the summary are theirs. Not ours.’ Given the huge amount of time and effort which has gone into this exercise it is hugely worrying. We can only hope the services designed around this prove they have really listened to us and that the next stages will prove us wrong.”
Cllr Morgan said: “What Grantham needs is a fully operational District Hospital with a 24/7 Accident & Emergency unit, maternity unit with neo natal services, emergency stroke unit and delivering both elective and non-elective care.
“What we will get will be something entirely different, I suspect.”