'Landmark day' for patient care as changes at Lincolnshire hospitals are unanimously approved

Dr Sunil Hindocha was referring to changes to four key services which will see centres of excellence created for planned orthopaedic surgery at Grantham and District Hospital and for hyper-acute and acute stroke services at Lincoln County Hospital.

"I have been a clinician for 30 years and what patients want when they walk through the door is for me to make them better,” he said.

"However, we have seen people travelling miles out of our county to get the care they need.

"This is a landmark day because our colleagues have stepped up and taken responsibility to treat patients in our own county.

"We are setting not just a regional example but a national best example here.

"We will minimise the time people need to spend in hospital and provide the after care they need close to home.

"This will result in better outcomes and getting people back on their feet quicker and back to their lives.

"Our aim is to get you back to what you want, not to keep you.”

The NHS Clinical Commissioning Board met this morning to discuss recommendations covering Orthopaedic surgery, Urgent and Emergency Care in Grantham, Acute Medical beds and Stroke services.

A review of hospital services began in 2017 following concerns they were becoming “fragile”, with staff overstretched and hospitals struggling to fill vacances, resulting in poor quality of care and outcomes.

NHS Lincolnshire Clinical Commissioning Group (CCG) launched a 12 week public consultation last year resulting in the Decision Making Business Case presented at this morning’s meeting.

It was the culmination of “many years of work”, they said, outlining the rigorous procedure taken to arrive at the recommendations.

The LCCG said the consultation generated lots of insightful and helpful feedback and this progressed some elements of thinking – for example, the need for clear public communications around any service change implementation.

However, no feedback was received that materially altered the proposals, identified a risk requiring any change, or provided suggestions or ideas that, after exploration, could enhance or alter the proposals.

Statistics showed changes in real terms would only affect “one or two” patients at hospitals a day and the outcomes of better care outweighed any risk.

One of the main concerns addressed was transport issues to the centres of excellence for patients and families, particularly those in rural areas and the coast, with no car and limited access to public transport.

However, the board heard that in addition to patient transport services already running at hospitals, discussions were taking place to promote public transport and improve travel solutions.

Negotiations with East Midlands Ambulance Service had also established that they would be able to accommodate the changes.

An outline of the consultation process and evidence to show “anyone who wanted to comment was able to” was delivered to the LCCG board in a four-hours meeting before they approved the following changes to Lincolnshire NHS services:

- The establishment of a ‘centre of excellence’ in Lincolnshire for planned orthopaedic surgery at Grantham and District Hospital, and a dedicated day case centre at County Hospital, Louth.

- The creation of a 24/7 walk-in Urgent Treatment Centre (UTC) at Grantham and District Hospital, in place of the current Accident and Emergency (A&E) department.

- The implementation of integrated community/acute medical beds at Grantham and District Hospital, in place of the current acute medical beds.

- The establishment of a ‘centre of excellence’ for hyper-acute and acute stroke services at Lincoln County Hospital, supported by an increase in the capacity and capability of the community stroke rehabilitation service. Hyper-acute and acute stroke services will be consolidated at Lincoln County Hospital and no longer provided from Pilgrim Hospital, Boston.

These changes, according to the Decision Making Business Case, would result in bettor outcomes, reduced waiting lists and make the services “more attractive when recruiting staff”.

Expanding on how patients would receive care closer to home after being discharged from a centre of excellence, Dr Hindocha said there were plans to increase the number of carers in the community across the county.

He paid tribute to the “stirling work” of carers during the pandemic across Lincolnshire.

"May I take this opportunity to publicly thank GPs and the care sector for the sterling work they did during the pandemic,” he added.

Dr John Turner, Chief Executive of NHS Lincolnshire CCG said: “The review of these four services, and consideration of the public feedback received through the consultation, has been led by the senior clinicians who work in and with these four services. They have consistently recommended this set of proposals in order to deliver improvements in quality and the best possible outcomes for their patients.

“Through the public consultation, we were able to engage with the people of Lincolnshire about the full background of our thinking, the challenges that we face and the recommendations which we believe will best serve our population.

“We are extremely grateful to all of those who gave their open and honest opinions via the consultation questionnaire and face-to-face and virtual events across the twelve-week consultation, helping us to shape the future of these county services.”

In summing up, Dr David Baker, GP and clinical lead, NHS Lincolnshire Clinical Commissioning Group, said: “There has been concern about the fragility of services at Lincolnshire hospitals.

"The proposals will improve quality of care and outcomes for patients.”