Friday, 26 August 2016

Chorley A&E re-opening 'option' back on the table

At an SRG meeting earlier this month it was revealed that a previously discounted option for re-opening the Chorley A&E was now back on the table. And Chorley A&E could now initially be re-opened on a part-time basis.

The option, known as 'option 3' was to re-open Chorley & South Ribble A&E on a limited hours basis pending certain parameters were met, such as the ongoing recruitment of middle-grade doctors and locum cover.

The minutes of the meeting state that the hospital trust now have another mid-grade post filled with a further yet to be accepted. The CCG should hear if the post offered has been accepted later this month.

Work also continued to secure two more overseas training posts [MTI] which [training] should be completed December/January.

The revisited option 3 appears to come about from an earlier teleconference meeting between the trust and the SRG. The emergency teleconference meeting was to discuss just how fragile the urgent care services had become since both the Chorley Medics and Preston Primary Care withdrew its GP's
from the service following the tender of the urgent care centres to a private provider.

It's likely however that GP service withdrawal was only a part of the reason, and the fact that overcrowding at Preston hospital plus ambulances queueing outside generated the emergency conference with the SRG.

Initially, option 3 was to reopen the A&E from 9am to 4pm (limited hours). But several SRG members stated at the tele-meeting that the option had not been fully exhausted and that staffing itself should not exclude a potential 7-hour A&E service.

At an earlier meeting the Trust provided an outline of an assessment that had been undertaken to provide a 14-hour [A&E] service along with middle grade cover to the 24/7 major trauma centre at Preston hospital.

It was mentioned that NHS England guidelines were that the A&E should be open no less than 14 hours.

It was also noted that there was now an option to consider opening the Chorley emergency department for 14 hours per day which had not previously been discussed and the SRG would be working towards that aim.

The Chorley & South Ribble CCG chair supported the comments and noted that work was being undertaken towards the 14 hours option although [he] recognised that the workforce was short of providing that service. The Trust confirmed that achieving 10 permanent middle grade doctors would provide a sustainable model and the additional two December 2016 appointments would put the Trust in a better position, as would the two MTI doctors.

The Operations Director at Lancashire Teaching Hospitals Trust also confirmed that re-opening Chorley A&E, albeit on limited hours, would take pressures away from the [Preston] emergency department was the right thing to do...

But it's not as simple as that, and it appears the new Urgent Care Centre at Preston was causing financial problems, possibly due to financial penalties via sanctions imposed by the CCG's for failing to meet certain targets (which would mean a budget re-adjustment).

Nevertheless, there is now a plan to re-open Chorley as a 14 -hour emergency department option to be developed by the A&E project group. The review is to be at the end of this month.

Before any of this can happen, the SRG and Hospital Trust must undertake an engagement and consultation process, and this time, it will involve the Health scrutiny committee, MP's and the Public!

"Given that discussions were being held on a 14-hour service provision option which was different to the information provided to the public to date then there was now an opportunity for wider engagement/consultation"..

In summary, campaigners demand a 24 hour full time A&E at Chorley hospital. But let's face it, an A&E that's open part-time will likely attract the staff needed and its a start to full-time opening.

The option (3) appears to be fraught with risks, something the service providers [Trust] are reluctant to take, especially since the CQC are about to come down on them like a tonne of bricks if the Trust haven't made improvements since the last CQC visit in 2014.

And the word is, the Trust are now in a worse position than they were in 2014.

Considering we've been let down in the past with potential re-opening of Chorley A&E, I'm not holding my breath.

But there does now seem to be fire in the belly of GP's on the SRG. And quite rightly so, they are paying for services for the population they represent, and they should no longer take excuses from the hospital trust.

Will the option of re-opening Chorley A&E be rejected?

It's all down to numbers, but this time, the CCG members on the SRG panel are making demands, and for some bizarre reason, the hospital Trust are making progress. He who pays the piper...

We await the consultation...

A&E SRG Minutes 10Aug

Wednesday, 24 August 2016

Chorley A&E closure, the Hidden Agenda revealed

image courtesy
Let's get this straight, the Lancashire Teaching Hospitals trust board have manipulated the facts about the Chorley A&E closure and its repercussions on surrounding hospitals.

Even when faced with Facts from the North west ambulance service about huge increases in handover delays at Preston after the Chorley A&E closure, the 'Trust' claim severe handover delays are due to more people year-on-year attending the Royal Preston each day.

What utter nonsense. Facts are facts, something these people seem to enjoy trying to manipulate. A whopping 1330% increase in handover delays from Last May [2015] to this May [2016]. It's even on record at the Preston CCG since the Preston CCG have sanctioned the trust to the tune of over £132,000 alone this year already for the ambulance handover breaches!

So now we know what we are dealing with the gloves are off.
Let's see what the CQC have to say about the facts about the disgraceful knock on effect of closing Chorley A&E and the fact that the teaching hospital trust should have started their A&E staff recruitment campaign in November... 2014 !
I see not the hand of 'the Trust' behind all this but that of the authors of the Sustainability & Transformation Plan (STP), part of NHS England's '5 year forward view'.

STP and the 5-year forward view- the hidden agenda

The A&E closure was simply part of that forward view as we've seen with the threat of BOTH Preston & Chorley hospitals losing their A&E's and replacing them with a super-hospital near Lostock hall.

Simon Stevens under the order of Jeremy Hunt, has just carved our NHS into 44 bite sized regions, called ‘footprints’. And he’s told local health bosses that they must come up with a plan by 30th June to completely clear their massive shortfalls - within a year.
That's why the Lancashire Teaching hospitals Trust waited until now to tell you about the 'super-hospital plan, its all hush hush, they don't want YOU to know what's coming next!
Trusts have been told if they don’t come up with a new big cuts plan in a hurry, they won’t get any financial or other help, he’s told them. And he’s made clear that if they fail to deliver on the plans, they face being sacked or taken over by other – unspecified – organisations.

Only today the Chorley & Preston Clinical Commissioning Groups 'celebrated'  the sell-off of vital NHS services at urgent care centres in Preston & Chorley. GP out of hours services have also gone to the private company GTD Healthcare. Bit by bit, piece by piece, our NHS services are gradually being contracted out to private providers.

The battle is on,,, more than ever before our NHS is at risk of being privatised, and we may not even see it so,  BE PREPARED to fight to save OUR NHS!

Please read the link/page below very carefully to see their plans all falling into place,,


Useful Links

A brief explanation of the 5 Year Forward View - click image below

Sunday, 21 August 2016

CCG's selling off Lancashire's NHS to Private Companies

   'Clinical Commissioning Groups' (CCG's) are now opting to privatise other NHS services in the Lancashire area. The NHS cattle market is now open to PRIVATEERS!

There's a new cattle market auction over at the Lancashire CCG farm with the auctioneer waiting for the highest bidder, selling off our NHS services with us mere 'service users' locked outside shouting 'it's Our NHS'.
Well, other NHS services in the Lancashire area have now 'gone to market' and you guessed it, the NHS bid by Southport and Ormskirk NHS Trust to retain the contract for services such as GP out-of-hours services and walk-in centres; was rejected by West Lancashire CCG in favour of private companies

The West Lancashire CCG remains in talks with United Healthcare and Virgin Care about the contract.
West Lancashire CCG said: “This re-procurement of local community health services is standard practice for CCGs. This process is subject to national procurement legislation which requires the CCGs to enable both NGS and independent [private] providers to compete.”
And the legislation is?  The Health & Social Care Act 2012
The LibCon coalition shake up of the 2012 Act imposed an obligation on CCG's to allow private investors to bid on NHS contracts.
The Health and Social Care Act 2012 was the most controversial set of reforms in NHS history - greatly expanding the role that private companies play in delivering health services. Instead of a publicly funded and publicly owned NHS in England, the Act created a competitive market for health services where the government pays for, but does not provide healthcare.

This is evident when we look at the reasons why a failing hospital trust, such as the Lancashire teaching hospitals trust, place a bid to the CCG to run services such as their recently acquired urgent care centres (UCC) at Preston and Chorley.

The Lancashire trust had just lost their tariffs for A&E treatments at Chorley after closing it for patient safety reasons, yet the money raised elsewhere still wouldn't cover the budget for running the UCC on the same site.

Since the CCG's buy these services they aren't going to invest in a flagging trust that couldn't run a bath!

Still, there is no evidence that the Lancashire NHS Trust actually placed a bid to retain the UCC at Chorley, which would have kept the clinic in public ownership. There is also no evidence of any other bids on the contract, which apparently is worth between £32m to £36m.

So like the Southport and Ormskirk NHS services, it was put out to pasture and the first and ONLY sniff of a bid was from a private consortium. 

Some might say that under the circumstances the CCG had no other option but to sell off the NHS services to a 'private' provider.

The question is, why is the NHS finding itself in such a position?
Are publicly funded services now having to rely on a private provider to take-over those NHS services?

If so, we are well and truly on our way to the American 'insurance based'  model of healthcare.

Can NHS privatisation be stopped?

Today's politician is vastly different to those around when the NHS first started.

Every successive government has tinkered with the NHS to the extent where people are so confused they become 'lost' in how their healthcare system is managed. And when it comes to privatisation by stealth, that plays to the advantage of private healthcare service providers. NHS services begin to become indistinguishable from those provided by a private company.

So 'daan saath' in the house if buffoons we have the two main parties of Labour and Conservative who ironically both support private investment in the NHS. Take for example the warmonger Tony Blair who implemented the 'private finance initiatives' (PFI) for NHS reform. Even now, the extensions at Burnley hospital and Blackburn hospital equate to over £ONE BILLION in interest alone over the 35 year deal with private consortium's. 

It's no wonder the Blackburn hospital A&E temporaily shut its doors to patients in 2008 sending ambulances elsewhere in Lancashire. Money that should have been going towards staff and resources was being eaten up in interest on the PFi deals.

It was like having a 50% cut in East Lancs Hospitals budget leaving very little for investment in patient services to alleviate pressure on the Trusts only A&E in East Lancashire.

People who sit on the boards of CCG's provide money to the hospital trust they believe they are buying services from. When problems arise at the hospital trust, the trust will notify the CCG who in turn HAVE NO OPTION but to increase their monetary provision to the trust since they have no alternative supplier.
It's the same with council tax, YOU can't choose an alternative provider if your bins don't get emptied or you feel the service being provided 'requires improvement'.
The governments intention is to run down the NHS to such an extent that filling the gaps with private provision seems the best solution. 

The question is, what are you going to do about it?

Is your local hospital under threat of losing some services? 

Why not leave a comment in the 'Post a Comment' box below. 

You can also Click Top-Left and Contact me via email, if your posts are any good I'll publish them on here. *Your email and other personal information will not be published.

Friday, 19 August 2016

Chorley A&E closure - Share your views in 3 Surveys!



Copy & Paste your experiences into each of the surveys below. Just click each Logo image. A brief history of events after the A&E closure are shown at the bottom of this page which provides help and advice before you begin...


CQC Share your views

Share your experience of Chorley and South Ribble Hospital. Most important survey. The purpose of this survey is to see if any services have improved since the last CQC visit in 2014 where the LTH trust were rated as 'requiring improvement' in certain service areas.

Click to go to the CCG survey
Share your views on the temporary closure of Chorley Hospital's A&E. Have you or a family member have been affected by these changes, or would you like to give us feedback on the temporary closure?

Go to Healthwatch survey
Healthwatch Lancashire wants to hear stories from people in Lancashire about their views and how they have been affected by the changes at Chorley emergency department.

ADVICE/GUIDANCE Before you begin each survey...

The last CQC investigation into Lancashire Teaching Hospitals NHS foundation Trust was in 2014 where the trust was rated as requiring improvement at both its hospitals in Chorley & Preston.

The link below directs you to a page showing what the CQC found in 2014, and what service improvements they'll be looking at in September 2016....

BEFORE A&E CLOSURE (key CQC findings)


Below is a shortlist of events that occurred after the closure of Chorley and South Ribble A&E
  • Lack of openness and transparency- the local Chorley MP and Council Leader barred from the system resilience group meetings where NHS service decisions (A&E closure + urgent care centre management) were being discussed. These issues affected the MP's constituents who are ALL stakeholders & patients in the NHS.
  • patients turned away from Chorley urgent care centre after 8pm, told to 'get an ambulance' or go to Preston. No ambulances available due to them queuing at Preston hospital.
  • APRIL 2016: Before Chorley A&E was closed there were 43 Severe handover breaches >60 min at Preston hospital. 
    MAY 2016: After Chorley A&E was closed there were 141 Severe handover breaches >60 min at Preston hospital. 
    • When the Chorley A&E closed in April, the attendances at Wigan hospital arriving by ambulance went from 14 to 83 in a few weeks. A 493% increase in patients attending Wigan hospital by ambulance!
  • knock-on effect of closing the A&E at Chorley & South Ribble hospital has consequences on much wider areas such as Blackburn, Wigan, Preston and beyond as shown in the briefing on the Ambulance impact & attendance report on the CCG website .
  • the Trust have censored the results of a Freedom Of Information request about their recruitment drive which has led to suspicion that the Trust may be intentionally starving Chorley hospital of doctors in a drive to ultimately close the A&E and replace it with an urgent care centre. Again, a lack of openness and transparency.

    Due to the A&E closure at Chorley Hospital....
  • elective surgery may have to be cancelled or re-scheduled
  • ambulance turnaround times at Preston hospital have increased 3-fold
  • ambulance handover times at Preston hospital increased ten-fold after the Chorley A&E closure
  • re-admission rates at Preston hospital will no doubt increase
  • I heard there have been increase in number of doctors & nurses at Preston in an attempt to deal with overcrowding problems at Preston since the closure of the A&E at Chorley.
  • I heard that there has been an increase in agency staff & accompanying rota problems
  • severe decrease in quality of patient care as reported in the media since the Chorley A&E was closed
  • ambulances have had to be re-directed to alternative ED sites such as Wigan and Blackburn
  • Lancaster hospital has told the Lancashire teaching hospitals trust not to send Ambulances there since they cannot cope with any more excess patients, same for Wigan and Blackburn as reported in the media..
  • hospital service reconfiguration plans have been published in the media, such as Chorley hospital & Preston hospital being closed and replaced with a Super-hospital, yet there has been no public consultation on this! how come the media know this but the public don't?

Get Posting into all 3 surveys, Good luck!

Wednesday, 17 August 2016

Chorley A&E closure, super-hospitals, and NHS Privatisation

The A&E at Chorley and South Ribble hospital was recently closed due to a shortage of doctors which Lancashire teaching hospitals NHS trust say could lead to a breach of patient safety.

A picture of a big hospital
So imagine my surprise when today [16/08/2016], I read in the newspaper that Chorley’s hospital, along with its sister hospital in Preston, could be demolished to make way for a new ‘super hospital’.


 Apparently, Lancashire Teaching hospitals NHS trust have drawn up a 'master-plan' under its 'Our Health Our Care' programme which, amongst other 'options', includes removing emergency services altogether from Chorley & Preston and having one super A&E in the Bamber Bridge/Clayton Brook/Lostock Hall area.

According to a 'spokesperson' for the Our Health Our Care programme, work was undertaken by Lancashire Teaching Hospitals NHS Trust, with a range of stakeholders including members of the public, to consider possible models of care for the future.

Note the word 'was' and the aforementioned work included members of the public...

This would include an option of converting Chorley & Preston hospitals into elective surgery only with emergency services provided at the new super hospital.
h Our Care programme

Read more at:

The 'Decision Makers'

Apparently, the 'Our Health Our Care' programme consists of representatives from NHS Greater Preston CCG, NHS Chorley and South Ribble CCG, Lancashire Care NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, local councils and NHS England specialist commissioners.
The Our Health Our Care programme consists of representatives from NHS Greater Preston Clinical Commissioning Group, NHS Chorley and South Ribble Clinical Commissioning Group, Lancashire Care NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, local councils and NHS England specialist commissioners.

Read more at:
The Our Health Our Care programme consists of representatives from NHS Greater Preston Clinical Commissioning Group, NHS Chorley and South Ribble Clinical Commissioning Group, Lancashire Care NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, local councils and NHS England specialist commissioners.

Read more at:

Our Health, Our Care, Our....

So I thought, that's quite a few programme representatives; surely there must be something in the public domain about this master-plan?

I thought I'd research info on the 'Our Health Our Care' programme, and see what these 'options' were. And guess what I found?

Nothing! Zilch, absolutely nada.
No 'work' undertaken with stakeholders and the public, nothing.

However, I did discover something very interesting...

  1. Nobody in the public domain has actually seen the 'our health our care'  'masterplan'
  2. The programme title 'Our Health Our Care' is taken from Labour's 2006 white paper which includes issues around placing large swathes of the NHS out to tender (private sector).
    The title?  "Our Health, Our Care, Our Say". 
 Sound familiar?

 Here's an excerpt from the King's Fund which offers some analysis of the white paper...

Another issue reflected in this White Paper relates to the optimal size and configuration of hospitals in relation to new technology and working practices. The size, location and function of hospitals had once been the object of considerable central planning,6 but the government’s early efforts on this issue were channelled into enabling the Private Finance Initiative to flourish and decisions about size and function were left at local level. The tendency to close small local hospitals continued on the grounds of clinical and economic efficiency...
So ask yourselves this question; how can a hospital trust with a current rating [for both its hospitals] of 'requiring improvement' from the care quality commission; take on such a huge amount of greater responsibility for running a super-hospital?

The answer is of course, it won't, since it won't be running the super-hospital.

Now add to this the fact that the health watchdog NHS Improvement investigated the Trust, which runs the Royal Preston and Chorley hospitals, found that it lacked "both the robust plans and financial management" needed to address a "deepening hole" in its finances.

Would you have confidence in a hospital Trust to manage a 'super-hospital' when that Trust is in serious deficit and lacked "both the robust plans and financial management" needed to address a "deepening hole" in its finances?

Chorley & South Ribble A&E was closed due a shortage of doctors to run both A&E's at Preston and Chorley. The Trust had enough to run the Preston A&E, but it won't say how many doctors are needed to run the Chorley site and how many on the Preston hospital site.

Doesn't fill you with much confidence now does it?

But let's not jump the gun here since the consultation on the 'Our Health Our Care' master-plan has yet to be formally put to the public.  Late summer apparently.

Now scroll back up this page and take a look at the paragraph titled 'The Decision Makers'. Remember them? All those public health representatives who have already seen this master-plan, remember those? They sit on the Our Health Our Care Joint Programme Board.

I didn't hear them running to the media when they got wind of such huge NHS service configurations.

I smell something fishy, and I'm not talking about the contents of Baldrick's apple crumble.

Why not leave a message below, maybe you know where the money will come from for all these proposed service configurations?  Think about it, NHS privatisation already accounts for £10 billion of the NHS budget, the rest is now up for grabs...


Dr Sakthi Karunanithi, the county council’s Director of Public Health and Wellbeing, predicts such changes are possible as the county comes to grips with a health crisis which extends far beyond the recent closure of the Accident & Emergency department at Chorley’s Hospital.

Super hospital’ proposal to serve Morecambe

Read more at:

Super hospital’ proposal to serve Morecambe

y’s hospital could be demolished to make way for a new ‘super hospital’.

Read more at:
Chorley’s hospital could be demolished to make way for a new ‘super hospital’.

Read more at:

Saturday, 13 August 2016

Hospital Trust 'worst financial deficit' of any NHS trust in England

Lancashire Teaching Hospitals Trust 'worst financial deficit' of any NHS trust in England

 In June last year, the health watchdog 'NHS Improvement' said it had "serious concerns" over a Lancashire hospital trust's finances after it predicted a £44m rise in its deficit. Lancashire Teaching Hospitals NHS Trust's budget was forecast to rise from £2.8m in 2015 to £46.8m this year [2016].

Health regulator Monitor, now renamed NHS Improvement (NHSI) said it was appointing a financial director after the "biggest deterioration" of any NHS foundation trust in England.
The probe into the Lancashire foundation trust found it lacked "both the robust plans and financial management" needed to address a "deepening hole" in its finances. So NHSI said they'd assigned a new financial improvement director to scrutinise the trust and will "hold it to account for making progress".

The regulator amended the trust's licence which will see its leadership team changed if it fails to make the changes required.

■ Sadly, the same leadership team are still leading the trust, but unfortunately, leading it just a little further down the road of privatisation.

A trust spokeswoman said a rising number of patients had been placing a bigger strain on its finances as extra beds and staff - including agency workers - were needed to cope with demand. Cancelled surgery due to a shortage of beds left the trust out of pocket as it had to pay for extra clinics and "outsource" operations to other trusts.

The trust also received less government funding for some specialist services. But that's part and parcel of a trust wanting foundation trust status, isn't it?

Karen Partington, chief executive of Lancashire Teaching Hospitals NHS Foundation Trust, said she was committed to complying with NHSI' actions.

She added: "I'm confident that we'll be able to take the necessary action to demonstrate that we can manage our finances now and for the future."

■ She did, in fact she was so confident she recommended closing the A&E at Chorley and privatising the Urgent Care Centre on the same site. Both recommendations have now been carried out, leaving Chorley & south Ribble folk with a plaster post run for profit.

Closure of the A&E meant a loss of tariff for the procedures carried out there, but these couldn't be passed on via the Urgent Care Centre so to minimise financial loss they sold the day to day management of the clinic plus other services to a private buyer. The contract went out to tender via the CCG's and is valued at between £32m - £35m

So if the regulator can't change the leadership, who can?

■ I know one thing, if I had my way I'd boot the lot of them out and replace them with people who understand how to run an open and transparent health service, serving the public and run by the public.

Thursday, 11 August 2016

Chorley A&E Closure leads to ten-fold increase in Ambulance waiting times

Ambulances queue outside Preston hospital July 2016. image source. Steve Holgate

Ambulances waiting outside hospitals are 'delays' that cost lives.

Paramedics and ambulances outside a hospital cannot tend to other emergencies until the patient is handed over and signed-off at the hospital.

The Lancashire Teaching Hospitals NHS foundation Trust, responsible for Preston and Chorley hospitals, made a decision to [temporarily] close the A&E at their Chorley site in April due to a shortage of middle-grade doctors.

But since the closure of Chorley's A&E department in April, there has been a huge increase in breaches of ambulance handover delay times at the only other A&E at the Royal Preston Hospital...there are 2 measures of breaches in delay...

handover breaches greater than 30 minutes, and
severe handover delays (greater than 60 minutes)

APRIL 2016: Before Chorley A&E was closed there were 43 Severe handover breaches >60 min at Preston hospital. 
MAY 2016: After Chorley A&E was closed there were 141 Severe handover breaches >60 min at Preston hospital.
That's a huge  228% increase in Ambulance delays (severe breaches) at the Royal Preston hospital only a few weeks after the closure of Chorley A&E in April. 

Only last week, Lancashire county Councillor Steve Holgate reported over 15 Ambulances queuing outside Preston hospital.  The Lancashire Teaching Hospitals NHS Trust said allegations of excess ambulances outside Preston hospital were 'unfounded'. 
The facts presented by the North West Ambulance Trust today clearly highlight how out of touch the Lancashire teaching hospitals trust are, and they can no longer fool the public of their mis-management that has led to this crisis.

Below shows the shocking 2015-2016 increases...

Ten-Fold Increase

From above we can see that in May 2015 there were 21 thirty-minute handover breaches.
In 2016 this was 313
thirty-minute handover breaches, over a ten-fold increase of 1390%

 Other Hospitals are also affected

The North West Ambulance Service (NWAS) also show that whilst there has been an increase in ambulances attending the Royal Preston Hospital, other hospitals have also been affected by the closure of the A&E at Chorley.
When the Chorley A&E closed in April, the attendances at Wigan hospital arriving by ambulance went from 14 to 83 in a few weeks. A 493% increase in patients attending Wigan hospital by ambulance!

There is now no doubt that the closure of the A&E at Chorley & South Ribble Hospital has led to a crisis at neighbouring hospitals.


Figures released earlier by NWAS show that A&E attendances year on year are at an all time high and that in the last 12 months alone attendances at A&E departments in Lancashire have risen by over 20%.

The Royal College of Emergency Medicine state that the A&E attendances via ambulance clearly show that replacing A&E's with Urgent Care Centres in most cases simply increases attendances at other hospitals and contributes to an increased risk to patients.

The fight to re-open the A&E at Chorley & South Ribble hospital is no longer confined to Chorley.

Clearly the knock-on effect of closing the A&E at Chorley has consequences on much wider areas such as Blackburn, Wigan, Preston and beyond.

The battle is now on for an all out Rally to STOP THIS LUNACY and gain back control of our NHS!

 Protect Chorley Hospital from Cuts and Privatisation

NHS Chorley and South Ribble CCG (CSRCCG) - ED Attendance Impact Assessment (PDF) 

Briefing ED Attendance Impact Assessment C&SR CCG

Related articles

Wednesday, 10 August 2016

Grantham Hospital A&E and the Chorley A&E link

 It seems the doctor shortage excuse is now being used to close other A&E's?

I've just heard that the A&E at Grantham hospital, one of 3 hospital A&E's run by United Lincolnshire Hospitals Trust (ULHT), is proposed to be closed during night hours due to a shortage of doctors. However, as usual, since Grantham is the smallest A&E of three A&E's (the others being at Lincoln and Boston) so it is a prime target to be closed and replaced with an Urgent care centre.

The Lincolnshire Trust tried to close the Grantham A&E in May saying patients would receive better and more specialist care at Lincoln, but that proposal came across a storm of protest from MP's, residents and the council.

NOW, the Lincolnshire Trust are back again but this time the justification for closing the Grantham A&E is a shortage of doctors (sound familiar?).

The Lincolnshire trust claim there are not enough doctors to cover the Grantham A&E yet clearly the doctor cover at the other 2 A&E's aren't even mentioned!

ALL doctor numbers given are for all THREE A&E's and they refusing to say WHY they've allowed this to happen.
It seems the doctor shortage excuse is now being used to close many A&E's?
Ironically, as with the May proposal, Dr Kapadia, medical director at the Lincolnshire Trust, is once again pushing to close the A&E under the doctor shortage pretext... .. but check out his comments from May this year....
"Dr Sunil Kapadia, medical director of ULHT, agreed that the A&E department at Grantham is already an urgent care centre in all but name. He said centralised specialist centres, such as the Heart Centre in Lincoln, proved that the system worked providing a better standard of care with better results.

Dr Kapadia said: “There are clear standards set down by Government that are expected from emergency departments and if you cannot meet them then you are an urgent care centre.
I wonder if the medical director of LTH Trust is thinking the same way as this about the A&E at Chorley hospital? "an urgent care centre in all but name", "don't meet government standards then it's adios A&E at Chorley? "

Can the reasons given for closing our A&E departments be justified?

Whichever way, the people of Chorley & South Ribble will be doing all they can and protests will continue until our A&E at Chorley is re-opened.


Sunday, 7 August 2016

North West Ambulance Service under pressure

Lancashire Teaching Hospital NHS foundation Trust knew beforehand that the closure of Chorley hospitals A&E  would result in ambulances queuing outside other hospitals.

I can just imagine the top brass at the North West Ambulance Service (NWAS) having a near heart attack when they hear yet another A&E in the region is to be closed.

The A&E at Chorley was closed in April this year [2016] due to a lack of mid-grade doctors leading to an increased risk to patient safety.

The Lancashire Teaching Hospitals NHS foundation Trust, responsible for Preston and Chorley hospitals, made a decision to [temporarily] close the A&E at their Chorley site. This would leave people of Chorley & South Ribble with an Urgent Care Centre (UCC) treating minor ailments.

With the A&E at Chorley closed, any patients needing emergency treatment would have to attend the alternative Preston Royal Hospital.

Some may say that due to a lack of A&E doctors at Chorley; the trust had no alternative but to close the service and send everyone to Preston hospital.

The hospital trust board have come under some flack since they have constantly refused to provide evidence that they were doing enough to re-open the Chorley A&E.

Inevitably, the knock on effect of an A&E closure would be that ambulances would swamp surrounding hospitals. Something the Trust knew would happen, here's why...

At a board meeting in early April, analysis showed that closing the A&E at Chorley would create problems at the Preston hospital, the report stated "a 50:50 split of attendances was analysed which showed that there would be increased pressure on patient attendances at Royal Preston Hospital".

Furthermore, in the same month, just before closing Chorley' A&E, the Hospital trust chief executive Mrs K Partington confirmed that..

"conversations had been held with Wigan and Bolton Chief Executives and similar contact had been made with the Chief Executives at Blackpool, East Lancashire, Morecambe Bay and Lancashire Care to determine whether support could be provided although all organisations had confirmed that support could not be provided as similar pressures were being experienced within each Trust".
It was made expressly clear that closing Chorley A&E and diverting patients to any of these already overcrowded trusts would risk patient safety. Nevertheless, the patients were diverted.

The result?....
  • 11th May - Ambulances forced to queue at Royal Blackburn Hospital as A&E department stretched to breaking point (source: L.E. Telegraph)

  • 9th June - Ambulances queue outside Wigan A&E after patients from Chorley A&E were diverted there.
    (source LEP)

  • 1st August - Waiting times at Royal Preston A&E hit worst recorded level ever
    (source 2BR)

  • 15 Ambulances queue outside Preston hospital.
    source: ITV news
Hopefully the queues will reduce and the system will stabalise, but somehow with winter approaching it's likely to get worse.

The solution?

You tell me, leave a comment below or join us on Facebook at
Protect Chorley Hospital from Cuts and Privatisation

Saturday, 6 August 2016

Chorley A&E closure - the start of privatisation

Ambulances queue outside Preston Hospital, Credit: Steve Holgate

I think I need to go on an anger management course after hearing the news this week that Chorley hospital's newly built Urgent Care Centre is to be privatised.

I BLOGGED earlier about the Trust attempting to justify the A&E closure with the mantra of can't recruit enough suitably qualified and experienced doctors.

I proved that this wasn't the case and the ultimate goal was for patients to be served via two urgent care centres and upon escalation fed into a single A&E at Preston.
The Trust had staffing problems back in 2014 and were rated as 'requiring improvements' by the Care Quality Commission (CQC). But instead of recruiting more permanent staff, the Trust filled the rotas with locums & agency staff and paid a consultant £375,000 to work overtime for the rest of the rota gap.

How temporary is 'temporary'

The trust claim the Chorley A&E  closure is 'temporary' due to a lack of doctors. Yet how is it possible to close an A&E for 12 months on a temporary basis when its taken the trust TWO YEARS to find enough doctors and they STILL haven't come up with a solution?
The people of Chorley & South Ribble have good reason to be wary. Historically, there is a direct correlation between the opening of a hospitals Urgent Care Centre immediately followed by the closure of its A&E department.
The motto of Chorley council is 'be aware', but on occasion no matter how wary we are some things slip through the net. The closure of the A&E at Chorley and subsequent privatisation of the Trusts urgent care centres is not going to slip through the net.

A Tsunami of Patients

Since the Trust board closed the A&E at Chorley, Lancashire Teaching Hospitals NHS foundation Trust must now deal with the overcrowding problems at their only other A&E in Preston.

Campaigners have called for the Trust board to resign, and quite rightly so.
Only this week, a county Councillor reported up to FIFTEEN ambulances queued outside the Preston hospital. And yesterday an elderly pensioner in chorley had to wait over TWO HOURS for an ambulance to arrive after falling and seriously injuring themselves.

When one or more hospital trusts 'merge' into a single trust covering a larger area, service reconfigurations, such as A&E closures ALWAYS follow.

On closing an A&E, the same problems arise at the surrounding A&E hospitals due to the inability to cope with the demand:

  • elective surgery cancelled or re-scheduled
  • ambulance turnaround times increase
  • re-admission rates increase
  • radiography data backlogs
  • increase in number of doctors & nurses in attempt to deal with problem
  • additional finances thrown at MAU's and SAU's 
  • increase in agency staff & accompanying rota problems
  • severe decrease in quality of patient care
  • increase in mortality rates
  • ambulances re-directed to alternative ED sites (cross border)
  • increase in staff becoming sick/ill leading to more locum/agency dependency
  • intimidation, harassment and bullying of staff to get the job done
  • ....
the list is endless, and all is needed is for someone who knows how frontline services should be run and funds allocated appropriately.

The NHS is run, not by consultants, doctors and nurses, or commissioning groups. It is run by incompetent bureaucrats whose solution to a problem is to follow a service reconfiguration plan based on no evidence apart from if the plan fails, as we know it will, we can introduce our external private provider.

The public are usually the last to know when hospital service reconfiguration plans are in the pipeline.
Nor more so than the tender by the clinical commissioning group to allow a private company to run the urgent care centres at Chorley and Preston.  more on this later...

The people of Chorley who funded the initial build of the hospital are akin to bull terriers, once they get their teeth into an issue, they will not let go. I've experienced over 23 years of campaigning to improve and save NHS services, yet I've never seen such resolve of the people of Chorley & south Ribble and surrounding areas.

I'm proud to stand alongside them..............

Thursday, 4 August 2016

Chorley Hospital A&E Closure was planned (proof)

Well, I must confess I wasn't surprised when I heard the announcement today that the re-opening of Chorley Hospital A&E won't be reviewed again until April 2017.

In fact, Mystic Maverick actually predicted the EXACT MONTH in 2017 the Hospital Trust said they would consider re-opening the A&E at Chorley. I'll explain in a minute how I did this, for now just make a note of the month the A&E was closed (April) 2016.

The A&E at Chorley was closed in April this year [2016] due to a lack of staff leading to an increased risk to patient safety. Or so we're told.

Lancashire Teaching Hospital NHS Trust told Campaigners a while back that there should be enough doctors in place to open the A&E late August.

But last week hopes again were dashed when campaigners were told an August re-opening was OFF and it would be another six months before the A&E would open.

Today [3rd August 2016], after a meeting between multi NHS agencies at the local Clinical Commissioning Group (CCG) offices in Leyland, a decision was made to Privatise the urgent care centre (built last year at the side of the A&E) and only revisit the issue of re-opening the Chorley A&E in April 2017. Note the date April.

When the urgent care centre (UCC) at Chorley hospital was opened in October 2015, many suspected it was built to replace the A&E. But immediately closing the A&E and telling people to use the new UCC instead would reveal the obvious pre-determined plan of a major service reconfiguration.
So the Trust were advised to wait a while.......

The Master Plan Revealed

When any major hospital reconfiguration is proposed, such as centralising acute A&E services at another hospital, evidence must be provided that changes must be clinically safe and financially viable.

This can be done in two ways:

1) using an existing model that has already undergone configuration (the model must have a similar population catchment area with supporting ambulance services).

2) Using a progressive step-down model which utilises a 12 month trial period where the service [eg. A&E] is temporarily replaced with a UCC to allow study data which will determine if surrounding hospitals can take up the demand from the temporary closed service [eg. A&E].

source:  The reconfiguration of clinical service, (Strategy Unit NHS England 2013) King's Fund

Model 2) requires 12 months clinical trial which tallies EXACTLY with the date the A&E at Chorley was temporarily closed (April), and today's announcement of when the A&E will be revisited (April).
April to April, 12 months exactly.

The initial whole system proposal is part of the Trust's ‘Our Health Our Care’ service reconfiguration programme. The proposal can be found here in the Trust's Annual report & accounts 2015-16
Note. the above is a PDF download..

The winter period is the most challenging time for any A&E so it's little surprise the Lancashire Hospitals Trust avoided any re-opening date before the new year [2017].

There is more to it than that of course, but when a Hospital foundation trust is rated poor (requires improvement) in 5 out of 7 clinical categories they will stop at nothing to resolve the issue.

Now consider this...
the hospital trust 2 weeks ago claimed they needed to recruit TWO permanent doctors to reopen the A&E at Chorley hospital. Today, they said they need EIGHT.

A source at the hospital confirmed no wte doctors (junior or consultant) leaving A&E services.

But I hear you saying "what if you're wrong? And the recruitment issue was correct all along?

Then I'd say do your research, take a look at the trusts annual report 2015-16  (PDF download) where service reconfiguration was first proposed. Then look at the trust board papers over the last 2 years which shows a deficit of over £41 million and how they've just loaned £21M from Monitor. Take a look at the local CCG board papers and how the reconfiguration was slowly introduced.

A forum of over 55,000 doctors have been following my plea to join and help out the Lancashire trust and time and again they say applications have been made.


Finally, a freedom of information (FOI) request was submitted to the trust in May this year asking how long the Trusts doctor recruitment campaign had been ongoing, how many doctors/consultants and what level they Trust had recruited to support re-opening of the A&E at Chorley Hospital.

I was astonished to see the Trust had used section 70 of the FOI act to censor the results, indicating that many doctors who COULD have been recruited, may have been told the vacancies were no longer available. In the FOI response, the Trust had censored the number of doctors required to safely run the A&E. Andrew Oddy, who initiated the FOI request said..
"Sadly the Trust chose to redact [censor] most of the information sought despite it being of a non-personal nature - the answer is meaningless without context".

The Censored recruitment figures can be found here

Campaigners have been told by the hospital trust to wait until April next year before the issue of re-opening the A&E is revisited.
The only way forward is not to wait until next year but demand an independant investigation NOW as to why this Trust are failing them so badly, and why we should believe the lies they are so blatantly telling us.
In the meantime, question everything you are told, after all it's OUR NHS!

Tuesday, 2 August 2016

Chorley A&E closure - nearby hospitals also under-staffed

In April this year [2016] the A&E at Chorley & South Ribble Hospital was temporarily closed due to a lack of staff to run the department leading to increased risks for patients. 

Lancashire Teaching Hospitals NHS trust have now confirmed they have requested support from other surrounding hospitals but have been told those hospitals are also experiencing similar staff shortages.

In a Frequently Asked Questions (FAQ) document released earlier, the Trust stated: "We have asked other local hospitals for support but they are experiencing similar challenges and so haven’t any staff available to help".

This means that with the A&E at Chorley being closed, patients are being transferred or taken to already under-staffed surrounding hospitals as mentioned in the Trusts FAQ.

So it's now unsafe to transport patients from Chorley to other nearby under-staffed hospitals.

It seems the only solution is for the Lancashire Hospitals NHS foundation Trust to hurry up and recruit some doctors and re-open the A&E at Chorley. 

Are surrounding hospitals already under-staffed?
Do you work or know someone who works at a nearby hospital who can verify claims that those hospitals are under-staffed?

Nearby hospitals providing A&E services include: Preston, Wigan, Blackburn.

Email or leave a message below...

The FAQ can be downloaded from the local CCG site here