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

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