14th Sept 2016
"we receive lower income for non-elective activity as compared to elective activity, and this year our non-elective activity levels have driven down our elective activity".
(Mr P Havey Acting Chief Executive Lancashire Teaching Hospitals NHS trust at a council of governor meeting April 2016)
Existence of foundation trusts rely on financial viability, if a service becomes financially less-profitable then that service may go out the window or take a lower priority.
In the above, non-elective (emergency) activity (services) have forced the trust to delay or abandon some of the more lucrative 'elective' services. Each time a planned elective operation is cancelled the trust risk facing sanctions plus a loss of income due to the non-elective taking up resources. Emergency services are also higher commercial and clinical risk.
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's chief executive said she will take "necessary action". Source: Lancashire teaching hospitals NHS trust, June 2015
One way to 'take necessary action' and turn-around a loss of income and drive up the lucrative elective activity would be to remove the emergency service, or reconfigure it in some way so that less time and resources (i.e. money) are spent on that activity. One reconfiguration is to close the A&E thus downgrading it to an urgent care centre. There are several other methods LTH have supported such as paramedics ringing for a doctor home appointment so as to avoid taking patients to A&E...
Of course, closing the A&E means the emergency service would need to be provided elsewhere, but that's not such a problem for a hospital trust with '2' emergency departments. is it?
I'm not saying this is what's happened at Chorley & South Ribble hospital, but when campaigning to reinstate such a treasured service we must consider all possibilities.
After all, even though the Lancashire Teaching Hospital NHS Trust are in serious deficit they say that money is not the reason for the closure of Chorley A&E. But I'll let you decide...