From Coun Charmaine Morgan

During the July meeting of the Lincolnshire County Council Health Scrutiny Committee a number of matters were covered which related to residents in Lincolnshire, and Grantham in particular. The Agenda included a review of the provision of the Mental Health Rehabilitation Unit at Ashley House, Grantham, an update on the progress towards implementing the outcome of the Acute Services Review which proposed to downgrade Grantham Hospital A&E to a 24/7 Urgent Treatment Centre, and, a review of NHS Dental services across the District.
A Public Consultation took place in covering the provision of Mental Health Rehabilitation Care between 16 January and 31 March 2023. During this time targeted patients, carers, service providers were consulted. The results of the survey, which had fifty-four responses, indicated that despite concerns regarding transport, the majority of people felt it best if patients with severe mental health issues could be supported to stay at home.
As a result, a new structure is proposed which will see intensive support for those facing a mental health crisis to help those affected remain at home. The most severe patients will still have the ability to stay in a Rehab Centre, but not at Ashley House, Grantham. Where necessary, committee members were assured, transport will be provided to support those patients.
The majority of those needing help will receive it through a wide range of services available in the Community through professional and voluntary support including the NightLight Café, of which there is one in Beehive Grantham.
During the review of services, Cllr Charmaine Morgan, representing South Kesteven District Council noted the disparity in response times for support should someone in crisis need help and attend an A&E Unit. The response times at Lincoln and Boston A&E were significantly shorter than those at Grantham, where someone would have to wait up to 4 hours for help. Mental Health speakers stated that this disparity was recognised and efforts being made to address it.
When looking at the presentation relating to the Acute Service Review outcome and planned downgrade of Grantham Hospital A&E to a 24/7 Urgent Treatment Centre there was some reiteration of the fact a decision had already been made and that it would not be possible to revisit that decision. Regardless, Cllrs Ray Wootten, Linda Wootten and Charmaine Morgan all expressed their concerns however at the impact the decision would have.
A representative from ULHT argued that ‘only 2 patients a day’ would be affected. This equates to over 700 patients who are critically ill a year. He also stated that Grantham Hospital has not had an A&E since 2008. Cllr Morgan strongly disputed this statement referring to the ULHT response to Freedom of Information Requests submitted in 2018 and 2019 in which the breadth of cases managed and severity were appropriate to any A&E Unit.
She added that Lincoln A&E could not handle trauma cases and yet its’ status was not questioned. However the main concern she raised, given a decision has already been made to go ahead with the UTC was the lack of information in the report overall over exactly what treatment patients may expect. Two points which were available were that the Clinical Senate had refused a request for the Urgent Treatment Centre to be given any other name, although this had been an initial proposal to indicate there would be a higher level of support than usually available at a UTC.
Due to the need for mid-grade doctors to be on site to support the enhanced care it had also been determined that the UTC would be run by United Lincolnshire Hospital Trust. It was agreed further detail would be required at the next review in November 2023.
A review of the NHS Dental services in the County revealed the fragile state of dental care nationally and locally with a ‘post-code lottery’ regarding what level of NHS Dental access is available. Grantham fared better than the majority of rural areas where NHS Dental support is stark and virtually non-existent.
A BUPA site offering NHS case on the East Coast has closed due to making a significant loss causing further pressure on remaining services. It was shocking to learn that overall only 25% of the population has access to NHS Dental care with the majority of people reliant on costly private medical support. There was an important clarification made during the meeting regarding the management of Dental patient lists. Unlike GPs, dentists are not required to maintain patients on their records and the NHS have moved away from providing preventative care to the provision of treatment based on need with emergency care being offered in specific sites across the County, including Sleaford, but not Grantham.
Councillor expressed concern at this short-term approach although understood the reasons why. The committee concluded that urgent Government intervention is needed to save our NHS Dental practises with more support for those training to be dentists required. The work taking place to create a new Dental School in Lincolnshire was well received although it could take some time for patients to benefit from this imitative.
A presentation was also made on plans to increase fluoridation of water across the County. At present Grantham has fluoridation which is said to significantly improve the reduction in dental decay. Concerns were raised at the poor level of dental hygiene among children resulting in the removal of teeth due to decay leading to a need for general anaesthetic.
Councillors were told that unlike other parts of the UK, Lincolnshire has a relatively short waiting list for such treatment but it is largely avoidable if children brush their teeth regularly. An NHS initiative provides toothbrushes and toothpaste to Foodbank and other organisations where poverty is identified as a reason for the failure to do this.
The committee agreed to continue to monitor the need for dental care. Cllr Morgan called for the Chair to write to the Government on behalf of the committee to call for this issue to be addressed.
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