Healthy Conversations event – report

Having attended the ‘Healthy Conversation’ event at the Jubilee Church, Grantham on 20 March hosted by Lincs Health and Care, Chair SOS Grantham Hospital Charmaine Morgan said:

It was encouraging to see so many people present today, thanks to all concerned, campaigners, local people and organisers.

I had a number of lengthy conversations with both the Community Nursing team, Dr Baker and John Turner, Chair SWLincs Clinical Commissioning Group regarding future plans for Grantham District Hospital.

The proposals to provide better co-ordinated improved patient centric preventative care are to be welcomed. However, as a former Home Care worker myself I am aware that to succeed such plans need considerable levels of resource and a strong committed team of community nurses, other specialists and home care workers.

The current working conditions. status and pay of home care workers in particular must be improved to attract people into this important role for the plans to work. Ideally bringing their role back into the NHS. SOSGH workshop activity showed convalescent homes remain popular with patients and should also be considered also.

I commented that the Countywide loss of Meals on Wheels needs addressing. Some patients are being released from hospital without access to food. The valuable Meals on Wheels service ensured those participating received at least one hot meal a day. Furthermore people had the security of knowing someone would check up on them and say hello everyday. The fragmented replacement of this service by Lincolnshire County Council with private microwave dinner providers does not fully cater to the needs of our most vulnerable people. This gap must be addressed.

A pilot to identify patients handling isolation by making regular GP appointments seems an excellent idea, provided medical needs are still properly assessed and opportunities for isolated people to socialise are fully supported.

The discussion around Acute Care proposals revealed differing views within our healthcare provider structure over what services our A+E unit should  deliver. This has resulted in a lack of clarity and mixed messages going out to staff and members of the public over the future plans for our A+E. This issue must be resolved.

Whilst ULHT remains committed to the downgrade of our A+E department to an Urgent Care Centre it was encouraging to hear that the Clinical Commissioning Group, who commission services, have more ambitious sustainable plans that more closely reflect the needs and concerns of our community. Crucially they include retaining vital patient stabilisation and resuscitation at GDH for all ages, and, continuing to support the majority of acutely sick or injured patients.

We discussed the planned access to the A+E at night and I reminded Dr Baker and John Turner Chair of the CCG of the need for 24/7 access to cater for people, especially those who self-present at the hospital. Delay caused by dialling the 111 service, currently proposed, could put people.more at risk. Dr Baker said this is a common request emerging from the event and he would be willing to reconsider access to our A+E at night.

I also received a commitment for those leading the programme of change to accept the SOS Grantham Hospital petition for consideration. Over 62k of us called for an A+E with patient stabilisation and resuscitation to be available 24/7. I explained how important it is that patient numbers are kept high at the unit to ensure it is sustainable.

Historic changes have resulted in numbers falling. A line must be drawn. Approximately 5000 patients less have used the unit since the night closure by ULHT. Of these Dr Baker estimated 140 would be severely ill and need transfer elsewhere.

Others could be treated and admitted into Grantham Hospital if necessary. If the doors were open 24/7, as we ask, all would receive resuscitation and stabilisation in an emergency, or transfer elsewhere in an ambulance.

I raised concerns regarding the experience of patients and carers left stranded at night at our A+E units or hospitals as well. I suggested an inter-hospital bus loop service ideally linking Nottingham QMC to Grantham, Sleaford, Lincoln, Boston, Louth and Skegness Hospitals to be run on an hourly basis as a minimum ideally 24/7. This could help people unable to drive needing to visit friends/family. This proposal was warmly received.

The discussions left me cautiously optimistic but much depends on the outcome of a detailed analysis of the documentation provided. The questions identified so far include:-

1. What medical conditions will continue to be supported?

2. What patients would be ‘excluded’ when the ambulance service is used?

3.What staff would provide acute care?

4. Will direct access 24/7 be restored?

An assurance that ULHT plans will not prevail is required given their ongoing involvement as a supplier.

It is important the needs and views of thousands of local people with ‘protected characteristics’ are also taken fully into account.

Further Healthy Conversations are to take place. The next proposals will reveal just how much we have been listened to.