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Plans for one A&E in Lincolnshire

By Lincolnshire Echo  |  Posted: December 05, 2013

Plans for one  A&E in Lincolnshire
Comments (17)

The whole of Lincolnshire could be served by one major A&E department and one maternity unit as part of a radical shake-up of the county's health service.

Meanwhile, a new children's unit could be built as a one-stop shop for paediatric care.

The plans are included in a new blueprint for how the county's health and social care services might look in future.

It includes a raft of proposals which are designed to save money, cope with an increasing demand for services and ensure patients are receiving the best possible care.

It comes after the director of NHS England Sir Bruce Keogh said patient safety was being compromised in Lincolnshire.

Among the ideas are:

Establishing a single main A&E department covering the whole county.

Setting up a network of "A&E Locals", which would consolidate the work of the current minor injuries units, primary care centres and urgent care centres.

Bringing the midwifery-led and obstetric-led clinics at Lincoln County and Boston Pilgrim on to a single site.

Consolidating the children's services currently on offer in Lincoln, Boston and Grantham and at outpatient centres in Louth, Gainsborough, Skegness, Spalding and Holbeach.

The construction of a "purpose-built paediatric unit" in a central location, such as Sleaford, to service the whole county.

The ideas come from the first phase of a Sustainable Services Review, which was launched to look at "how to provide more efficient services that are easier to recruit for and better co-ordinated, and make the best use of the funding and resources that health and care organisations have".

It is being conducted by the 11 groups responsible for health and social care in Lincolnshire, which together are facing a projected £105 million funding 'gap'. The group is chaired by Dr Tony Hill, the county council's director of public health.

He said: "If we don't sort this situation then people from outside will sort it for us.

"The health and wellbeing board can agree a way forward, drive it through and speak with one voice.

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"And the primary focus has been in maintaining the highest standards of public and patient safety."

The blueprint's authors say the project is in its infancy and that the options being suggested at the moment are not set in stone.

And while they accept that the project is designed to save money, they insist it will not lead to a reduction in service.

United Lincolnshire Hospitals NHS Trust said: "From April this year nationally and locally across health and social care, major change has taken place – and these changes will continue over the next few years.

"In response to these changes, Lincolnshire has embarked on a county wide review covering the whole of health and social care.

"A range of services are part of the review including urgent care, planned care, early intervention and long term care.

"The review is in its early stages and in October a health and social care summit was held.

"It involved 80 people from a range of organisations and patient representative groups across the county to discuss potential ideas that could be put forward.

"We have been involved in the work following the care summit and a blueprint has been developed which will go out to public consultation next year."

The review is being carried out by senior managers and elected members of the four Lincolnshire clinical commissioning groups, along with United Lincolnshire Hospitals NHS Trust, Lincolnshire Community Health Services NHS Trust, Lincolnshire Partnership NHS Foundation Trust, East Midlands Ambulance Service NHS Trust, NHS England Area Team, Lincolnshire County Council and HealthWatch.

The blueprint will be discussed at a meeting of Lincolnshire County Council's Health and Wellbeing Board on Tuesday, December 10.

The meeting is open to the public and starts at 2pm in Committee Room One, County Offices, Newland.

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17 comments

  • jimub40  |  December 10 2013, 4:34PM

    It is not about having one central unit its about patient care and trust and having lost my partner in 2009 thanks to useless idiots at Lincoln county hospital surely its not about having one unit or 100 its about the competance of the people running them.

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  • Hertsman  |  December 10 2013, 11:22AM

    Look on the bright side, least we will only be turned away from one centre. In the light of yesterday's news to avoid Lincoln A & E, I can't see how anyone can consider this to be a feasible option. Might look good on paper and tick many boxes but is it right for such a diverse county as Lincolnshire?

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  • mervhob  |  December 06 2013, 3:33PM

    Pete - Unfortunately most politicians come from the comfortable milieu of the middle class professions such as the law, where giving value for money in return for substantial rewards never bulked large in their imaginations. I spent 35 years in industry fighting a battle against management which like a weather cock, pointed in whatever direction the wind of prevailing management fashion blew. Their ability to tackle the deep rooted organisational problems was as close to zero as might be imagined and the idea that the administrative systems should properly serve the needs of the business was an anathema to them. Work avoidance was their sole aim and responsibility was something to be carefully avoided. So I have absolutely no expectation that the current review will ruffle any delicate feathers in the administration block - it will mean that front line staff will have to work harder and the public will receive a poorer service in the long term. But hey, just think of those magnificent severance packages for abject failure they will receive, even if they are found out to be wrong!

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  • Pete67  |  December 06 2013, 3:05PM

    mervhob - - - It's a pity a few of the politicians don't think like you.

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  • mervhob  |  December 06 2013, 2:09PM

    A need to save money on Health Care? - that's an easy one. Firstly, sacked 2/3 of all those employed in management and administration. Then tell the remaining 1/3 they are on a 3 shift system, 24/7 as it is obvious that they just can't cope while working a 9 to 5 paid holiday. And tell the sacked 2/3 that there are no cosy severance deals - legal minimum only, just as is the case in industry. And if they threaten to sue, smile sweetly and say, 'You were in breech of contract - the figures don't lie.' Next you tell all subcontract services that their contracts are no longer valid - they must be renegotiated with strict penalty clauses for non-compliance. This will include all professional services in accountancy, management consultancy and the law. Computer services will be subject to draconian penalty clauses - non-compliance will be at the vendors expense with no time limit on the duration - only compliance will end the levying of penalties. Subcontract medical services will likewise be subject to strict financial controls - in particular with regard to profit and overhead charges - the directors of such companies to sign as personally liable for any over charge or excessive overhead. All employees will have new contracts of employment - these will specify that those in a particular profession or discipline must accept responsibility for all work in that area - no sliding away from responsibility via a subcontract to a third party. Thus the collection and correlation of statistical information will be carried out by employed staff - not downloaded onto the medical staff as it is at present. The above measures will help to end a culture of work avoidance and poor performance in management and administration that started in the 1980s and has ruined our productivity as a culture. The idea of actually earning the salary they are paid, will, I am sure, come as a terrible shock to many, as will the request that they bring something to the job other than their opinion. A health service with sharply controlled overheads, computer systems that enhance productivity rather than strangling it, managers that have the ability to design proper working systems that support clinical staff rather than increasing their workload - is that really too much too ask?

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  • Pete67  |  December 06 2013, 12:59PM

    Maybe it is unfeasible, but if the want the absolute best care they would make it every five miles let alone ten. I didn't suggest they did as all I'm doing is pointing out they are wanting to increase the mileage some people will have to go if they have just one A&E in Lincolnshire. By the way if Labour (I'm not one of their lot), bankrupted the Country how come were a lot more in debt now, and it's going up everyday with all the cuts we are having to put up with (apart from the filthy rich). There was a very interesting article in the DM (tory and against all other parties), about a week ago and even that made Labour look good with the economy. The more were are paying back now, and like borrowing from a payday lender the more we owe.

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  • walker58  |  December 06 2013, 10:41AM

    Pete you cannot have an A&E department dotted every 10 miles. Even before Labour bankrupted the country that wouldn't be affordable, realistic or even desirable, requiring armies of sub-standard doctors and nurses just to fill the gaps.

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  • Pete67  |  December 06 2013, 10:26AM

    walker58 - - - It also says 'Establishing a single main A&E department covering the whole county' which going by the current Government ideas would be the most likely outcome. If we are to believe 'And the primary focus has been in maintaining the highest standards of public and patient safety' they would make sure that there's an A&E within ten miles of anywhere in the county, but they don't go suggesting more, but only less. You may not believe in jumping in feet first in situations like this, but don't forget when people show apathy they just go ahead and do it. If people stand up and complain to start with it might not make any difference, but at least they know some people don't want it and try to sneak it past rather than blatantly slapping it in peoples faces.

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  • Holdingham  |  December 06 2013, 10:12AM

    These proposals are a broad brush at the moment. As far as A&E is concerned, and as the name implies, it is necessary to have local access points. The A&E Locals will be key. I find the A&E at Grantham very useful rather than trying to get through Lincoln on a busy day.

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  • walker58  |  December 06 2013, 9:29AM

    Pete if you read the whole article it says the following: "Setting up a network of "A&E Locals", which would consolidate the work of the current minor injuries units, primary care centres and urgent care centres". So it wouldn't just be "one A&E for the whole county". One major A&E yes, but with secondary support. I do think more facts are needed before rushing to a judgement, but unfortunately no one bothers to wait for full information these days before having a rant...

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