Acute Service Review :: Lincolnshire STP

Let’s have a Healthy Conversation about our Acute Hospital Services

Acute hospital services treat patients for a brief but severe episode of illness, for conditions that are the result of disease or trauma, and for surgery.

Some people living in Lincolnshire use acute hospitals in Peterborough, Grimsby, Scunthorpe, Kings Lynn and Nottingham as their nearest hospital. Within Lincolnshire, our acute hospital services are provided at Lincoln, Pilgrim and Grantham Hospitals plus day case surgery is provided at Louth Hospital. The future of these hospitals and our community hospitals in the county is strong. Whether receiving care in the county or elsewhere, you will continue to choose where you receive your care.

We need your help to improve services in Lincolnshire because our hospital services are amongst those most under pressure. Over the last year, our county’s senior specialist doctors, nurses and healthcare professionals, supported by external clinical colleagues, have led the review of eight acute hospital services most in need of improvement. These are:

Breast services
Stroke services
Women’s and Children’s services
Medical services
Trauma and Orthopaedic services
General Surgery services
Haematology and Oncology services
Urgent and Emergency Care services

At the same time over the last year, we were listening to patients, public and other stakeholders in Lincolnshire, to understand what is important to people about these hospital services. All of these discussions have informed our review work and as part of the Healthy Conversation 2019, we now want to hear more, so this next period of public engagement with you is important. We have some emerging options to discuss. Nothing has been decided, this is simply an open conversation about what’s important to you. We don’t have all the answers so we need your help.

It’s important to remember that this stage is not a public consultation – these conversations will help shape the options for a full public consultation, without which no permanent changes can be made to services.

Our emerging options are designed to address the problems within these services and ensure a vibrant future for our three main hospitals - Lincoln, Pilgrim and Grantham, and do not propose any change to our acute services at Louth or our community hospitals. In addition,

The majority of outpatients appointments will remain the same as they currently are at all three sites
The majority of urgent and emergency care needs will continue to be available locally
For hospital medical services, the majority of patients will continue to be able to access the same services at the same sites
Maternity, obstetrics and neonatal services will remain available at both Lincoln and Pilgrim sites
Please click here to read the engagement to date which informed the Healthy Conversation 2019

Why are we only looking at eight specific services?

We initially reviewed 32 of the services within our hospitals, the quality of the care they delivered and their staffing and financial position. We assessed these services against our criteria of quality, access, sustainability and deliverability. It soon became clear that the eight services in question were the highest priorities in order to improve quality of care for patients.

ASR case for change

For each of the eight acute hospital services that we are reviewing in detail, we will explain the case for change specific to each. There is, however, a more general set of reasons as to why improvement as a whole is needed.

To simplify the challenges facing our acute hospitals and our NHS in Lincolnshire, we have summarised this into three key areas:

Quality of care for patients:

We are not meeting quality standards in many services
We are not meeting national performance standards for A&E, cancer or the 18-week wait for hospital treatment. This means that patients are waiting too long for treatment which is just not good enough
We cancel many planned hospital appointments and procedures because staff must prioritise urgent patients. This causes stress, worry and great inconvenience for patients and their families
Patients stay in hospital longer than they need to which affects the quality of care for them and other patients
Lincolnshire’s hospital trust (ULHT) is rated as ‘requires improvement’ by the Care Quality Commission (CQC) and is in quality and financial ‘special measures’
With services delivered across four acute hospital sites, some of our clinicians do not see enough complex cases to retain and/or improve their skills

Workforce:

Quality problems make it more difficult to attract, motivate and retain staff in some services. We have a 13% vacancy rate in our hospitals; the equivalent to approximately 840 posts
In the NHS nationally there are 100,000 vacant posts so we have to work hard to recruit and retain great staff
Our geography and location adds another challenge to attracting staff from outside the county

Finance:

Lincolnshire’s healthcare is currently costing approximately 8% more than the county is allocated and in 2018/19, we will overspend by approximately £100million.
Staff shortages mean we have to use temporary locum and agency staff. This is currently costing us an extra £4million every month
Our geography means that it costs us more to run services across multiple hospital sites, compared to big city hospitals who care for many more people on one site
Many of our buildings are in poor condition and maintenance costs are high
Unless these issues are addressed, Lincolnshire’s NHS will be £200million in debt by 2022/23

How you can get involved?

Our Healthy Conversation 2019 means many things and there are a number of ways that you can get involved:

We will be holding events (for public and staff) throughout the year that you can attend to share your views – full details are on our engagement calendar.
We will also be attending as many of our partners’ events as possible – all of these dates will also be shared on our engagement calendar
Our website and social media pages will be sharing the latest information on the topics above, and you will always be able to contact us through them, or via phone, to feed back. Full details of how to can found on our contact us page.
We will be sharing information through our hospital sites, GP practices, and other places to ensure you remain fully up-to-date

Breast Services

A range of services for screening, diagnosis and treatment of breast problems, including cancer.

Stroke Services

A range of services for the diagnosis of stroke, acute treatment, rehabilitation and follow-up after discharge from hospital.

Women’s and Children’s Services

Women’s and children’s services refer to maternity, neonatal, obstetrics, paediatric care and gynaecology.

Medical services at Grantham Hospital

The medical services at Grantham Hospital support urgent and acute patients in the A&E Department, on the in-patient wards and in the out-patients department.

Trauma and Orthopaedic Services

These services diagnose and treat a wide range of conditions of the musculoskeletal system.

General Surgery Services

These services focus mainly on the abdominal organs; stomach, gall bladder, small bowel, colon, rectum and anus.

Haematology and Oncology Services

Haematology services diagnose and treat blood disorders for conditions such as haemophilia and leukaemia and provide treatments including blood transfusion services. Oncology deals with the treatment of cancer.

Urgent and Emergency Care Services

Emergency care is when you have a life threatening accident or illness and you have to be treated in a major hospital.

The health care vision - Lincolnshire's Hospitals

We want thriving acute hospitals in Lincolnshire; focussed on delivering high quality specialist hospital care, when that care cannot be provided in local community health settings.

<<Back to Healthy Conversation 2019