Trust A&E night closure over staffing crisis ‘disappointing, yet unsurprising’

Plans have been put forward to temporarily reduce the opening hours of Grantham Hospital’s emergency department, including a nigh closure, as staffing shortages have reached a “crisis point”. 

United Lincolnshire Hospitals NHS Trust (ULHT) said it doesn’t have enough doctors to fill shifts in three departments 24 hours a day, seven days a week. 

The trust added that it has ruled out reducing the opening hours at Lincoln County Hospital and Pilgrim Hospital, Boston, because they both take more seriously ill patients and have a higher number of people attending A&E than Grantham and District Hospital. 

Dr Suneil Kapadia, medical director at ULHT, said: “We haven’t made a final decision yet, and we hope to avoid this, but the reality is we will need to temporarily reduce the opening hours of A&E at Grantham.” 

ULHT emergency departments normally work based on having 15 consultants and 28 registrar or middle grade doctors. But at present, it is now down to 14 consultants, of whom 10 are locums, and just 12 are middle grades. This means it has only 43% of the middle grades it needs. 

Dr Clifford Mann, the outgoing president of the Royal College of Emergency Medicine, and NHS England’s recently appointed clinical lead for its A&E improvement plan, said that another emergency department having to close at night due to staffing difficulties is “disappointing, yet unsurprising”.

“The great efforts made by doctors and nurses to help patients in under-resourced locations sometimes is not sustainable,” he said.   

“As well as potentially putting patient safety at risk, placing an ever increasing workload on overstretched staff can create a vicious circle in retention and recruitment with many overworked trainees simply choosing to leave the country or indeed the specialty altogether. 

“The wider picture is there is a real crisis in Emergency Medicine as our workforce numbers are not growing fast enough to keep pace with rising numbers of patients attending A&E departments.” 

The College believes the answer lies in increased workforce, not just recruitment but the retention of emergency physicians in the UK. 

ULHT added it is working with other A&E providers, East Midlands Ambulance Service and the CCGs to find a solution to this crisis to avoid changing A&E services. 

Allan Kitt, chief officer at South West Lincolnshire CCG, said: “Any temporary emergency closure is very concerning, whilst we are disappointed that we may be forced to take this action, we do believe that closing A&E at Grantham overnight is the best way to ensure that services for our patients remain as safe as possible. 

“We will be working closely with ULHT, local GPs and our community services to develop a range of services to ensure that those people who have less serious illnesses but might currently use A&E can get a service locally during the temporary closure. We will be sharing these plans with the public in the next week.” 

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