Chorley A&E: county councillors oppose any closure without "clinical justification"
Lancashire County Council has voted to oppose any closure or downgrading of the the accident and emergency department at Chorley and South Ribble Hospital - unless there is “truly independent clinical justification” for such a move.
The resolution received cross-party support after county councillors representing the two boroughs left the chamber to negotiate the exact wording of the motion.
Some of the assessments suggested that there had been little effect on surrounding hospitals - including the Royal Preston - when the department was closed for nine months during a staffing crisis in 2016.
But Labour county councillor Kim Snape, who secured the emergency debate on the subject at County Hall, said that the public was being “misled”.
She said figures showed that there was a more than tenfold increase in the number of A&E patients waiting over 30 minutes to be handed over from ambulance staff to the Royal Preston between May 2015 and May 2016, just weeks after the Chorley facility shut its doors. Numbers rose from 21 patients to 313 over that period.
“The reports claiming that there was no impact on neighbouring hospitals when [the A&E] closed in 2016 are quite simply not true,” County Cllr Snape said.
“I’ve even been contacted by residents who were taken as far as Lancaster because of the closure. In June 2016, Wigan Hospital said it had seen a four fold increase in people with a Chorley postcode attending its A&E.”
More recently, Lancashire Teaching Hospitals has been praised by the North West Ambulance Service for improvements in handover times and is now one of the best-performing trusts in the country. A new rapid assessment area for patients arriving at the Royal Preston was opened just over a year ago.
Conservative county councillor Aidy Riggott said that he was happy to support the motion after amending it to ensure that the council’s opposition to any proposed closure was caveated with a call for clinical evidence to enable the best decision to be made.
“It is exactly the type of issue that sits right in the niche where the urge to make a knee-jerk response straight from the heart is directly in conflict with the role we, as elected members, are charged with carrying out,” said County Cllr Riggott, who recalled several of his own trips to A&E when he was a child.
“If either of my children followed in their father’s footsteps and suffered similar mishaps, all of these ‘accidents and emergencies’ would now probably be treated at an urgent care centre, allowing A&E to serve those really in need of that level of care.”
A special committee will decide in the coming months on the opinions to be put forward for public consultation into the future of Chorley A&E and the type of services to be offered on the wider site.
It appears likely that three options will be on the table - one of two versions of a 24-hour urgent care centre and the continuation of the current part-time A&E. Although deemed clinically unviable, the latter option is set to remain as benchmark by which the other proposals can be judged - and in case either of them prove to be unsustainable.
Respondents to the consultation will still be free to put forward their own suggestions beyond those officially listed.
When Chorley A&E temporarily closed in April 2016, Lancashire Teaching Hospitals said that it was the result of a shortage of middle grade doctors which meant that the unit could not be staffed safely.
The clinical assessments published last month suggest that such a staffing shortage persists, making any return to a round-the clock facility likely to fail.
But County Cllr Snape questioned how hard the trust was trying to recruit.
“We continue to be informed of numerous examples of people going for interviews to work at the Chorley site - they get turned down, claiming they weren’t up to standard, but they then manage to gain employment at the same level, almost instantaneously, at other hospitals in the region,” she claimed.
Lancashire Teaching Hospitals has previously said that it recruits for staff as a whole trust and not for one of its hospital sites in particular.
“NO DECISIONS HAVE BEEN MADE”
Speaking on behalf of the Our Health Our Care programme partners, Denis Gizzi, chief accountable officer at the Chorley and South Ribble and Greater Preston NHS Clinical Commissioning Groups, said:
“We completely understand the democratic right of elected representatives to voice their concerns on behalf of residents and therefore note the motion recently passed by Lancashire County Council. We recognise the place Chorley and South Ribble District General Hospital holds in the heart of our community, and the emotional impact this has on discussions about the future of services. This is exactly why we are working together with health and care partners, including the county council, to safeguard a long-term future for the hospital as a place that local people can receive excellent care.
“Choosing to make no changes to the way our services are configured across the Royal Preston and Chorley and South Ribble hospitals would make it more difficult for us to make improvements and deliver essential clinical standards linked to quality. Our own local clinicians, including those who work at the hospitals and care for local people on a daily basis, have long believed that things need to change if the care they are able to provide is to be improved.
“It is absolutely right that any changes to services should be clinically-led and robustly scrutinised by independent experts. As a programme, we have already received and published the findings of independent clinical bodies who have reviewed our options for change. The reports all reached an agreed consensus that the clinical evidence requires us to rethink the way our local emergency and wider acute hospital services are currently configured across central Lancashire.
“These expert reviews all fully considered the growing size of the local population in their findings and all reach a clear consensus that a 24/7 full (or Type 1) A&E at Chorley and South Ribble District General Hospital is not a realistic way forward.
“At this stage, no decisions have been made about the future of services in central Lancashire and certainly not about the future of Chorley and South Ribble hospital in particular. Any significant changes to our local hospital services would be subject to an open, honest, and transparent staff and public consultation which we expect to take place this summer. No final decisions will take place until this consultation has concluded.”