Chorley A&E 'must reopen' before consultation over proposed closure begins

Residents were expected to be asked for their views on the future of the unit over the summer, but the process was delayed by the pandemic. It was then indicated that the consultation could begin in a Covid-secure way during the autumn.

However, it has now emerged that NHS England wants to see the department back in operation before the opinions of the public are sought.

There is no firm date for that prospect after a provisional plan to reopen the facility earlier this week was abandoned because only half the necessary number of senior doctors had been recruited to run it in Covid-segregated conditions.

The position is due to be reviewed on a monthly basis and formally considered at the December board meeting of Lancashire Teaching Hospitals NHS Foundation Trust (LTH).

LTH chief executive Karen Partington told the latest gathering of that group that the delay to the consultation risked “reputational damage” to the trust, because of the length of time that it had been in the pipeline.

It was first anticipated to begin in January 2019, but has been repeatedly put back because of clashes with local election periods and the emergence of several additional requirements as part of the pre-consultation process.

As the Local Democracy Reporting Service revealed at the start of this year, two main options are set to be put to the public, both of which involve the closure of the A&E and its replacement with one of two versions of an urgent treatment centre.

The pre-Covid status quo of 12-hour-a-day operation will also be included as a benchmark option and respondents are also able to make suggestions that have not formally been put forward. The emergency unit at the Euxton Lane site was deemed clinically unviable by four groups of clinicians in a series of reviews late last year.

LTH medical director Dr. Gerry Skailes said that the paused consultation process raised issues of “clinical risk if we continue to be…unable to move to a final position on how our services should be configured”.

However, board members heard that there had been further progress on recruiting the ten middle-grade doctors and two consultants needed to reopen the A&E. Seven have so far accepted offers, two of whom are in post, with the remainder arriving this month and next. Four other offers have been made and are awaiting a response.

Dr. Skailes said that plans were being made to fill “as many of the gaps as we can with locums” in advance of the new medics joining the trust – and that a recommendation to reopen would be made to the board as soon as it was safe to do so.

However, she added that it was not possible to use trainee doctors for cover, because Chorley Hospital is not recognised as a training site.

Board member Paul O’ Neill said that it would be “easy to underestimate the amount of work people have done [to get] to this point”.

NO CHANGE TO CONSULTATION OPTIONS

Papers presented to the LTH board reveal that, in August, NHS England requested a “material review” of the consultation options to be put to the public.

Local NHS leaders were specifically asked to reconsider their proposals in light of both the pandemic and the rollout of the new NHS 111 First initiative, which will soon see Central Lancashire patients encouraged to phone ahead to book a slot at A&E in non-life-threatening situations.

However, it was concluded that no change to the proposed options was required.

NHS England has to approve the consultation – and the work done to inform it – before it can begin. That decision is not now expected until the end of November.

A joint committee of the Chorley and South Ribble and Greater Preston clinical commission groups (CCGs) also then has to give its approval.

Draft materials for the consultation have been drawn up and it is understood that the process would be able to be launched within six weeks of it getting the green light. However, the requirement to wait until the A&E has reopened could delay it further.

There is also an “increasingly likely prospect that the consultation will need to be managed in accordance with prevailing public health restrictions, due to Covid-19,” a report to the LTH board warned.