A public presentation by NHS officials in Chorley was abandoned after a clamour to ask questions led to the event being turned into a 2-hour Q&A session.
Around 200 residents gathered in Chorley Town Hall for the second of three engagement meetings being held this week over a proposed reorganisation of health services.
WATCH & READ MORE >>> Public to be asked for its opinion on single A&E for Central Lancashire
But just minutes into a slideshow presentation by the Our Health Our Care partnership, the floor was opened up to an increasingly angry audience - and attention inevitably turned to the future of the town’s A&E.
A draft document published last month revealed a plan for Central Lancashire to be served by a single Accident and Emergency unit, two urgent care centres and a pre-planned treatment facility - but locations for each of the services were not suggested.
The meeting heard several stories of residents’ own experience of the NHS - with the impact on the ambulance service of Chorley A&E’s current part-time status becoming a recurrent theme.
“Fifteen months ago, I stood round the corner from here and watched my friend die on the pavement, because we had to wait 40 minutes for an ambulance from Manchester,” one woman said. “Nobody should have to die on the pavement.”
When an NHS official said it was an “affecting” story, several people shouted out: “What’s your answer?”
Chorley MP, Sir Lindsay Hoyle, offered his own. “The answer is that the A&E was closed and so there wasn’t an ambulance, because they were all queing up elsewhere,” he said.
WATCH & READ MORE >>> MP demands "all options" are put on the table over Chorley A&E
Another woman told the meeting that the complete closure of the unit for much of 2016 had left neighbouring hospitals “unable to cope”.
Dr. Geraldine Skailes, Medical Director at Lancashire Teaching Hospitals (LTH), said queues of ambulances were “unacceptable”.
“When Chorley A&E closed in 2016, that was done as a rapid response to a staff crisis - it was not done in a planned way. Any changes that we make [in future] will be planned and not done as a knee-jerk reaction,” she said.
But as a microphone made its way from one audience member to another, the request remained the same - a 24-hour emergency unit serving Chorley and South Ribble.
David Carpenter, from the Protect Chorley Hospital campaign group, said that if Chorley became the location for a planned care centre, it would need to have all of the facilities of an A&E anyway.
“In case operations go wrong, you need pathology, x-rays and scans - exactly the same services that support your A&E,” he said “You talk about maximising use of resources - if you have planned care, you’re going to have all the resources you need in place.
“In Chorley, we need an emergency service that can deal with whatever presents, even if it’s only to maintain the patient in whatever state they’re in until we can get them to the right place. Do we all agree with that?” Mr Carpenter asked to loud cheers from the audience.
Karen Partington, Chief Executive of LTH, which runs the Royal Preston and Chorley and South Ribble Hospitals, said staff were sometimes more scarce than the money to pay for them.
“That is a significant challenge across many areas of the NHS - and our hospitals are no different. We have the funding, but we can’t recruit enough nurses to provide the care we need,” she said.
One woman responded: “What professional is going to be banging your door down to work at [an A&E] which could potentially be closing?”
The audience was also given more detail about the reasons for the delay to the formal public consultation on the future of services in the area. That had been due to start in January, but it emerged earlier this week that it was now pencilled in for next May.
Dr. Skailes said that independent clinicians from elsewhere in the North of England had to scrutinise the plans before they could be considered by national NHS bosses.
She added that the “level of detail” required by NHS England meant that the “due process” would now take longer than expected - and that the three-month consultation with the public could not take place in the run-up to next spring’s local elections.
The final question of the evening went to a man who wanted to know whether the panel of NHS officials had “absorbed the sense of anger, frustration and the overwhelming desire that an A&E remains in Chorley?”
He then pleaded for a pledge. “Could we have your assurance that you will do, personally, whatever is in your power to ensure that Chorley A&E stays open?”
Denis Gizzi, Chief Officer at Central Lancashire’s two Clinical Commissioning Groups, told him: “What I can guarantee is [that] we will run a proper process, taking in everybody’s opinions.”
As shouts of “It’s a yes or no answer!” rang around the room, the meeting ended in much the same way as it began - amidst acrimony and uncertainty.
WHAT THE NHS OFFICIALS CAME TO SAY
The official presentation was stopped after just two slides. Here is a flavour of what else was due to be discussed:
A pledge for more "joined-up" care in the county, which is "patient-centred, safe and of high quality":
***Care closer to home - that includes support in the community/primary care
***Enhanced mental health liaison to connect support for people with mental
health needs from the community through to hospital and/or emergency care
and in-patient treatment
****Intermediate care for patients to reduce length of stay in hospital, or stop the
need for hospital care
Proposals for out-of-hospital care:
***GP surgeries working closely together and at scale
***Access to appointments
***GP surgeries working closely with community, hospital and mental health services to deliver integrated care via integrated teams
***Care for people who are frail and/or elderly
Details of the urgent care service:
***Be open 24/7
***Be staffed by a range of clinicians with a range of skills
***Treat minor injuries and illness, fractures and lacerations, and infections
***Accept patients arriving by ambulance