THE CHIEF Executive of the Lancashire Teaching Hospitals Trust Karen Partington was in the firing line for more than two hours today - as county councillors lined up to quiz her over the controversial closure of Chorley Hospital’s accident and emergency department.
She stressed again and again that there is no intention to close the Chorley’s service permanently - but revealed just how hard it has been to recruit staff to work in the town’s hospital saying: ”The single issue that we have is around our middle grade staff. The gaps we have are such that we are unable to provide a safe service across a 24 hour period.”
Councillors used a special health scrutiny committee meeting yesterday to see if any lessons could be learned from the crisis afflicting the Trust.
Ms Partington told councillors she cannot give an exact date for reopening, because she could not say when any new staff they managed to recruit would be in post. This was because any new recruits might have to serve long periods of notice with other employers.
But she said there might be more information following an update meeting tomorrow. She said relevant authorities had been alerted since August of the impending risks and staffing issues,
She described how a shortage of six middle grade doctors brought Chorley hospital’s accident and emergency service to a halt. Tipping point was reached when two staff medics had to take sick leave, escalating the staffing crisis.
She said despite extensive efforts - including looking to recruit overseas and bringing in GPs to provide additional support - it had been impossible to recruit enough staff to Chorley hospital’s accident and emergency team for it to operate safely. Locum staff have to give just 24 hours notice to leave and now one of the current locum doctors had also advised they would not be available in May and June.
Other efforts had included abandoning a cap on salaries to try to attract extra staff.
A special ten page briefing paper was presented to the scrutiny committee amid rising anger over the way the Chorley emergency service was closed with only a few days’ notice on April 18 to be replaced by a daytime (8am -8pm) Urgent Care Service, able to treat minor injuries and illnesses but not life threatening conditions.
The report warned that consultants had been working extra shifts to cover staffing shortage and said: “The Emergency Department consultants have raised a significant concern about patient safety.”
It revealed that the staffing crisis had been growing for the previous 18 months as the hospital took measures to recruit staff, employ agency doctors and - over the past six months - to “transform urgent care”.
Councillors demanded to know the rationale for the decision to temporarily close the accident and emergency department to help them recommend steps which will need taking to prevent a repeat situation. The committee called for more information to be shared by the Trust and asked for regular and fact filled updates on the crisis so information can be shared with the public.
The council had also demanded to know if any consideration is being given to closing the accident and emergency department at Chorley permanently.
Ms Partington said that there had not been an increase in numbers attending either Royal Preston Hospital’s or Chorley’s accident and emergency units - but there had been a division of cases, so that the acute cases went to Preston and patients with less critical needs went to Chorley. Extra resources had been put into RPH to create a 20 rather than 10 bed emergency assessment unit.
There had not been large increases in casualty patients in the Wigan and Leigh area as a result of Chorley’s closure - with just eight extra local cases reported.There had not been large increases in the Wigan area - with just eight extra admissions reported.ut she acknowledged this was after a week and the situation could change.The debate highlighted that Chorley could be a lesson for the nation - it is where the staffing crisis escalated but its problems are part of a national recruitment crisis. Ms Partington denied the crisis had been caused by financial problem after Coun Yusuf Motala asked was it anything to do with the £14m plus overspend reported last year.
Jan Ledward, Chief Operating Officer for the Chorley and South Ribble Clinical Commissioning Group advised councillors that later this year there would be consutlations on wider transformations of the health service across the entire county to meet the demands on the health service.
Councillors now want to see more experts and witnesses to see what lessons could be learned to prevent the same problems recurring.
Scrutiny committee Chairman Coun Coun Steven Holgate declared it was an “intolerable position” and it was essential to get to a situation where “the health service frontline is not being crisis managed.”
Meanwhile Green councillor Gina Dowding said there was a need for more leadership in health planning across the county and better communications.
After the meeting Coun Holgate said the current situation was unacceptable, particularly as demographically “there are more people living below the Ribble than above it, therefore travelling times are absolutely key to providing a safe service.”
He continued: “It’s become apparent throughout the meeting that the situation is not one that’s restricted to Chorley but it has been the first victim of a chronic shortage of people to take up permanent positions.”
He said it left hospital bosses managing “a crisis based on limited commitment from some locums”. adding: “It’s clearly not the way forward to create a resilient and healthy NHS service.”