Agenda item

Notice of Motion submitted by Councillors Alistair Bradley and Peter Wilson.

“Chorley Council expresses its alarm at the decision taken by Lancashire Teaching Hospitals Trust to close the Accident & Emergency Department at Chorley & South Ribble Hospital. The Council recognises the importance of the A&E service here in Chorley and is deeply concerned about the impact its closure will have on our residents, in particular the additional burden that will be placed on Preston Hospital and the capacity to deal with all emergency cases in an appropriate manner.  The Council recognises the financial pressures faced by the NHS and the national shortage of doctors, but is deeply concerned that the problem at Chorley & South Ribble appears to be more acute than anywhere else and therefore asks the Trust for an explanation as to why this is the case and what efforts have been made to recruit staff and avoid closure.  Given the concerns about treatment and quality of care for Chorley residents, we ask that the A&E department at Chorley Hospital is re-opened as a matter of urgency.”

In relation to the motion submitted, it is hoped that information will be available from Lancashire Teaching Hospitals and this will be circulated as soon as possible.

Councillor Alistair Bradley, Executive Leader proposed the motion to which an amendment had been included since the publication of the agenda. The revised motion was as follows:

“Chorley Council expresses its alarm at the decision taken by Lancashire Teaching Hospitals Trust to close the Accident & Emergency Department at Chorley & South Ribble Hospital. The Council recognises the importance of the A&E service here in Chorley and is deeply concerned about the impact its closure will have on our residents, in particular the additional burden that will be placed on Preston Hospital and the capacity to deal with all emergency cases in an appropriate manner.  The Council recognises the financial pressures faced by the NHS and the national shortage of doctors, but is deeply concerned that the problem at Chorley & South Ribble appears to be more acute than anywhere else and therefore asks the Trust for an explanation as to why this is the case and what efforts have been made to recruit staff and avoid closure.  Given the concerns about treatment and quality of care for Chorley residents, and the potential uncertainty and impact this could have on staff with regard to jobs, we ask that the A&E department at Chorley Hospital is re-opened as a matter of urgency.”

In addition to the motion, information had been circulated from Lancashire Teaching Hospitals NHS Foundation Trust which responded to the motion from the Council and included a briefing paper which provided some background to the emergency care crisis which was as a result of a major staffing problem. There was a shortage of staff for the rota and it was an unacceptable risk to patient safety to attempt to provide an emergency department service with insufficient doctors. The measures were temporary and the Trust stated that they would continue to do everything possible to secure the staff needed and reinstate the emergency department service at Chorley and South Ribble Hospital.

In addition to the briefing paper, a presentation which had been provided by Lancashire Teaching Hospitals as part of their stakeholder involvement earlier in the day, was circulated to Members. This provided a more detailed and up to date account of the staffing problems; measures undertaken to try and manage those problems including a timeline of actions; issues in relation to ensuring patient safety; detailed recruitment actions; and activity and performance information for the emergency service at the Hospital.

In opening the debate and presenting the motion, Councillor Bradley referred to first becoming aware informally of staffing problems at the hospital at the end of March but that it wasn’t until 12 April that the full extent of the problems and the possibility of the closure of A & E was announced. When the closure was announced it took place very quickly with no real notice or discussion with local residents. All political parties on the Council had worked together and with the Hospital Trust to try and ensure that A & E services at Chorley Hospital were re-instated as quickly as possible.

The timeline and problems with staffing as explained by the Hospital Trust were:

·         There is a shortage of mid grade doctors (those with at least 4 years experience) at the hospital and the Trust had been in consultation with the Clinical Commissioning Group, the Lancashire Care Foundation Trust and Lancashire County Council over a number of months to manage the recruitment problems.

·         There is a national shortage of doctors but the problem appears more acute in Chorley and by late February, despite recruitment efforts, the lifting of the salary cap and use of locum staff there was a perceived risk to patient safety and the closure was announced in April.

·         Whether the situation had been avoidable when there had been long term staffing shortages was of concern, however the key issue now was to get the service back up and running as soon as possible to avoid a long term, potentially permanent loss of A & E services in Chorley.

·         Since the closure on Monday 18 April there had been no information on how many people were going to Blackburn, Wigan and Bolton Hospitals for emergency services, in addition to those going to Preston Hospital. Regular updates had been requested from the Hospital Trust on proposals for reopening and Councillor Bradley reported that he had offered every assistance from the Council.

The Mayor read out a statement from Councillors Ralph and Joyce Snape who were unable to attend the meeting due to medical treatment. They gave their support in strongly opposing the closure of A & E services at Chorley Hospital and the lives it endangered in having to travel to Preston. They also referred to their membership of the Hospital Trust, their disappointment at not receiving any notification about the situation as Trust members, and their subsequent resignation from that body.

Councillor Greg Morgan, on behalf of the Conservative Group reported that his group were wholly in support of the motion and welcomed the involvement of the MPs in this serious issue for the Borough. The focus must be on getting A & E services re-instated as soon as possible for the residents of Chorley and South Ribble.

During the debate Members raised the following issues:

·         The lack of information and consultation with local residents was of concern. There had been a long term staffing issue which was either financially driven or had not been properly managed.

·         The longer travel time could have a serious impact on the recovery chances for victims of serious illnesses and injuries including road traffic accidents. Many residents would go to Wigan, Bolton or Blackburn rather than Preston, adding pressure to those hospital emergency services.

·         The misinformation about current service availability meant that residents were going elsewhere for minor injuries which could still be dealt with at Chorley Hospital through the Urgent Care provision which was open 8.00am to 8.00pm. 

·         Why if there was difficulty in attracting staff, had the Hospital Trust got rid of onsite housing accommodation which could help attract staff especially those on a short term/locum basis.

·         The growing population in Chorley and South Ribble demonstrates a need for improved hospital services and emergency services.

·         Concerns that the closure was financially motivated and that if A & E did not reopen in the next few weeks, then it was unlikely to reopen at all.

Lindsay Hoyle, MP for Chorley, thanked Councillors for inviting him to attend this Extraordinary Council meeting and allowing him to speak on this important local issue. He gave his whole hearted support to the motion proposed, expressing concern that he and the Council had not been informed sooner of the crisis in staffing the A & E service at Chorley and South Ribble Hospital which threatened closure. Notification had first come via staff being informed that their jobs were at risk. The CCG claimed to be pulling out all the stops to re-instate A & E services but there were some major concerns and questions to be answered, in particular:

·         Why had the Armed Forces not been contacted to provide some capacity and resilience in service provision?

·         If there had been a long term staffing issue why had the salary cap not been lifted sooner and job adverts been placed nationally?

·         There appeared to be barriers to recruitment to the extent that the NHS Inspectorate had asked to see those CVs which the Trust had turned down as unsuitable.

·         Why was the recruitment problem so acute in Chorley? Hard to believe that Chorley would not be seen as an attractive place to live and work compared to many others.

·         Evidence shows that Urgent Care Centre provision does work well but alongside an A & E services, not on its own.

·         If patient safety was the reason for closure, isn’t patient safety being compromised by a longer journey to A & E services at Preston?

Seema Kennedy, MP for South Ribble, also thanked Members for the invitation to attend and speak at the Meeting. Both MPs had been working closely on this important local issue and it was crucial to get A & E services back up and running for Chorley and South Ribble residents. Re-instatement was categorically what the Trust claimed to be working towards but there had been serious concerns about the lack of notice and information about the closure.

Councillor Peter Wilson in seconding the motion, thanked everyone for their support, in particular the MPs. The information provided by Lancashire Teaching Hospitals NHS Foundation Trust provided a detailed explanation of the staffing and recruitment problems leading to closure, but no reassurance that services could or would be restored quickly. This had to be the key focus, to make sure reopening took place in the next few weeks and didn’t become a longer term issue attributable to the financial crisis in the NHS.

The Mayor thanked everyone for their contributions and put the motion (as amended and set out in bold italics above) to the vote and it was RESOLVED that there be unanimous support for the motion.