• A&E department at Chorley and South Ribble Hospital was suddenly downgraded in April this year due to staffing shortages
  • In August local leaders said efforts to recruit adequate numbers of doctors had been unsuccessful
  • Simon Stevens had praised the trust over its decisions
  • An independent review has recommended the service be reinstated for a 12 to 18 month period, although for 12 hours per day instead of 24 hours

A downgraded accident and emergency department is set to be partially reopened in January, after NHS Improvement said “more could be done” to reinstate the service.

The A&E department at Chorley and South Ribble Hospital was suddenly downgraded in April this year due to staffing shortages, which Lancashire Teaching Hospitals Foundation Trust said was partly due to the introduction of pay caps for agency doctors.

Urgent care services have been provided in its place, with serious cases diverted to the Royal Preston Hospital.

There has been a high-profile campaign to reopen the department, but in early August the trust and its local commissioners said efforts to recruit adequate numbers of doctors had been unsuccessful, and the situation would be reviewed in April 2017.

NHS England chief executive Simon Stevens had previously singled out the FT’s chief executive Karen Partington for praise in an interview with HSJ, for making the “right decision about what was needed in Lancashire”. He said it was an example of how he would support and create a “safe harbour” for local leaders who would take brave decisions and who were “going to drive” change in the health service.

But now a review commissioned by NHS Improvement and NHS England - following a request from Chorley MP Lindsay Hoyle, the trust and its commissioners - has recommended the service be reinstated for a 12 to 18 month period, although for 12 hours per day instead of the previous 24 hours. This has been accepted by local leaders and regulators, who said the changes can be implemented in January.

The department’s future after that period will be determined as part of a wider reconfiguration of acute services which is currently in the planning stages.

The review document, which has been published by NHSI, said: “Current provision of medical and nursing staffing levels at CSRH provides an opportunity to enable reopening of the ED.

“We recognise that the staffing levels across both EDs would not meet royal colleges’ best practice guidelines but this is not an unusual situation and many organisations are unable to do so.”

NHSI said the review was conducted by an independent review panel. HSJ has requested details about the panel’s membership, which have not so far been published.

A letter from NHSI chief executive Jim Mackey to the people and organisations involved, said: “The reviewers felt that more could be done to reopen the department sooner.

“However, the trust has expressed strongly to us that this is not practical given pressures at its Preston site…These are very real risks and the trust is best placed to weigh up the risks involved in their decision making.

“As a result, we have said that we will accept a position whereby the department reopens when a newly-agreed contract to provide more GPs in the co-located urgent care centre is implemented.”

A five-year contract for the urgent care centre was recently awarded to Manchester-based urgent care provider GTD Healthcare, with the services due to launch in January.

Karen Partington, the trust’s chief executive, said this would enable the trust to redeploy staff in order to “safely reinstate the emergency department part time”.

She added: “We have just successfully appointed a middle grade doctor, and will be continuing to try to recruit more, as well as extra consultants and nurses to ensure the service is sustainable.”