Special measures trust to centralise services due to 'immediate' safety concerns

Northern Lincolnshire and Goole Foundation Trust, which is in both quality and financial special measures, say vacancies and sickness levels affecting urology and ENT services are set to worsen over the coming weeks.

The trust’s board, which is meeting tomorrow, has been asked by clinicians to centralise ENT inpatient care at Diana, Princess of Wales Hospital in Grimsby and emergency inpatient care in urology at Scunthorpe General Hospital “no later than 1 September”.

Ahead of the meeting, interim chief executive Richard Sunley said: “We are aware that both services are set to lose more capacity in September and our clinicians are telling us that we need to urgently reconfigure these services to make sure they can continue to operate safely.

“What we must do now is listen to our clinical leaders and take action to prevent these services from becoming unsafe.”

The trust received almost 10,000 ENT referrals in 2016-17 and the service has been “emergency centralised” three times in the past year to make sure there were enough clinical staff to treat patients.

A report due to be presented to the board says: “The workforce delivering ENT care is suffering from significant sickness and vacancy levels. This is resulting in an inability to provide a safe inpatient service.

“ENT inpatient provision is at a critical point and whilst we are receiving support from a neighbouring provider, the level of demand continues to grow.

“Continuing in the current configuration would mean accepting the significant clinical risk and poor patient experience for emergency and longer stay inpatients.

“This is not acceptable and therefore a ‘do nothing’ option is not included as a viable option.”

Problems in recruiting staff for urology is resulting in “an immediate safety risk”, particularly in emergency admissions and out of hours activity. The trust has four consultants, set to reduce to three in September, when the service should have six.

Basing the team at one site will prevent consultants having to travel between sites, delaying care for emergency patients.

The report adds: “The clinical review of the urology service proposes transferring the emergency on call service to one main site… to ensure safe and appropriate management of patients requiring emergency admission under a urologist.”

The board is also being asked to reconfigure on call arrangements to add a middle grade tier to provide “a more responsive and safe service to patients”.

Liane Langdon, chief officer at North Lincolnshire Clinical Commissioning Group, said commissioners understood the need for urgent action. She said: “We will ensure patients and the wider population are involved as we make changes to the way we organise and deliver these and other services.”