Agenda item

(To receive a report from United Lincolnshire Hospitals NHS Trust (ULHT), which invites the Committee to respond to the consultation on hospital urology services.  Mark Brassington, Deputy Chief Executive and Director of Improvement and Integration, Andrew Simpson, Consultant Urologist and Chloe Scruton, General Manager Surgery from ULHT will be in attendance for this item)  

The Chairman invited Mark Brassington, Deputy Chief Executive and Director of Improvement and Integration, Andrew Simpson Consultant Urologist, Chloe Scruton, General Manager Surgery and Anna Richards, Associate Director of Communications and Engagement, to remotely present the report to the Committee.

The Committee was advised that planned urology services were currently delivered from Lincoln County Hospital, Pilgrim Hospital, Boston, Grantham and District Hospital and County Hospital, Louth; and emergency urology admissions at the weekends went through one single site-alternating between Lincoln and Pilgrim hospitals.  It was highlighted that there were emergency admissions at both Lincoln and Pilgrim hospitals during the week.

It was noted that ULHT were consulting patients on a proposal that Lincoln County Hospital in future received all emergency urology admissions seven days per week as they believed that this change would increase ULHT's capacity to perform planned surgery without disruption to patients, better meet the needs of ULHT's emergency cases and allow for more patients to seen and treated.

It was reported that at present, consultants and middle grade doctors within the urology service were required to perform planned surgery and be on-call for urgent surgical requirements at the same time. This was of concern as staff were becoming exhausted as they could be preforming planned surgery in the day and then be called out to perform an emergency surgery; this then impacted on the ability for the service to respond as quickly as it would like to emergency surgical needs; and it also caused the cancellation at short notice of planned surgeries, typically over 1,300 operations per year across ULHT every year for urology related procedures.

The Committee noted that the separation of duty to enable consultants to be either on-call or scheduled to perform planned surgery, would avoid the requirement to fulfil both duties at the same time.  Full details of what was being proposed were shown on pages 45 to 47 of the report pack and page 52 provided the Committee with a list of the benefits to patients of the proposal.

Detailed at Appendix 1 to the report was a copy of a document entitled   Hospital Urology Services Consultation – Have Your Say (United Lincolnshire Hospitals NHS Trust-2021) for the Committee to consider.  The Committee was advised that the consultation was due to close on 23 July 2021.

During discussion, the Committee raised the following points:

·       Clarification whether the 1,900 cancelled procedures annually related to elective procedures.  Confirmation was given that the figure related to elective procedures;

·       Whether there was sufficient bed capacity to meet the increased demand in elective surgery at Grantham Hospital.  Confirmation was given that there was sufficient bed capacity at Grantham Hospital; as more surgical procedures were planned to be carried out at Grantham Hospital;

·       Operating theatre capacity at Grantham Hospital.  The Committee noted that currently there were two additional mobile theatres at Grantham Hospital, one of which was due to be removed from the site, as the temporary contract for its hire was due to expire.  The Trust was now looking into replacing the theatre with a more permanent modular unit which would be available for use later in the year;

·       Some concern was raised that services were being removed from Pilgrim Hospital Boston.  The Committee was advised that the proposal was subject to consultation.  Reassurance was given that it was not the intention of the Trust to remove services from Pilgrim Hospital, Boston.  The intention was to ensure that the best service possible was provided and that all sites had a role to play in providing that service.  The Committee was advised that discussions had taken place with staff at Pilgrim Hospital, Boston and colleagues from Boston had welcomed the opportunity to work with the Lincoln site, as a specialist site, with the development of specialist knowledge and skills; 

·       That the consultation period had been extended to ten weeks;

·       Whether there was a detailed impact assessment for the proposal.  The Committee was advised that a quality impact assessment was being finalised and that once completed could be shared with the Committee;

·       The level of response to the consultation and what the general theme was of the responses received so far?  It was reported that so far 120 responses had been received and the responses had been divided, some were in favour of the proposal and understood the reasons for the changes, others had raised concerns regarding have to travel further for emergency treatment.  It was also noted that the ambulance service had been supportive of the proposal; and

·       Reference was made to page 45 of the report which stated under the proposed changes if a patient was to arrive at Pilgrim Hospital, Boston and it was deemed urgent, the patient would then be transferred by ambulance to Lincoln County Hospital.  Some concern was expressed as to whether any consideration had been given as to how the patient would then be transferred to Pilgrim Hospital, Boston, to collect their vehicle if it had been parked at Pilgrim.  The Committee was advised that based on normal pathways the patient would be returned back to the home site.

The Chairman on behalf of the Committee extended his thanks on behalf of the Committee to the representatives for their presentation.

RESOLVED

That a draft response, based on the Committee's comments today, be submitted to the next meeting of the Committee on 21 July 2021 for consideration and approval.