The health care vision - Lincolnshire’s Hospitals
We want thriving acute hospitals in Lincolnshire; focussed on delivering high quality specialist hospital care, when that care cannot be provided in local community health settings. There is a strong future for our acute hospitals at Lincoln, Pilgrim and Grantham, as well as our community hospitals at Louth, Gainsborough, Skegness, Spalding, and Stamford.
Our acute hospitals will be there to support excellent, integrated community-focused services delivered by the NHS, social care and our partners in the care sector. Some acute hospital specialists will also be providing more services in local communities as part of our drive to provide more and integrated care, locally.
The configuration of these acute hospital services will be determined in due course by the outcome of a formal public consultation exercise about them. For illustrative purposes we have described below what our current vision for this strong future would be for each of our hospitals incorporating the NHS’s current preferred emerging options.
The vision for Pilgrim Hospital, Boston
“A modern general hospital with a focus on emergency care and more complex surgical services”
Pilgrim Hospital is a vitally important asset and will continue to provide a wide range of hospital services to the people of Boston and the surrounding area in the future.
Pilgrim Hospital will continue to provide urgent and emergency care services. The current A&E service will be boosted by the addition of an Urgent Treatment Centre. This will help care for those patients who require urgent care or advice, but who don’t need the emergency support of an A&E, meaning those who do will be able to access it more quickly. This will help with the problems of long waiting times that Pilgrim Hospital’s A&E is currently experiencing.
Our emerging option for Women and Children’s Services at Pilgrim Hospital improves upon the service model which has been working well since August 2018. It will be enhanced by:
- Increasing the unplanned admission length of stay to 23 hours from 12 hours
- A children’s day case surgery service
- Adding low acuity overnight beds for children
- Adding a midwife-led unit.
Consultant-led obstetrics, neonatal and gynaecology services will continue, along with the consultant-led paediatric assessment and outpatient service, which will be supported by immediate access to a paediatric inpatient service at Lincoln County Hospital for high acuity patients.
This means that children who need acute care quickly, get it safely from the right people.
Surgical services (for example general surgery, trauma & orthopaedics) will also continue to be provided at Pilgrim Hospital, providing unplanned surgical care, complex elective (planned) surgery and day case care for patients with complex health conditions.
We know that Pilgrim Hospital is currently challenged, due to staffing issues and service quality. Confirming a positive future vision for the hospital and clarifying future service provision will provide certainty for local people and staff, as well as help to attract new staff and further stimulate innovation.
The vision for Grantham Hospital
“High quality, local urgent care and medical services with an “Elective Surgery Centre of Excellence”
Grantham and District Hospital will continue to provide a range of services to the local population and our emerging option is to develop a Centre of Excellence for Elective Surgery serving the county and surrounding areas. Our vision for Grantham hospital is, therefore, provision of high quality, local urgent care and medical services, and a Centre of Excellence for Elective Surgery for the county.
In becoming Lincolnshire’s elective surgery centre, Grantham will see the majority of planned operations, ensuring that people from across the county can have their operation without the risk of cancellation. In 2017/18, 33% of all planned orthopaedic operations and 15% of all general surgery operations in the county were cancelled – this is because planned surgery, unplanned surgery and medical services are currently situated together, and staff and resources are often redirected to emergency surgery and medical services. The Centre of Excellence for Elective Surgery will be run by ULHT and give certainty to patients that their operation will not be cancelled. The current pilot in orthopaedic services at Grantham has almost eliminated cancelled operations.
As has been widely discussed in the public domain, Grantham’s A&E Department has had restricted opening hours since August 2016, due to significant medical staffing issues across the county’s A&E services.
Our emerging option is to develop an Urgent Treatment Centre at Grantham Hospital to provide 24 hour, 7 day a week access to urgent care services locally. This would replace the current restricted A&E service and reinstate 24/7 urgent care, meaning that the vast majority of local patients who need care quickly would receive it in Grantham. To ensure that the local population receive the right urgent and emergency care, overnight, access to this Urgent Treatment Centre will be supported by NHS111, to ensure patients are sent to the right place, first time. NHS111 will serve as the entry point to the Urgent Treatment Centre during this ‘out of hours’ period. Critically injured and ill patients will be cared for at their nearest specialist hospital and treated safely and quickly by staff who have the right training and experience to give the best outcome.
This emerging option would also see the Urgent Treatment Centre provided by Community Health Services rather than ULHT, with ULHT clinicians being available to provide specialist support and advice where this is required for patients.
We also envisage maintaining medical services at Grantham Hospital by adopting a new model of care whereby the hospital services are joined up with local primary and community services and managed as part of the local enhanced neighbourhood team. This new model would be led by Community Health Services (not ULHT) with hospital doctors and the hospital service being part of an integrated service with GP services, community health and other local services. This would also mean that medical staff would in future be able to provide care in people’s homes and local community settings as part of a local integrated service, as well as to patients in the hospital.
The vision for Lincoln Hospital
“A modern general hospital with a focus on urgent care, complex surgery, cardiac and cancer care”
Lincoln will provide some of our most complex hospital care. It will remain home to an A&E, supported by an additional Urgent Treatment Centre (UTC) which will treat those patients with urgent care needs.
It will continue to provide inpatient and outpatient acute medicine plus all specialisms within emergency surgery.
We will continue to build on the success of our high performing Lincolnshire Heart Centre; this centre saves 40% more patients who arrive after a cardiac arrest than its national counterparts.
Our preferred emerging option envisages consolidating our stroke services at Lincoln Hospital to improve outcomes for patients and shorten the amount of time people need to spend in hospital following a stroke.
This hospital will continue to provide the most complex cancer treatment. We envisage that Lincoln Hospital will be our ‘one-stop’ destination for all diagnostic and surgical breast treatment. The county’s specialised rehabilitation medicine will continue to be delivered at Lincoln County Hospital.
Our Women and Children’s services will be consultant-led obstetrics and gynaecology, and consultant-led paediatric and neonatal services. We will establish a new midwife-led unit too, offering better birth choices to mothers in line with national guidelines.
Lincoln Hospital will become a high performing hospital which will offer specialised care to all of Lincolnshire’s residents, reducing the number of cancelled appointments and the length of wait for treatment. Hospital services will consistently meet national best practice standards.
A strong future for Louth Hospital
Louth Hospital will continue to operate as a centre for day-case surgery and diagnostics and provide a wide range of community hospital and care services to support local people into the future”
Louth Hospital has both acute and community services operating on the site. It remains an integral part of our plans for the future and will continue to provide vital services.
It will continue to provide day-case surgery for urology, ophthalmology and gynaecology, with outpatient clinics and diagnostic services also provided for selected specialities. These services will continue to be provided by ULHT.
Louth Hospital currently has an Urgent Care Centre which operates on a 24/7 basis. Our emerging option is for Louth to have an Urgent Treatment Centre, which would also operate 24/7.
As well as continuing to provide these acute services described above, community services will continue to evolve on the site with the aim of keeping local people as close to home as possible. These services are provided by Lincolnshire Community Health Services NHS Trust.
A strong future for Lincolnshire’s community hospitals
We are committed to our local community hospitals and developing local services there.
We have five community hospitals within Lincolnshire. In addition to County Hospital, Louth we have John Coupland Hospital in Gainsborough; Johnson Community Hospital in Spalding; Skegness Hospital; and Stamford and Rutland Hospital. We envisage that all of our community hospitals will have a strong future.
We know that our community hospitals are highly valued by the local community and receive excellent feedback from patients. The role of a community hospital is pivotal to delivering integrated care closer to home and protecting patients’ independence.
Community hospitals provide a wide range of services, including in-patient rehabilitation, end of life care, outpatient consultations in major specialities such as surgery, Oncology, therapy and rehabilitation services, minor procedures, urgent care services including minor injuries, minor illness, and GP out of hours services, diagnostics such as x-ray and phlebotomy, and sexual health clinics. Services vary from hospital to hospital and no two hospitals are exactly the same because of the history, geography and needs of the local population.
Our community hospitals already have many different NHS services and providers working together on hospital sites. This works well for patients and makes best use of NHS buildings. We intend to encourage this further in coming years. By NHS services working more closely with those provided by county and district councils and the third sector, our clinicians believe people can be cared for more successfully at home or in local community hospitals.
By supporting people to return home as soon as it is safe to do so, we can support them to maintain their independence, share more time with family and friends, provide opportunities for self-care and reduce the risk of infection.
We already have a number of great examples of the positive work taking place in our community hospitals. Staff at John Coupland Hospital in Gainsborough have worked with the local community to raise more than £56,000 to refurbish two palliative care suites on Scotter Ward. In Skegness, the teams developed one of the first ‘dementia friendly’ wards in the country. The team at Skegness was also recognised for its outstanding practice in reducing falls with a ‘Slippers for Trippers’ scheme by the Care Quality Commission (CQC).
Staff at Johnson Hospital at Spalding hold an annual Johnson Community Hospital Ball to raise money. The event has previously raised approximately £35,000 for a range of services at the hospital, including equipment to support cataract surgery, special mattresses and cushions for Welland ward, educational equipment for diabetic patients and palliative care training courses for staff.
There has been an investment programme to improve Lincolnshire community hospital buildings. This was part of a major programme of fire protection works and includes improvements to the patient environment. This fire safety work began at County Hospital, Louth, with further fire protection improvements being made at John Coupland Hospital, Gainsborough, and Skegness Hospital. A redevelopment project at Stamford Hospital completed in 2017 has resulted in a number of improved clinics and facilities.
In addition, our emerging options for Urgent Treatment Centres (UTC) in our community hospitals are;
- UTCs at Louth and Skegness Hospitals with 24/7 access maintained
- UTC at Stamford, open for a minimum of 12 hours a day
- We also want to explore whether the current Minor Injury Units at Spalding and Gainsborough should be maintained as they are currently, or developed further into UTCs.
There is a vibrant future for all of our community hospitals, and their role will continue to evolve to support the needs of our communities into the future. We want you to work with us to help us shape that future.