Hospitals trust faces £5.9m question as it reviews children's services at Pilgrim

The United Lincolnshire Hospitals Trust health board, which oversees services, is set to consider five options ranging from maintaining the current service to temporarily closing inpatient wards, redirecting emergencies, and establishing midwifery -led birthing units, at a meeting this Friday.

Bosses at the hospital say under-pressure frontline staff have approached them asking for action to be taken ‘as soon as possible’ because there may not be enough doctors or nurses to carry out safe care in the coming months.

For children’s services, Pilgrim should have eight middle grade doctors for necessary cover.

However, currently just 4.5 staff are available out of the 8 required to run the service fully – and this is set to decrease to just one from July 1.

From that date the trust forecasts that with just one middle grade doctor the rest of the rota will have to be covered by temporary staff.

The trust also currently has 20.48 whole time equivelant nurses, but only has 17.18 available to work in children’s services to cover rotas – it should have 29.

Dr Neill Hepburn, medical director at the trust, said that none of the options going to the trust’s board are preferred, but described the staffing situation as ‘volatile’

He said: “We have discussed this with them on many occasions, we have also had discussions with them for a few months now.

“Previously, staff have said they’d like to carry on, however, recently they have come to us and said they cannot see an end to this and have asked us to take action.”

Bosses are adamant the net has been spread wide to try and recruit new nurses and doctors - especially in light of a national shortage.

However, even attempts to recruit internationally have failed, in one section there were 37 applicants, and 14 interviews carried out. However, only one of those is now working for the trust, with another awaiting a visa.

Mr Hepburn, said: “As a management team we need to take action to ensure that if it doesn’t resolve then what would we do and we’ve got a number of options.”

Closing the inpatient service from June 4 is just one of five ‘temporary’ options that will go before ULHT’s board meeting on Friday, April 27. No decision has yet been made on the future of the service.

The option would also see paediatric patients coming into the emergency department at Boston Pilgrim redirected to Lincoln A&E.

However, health bosses have reassured patients that the current service is safe.

Other options going to the board include:

l Maintaining services as they are.

l Closing paediatric services from June 4 and retaining consultant led obstetrics and neonatology until July 1 when staffing can no longer support neonatology.

l Maintain current services including neonatology but stop all planned paediatric operations at both Pilgrim and Lincoln County Hospitals. Providers across the region to cover neonatal services for Pilgrim maternity and neonatology from July 1.

Mr Hepburn added that the move has nothing to do with money.

In fact, each of the five options between just May and July could cost the trust, which is already in financial special measures, between £115,287-£961,260 depending on which option was chosen.

If the option selected lasted for a whole year, these losses rise to between £498,740-£5,916,378.

Some of the options could see the trust hiring private ambulances to transport patients so as not to affect East Midlands Ambulances which are already struggling to meet targets.

Mr Hepburn said: “Financially this is a disaster, we’re not doing this on finance grounds we are doing it on safety grounds. It’s a problem we need to work through, there are lots of problems we need to work through.”

However, he said this was not a ‘deal-breaking problem and was not an impossible problem’. Mr Hepburn also rejected any suggestion the decisions were related to the Sustainability and Transformation Plans (STPs) which have been on the cards for a while.

“None of these options are palatable, we don’t want to be here and we don’t want to have to face this problem, but what we need to do is get it right so the solution is right for the patients,” he said.

There are concerns any temporary solution could be similar to the situation at Grantham hospital, which has seen it’s accident and emergency temporarily closed for more than a year now with no end in sight.

Mr Hepburn said : “This is an organisation that’s taking control, this is a problem and we could ignore it hoping it will go away, or make plans to ensure we continue to provide safe care and that is what we are doing.”