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Pilgrim chiefs hear of public mistrust, suspicion and anxiety

Pilgrim Hospital chiefs faced a three-hour grilling when a raft of questions were posed by councillors and members of the public at a Boston Borough Council scrutiny committee meeting on Wednesday night.

The meeting was held on the very day that the hospital declared that any child requiring more than 12 hours observation would be moved to another hospital, as would any expectant mother not yet at 37 weeks gestation requiring medical attention - an increase from 34 weeks.

These interim measures have been introduced while the hospital grapples with staff shortages. Dr Neill Hepburn, Medical Director, United Lincolnshire Hospitals Trust (ULHT) was candid, admitting that staff recruitment and retention had been poor and they had failed to provide career advancement for staff.

Samantha Milbank, Accountable Officer, Lincolnshire East Commissioning Group said an average of 19 children came into Pilgrim accident and emergency each day, of which three or four were admitted and only half would stay for less than 12 hours.

But the hospital panel heard time and again that measures had been introduced, impacting patients and family members, without consultation and that had bred an atmosphere of mistrust, suspicion and anxiety.

Mr John Turner, Senior Responsible Officer for the Lincolnshire Sustainability and Transformation (STP) Partnership, agreed that there had been rumour and the "grapevine" had been at work.

Cllr Paul Gleeson, chairman of the corporate and community scrutiny committee, listened to Mr Turner's overview of the STP and the review of acute services at the Pilgrim and responses to questions and was applauded by the public when he summed up: "There has been no consultation and I cannot see how you cannot see that people are terribly suspicious. You need to engage with the community properly and that's not happening. At the moment you cannot even spin a good story."

Cllr Michael Brookes said: "The most important part is public consultation when there are proposals to downgrade. This is all happening prior to consultation under the guise of safety and it undermines public confidence in the process. All think that it's just a way of getting ULHT proposals by short circuiting the system and not being answerable to the public. It is similar to the Grantham A and E situation and creates a lot of anxiety."

He said a short-term plan was needed to keep services at the Pilgrim and a long-term plan to make health services viable.

Matt Warman MP said there had been an improvement with the interim measures from earlier threats which might have seen the removal of all children's services and maternity services from the Pilgrim.

Nine members of the public had submitted questions for the committee and the hospital panel, seeking clarity on the STP and its possible effects on services at the hospital and the involvement in the process of the committee and its task and finish group. Several said changes at the Pilgrim were being made "under the guise of safety".

The panel also faced a barrage of questions from councillors ranging from why had ULHT again been placed in special measures, why did the NHS have so many layers of bureaucracy, why should people living in rural areas be penalised when accessing the NHS, how much had agency staff cost and why did the NHS pay as much as five times the cost of some drugs which can be bought over the counter.

Mr Turner divulged that a so-far unpublished CQC report by independent inspectors had found "a whole range of significant improvements" at ULHT.

At the end of the meeting it was unanimously agreed that the STP task and finish group should continue its work, that it should expand its remit to take account of the developing crisis at the Pilgrim, involve other organisations who want to make submissions and prepare a report with recommendations for the full council and other relevant organisations.

Mr Turner said they faced a tricky problem with an NHS that was not fit for the future. He said the staffing issues at the Pilgrim were the same across the country. "Quality of care and outcomes are not always what we wish them to be. We need to rebalance the health system for the future."

He said they were spending ten per cent over budget but could not recruit specialist staff. However, he believed the agreement to develop a medical school in Lincoln would help and said that would "go live" next Autumn.

He said there would be full public consultation lasting 12 to 14 weeks on the STP. He could not say when that might be but added: "It cannot come soon enough."

He gave assurance that the Pilgrim would continue to play a vital role and the STP would take into account its geographical position and the issues of access to services in a sparsely-populated rural area.

Samantha Milbank explained a key factor would be more community care to keep people out of hospital and said there were a number of initiatives aimed at avoiding the need for hospital admission with additional funding made available. She said prescribing generic drugs which could be bought cheaper over the counter was coming to an end and the NHS was working hard to source drugs at reduced cost.

Cllr Alison Austin was concerned that GPs would be expected to do more when many were already under strain.