ULHT and the CCG frequently review the provision of key services. This latest consultation is hugely important and could have serious ramifications for the people not only in Grantham but across our County. It is really important as many people as possible take part.

The review in 2016 had responses from a few hundred participants. Over 120k people are potentially affected by any changes in Grantham Hospital catchment area alone. Likely to increase to 150k over the next decade or so.

In December 2018 we were told at a ULHT board meeting that NHS Improvement were challenging the presence of 3 A&E units in Lincolnshire.

It was largely as a result of this board members did not reinstate 24/7 A&E service at Grantham District Hospital when they had the resources to do so. They were told to complete a cross county Acute Service Review (ASR). Due to a number of reasons this was delayed.

The delay has meant the previous landscape has changed dramatically with continued staffing difficulties and Covid 19 putting huge pressure and added risk on ULHT resources and our communities.

But, despite all this, the fact remains the response of the public consultations held do not compare to the petition signed by over 80k residents and visitors to Grantham over a year. That message was very clear. There can be no downgrading of our A&E and Acute services at Grantham District Hospital. This message remains.

The reason is not that we are awkward or parochial, as some ULHT board members have indicated in the past, but that the Critical Constraints affecting our communities have not changed. They have and will get worse.

These are:-

Distance to nearest alternative A&E;

Demographics including population size, age and income;

Lack of local maternity unit despite 1000 babies a year being born in the area;

We have a high population of residents, especially families, on low and insecure incomes.

We have a high population of elderly residents.

Our poor road infrastructure makes travelling cross country difficult and potentially dangerous in wet or winter conditions.

The majority of the town and surrounding villages have virtually non existent public transport availability. Further considerations include new retail parks, diverse employment from agriculture to office services. A further consideration is the cross county border need with Newark and Melton Mowbray residents and villages in between relying on GDH. An overall increase in population in the District and region is putting more pressure on alternative sites. Peterborough A&E has people standing waiting to be seen. As a result of these factors we need a local A&E and good Acute service as much as we ever did now and more so. Moving acutely ill patients between wards after admission can also put them more at risk. Grantham had an excellent Acute Care Unit with excellent training facilities. There is more need than ever for such a unit. The ACU not only stabilised very ill, usually elderly patients with complex needs, it subsequently sent them home. It is not clear if this unique service can be matched across the other District Hospitals. Public transport services have halved in a decade, not improved. ULHT had an opportunity to provide transport for non ambulance access but have not done so consistently nor covering out of hours. This affects all out patients and inpatients without a car or unable to drive. The population of Grantham is growing significantly. I have asked ULHT what additional resources will be put in place but the matter was referred to the CCG who have yet to respond. The NHS providers receive additional funding from s106 agreements to enhance health services with new developments. They have an opportunity to state what funds they will need. They must factor in acute and hospital care and must deliver them. The diverse needs of our those people with protected characteristics must be considered throughout. All of the services being considered within the review are affected by these constraints and considerations. It is not acceptable to make someone in pain travel hours for an outpatient appointment. Nor expect people to pay £80 at night for a taxi to get home or make someone travel an hour in an emergency ambulance when their life is on the line. Nor make a frail elderly person struggling to breathe for whom any movement is painful travel cross county on poor roads to another ward. Whilst some receive excellent care these are the experiences of many of our people now. You cannot meet these needs with an online session or phone call. Public engagement and consultation are welcome.

During the Judicial Review the judge indicated when our hospital was virtually closed overnight, that had ULHT engaged and consulted Grantham residents earlier they may have come to a different conclusion.

Let's hope that engagement and consultation is meaningful and reaches out to those most likely to be affected. ULHT is facing real challenges but cannot keep chipping away at Grantham A&E and acute services to solve its problems. We pay for and are entitled to parity with other residents across our county.

We ask ULHT enter the ASR with an open mind treating us all fairly.