Lincolnshire hospitals bosses have appeared before a high court judge to defend their decision to close Grantham Hospital A&E and create a "green site" against COVID-19.

United Lincolnshire Hospitals Trust appeared before London's High Court on Thursday to face campaigners' accusations that the decision in June 2020 to replace the A&E with an Urgent Treatment Centre was unlawful and lacked consultation or risk assessment.

Campaigners argued that the move, which resulted in the loss of 70-80 medical beds, had not provided enough information, or involved patients enough and left service users without locally accessible services.

They argued patients could have been brought into discussions at an earlier stage. Speaking on behalf of the campaigners, Vikram Sachdeva QC said they recognised the "difficult position all trusts in the country are in" and said it would not be "reasonable for the court to set a standard for them to adhere to". "The pandemic is the worst public health crisis in 70 or 100 years and let's not beat around the bush, all over the country trusts are in real trouble and are still in real trouble, and are pushed to the absolute limits of their abilities," he said. However, he said the pandemic was not enough to justify a failure to consult the public. QC Sachdeva added: "The primary question is did they make adequate arrangements to secure involvement? And when one looks at the evidence, there seems to have been a conscious decision not to involve the public until the proposals were out," he said. "It's really not for us to set out what consultation, what involvement was required, but there is a minimum, and the minimum we say, given the significance of the changes, was not complied with." The trust however, said there had been an urgent need to make the decision, that releasing proposals at an earlier stage could have been confusing, and raised unnecessary concerns if they had changed and that the green site was the only option that met their criteria. It added that reviews did take place on a regular basis.

Fenella Morris QC, on behalf of the trust, said the requirement to consult was couched in a way that extreme emergencies such as outbreaks might force instantaneous changes and there had to be a balance with other statutory obligations the trust had, such as patient safety.

She said the public were invited to trust board meetings and emails had been sent to stakeholders – including the chairman of the SOS Grantham Hospital group. She added that media interviews had taken place on a regular basis.

"We've got huge amounts of evidence both locally and nationally that people were just simply afraid to go to hospital," she said, adding that the trust had to be fair, not just to those who felt they were losing services, but also to those who were worried about attending healthcare facilities.

"The clinical imperatives were really, really powerful," she said.

"Where you've got such an anxious public having that regular slot on local radio and a Chief Executive that goes on and says this is what we're doing is a very effective way of reaching out to the public and making sure that they know what's going on."

"What is patently the case is that at the time that the proposals were gradually being developed the public wasn't involved, but it's also the case that at the point that they did become involved, there was still scope for them to make a contribution to how the outcome would be.

"Where you've got a very limited timescale in my submission, that amounts to involvement in development."

She said that at the time, there had been a "high premium on absolute clarity".

Mr Justice Linden will now examine the evidence and make a decision at a later date.