Lincolnshire NHS Trust criticised for failure over covid-related A&E closure

An NHS Trust has been criticised by a High Court judge for a "total failure'' to consider the views of hospital users before temporarily closing an A&E department.

In June 2020, United Lincolnshire Hospitals NHS Trust shut the A&E at Grantham and District Hospital as part of measures to make the hospital a coronavirus-free "green'' site until at least March 2021.

All patients would require a known Covid-19 status on admission, as elective treatment and chemotherapy would be carried out at the site, while elective surgeries and some outpatient treatment would be transferred to other hospitals in Lincolnshire.

Trust staff replaced the A&E department with an urgent treatment centre in a separate part of the site, meaning those with more serious injuries or conditions would have to go to a different hospital in the area.

Mr Justice Linden said the decision caused "significant inconvenience to certain users of the services'' as a variety of outpatient services stopped on-site and two wards were no longer available.

Jayne Dawson, a 54-year-old wheelchair user with conditions including spina bifida and hydrocephalus, took legal action against the NHS trust over the decision.

The court heard Ms Dawson had to travel 27 miles each way to a hospital in Boston rather than her usual seven miles each way for her consultant appointments.

Ms Dawson argued the trust acted unlawfully by failing to make arrangements for service users to be involved in considering the proposals and making the decision itself.

The court heard the decision was considered from May 12 2020 "at the latest'', but was not announced to the public until June 8, and the decision was ultimately made three days later.

Ms Dawson argued the arrangements were "wholly inadequate'' and suspected the trust's approach was influenced by a longstanding agenda to close the A&E department, which is denied by the trust.

United Lincolnshire Hospitals NHS Trust said service users were involved at the earliest practical opportunity.

It also argued it was mindful of the fact that there would ordinarily be an obligation to consult, but that the trust was advised that this did not apply because the changes were temporary.

Mr Justice Linden had to consider whether the trust could have involved service users at an earlier stage, and to what extent the pandemic could be used to justify any issues.

He found there had been a "total failure'' to comply with the legal requirement to give people affected a meaningful opportunity to be involved in decision making.

The judge added:

"The greater the impact of a decision, the higher will be the requirement of service user involvement in the decision making process.''

"Although I have no doubt at all that frontline staff were under a huge amount of pressure, there were resources available to do more to involve service users.''

He concluded:

"Steps could and should have been taken to involve service users in the development and consideration of the proposal.

"There was no good reason why the steps which the trust eventually took in terms of publicity for the proposal, virtual public meetings, surveys etc, could not have been taken at this stage.''