Service proposals - General

Yes. We have already considered a long list of potential scenarios but we will carefully consider any new ideas that are put forward as part of this public consultation.   We encourage people who are making a comment about their local area to bear in mind all the effects that might result from their suggestions.

We have a duty to ensure that we buy services which provide value for your money, but this public consultation is not about saving money; it’s about making the best use of resources and the preferred options would not result in significant savings compared to what we currently spend each year on these services. We have prioritised quality of care, patient outcomes and the future sustainability of these services.​​​​​​

The public consultation and redesign of these services is not about saving money or reducing staff numbers. Rather, the ambition is to increase staffing levels in a number of them. Depending on the outcome, it could involve a change in working location or opportunities for training and upskilling, and if this becomes the case, we will undergo the appropriate staff engagement and public consultation processes at that stage.

Across the UK, there is a severe shortage of healthcare staff, particularly in the services we are consulting about. Staff shortages have meant that our teams have had to be on-call more often or work extra hours across two hospital sites in order to keep patients safe. We have also had to recruit temporary staff that are not as familiar with our hospitals and have therefore needed additional support.

By offering a more attractive workplace, with a more sustainable future, we believe we will be able to recruit more staff in to the services to alleviate some of the current staffing pressures.​​​​​​

Due to the limited capital funding available to the NHS, both nationally and locally, it is not currently possible to progress all the proposed service level changes that were included in discussion during Healthy Conversation 2019, and make up the preferred overall option described at that time. So as not to delay the benefits to patients of service change proposals, four NHS services were identified where the proposed changes could be taken forward without significant capital funding and /or the service is extremely fragile in its current state. We are pleased to be able to consult the public on these four NHS services through this process.

The only hospitals and services potentially affected by the outcome of this public consultation will be those ltation docuoutlined within the public consu

No.  A clinically led review of Lincolnshire Services was started in 2017 and followed with the Healthy Conversation exercise in 2019 which looked at the preferred options for change.  The pandemic has provided us with the opportunity to see elements of some of the proposals in action and assess any potential impact, but this public consultation is focused on the proposals and any comparison made is with the permanent service model, even when that has had to be temporarily altered due to Covid or other reasons.

Yes, in particular we are trying to adhere to the following rights about quality of services: You have the right to be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality.

You have the right to expect NHS bodies to monitor, and make efforts to improve continuously, the quality of healthcare they commission or provide. This includes improvements to the safety, effectiveness and experience of services. See page 7 of the NHS Constitution which is available here: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

Money on its own will not address the problems we are facing. This is not just about money. Staying as we are is not an option. We have to change the way we deliver the services at our hospitals to make sure we provide high quality, safe services for all patients for the long term.

Across the UK, there is a severe shortage of healthcare staff. When we look at certain services, such as stroke, the situation is even worse in Lincolnshire. This makes our hospitals a less desirable place to work and therefore makes it difficult to recruit new staff. It is also difficult to keep our staff as some leave to take up jobs at other hospitals where they can enjoy a better balance between their work and their personal lives.

In addition to this, the needs of people and their expectations have also changed. Evidence and guidance tells us that we need to deliver as much of the care people need at home or as close to home as possible. When people come to a hospital, we need to have all the relevant specialists in the same place so we can see, assess and treat them as safely and quickly as possible, and where appropriate help them to get home without delay. It is not possible to have multiple hospitals offering all specialities, due to the issues highlighted.

Our data originates from a number of organisations. These include the NHS in the county, East Midlands Ambulance Services NHS Trust, and various specialist organisations, such as the national ‘Getting it right first time’ programme (GIRFT).​​​​​​

If your reason for going to hospital is not an emergency, you will normally be expected to make your own way there. Wherever possible, patients are advised to make their own arrangements with a relative or friend, or to use public transport.

If there is difficulty in meeting the cost of transport to and from hospital, you may be able to claim a refund of the cost of travelling under the ‘Healthcare Travel Costs Scheme’ (HTCS). This is part of the NHS Low Income Scheme and was set up to provide financial assistance to those patients who do not have a medical need for ambulance transport, but who require assistance with their travel costs to attend NHS appointments. For more information please visit https://www.nhs.uk/nhsengland/healthcosts/pages/travelcosts.aspx or ask your GP or the healthcare professional who referred you to hospital.

Alternatively, some people are eligible for non-emergency patient transport services. These services provide free transport to and from hospital for:

• people whose condition means they need additional medical support during their journey
• people who find it difficult to walk
• parents or guardians of children who are being transported

To find out if you are eligible for patient transport services and how to access it, you will need to speak to your GP or the healthcare professional who referred you to hospital.

We do understand that travel and transport are important considerations for people and that any change to our hospital services would have an impact on travel for some of our patients, visitors and staff. Travel and transport were key factors in developing our proposed model of hospital care and deciding our proposal. ​​​​​​​​​​

Ordinarily, responsibility for getting to and from NHS appointments lies with the patient, though there are some obvious exceptions to this, such as when a patients travels by emergency ambulance. In Lincolnshire, we want to make NHS services as accessible as possible, and therefore there are a number of initiatives in place to support people, when travel to and from an appointment may be difficult. Regarding hospital appointments, these are:

• The option to be dropped off at the main entrances of the hospital or outpatient departments so that you don’t have as far to walk.
• Requesting later appointment times by booking future appointments with the outpatient reception staff for later in the day. Alternatively, patients can contact the department detailed in their appointment letter. Every effort will be made to help where possible.
• Patients living in Lincolnshire with a medical condition that prevents them from using public transport or their own transport, may be eligible for patient transport. This is an ambulance service, currently run by TASL, that transports the patient directly from their home to their appointment. Anyone living in the county who is eligible and requires transport can contact TASL on 0808 164 4586
• Many local Lincolnshire GP surgeries are also supported by a volunteer driver service, which can also transport people directly from their home to their appointment. Please enquire with your GP practice regarding availability and access.
• Lincolnshire County Council’s Transport Helpline is another good source of advice on travel and transport options in the county. Full details and contact information can be found here Transport Helpline - Lincolnshire Transport Services Group (lincsbus.info)
• The national Healthcare Travel Costs Scheme was established to help those who need support to pay for travel to NHS appointments. For more information about access and eligibility, please visit Healthcare Travel Costs Scheme (HTCS) - NHS (www.nhs.uk)

Those who took part in Healthy Conversation 2019 will note that there are only four of the services which were discussed at that point included in this consultation. This is because we are not currently able to progress improvements to all of the eight original services discussed at that time, due to not having sufficient capital funding. This means that there is not enough ‘one-off’ funding available to, for example, adapt the buildings to accommodate all of the potential service changes we are proposing. The reason we are focusing on the current four NHS services is either because we can take the proposed changes forward without significant capital funding, or because the service is extremely fragile in its current state, and must therefore be prioritised for improvement in order to continue caring for Lincolnshire’s population.

The four services that were within the scope of the review work but are not being consulted on for this reason are:

• Breast services
• General surgery
• Haematology & oncology
• Women’s and children’s services

Of course, we continue to seek improvement to these four services, and their ongoing transformation is being worked on by the senior clinicians within those services, acknowledging the current lack of capital to contribute to this transformation. As this review work reaches completion, details will be shared with staff, stakeholders and the public accordingly. If this review results in the recommendation of a permanent change to the service provision, it will be subject to a public consultation before any decisions are made and any changes are implemented.