Summary of our change proposals

For each of the four NHS services within the scope of this consultation, the tables below set out the options considered at the shortlist stage, the preferred option identified following the appraisal of the shortlist and a summary of the preferred option.

Orthopaedic surgery

Options appraised at shortlist stage

 

Preferred option identified following appraisal

Consolidate planned orthopaedic surgery at Grantham & District Hospital

Other options were considered initially, however these did not progress to the shortlist stage following the clinically led evaluation of the long list of options

 

Consolidate planned orthopaedic surgery at Grantham & District Hospital

A dedicated day centre at County Hospital Louth (developed through the pilot (which is described on p18))

Overview of preferred option

A ‘centre of excellence’ in Lincolnshire for planned (only) oropaedic surgery would be established at Grantham & District Hospital

A dedicated day case centre at County Hospital Louth for planned orthopaedic surgery

A pilot of these services has demonstrated:

Reductions in the number of patients who have their planned orthopaedic surgery cancelled due to a lack of beds

Care provided in line with national best practice and care standards

A reduction in the amount of time patients wait for their planned orthopaedic surgery

A reduction in the amount of time patients spend in hospital after their planned surgery

An improvement in patient satisfaction and experience

A reduction in the number of patients receiving their care in the private sector, funded by the NHS.

 

Urgent and emergency care at Grantham & District Hospital

Options appraised at shortlist stage

 

Preferred option identified following appraisal

Grantham & District Hospital A&E department to become a 24/7 Urgent Treatment Centre (UTC)

Other options were considered initially, however these did not progress to the shortlist stage following the clinically led evaluation of the long list of options

Grantham & District Hospital A&E department to become a 24/7 Urgent Treatment Centre (UTC)

Overview of preferred option

24/7 walk-in urgent care services at Grantham & District Hospital would be provided by a sustainable and permanent UTC

The vast majority (estimated to be around 97%) of patients currently seen by the A&E department at Grantham & District Hospital would continue to be treated by the proposed Urgent Treatment Centre (UTC).

Compared to the current Grantham & District Hospital A&E Department, access overall would increase as the UTC would be open 24/7. Greater access would also be provided for children.

The UTC would be provided by a community health service provider, which will support better integration with primary care and community services and the provision of care closer to home.

For the small number of patients who wouldn’t be able to have their care needs met by the UTC in Grantham, care would be received at an alternative site with the right facilities and expertise to ensure the best patient care.

 

Acute medical beds at Grantham & District Hospital

Options appraised at shortlist stage

 

Preferred option identified following appraisal

No acute medical beds at Grantham & District Hospital

Integrated community/acute medical beds at Grantham & District Hospital

Integrated community/acute medical beds at Grantham & District Hospital

Overview of preferred option

Acute medical beds would be retained locally at Grantham & District Hospital in a sustainable way.

The vast majority (estimated to be around ???%) of patients currently receiving care in the acute medical beds at Grantham & District Hospital would continue to be treated in the integrated community/acute medical beds.

Compared to the current Grantham & District Hospital acute medical beds, a more comprehensive service would be delivered, particularly for frail people, which enables greater integration with community health and care services.

Maintaining a local service at Grantham & District Hospital would reduce pressure on Lincoln County Hospital and Pilgrim, Boston Hospital.

For the small number of patients who would not be able to have their care needs met by the integrated community / acute medical beds in Grantham, care would be received at an alternative site with the right facilities and expertise to ensure the best patient care.

 

Stroke services

Options appraised at shortlist stage

 

Preferred option identified following appraisal

Consolidate hyper-acute and acute stroke services on the Lincoln County Hospital site, supported by an enhanced community stroke rehabilitation service

Provide hyper-acute and acute stroke services from Lincoln County Hospital and Pilgrim, Boston Hospital, supported by a combined medical on-call rota

Consolidate hyper-acute and acute stroke services on the Lincoln County Hospital site, supported by an enhanced community stroke rehabilitation service

Overview of preferred option

A ‘centre of excellence’ in Lincolnshire for hyper-acute and acute stroke services would be established at Lincoln County Hospital – Pilgrim, Boston Hospital would no longer provide hyper-acute and acute stroke services.

Hospital stroke service provision would be based on national clinical evidence, which has demonstrated stroke patients are more likely to survive, recover more quickly and spend less time in hospital.

Hospital Stroke Services in Lincolnshire would be in a stronger position to attract and retain talented staff through building a strong, high quality and successful service – making it sustainable for the long term.

More patients would benefit from hospital stroke services being located on the same hospital site as the highly successful Lincolnshire Heart Centre, with benefits including increased access to important time critical interventions and acute imaging services, further reducing time to treatment.

Stroke patients would spend the minimum time necessary in a hospital bed, by ensuring enhanced community services have the right skills and capacity to provide high quality rehabilitation to stroke patients as they return home, or as close to home as possible.

 

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