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Senior clinicians at a Lancashire trust say their board has caved into political pressure by making an “unsafe” decision to reopen a small emergency department, having previously suggested this would not happen if there was a second wave of coronavirus.

In a letter to management at Lancashire teaching hospitals foundation trust, seen by the Health Service Journal, a group of 17 emergency medicine consultants have raised serious concerns over the planned reopening of the accident and emergency department at Chorley and South Ribble hospital next week.

The unit, which has long suffered from staffing shortages and temporary closures, was closed on a temporary basis at the start of the pandemic.

When Covid subsided in the summer, plans were put forward to reopen it in the autumn.

However, when announcing this, the chief executive, Karen Partington, said: “It is really important that everybody recognises that if Covid-19 cases begin to rise significantly, or other safety concerns are identified, we will need to revisit the situation.”

The trust has more than 100 Covid-positive patients on its wards, around three-quarters of the number it had during the first peak in April. The wider Lancashire and South Cumbria system has more than 700 Covid-positive patients, which is more than in April.

The trust, which also runs a larger A&E at Royal Preston hospital, has long faced pressure from local politicians to keep the unit open, particularly from the Chorley MP, Lindsay Hoyle, who is the Speaker of the House of Commons. The health and social care secretary, Matt Hancock has also spoken several times of his desire for the unit to re-open, and the pair held a meeting earlier this month after which Hancock confirmed the unit would reopen on 2 November.

The letter from the clinicians, addressed to the trust’s clinical director, Graham Ellis, said: “We consider that the trust has been subjected to an undercurrent of external pressure which has resulted in an unsafe decision being taken to reopen the ED prematurely …

“The timing is almost as poor as it could be. Lancashire is in the midst of a surge in Covid-19 cases, filling both inpatient and critical care beds.

“Infection control policies to protect staff and patients have already resulted in the ED team having to double their clinical footprint on the Royal Preston hospital site; significant numbers of nursing and medical staff are unable for health reasons to work with patients who are potentially infected with Covid-19.

“This greatly restricts our ability to flex staffing to cover sickness and mandatory isolation periods. To expect the same limited senior team to expand to cover a further two clinical areas at Chorley as winter influenza season starts is misguided and dangerous.”

The long-term future of the A&E at Chorley is the subject of a prolonged review of clinical configurations in Lancashire. Earlier this month the trust said it would reopen from 8am to 5pm. An urgent care centre is also provided alongside the unit, which has been maintained throughout the year.

The trust has been contacted for comment.


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