FEATURE: Question and answer - LHAC's case for change

Following the release of the Lincolnshire Health And Care review's Case for Change, The Standard put some questions to Tracy Pilcher, Chief Nurse, Lincolnshire East Clinical Commissioning Group.


Q: What confidence can you give to residents who use the Lincoln and Boston hospitals that they are going to be catered for?

A: The ‘Case for Change’ document explains the challenges faced by the Lincolnshire health and care system, which is currently spending £60m per year more than it receives in funding. It notes that - if nothing is done to address growing demand for health and care, coupled with a system that focuses on hospital care, resulting in a situation whereby services are struggling to deliver consistent high quality care – then the county’s deficit will grow to approximately £300m by 2021.

Case for Change introduces our vision for health and care in Lincolnshire in the future, including what future services might look like. It covers a range of themes, such as the challenges faced delivering care in a rural county, how emergency care might be improved, the concept of having centres of excellence, and what we can do to improve maternity and children’s services, to name a few.


The document is the next step towards a public consultation at which stage we will share with the public more detail about the options we are considering. Public engagement on this process is critically important and we will be talking with and listening to the views of all of our patients across Lincolnshire before a final decision is taken on any change to hospital or inpatient services.

We want all hospitals and services in Lincolnshire to be safe and viable. No decisions have been made about the future of any hospital services but we are confident all three hospitals in Lincolnshire have a positive future. Final proposals will be made after the public have been able to give their view on options through a full public consultation.

Q: In Boston, there is a campaign group looking at Women and Children’s services and the potential options on the table which could result in only one hospital having specific maternity services.

We have been told by ULHT that the current situation, both financially and due to a lack of staff, is ‘unsustainable’. The case for change report certainly supports that and seems to suggest, following national guidelines, having one hospital due to a lack of births – despite people coming to us saying they would rather give birth in Boston.


What reassurances can you give to people in Boston and towns which use the hospitals that their concerns over the locality of services versus safety and sustainability will be listened to?

A: Underpinning the LHAC process is robust and inclusive engagement with the public, patients and all key stakeholders. Part of this is the statutory consultation process via which we will ask for views on all of the options proposed and take into account and report on all of the feedback received. This will be undertaken using a variety of approaches to enable as many people as possible to get involved and tell us their views. Maintaining safe and sustainable services is a key focus for LHAC and we want to provide services closer to home, that are as easily as accessible as possible. A key requirement is safety and guidelines, and sometimes this means having to travel further afield, but feedback shows people are willing to travel if it means they can access safe and high quality services

Q: There has been some suggestion that the review, with its focus on saving money could lead to private companies being used similar to how the police use G4S. Is this a possibility?

A: Whilst we have an extremely challenging financial position, which will get worse if we don’t address it, this is not solely about funding. In fact, some of the problems we face cannot be fixed by having a bigger budget – for example, more funding would not resolve the challenges we face recruiting sufficient numbers of professionals into key health and care roles. Lincolnshire Health and Care is 13 organisations working together to try and find ways of transforming services. Proposals put to the public for consultation may include changing where some services are delivered, including potentially bringing together some specialist services onto a single site. Other solutions may include using technology to share patient records and help reduce the need for face-to-face appointments where they are not necessary. Whether or not private companies are used will depend on what the health and care system looks like going forwards and who is best placed to provide the services our patients need.