Under-staffed hospital A&E’s request for help from military medics turned down

The appeal to the military was unsuccessful as the right grade of medic was not available

Charlie Cooper
Whitehall Correspondent
Sunday 24 April 2016 05:18 EDT
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Chorley Hospital's A&E has been downgraded to an urgent care centre following a staff shortage
Chorley Hospital's A&E has been downgraded to an urgent care centre following a staff shortage (Rex)

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A crisis-hit hospital was forced to request support from military medics to care for patients at its chronically under-staffed A&E department, it has emerged.

Lancashire Teaching Hospitals NHS Foundation Trust held talks with the local barracks as it sought to resolve a dire staffing shortage in the emergency department of Chorley Hospital, which has since been forced to suspend its service.

The A&E had only eight of the 14 middle-grade doctors it required to continue running a safe service. But the request to the military was unsuccessful as the right grade of medic was not available. National NHS bosses are also said to have advised against the request, warning that military personnel should be requested only in the “the last resort”.

With junior doctors set to go on strike on Tuesday and Wednesday, walking out of emergency care for the first time, the local MP and the British Medical Association said the drastic situation in Chorley was an extreme symptom of a wider staffing crisis in the NHS.

It comes as a letter from more than 2,500 consultants, GPs and other senior doctors accuses the Government of leaving junior doctors with no choice but to strike by attempting to introduce seven-day services in the NHS “without funding or workforce planning” .

The letter, seen by The Independent, also reassures patients that consultants and other non-junior doctors will “keep the NHS safe” on strike days.

“Not only are we duty-bound to do so, but we will gladly provide this emergency cover to ensure that the juniors can take this action with the complete confidence that their patients are safe,” they write.

The signatories include Dr Clare Gerada, former chair of the Royal College of GPs, and other senior medics including leading surgeon Professor Nigel Standfield and vice-president of the Royal College of Paediatrics and Child Health Dr Andrew Long.

The Department of Health has called the latest strike action “extreme and irresponsible” and repeated its criticism of the BMA for failing to negotiate over Saturday pay. More than 12,700 operations have been cancelled as a result of the new industrial action. Senior figures including NHS England’s medical director Sir Bruce Keogh have warned that an all-out strike could “irreparably damage trust” in medics.

Junior doctors say their dispute is about more than pay, and warn that the new contract being forced upon them, which requires more weekend working for less pay on Saturday, will lead to the current workforce being overstretched, leading to further shortages on wards during the working week.

A Department of Health spokesperson said the Government had “continually sought a negotiated solution over three years of talks”.

“If the doctors' union had agreed to negotiate on that as they promised to do through [the arbitration body] Acas in November, we'd have a negotiated agreement by now. Instead, we had no choice but to proceed with proposals recommended and supported by NHS leaders — which were 90 per cent agreed with the BMA,” the spokesperson said.

Chorley’s A&E was downgraded to an urgent care centre last week after the hospital’s management proved unsuccessful in its attempts to fill rota gaps, blaming a national shortage of emergency doctors and Government restrictions on recruiting temporary agency staff.

In a memo to staff sent last week, the trust’s chief executive Karen Partington said that it was “exploring potential support from GPs and the military”.

The strategy of seeking support from the local Fulwood Barracks had been urged by the Chorley MP Lindsay Hoyle, who told The Independent yesterday that he believed the trust had not done enough to secure military support to help it through an “emergency”.

“We have an A&E on the edge of closure because of the lack of doctors,” he said. “Lives are put at risk if that A&E goes down. All you do by closing the A&E is put pressure on the nearby emergency departments.”

He added: “This isn’t unique to Chorley. We know there is a major crisis in the lack of staff for A&E.” But he criticised the trust’s management for not doing enough to keep the A&E open.

Johann Malawana, chair of the BMA’s junior doctor committee, said that the situation in Chorley was a sign of an NHS “in a state of crisis”.

“Staffing shortages are so acute in some areas that hospitals can no longer deliver safe care. Rather than addressing the root causes of this, the government is focussing on forcing through a junior doctor contract that will hit those areas of medicine where there are already recruitment and retention problems.

“The contract will undermine the ability of the NHS to attract and keep the next generation of doctors at a time when we desperately need more doctors, not fewer.”

In a statement on the trust’s website, Lancashire Teaching Hospitals NHS Foundation Trust chief executive Karen Partington said that management had held “conversations with colleagues at the local barracks because we already provide some training for their medics”.

“However they do not have the right kind of doctors available that we need,” she said. “We have requested advice from NHS England about the feasibility and process for accessing national armed services support. NHS England advises that such an application for support would constitute a ‘military aid to civilian authorities’ request, which is a last resort and would only be considered when all other options have been exhausted.

“NHS England advises that as plans are in place to maintain a safe and effective service, and discussions are continuing, such a request is therefore currently not appropriate.”

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