Call for rethink on children's A&E at Ormskirk Hospital
The government has been asked to step in after NHS bosses decided to close the department
An influential group of councillors will ask the government to step in over a controversial decision by NHS bosses to close the children’s accident and emergency unit at Ormskirk Hospital.
The facility is to move eight miles away to Southport Hospital in 2029 – a shift that health leaders say is necessary in order to reinstate round-the-clock emergency care for youngsters across West Lancashire and Sefton.
However, Lancashire County Council’s health scrutiny committee has now formally requested that health and social care secretary Wes Streeting ‘calls in’ the plans to consider them for himself. He has the power to reverse the change, should he choose to use it.
The cross-party group – made up of both county and district councillors – unanimously backed the move seeking his intervention on Monday. Members cited concerns over the process surrounding the NHS decision and questioned whether the shake-up was in “the best interests” of health services in West Lancashire.
The young people’s A&E at Ormskirk and District General Hospital currently closes between midnight and 8am – its hours of operation having first been reduced at the height of the pandemic in 2020. There has been no emergency unit for children at Southport and Formby District General Hospital since 2003, while the adult emergency facility at Ormskirk shut in 2005.
The relocation plan – which will create a single 24-hour A&E service for adults and children in Southport – was approved by a joint committee of the NHS integrated care boards (ICBs) for Lancashire and South Cumbria, and Cheshire and Merseyside on 13th March.
A 13-week public consultation was carried out between July and October last year. However, health scrutiny committee member County Cllr Shaun Crimmins condemned the fact that a “preferred option” – to move the children’s A&E to Southport, as opposed to the adult emergency unit to Ormskirk – had been set out by health officials before residents were asked for their opinion.
He said: “A lot of people disengaged from the consultation, because they said it was a done deal.”
The prospects of either having an all-age service on both sites or maintaining the status quo were both ruled out prior to the survey beginning, having been deemed unsustainable as part of the ‘Shaping Care Together’ programme.
The ICBs say that the involvement of more than 7,800 people with the consultation equated to just over three percent of the local population, well above the national average response rate of 0.7 percent. Respondents generally wanted services located closer to where they lived.
In that vein, the committee heard concerns about the travel times to Southport Hospital for residents living in parts of West Lancashire, particularly on the Skelemersdale side of the borough.
County Cllr Gaynor Hargreaves said she was worried about any delay in children receiving emergency care. “Those few minutes could make a difference to life and death,” she said, adding that she did not feel the matter had been “addressed in full, like it should be”.
The issue of transport between West Lancashire and Southport was also raised, with County Cllr Mark Jewell telling the meeting that the “mitigations” promised by the NHS as part of the overhaul were not “obvious”.
Meanwhile, committee member Cllr Ann Fennell – who sits on West Lancashire Borough Council – said the change was likely to lead to Ormskirk also losing maternity services in future.
However, Cllr Martin Gawith, a Lancaster City Council member, said it was important that care – in particular, any specialist procedures – was provided at a “centre of excellence”.
“Having somewhere at the end of the road might be very nice to get to, but if we haven’t got the skills in there, there’s no point in having it,” he said.
The health scrutiny committees of both Lancashire County Council and Sefton Council – the standalone local authority area in which Southport Hospital sits – had previously formed a joint group to assess the proposals.
However, the Lancashire committee’s deputy chair, County Cllr Hamish Mills, said any concerns raised through that forum had merely been noted by health chiefs – and no “significant response” was ever received to them.
Lancashire County Council’s health scrutiny committee will now set out the reasons for their call-in request in a letter to the health secretary. But government guidance on the procedure stresses that the power is not expected to be used “on a regular basis”.
Before a request is accepted, NHS commissioning bodies and local authorities should have taken “all reasonable steps to try to resolve any issues”.
West Lancashire MP Ashley Dalton said on the day of the ICBs’ decision that she would make her own call-in bid over the issue.
The current split-site A&E arrangement for children and adults in Ormskirk and Southport is the only such set-up between any two district general hospitals in the country, according to local health leaders.
WHAT DOES THE NHS SAY?
In a joint statement responding to the committee’s call-in request, the Lancashire and South Cumbria and Cheshire and Merseyside ICBs told the Local Democracy Reporting Service: “We note the decision taken by Lancashire County Council’s health and adult services scrutiny committee.
“The joint committee of the two ICBs made the decision to co-locate adult and children’s A&E at Southport Hospital based on the public consultation findings alongside clinical, financial, equalities, workforce and quality evidence.
“The decision was about making sure we have a 24/7 emergency department for both adults and children at the same site which will safely and sustainably deliver emergency care for people living in Southport, Formby and West Lancashire.
“It is important to note Ormskirk Hospital will remain open and continue to provide key services to patients, including outpatient services, urgent treatment, planned care, diagnostics, and inpatient services. There is active investment planned for the site and it’s vital to remember that currently 86 percent of activity is not A&E.”
Craig Harris, the Lancashire and South Cumbria ICB’s chief commissioning officer, told the joint meeting at which the relocation decision was taken that the NHS was “committed to the continuation” of the existing urgent treatment centre (UTC) on the Ormskirk Hospital site and walk-in centre in Skelmersdale.
Urgent treatment facilities usually deal with many of the common problems for which people might otherwise attend accident and emergency. However, as it is currently located alongside a children’s emergency department, the Ormskirk UTC – open from 8am until 8pm every day – states on its website that it welcomes young people with “minor ailments”, but directs those with “minor injuries” to A&E.
Mr. Harris said it would have to be considered “whether…we need additional paediatric nursing skills” at the UTC.
Meanwhile, the Skelmersdale walk-in, which also operates between 8am and 8pm each day, lists a raft of complaints that can be treated there, including minor injuries and muscle and joint injuries, along with the provision of “acute wound care”. The joint scrutiny committee has recommended that a UTC be established in the town.
The decision-making business for the overhaul case stated that more than seven in ten under-16s attending the children’s A&E at Ormskirk last year could have been treated in another suitable local health service.
“As a mitigation, we are working closely with system partners to ensure people get to the right place first time,” the document explained.
It added: “The aim of bringing adult and children’s emergency services together on a single site is to create a safer, more resilient and clinically sustainable emergency care model for the future. By consolidating services, the programme seeks to ensure that people receive high-quality, consistently staffed and specialist-supported care.”
The transfer of the children’s A&E to Southport was also described as being “substantially more affordable” than moving the adult service to Ormskirk – with estimated capital costs for the two schemes of £33.1m and £91.3m, respectively.
The NHS says the switch to Southport for children means only one “co-dependent service” – the paediatric inpatient unit – also has to move. However, if the adult A&E were relocated to Ormskirk, seven co-dependent services would have to go with it – general medicine, critical care, elderly medicine, respiratory medicine, medical gastroenterology, pathology and liaison psychiatry.