Victory For Patient Group As Declaration Granted In Judicial Review Of Hospital Trust’s Decision To Downgrade A & E

A High Court legal challenge has been successful against a decision to downgrade Grantham Hospital’s A&E department to an urgent care centre, close the hospital for medical admissions and relocate outpatient services as part of temporary reconfiguration of services in response to the COVID-19 pandemic.

United Lincolnshire Hospitals NHS Trust (ULHT) announced in June 2020 that it was to immediately implement proposals to convert Grantham District Hospital to a “Green Site” in order to carry out planned cancer and urgent surgery in a COVID-safe environment.

Mr Justice Linden determined that the Trust had breached its legal duty to involve service users in the development and consideration of the proposed changes and made a declaration that the decision in June was unlawful.  He found that in giving service users less than three days to respond to the proposals, the Trust did not make arrangements which complied with their duty to secure meaningful or fair involvement of service users in development or consideration of the proposal at Grantham. He also found that publicising the decision after it had been taken did not amount to meaningful involvement and that steps could have been taken to involve service users in the development and consideration of the proposal at an earlier stage.

While the judge considered the impact of the COVID-19 pandemic on ULHT, he decided that the legal duty to involve service users was not a duty that can be sacrificed without clear evidence that a Trust is unable to comply with its other duties as a result of having to comply with its duty of involvement. On the facts of the case, this was not made out and the Trust could have made suitable arrangements to secure the meaningful participation of service users. The judge found that the Trust appeared to have been led by a concern about messaging and the reaction of service users. The Trust said the changes were temporary and made in response to the national health emergency. Since the court hearing, it has taken a decision to start restoring services at Grantham Hospital and this process is underway.

Local people, including campaigners for SOS Grantham Hospital fighting to protect and maintain Grantham Hospital’s A & E and acute services for over a decade, feel the plans were made without appropriate public consultation or engagement of the public given the significant impact on local service users.

Jayne Dawson was one of those affected and instructed Irwin Mitchell’s specialist public law and human rights team to bring the legal challenge.

Expert Opinion

“The judgment is a significant victory for patients. Any plans to downgrade hospital services such as A & E provision must follow a fair and lawful process. That did not happen in this case and the court’s decision sends a strong message about the importance of the legal duty to involve service users before plans are finalised, while involvement can still be meaningful.

Jayne is delighted that her case has been successful and a declaration that the Trust acted unlawfully has been granted. Although the Trust was under pressure to respond to the Covid-19 pandemic and considered it was acting in the interests of the Lincolnshire population, it was strongly felt that the views of hospital users were not taken into account and that people were denied the opportunity to comment while the proposals were being developed.

We are pleased that the Trust has recently decided to restore services at Grantham.

The court has recognised that the purpose of the legal duty is that the involvement of service users will lead to better informed decisions and will increase the likelihood that the human impact and implications of plans, proposals and decisions are taken into account. This is an important duty and not something that Trusts can opt out of.

Jayne hopes that the local NHS will carefully consider the judgment and take steps to ensure service users are properly involved in this process.”
Faith Salih - Associate Solicitor

Jayne, who has a number of serious health conditions and has had surgery to amputate her leg, said:“I am pleased the court’s decision is so clear. ULHT should have involved local people before the changes were made. While I understand the need for specialist care for those affected by the pandemic, local patients like me were put at risk of increased transmission of COVID-19 travelling out of the area for treatment. It was difficult for disabled and elderly people to travel, as I personally experienced. COVID cases in Lincolnshire were lower than other places and yet the action taken was more drastic.

“I hope that ULHT will now restore the services to Grantham in full and make sure people are involved properly in plans for the future of Grantham Hospital.”

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