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Senior clinicians at a Lancashire trust say their board bowed to political pressure in making a ‘dangerous’ decision to reopen a small emergency department, having previously suggested that would not happen if it there was a second wave of coronavirus.In a letter to the management of the Lancashire Teaching Hospitals Foundation Trust, viewed by the Health Service Journal, a group of 17 emergency medicine consultants expressed serious concerns about the planned reopening of the accidents and emergencies at Chorley and South Ribble Hospital next week.

The unit, which has long suffered from staff shortages and temporary closures, was temporarily closed at the start of the pandemic.

When Covid calmed down this summer, plans were put forward to reopen it in the fall.

However, announcing this, Chief Executive Officer Karen Partington said: “It is really important that everyone recognizes that if the cases of Covid-19 start to increase significantly or if other safety concerns are identified , we will have to review the situation. ”

The trust has more than 100 Covid-positive patients in its departments, about three-quarters of the number it had during the first peak in April. The wider Lancashire and southern Cumbrian system has more than 700 Covid-positive patients, 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 Chorley MP Lindsay Hoyle, who is chairman of the House of Commons. Health and Human Services Secretary Matt Hancock has also repeatedly expressed his wish to see the unit reopen, and the couple held a meeting earlier this month, after which Hancock confirmed that the unit would reopen on November 2.

The clinicians’ letter, addressed to the clinical director of the trust, Graham Ellis, said: “We consider that the trust has been subjected to an undercurrent of external pressure which has resulted in a dangerous decision to prematurely reopen the emergency. …

“The timing is almost as bad as it could be. Lancashire is in the midst of an increase in the number of Covid-19 cases, filling both inpatient and intensive care beds.

“Infection control policies to protect staff and patients have already forced the ED team to double its clinical footprint at the Royal Preston Hospital site; a significant number of nursing and medical personnel cannot, for health reasons, work with patients potentially infected with Covid-19.

“This severely limits our ability to adjust staffing to cover periods of sickness and mandatory isolation. Expecting the same limited senior team to expand to cover two more clinical areas at Chorley at the start of the winter flu season is misguided and dangerous.

The long-term future of A&E at Chorley is the subject of a lengthy examination of clinical settings in Lancashire. Earlier this month, the trust announced it would reopen from 8 a.m. to 5 p.m. An emergency care center is also planned next to the unit, which has been maintained throughout the year.

The trust was contacted for comment.

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