For years, people in west Norfolk have campaigned for the replacement of a hospital that’s quite literally being held up by thousands of props. Finally, they know a new Queen Elizabeth Hospital (QEH) is going to be built. Now there’s a new worry. When the new hospital eventually opens, will all the services people rely on today still be there?
A review is under way into how clinical services are provided across the three hospitals in the Norfolk and Waveney University Hospitals Group – QEH, the Norfolk and Norwich and James Paget – as well as community hospitals in the area. Among the possibilities being discussed are changes to consultant-led A&E, intensive care and maternity services at King’s Lynn.
The group says no decisions have been made. It has also reiterated that patients will continue to have access to “urgent and emergency care at the QEH 24 hours a day, seven days a week”, though this could mean a number of scaled-down alternatives.
Locally, that’s done little to calm fears. A petition opposing any downgrade attracted more than 3,000 signatures in its first 24 hours. Its organiser, Liberal Democrat West Norfolk councillor Rob Colwell, sums up the concern: “We have spent years fighting for a new QEH. We must not win the battle for the building and lose the battle for the services.”
A long way to the next A&E
Geography is one reason the prospect of losing a full A&E is causing so much concern. QEH isn’t just King’s Lynn’s hospital. Its catchment stretches across west and north Norfolk and into north Cambridgeshire and south Lincolnshire.
If King’s Lynn were to lose its full Type 1 A&E, the alternatives are a considerable distance away. By road, it’s approximately 35 miles to Pilgrim Hospital in Boston, 36 miles to Peterborough City Hospital, and around 42 miles to both West Suffolk Hospital in Bury St Edmunds and the Norfolk and Norwich University Hospital.
That’s a very different picture from much of England. Research by the Nuffield Trust and Health Foundation found that the average distance travelled from home to a major A&E was 4.4 miles, with a median of just 2.6 miles. Only 3% of emergency hospital admissions were to hospitals more than 18.6 miles from a patient’s home. The figures are old – they’re based on 2011/12 data – but they give some idea of just how unusual journeys of 35 or 40 miles for emergency care would be.
And what if you don’t have a car? Not every injury or illness that needs A&E treatment is serious enough to justify calling 999. For people in King’s Lynn and the surrounding rural communities, getting to emergency care tens of miles away could itself become a considerable problem. When an emergency really is life-threatening, those distances raise a different question. Ambulance crews take patients to the most clinically appropriate hospital, which won’t necessarily be the closest, but removing a full A&E from a large rural area inevitably changes the geography of emergency care.
A hospital held together by props
The uncertainty comes after years of campaigning over the future of QEH itself. The hospital opened in 1980 and was designed to last for around 30 years. Much of the main building contains reinforced autoclaved aerated concrete (RAAC), which has now reached the end of its expected life.
East Anglia Bylines has reported repeatedly on the increasingly extraordinary measures needed to keep the building operating. There are now 8,598 steel and timber support props in 56 areas of the hospital, including wards, waiting areas, clinic rooms and offices.
Staff have had to provide modern healthcare in these conditions for years. The props intrude into corridors and working areas, sometimes standing immediately in front of desks, while patients and staff have to navigate around them as part of everyday hospital life. Signs around the hospital ask people to report if they’ve heard something in a wall or ceiling, spotted water where it shouldn’t be, or noticed a wall or ceiling crack: “If you see something, say something.”
These aren’t simply the inconveniences of working in an old building. The props and other failsafes are part of an extensive safety programme needed to keep the hospital operating safely while it waits to be replaced. QEH itself has acknowledged that the poor condition of the building and the prominence of the props have adversely affected staff and patient experience and the operational running of the hospital.
QEH does have serious performance problems. The Care Quality Commission currently rates the hospital overall as Requires Improvement. Urgent and emergency care, medical care and surgery all have that rating, with inspectors identifying concerns including patient safety, medicines management, monitoring, governance, staffing and training.
But there’s another side to that picture. The CQC rates the hospital Good for caring, and patients told inspectors that staff were kind and caring and doing their best in a busy service. The state of the building doesn’t explain away the failings identified by inspectors, but it would be hard to look at the conditions in which staff have been working and argue that they’re irrelevant when judging the performance of the hospital.
So what is being considered?
That’s the question nobody can yet answer. The clinical review covers far more than QEH. North East Cambridgeshire MP Steve Barclay met the group’s chief executive, Professor Lesley Dwyer, after reports about possible changes emerged. According to Barclay, she told him that a working group of around 80 clinicians had been looking at services since July. It covers the three main hospitals as well as community hospital sites at North Cambs, Thetford and Dereham.
Barclay says the work is already well advanced, although no final conclusions have been reached. The hospital group is equally emphatic that nothing has yet been decided.
Dwyer says: “I want to be clear that no decisions have been made about the future configuration of services at the QEH or any other hospital in our group.”
If the review does eventually recommend significant changes, the group says they would need robust clinical evidence and would have to go through NHS governance, staff and public engagement and consultation before any decisions were taken.
For people who spent years campaigning for a replacement QEH, though, the fact that major services are even being reconsidered just as the new hospital finally comes within sight is bound to cause alarm. They’ve already won one battle: after years of uncertainty, King’s Lynn is getting its new hospital.
Now the question is what kind of hospital will be inside it.
The Save life-saving departments at QEH Hospital King’s Lynn petition can be found here.
This article is based on a piece by the Local Democracy Reporting Service, compiled with assistance from AI tools. Additional research and editing by East Anglia Bylines.
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