Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group’s Governing Body will consider proposals for change at Weston Hospital next week, following the public consultation process which concluded in June this year.
The proposals, designed to improve safety, quality and sustainability, are backed by senior doctors and clinicians across the area, including the Hospital Consultants’ Body and a key group of local GPs. The Boards of Weston Area Health NHS Trust and University Hospitals Bristol NHS Foundation Trust have also expressed their support.
The proposals recommend making the temporary overnight closure of A&E permanent, meaning that the A&E at Weston Hospital would be open from 8am to 10pm, seven days a week. It was initially closed overnight in July 2017 following patient safety concerns.
Under the proposals, 24/7 urgent care access would be bolstered by improved GP services and an increase in the number of hospital admissions being made directly onto wards overnight – bypassing the need for A&E altogether. On average, around eight people per night currently attend neighbouring hospitals for emergency care, and through the introduction of direct admissions, this number would reduce to around five. Referrals directly onto wards would be made by GPs and paramedics.
The original proposals were designed to address a series of significant challenges, including quality and safety at the hospital, changing health needs of the population and significant variations in care. They have been further refined with senior doctors and assured by national regulators as well as a regional group of independent clinical experts. The additional recommendations are:
- To make specialist children’s urgent care provision available 7 days a week instead of 5, and extend the mid-week opening hours at the Seashore Centre to match those of A&E. This would mean around 1,100 more children in need of emergency care being treated at Weston Hospital each year; and a further 570 receiving their planned care at Weston instead of travelling further afield.
- Continue to provide emergency surgery at Weston Hospital 7 days a week, closing theatres from 8pm-8am. Patients needing emergency surgery overnight would be stabilised at Weston and transferred to neighbouring specialist hospitals for treatment, affecting around 80 people a year.
- Continue to provide up to Level 3 critical care for people who need single organ support at Weston Hospital. People requiring critical care for two or more organs at Level 2 or 3 - or people who would benefit from specialist clinical services - would be transferred to Bristol for treatment then brought back to Weston to continue their recovery. As a result of the consultation process a dedicated transfer team would be set up to support this change, which is expected to affect around 130 people a year.
The developments would be supported by a raft of wider improvements already in progress. These include the introduction of a new frailty service to meet the needs of the area’s growing population of older people, strengthened primary care, and a mental health crisis and recovery centre in central Weston which will open in early 2020.
Dr Martin Jones, Medical Director at BNSSG CCG, said:
“If agreed, these proposals would ensure that Weston Hospital is better able to achieve national clinical quality standards, as well as attract and retain the staff it needs. That means a better local service for patients and the public.
"Clinicians across our area are clear that ‘doing nothing’ is not an option for Weston, and that these proposals are a big step in the right direction. Our vision has always been to have a dynamic and focussed hospital at the heart of the community, providing more of the services local people need most often.
"The public consultation period has also meant we’ve been able to listen to a broad range of views and make improvements to the proposals we originally put forward.
"For example, we’ve reduced the number of people who would need to travel out of Weston for emergency surgery under our proposals from 560 to just 80 a year. People told us travel was a big concern, and we’ve worked to address that while staying focussed on quality and safety.
We remain hugely grateful to everyone who expressed their views during the consultation.”
Dr Peter Collins, Medical Director at Weston Area Health Trust, said:
“There are opportunities outlined in the CCG’s proposals to grow our services, including those for frail and older people – using the expertise of our award winning frailty teams - and for children and young people which would see access to paediatric specialists and our excellent acute paediatric Seashore Centre enhanced.
"We also welcome a final decision on how we continue to provide critical care and 24/7 urgent and emergency care for the people of Weston and surrounding areas.”
The CCG’s Governing Body will consider the proposals at its meeting on October 1st, being held at the Winter Gardens in central Weston. If the CCG decides to agree the changes, a phased implementation would begin immediately and run until April 2021.