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Major shake-up of A&E service in Gloucestershire

By Gloucestershire Echo  |  Posted: February 01, 2013

  • Cheltenham General Hospital Accident & Emergency Department

Comments (9)

EMERGENCY casualties in Cheltenham will be sent to Gloucester at night instead, under controversial new plans for the county's hospitals.

It comes as the trust faces a shortage of doctors to cover the hours in the town's hospital.

It is part of a national crisis to recruit staff into emergency medicine. Under the plans, an estimated 16 patients will be transferred to Gloucestershire Royal Hospital for emergency care every night, rather than being seen in Cheltenham General Hospital.

Travel times from Tewkesbury and the north Cotswolds will increase for some patients collected by ambulance.

Other proposals would see paediatric day care move to Gloucester, but improvements would be made to Cheltenham's cardiac care.

Health chiefs insisted no jobs were at risk, but said the plans were part of an urgent move to improve patient safety. The changes will not save any money from existing running costs.

A&E consultant Dr Tom Llewellyn said the changes were the best way to use existing staff.

He added: "Clinicians have been discussing how best to overcome the challenges we face and how to make best use of the specialist staff and skills available.

"We believe this proposal will help us provide safe, timely services to the people of Gloucestershire, 24 hours a day, seven days a week."

Doctors will see still see patients at night in Cheltenham's A&E if they have been sent to the hospital by a GP.

But patients who have critical illnesses at night or are in need of emergency treatment will be taken direct to GRH.

John Oliver, from the South West Ambulance Service, said the changes would only increase travel times for a small percentage of 999 patients.

"Increased clinical skills within the ambulance service means around half the patients we attend do not need to go to A&E," he said.

"For many patients needing to go to hospital, A&E is not the best place to take them. Specialist locations are often further away than the nearest A&E."

It is hoped the changes will improve patient safety as there is less demand for emergency treatment at night and it is harder to get medical cover from doctors.

Medical director Dr Sean Elyan insisted Gloucestershire Hospitals NHS Foundation Trust remained committed to both hospitals. He said: "When people need specialist hospital services, we need to make sure they are organised in a way that will ensure quality of care, safety of patients and make best use of the resources and expertise available."

Dr Caroline Bennett from Cotswold Medical Practice, Bourton on the Water, said fresh challenges had forced the change. "No change is not an option and services need to adapt to overcome the current challenges," she said.

But Unison South West spokeswoman Tanya Palmer, was concerned over the impact on staff and patients in the north of the county.

"I would seriously question if this was financially motivated, despite what the trust says," she said.

"There are serious concerns about how increased journey times will effect people there who need emergency treatment."

MP Martin Horwood is also seeking more information.

"I want a concrete plan saying how we are going to stop services being chopped bit by bit," he said.


From August 2013, there is no guarantee the trust will have the numbers of doctors it currently has, so it needs to plan now to ensure patient safety.

 Critically ill patients needing emergency treatment will be transferred from Cheltenham General to Gloucestershire Royal Hospital at night.

The Emergency Care Centre at CGH will be nurse-led under the proposals, with specially-trained staff capable of treating the majority of walk-in patients.

Doctors will continue to be on site at CGH to receive patients who had previously been reviewed by a GP.

 Extra beds needed to cope with more emergency patients at GRH will be freed up by some specialist services transferring to Cheltenham.

■For example, the proposal will improve facilities in the county's cardiac intervention unit at CGH by providing more beds in the unit and reducing delays there, particularly for those needing complex procedures.

Patients with non-critical gastrointestinal and respiratory conditions will also go to Cheltenham.

 An emergency bay will be provided at GRH for critical gastrointestinal conditions and some beds provided there for emergency respiratory conditions.

More beds will be freed up to cope with extra emergency demand and trauma cases at GRH.

Gastroenterology and liver patients will be treated in Cheltenham.

■The proposal is to concentrate the majority of beds for non-urgent gastroenterology inpatient care at CGH, while keeping a service for other patients in a single emergency bay at GRH.

 The NHS in Gloucestershire will be holding a series of public drop-in events across the county during the 12-week engagement period.

Information is available online at www.nhsglos.nhs.uk.

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  • xlitho  |  February 02 2013, 1:21AM

    They know best, less is more(pay for 'managers').

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  • johnstevens3  |  February 01 2013, 8:18PM

    The reason why there is a shortage of doctors is the EU working time directive, or so they tell us, which means where you had one doctor you now need two in A&E, causing a shortage. What I don't understand is when we needed nurse's a few years ago we recruited from as far a field as Australia so why can't we recruit Doctors from abroad? Well put simply its cuts in disguise, and the working time directive plays right into their hands, the perfect excuse.

    |   3
  • paul813  |  February 01 2013, 6:24PM

    tiltonterrier,you may have a point , but a lot of the problems with this country is the vast number of foreigners being let into this country , when i said workers i should of said the ones claiming benifits, also the massive ammounts of money spent on other countries problems , then things like this happen the gov make cuts and important services like the nhs suffer , we should NOT be without our A&E department , what next shall we close our schools ?, i am no racist good and bad in all races , but the gov cant say we need cutbacks and keep allowinglarge numbers of foreigners into the country because they can claim benifit and put further pressure on a struggling nhs service, just take a look at what it costs the country to get people in to translate alone . it just cant go on

    |   7
  • tiltonterrier  |  February 01 2013, 2:24PM

    paul813 like it or not but if this country wasn't "flooded" with foreign workers then the NHS would be in a much worse position then it is at the moment. They wouldn't be able to staff both the hospitals so one would probably close!

  • Alphonso2  |  February 01 2013, 12:10PM

    Perhaps the Trust would like to inform those with heart conditions how they will receive primary angioplasty outside office hours? Will a journey to Bristol or Oxford be necessary for this life-saving treatment?

    |   9
  • DG9999  |  February 01 2013, 11:29AM

    It is going to make it difficult for patients to be visited by family and friends-very frightening in view of http://tinyurl.com/bel237h

    |   3
  • paul813  |  February 01 2013, 10:59AM

    i have to agree with timonline2012 , it makes no sense to me , a big hosp like chelt general with no A&E DEPARTMENTthat surely cant be in the interest of sick or injured people !what about the people who dont drive the people who cant afford car park charges etc , more people will be calling for a ambulance knowing they will have to make the trip to glos , or will they no bother putting their lives at risk, some people will turn up at chelt gen saying i do not have transport or the finances to get to glos royal , if i had a sick child i would want to make my way to the nearest hospital. its wrong !! the people of chelt and glos do so much to raise funds for hospitals the cobalt appeal etc and to be denied treatment because of so called cut backs is not right , this country wants a bloody good shake up to much spent on other countries and flooding the country with foreign workers etc i am no racist but that is a big part of the problem why this country is in the position its in , the answere is not to close accident and emergency departments putting peoples lives at risk the gov needs to adress the real issues !!

    |   6
  • Alphonso2  |  February 01 2013, 9:40AM

    This news sneaked out on Thursday under cover of the NHS Lewisham downgrade

    |   9
  • TIMONLINE2010  |  February 01 2013, 9:34AM

    How does this 'improve patient safety' - are you more likely to survive a 10 minute drive to Chelt or a half hour drive to Gloucester?! Is anyone addressing the reason for shortage in A&E doctors? 'the changes would only increase travel times for a small percentage of 999 patients.' - how can this be?

    |   14