Overnight closure of a hospital’s minor injuries unit on the cards

Twm Owen Local Democracy Reporter

Health chiefs are being recommended to approve the overnight closure of a hospital’s minor injuries unit when they meet this week. 

The Aneurin Bevan University Health Board consulted from September to December on a proposal to close the nurse led service, that can treat injuries that are not life or limb-threatening, at Abergavenny’s Nevill Hall Hospital between 1am and 7am. 

It currently operates 24 hours a day, seven days a week but the health board has said it sees on average just one person a night and patients will instead have to attend the unit at the Royal Gwent Hospital in Newport, 14 miles away, which will be the only 24 hour minor injuries unit.

Concern

The units are intended to support the emergency department at the Grange Hospital, in Cwmbran, which receives the most seriously injured and sick patients from across Gwent. 

Board members will be asked to approve the overnight closure when they meet at St Cadoc’s Hospital in Caerleon on Wednesday, January 24. 

They will also be asked to make the overnight closure of the minor injuries unit at Ysbyty Ystrad Fawr, in Ystrad Mynach – which has closed between 1am and 7am as a temporary measure since the outset of the Covid pandemic – permanent. 

A report to the board states officials considered they have run a “successful” engagement exercises that prompted 2,207 responses which were mostly completed online and paper surveys while 5,182 people signed a petition calling for the overnight service at Nevill Hall to be saved. 

The report acknowledges a “majority of responses” expressed concern about the Nevill Hall closure, stating it would have a “detrimental impact on patient care in the hospital’s catchment area”. 

‘Safety net’

The health board, in response to concerns at the loss of the emergency nurse-led service, has said it will introduce an informal ‘safety net’ at both hospitals so anyone attending while the units are closed can have a basic assessment and be given advice on what they should do, such at contacting the 111 out or hours number, attending the emergency unit at the Grange or waiting until the unit reopens at 7am. 

However it is stressed the safety net is intended to deal with people who’ve attended by mistake rather than being a regular service people can rely on. 

The report to go before the board also acknowledges a “majority of responses” expressed concern about the Nevill Hall closure, stating it would have a “detrimental impact on patient care in the hospital’s catchment area”. 

Health board figures show on average just one person attends at Nevill Hall between 1am and 7am, and it has to ensure staff are seeing a sufficient number of patients to maintain their skills. 

However responses to the consultation suggested, based on their past experience, a peak in attendance overnight of around four people but the report states “prior personal experience” may have been a “key driver” for people to respond with attendance between 7pm and 6am “significantly higher” than its own figures. 

It said “no fundamental issues were raised that had not previously been considered” during the consultation.

“New opening times”

Patient watchdog Llais hasn’t objected to the plans but has suggested the board should instead refer to the reduction as “new opening times.” 

Its deputy regional director has suggested, in a letter to the board: “It would be helpful if outcome information and other materials could refer to the units as having ‘new opening times’, with reassurance that minor injury services are continuing as expected. This may enhance the public’s understanding of the changes as we are mindful that language such as ‘closure’ may continue to cause concern for some people.” 

An equality impact also noted increased travel time and costs for patients going to other hospitals will have an impact, it said “especially on those currently struggling with inflation as well as other areas of social deprivation.” 

The board has also been advised there is a lack of understanding among the public about when to attend a minor injuries unit or the emergency department at the Grange, with responses also highlighting concerns about waiting times at the major hospital. 

Of the more than 2,000 responses nearly 80 per cent had previously attended at a minor injuries unit and 28 per cent, or 608 responses, where from the Abergavenny area with 119, or 5.6 per cent, from Caerphilly borough.