Q&A: Changes for Weston-super-Mare’s A&E department explained
07:02 17 February 2017
Weston General Hospital has announced major changes could be in store for its A&E department – but what do the proposals mean for the town? The Mercury caught up with the hospital’s medical director, Dr Nick Lyons, and North Somerset Clinical Commissioning Group’s urgent care lead, Dr Kevin Haggerty, to find out more…
What are the proposed changes for the hospital’s A&E?
Weston Area Health NHS Trust (WAHT) – which runs Weston’s hospital – is asking for public opinion on potential changes to its A&E. The proposal would see a scaled-back emergency service between 10pm and 8am.
The doors would remain open 24 hours a day and many patients will still be able to walk in and receive care at night, but people being taken to hospital by ambulance will be diverted to Bristol or Taunton.
This would mean a smaller team of overnight staff would be needed, which could resolve some of its recruitment issues.
Dr Lyons said any changes will focus on what is best for patients. He added: “At Weston, it would be serious to not explore options and then find we are not able to recruit doctors for A&E and potentially see it close completely.
“The right thing is to have an A&E which supports patients in Weston and North Somerset, and we have had to look at the options to ensure it is sustainable and deliverable not just today and tomorrow, but in the long term.”
Why are changes being proposed?
Like much of the NHS Weston’s hospital is under pressure.
WAHT is the smallest trust in the UK and has a troubled financial history, meaning it has often struggled to fully fund its services.
North Somerset’s growing and ageing population means it is facing increasing demand and is regularly close to or at maximum capacity.
The hospital also struggles to recruit and retain doctors for some specialties, including in its emergency department (ED).
Dr Haggerty – who works as a GP in Weston and has been heavily involved in the plans for A&E – said: “There is a national shortage in ED doctors, so most of them want to work in bigger departments, with a larger team where they are seeing a whole range of emergency situations and are using their whole skill-set.”
What will it mean for patients?
For most patients the proposed changes will mean very little, according to Dr Lyons. He said: “Not every patient is seen by a doctor at the moment, but we are looking at the possibility of expanding the number of patients who are seen by senior nurses and whether that will make the department more sustainable.”
Patients who will be most affected will be those requiring emergency care overnight – for example trauma and paediatric cases or people who have had a heart attack or a stroke. They would be sent to one of three hospitals across Bristol and Taunton. Dr Haggerty said this already happens in Weston. He said an average of 140 people use the A&E department every day, but just 40 of those arrive between 8pm and 8am. He said the changes would likely mean four or five of these patients would no longer go to the hospital. He added: “Evidence shows that if you have a serious problem then driving further to get to the right team delivers better outcomes.
“We want to make sure patients get to the best place possible.”
But this means some patients will be admitted to hospitals miles away from home. Dr Lyons said: “Of course, if it was my mum who was in hospital I would want her to be as close to home as possible while making sure she was having the best possible care.”
Dr Lyons said some patients could be transferred back to Weston or community hospitals in Bridgwater or Clevedon for longer-term treatment, or even receive care in their own home.
What will this mean for staff?
It is hoped these changes will see more nurse practitioners employed at the hospital. They are qualified to treat more medical conditions without a doctor’s supervision than regular nurses.
Dr Lyons admitted the hospital may still struggle to recruit these highly-skilled nurses.
He added: “If we have got a larger pool of people to call on, it will make it easier to ensure we can provide safe, effective care.”
Weston’s hospital has also launched a formal partnership with University Hospitals Bristol NHS Foundation Trust (UHB) – which runs 10 hospitals including Bristol Royal Infirmary and Bristol Royal Hospital For Children.
Consultants and specialist doctors could work on rotation, meaning they will complete shifts across both trusts.
How will it affect the ambulance service?
South Western Ambulance Service (SWAS) has been working with the hospital on its ideas.
Dr Haggerty said: “The ambulance service is very good at monitoring activity and demand and ensuring they are where they need to be.”
He said SWAS is already used to working with the hospital to transfer patients to Bristol and Taunton while ensuring enough resources remain in North Somerset but said it is likely more resources will be put in place.
How can I have my say?
The hospital and the CCG both want people to give their feedback on the proposals.
People can visit www.northsomersetccg.nhs.uk/wgh-engagement to fill in an online survey, email their views to email@example.com, post their views to North Somerset CCG, Castlewood, Clevedon, BS21 6FW or call 01275 546702.