Weston General Hospital could be set for major changes to its accident and emergency (A&E) department, operating theatres and high-dependency care. This week the Mercury caught up with North Somerset Clinical Commissioning Group’s (CCG’s) chief clinical officer Dr Mary Backhouse and the hospital’s medical director Dr Nick Lyons to find out more about the idea to reduce emergency surgery…
Why is change needed?
Like much of the NHS, Weston-super-Mare’s hospital is struggling to meet demand.
So people living in North Somerset are being asked to share their views on proposed changes to the hospital, which include reducing its A&E services at night and transferring emergency patients to other hospitals, offering more pre-planned and non-complex surgeries, scaling back emergency surgeries and introducing more high-dependency beds.
The hospital is run by Weston Area Health NHS Trust, which is the smallest trust in the country. As a result it struggles to recruit healthcare professionals in some areas and has been unable to fully-fund its services with the money it has available.
So the CCG is looking at what changes are needed to secure the hospital’s future for decades to come.
Why reduce emergency surgery?
Emergency surgery requires large teams of staff to be ready to head into theatre at any moment and some emergency operations often require intense care when a patient comes out of surgery.
The hospital wants to increase the amount of non-complex, pre-planned surgery it does to make better use of resources, while reducing the number of emergency operations carried out within its four operating theatres, which were completely refurbished in 2015. Dr Lyons told the Mercury: “The question we are asking ourselves is ‘have we got the correct mix of what we do and don’t offer at Weston right?’ Particularly with what we do at night and at weekends.”
Some people who need emergency surgery are already taken straight to other hospitals – anyone who has suffered major trauma in a car accident, or someone who needs an operation which requires multiple surgeons, will already be sent to Bristol.
Dr Lyons told the Mercury more emergency surgery could be taken out of Weston to other hospitals where there are more surgeons, the hospitals have more capacity and surgeons already conduct emergency surgery on a day-to-day basis. He added: “We want to get the balance right between the need to go to the very best surgeon, who sees a lot of patients and carries out the surgery a lot, and the need to have it done closer to home.”
How will it benefit the hospital?
Dr Lyons said the hospital does not struggle to recruit good surgeons, but told the Mercury a reduction in emergency surgery will help manage staffing levels. He said: “If we do go down this road, it will mean less staff on-call at night. What we don’t want is staff on-call across all of the different hospitals, getting tired at night when actually it would be better for them to wake up fresh in the morning to carry out planned surgeries.”
Dr Backhouse added: “This is partly about medical staffing and it is about making sure we have got patients with the right specialists for their treatment.
“It is also about making sure we have got the right balance of services in the hospital.”
Under another one of the proposed ideas, Weston’s hospital could welcome more pre-planned surgery and Dr Lyons said: “It would mean we don’t need to reserve space in theatres every morning for surgeries which might have come in overnight and run over from the night before.
“We could book our theatre space more efficiently.”
How will it affect patients?
This idea could mean more patients must go to hospitals in Bristol and Taunton for emergency surgery, but Dr Backhouse said the full impact of the changes is not yet known. She said: “When looking at Weston’s future this is a theme which came up again and again in discussions with doctors from Weston and Bristol.
“We don’t yet know the detail, we don’t know how far it will go, but we do know we need to listen to the public and to the professionals and look at the feedback we get.
“My ideal is to have as few people travelling outside of North Somerset as possible but we also need to make sure people are getting the best care, in the best place.”
Dr Lyons said he believes some non-complex emergency operations will still be carried out in Weston.
He added: “If someone came in to Weston with a broken hip then they would be treated here. That’s a surgery we do a lot of and there’s not any question we would change that. If you needed an operation to remove your appendix, that is the type of emergency surgery you would have done in Weston – day or night – as it is a very simple surgery.”
But he said more complicated operations which might need more than one surgeon and require more intensive post-operative care will likely be sent to other hospitals under these plans.
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 wgh.engagement@nhs.net, post their views to North Somerset CCG, Castlewood, Clevedon, BS21 6FW or call 01275 546702.
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