Q&A: Weston General Hospital's board quizzed on A&E closure
PUBLISHED: 10:02 05 July 2017 | UPDATED: 10:29 05 July 2017
Weston General Hospital's A&E department has been temporarily closed overnight, from 10pm to 8am each day, on safety grounds. The hospital's board had a meeting to discuss the closure. Here are some questions on the closure answered…
Why has the A&E closed?
A report from the Care Quality Commission (CQC) found the hospital’s emergency and urgent care to be inadequate, and the hospital was issued a formal warning and ordered to overhaul its emergency services.
The hospital struggles to recruit specialist doctors for its emergency department and so relies heavily on expensive locum doctors and is at risk of not being able to safely staff its A&E.
The department should have 23 doctors in full-time posts, but the hospital employs just 13.58 full-time equivalent doctors for its A&E. Looking at just consultants, 50 per cent of the department’s consultant posts are empty. For middle-grade doctors, 71 per cent of posts are not filled.
The hospital’s chief executive James Rimmer said: “This is a long-standing issue. I got asked in my first hour in this hospital whether the A&E department would close, and I have been battling to keep that service.
“The CQC has come in and said other areas have improved, but the emergency department has got worse.
“We have had to take this unpalatable step, it is unpalatable the public and unpalatable for the board.”
How many people will the overnight closure affect?
Around 27 people attend the A&E overnight. Of these, 12 arrive by ambulance. Six of those people are then already transferred to other hospitals for more specialist care and treatment. Now patients will be taken directly from their pick-up point to a different hospital, in Bristol or Taunton, given telephone advice or treated by out-of-hours GP services.
When will A&E re-open?
It is not yet known when the service will re-open, or what type of A&E service it will be when it re-opens. The hospital’s board has said it is committed to a 24-hour emergency service, but its medical director Peter Collins admitted he does not know an end date for this temporary closure.
Mr Collins added: “What I am committed to, and what I understand, is the process of how we are going to get back to providing services overnight.
“What I am working out is what the needs of our population are and what we can provide in terms of the man power we have and in terms of working out how we can provide a safe service for as many people as possible.”
How is the A&E working now?
The A&E is still operating in the same way throughout the day, but its doors will close at 10pm.
Doctors will be working until 2am, to deal with any patients who may have come in during its opening hours. Nurses will be on hand throughout the night as a contingency for any patients who, for whatever reason, are unable to be sent elsewhere.
The A&E department will re-open at 8am each day.
Is this a money-saving exercise?
No. The hospital’s director of finance Steve Simmons was asked if the temporary closure would save the hospital cash at the board meeting but he said it is ‘not good news financially’. The hospital is not closing any beds and it will still have nursing staff working throughout the night.
The hospital could also lose out on some funding, as fewer patients will be using its services, although Mr Simmons said the final cost of the closure is ‘unknown’ but it makes ‘financial sense’ to resume running a 24-hour service as soon as possible.
What do I do in an emergency when A&E is closed?
People are being told to dial 999 or 111 for medical advice.
There will be phones outside of the A&E department which anyone who arrives at A&E when it is closed can use to call 999 or 111.
The hospital has increased the size of its security team and people will be monitoring CCTV outside of the A&E department each night, to ensure anyone who arrives at A&E while it is shut, but needs attention, can be identified. The hospital’s resuscitation team, who deal with crash calls on its wards, are able to be called should they be required.
If I’m admitted in Bristol or Taunton, will I be sent back to Weston?
Anyone who is expected to stay in hospital for less than 48 hours will be treated only in the hospital they are initially taken to via ambulance. If a patient’s treatment is expected to last for more than 48 hours, plans are in place to transfer them back to Weston General Hospital as soon as it is clinically safe to do so. The hospital is working with a private ambulance company and ensuring beds are available for this to happen.
Can the ambulance service cope?
The ambulance service is one of 10 organisations which have taken part in contingency planning for the A&E closure. Additional ambulances will be put on overnight in Weston to cope with any additional demand
What about the influx of holiday-makers during the summer months?
The hospital’s director of operations Phil Warmsley said tourism’s impact on the A&E service is ‘not as significant as you would expect’. He said many A&Es around the country see a drop in the number of patients during the summer months, but in Weston the number stays stable or rises by one or two patients a day.
What about people Weston’s night-time economy, and how busy it gets on Friday and Saturday nights?
Again, Mr Warmsley said there is not a significant rise in the number of people in A&E on these nights.
He said: “It doesn’t appear to be significantly different on a Friday or a Saturday night.”
What happens next for the A&E?
North Somerset Clinical Commissioning Group was already looking at an idea to scale back the A&E between 10pm and 8am. It had asked for public opinion on a plan which could mean it deals with only non-emergency cases at night, while the most unwell patients are sent directly to Bristol or Taunton via ambulance.