Secretary of State asked to intervene over controversial plans for minor injuries care in South Glos


The rally in Kingswood Park before today's meeting

The rally in Kingswood Park before today’s meeting

Controversial new plans for minor injuries care provision in South Gloucestershire were today referred to the Health Secretary Jeremy Hunt.

Members of South Gloucestershire’s Public Health & Health Scrutiny Committee were unanimous in saying that the local Clinical Commissioning Group’s plans would result in “inadequate provision for dealing with minor injuries”.

Instead of opening the long-awaited minor injuries unit at Cossham Hospital, the CCG will pilot a minor injuries service in GP surgeries for at least three to six months, but the group’s inability to answer key questions – such as at which practices – has sparked anger and concern.

During a long meeting today, punctuated by angry calls from scores of Cossham campaigners in the public gallery, the CCG was taken to task by one member of the health watchdog group after another.

What did emerge is that the pilot will cost around £150,000 to set up and will run in four or five (as yet) un-named surgeries, starting in the New Year. Extra nursing staff will be recruited in December, and the CCG is in talks with BrisDoc, which provides out-of-hours service from a base at Cossham, about providing the minor injuries service outside of GP surgery hours.

Cossham campaigners in the public gallery today

Cossham campaigners in the public gallery today

A final decision will be taken on whether to open an MIU at Cossham once the alternative pilot scheme has been tested.

Lead campaigner Reg Bennett told the meeting: “Our GPs are hard pushed to give us appointments now, surgeries are not coping and we are not convinced that there will be enough new staff in surgeries to take on the extra workload.”

He added: “The CCG are still saying that they have not ruled out a minor injuries unit at Cossham. What they are really saying is that they haven’t ruled it in. This is another smack in the face for the people of Kingswood and district, being told we will have to wait another year or more and that is not acceptable.”

Both Kingswood MP Chris Skidmore and Jo McCarron, Labour’s Parliamentary candidate for the constituency, also spoke in support of the campaigners and attended a rally in Kingswood Park before the meeting.

Mr Skidmore told the committee that people deserved to know as soon as possible about the details of the pilot scheme and that as there was room set aside for the unit at Cossham, it was a “no brainer” to at least trial it there.

Jo McCarron told the meeting that last week she and a group of campaigners had met CCG representatives last week and there was frustration that the plans for a pilot minor injuries service were still so vague.

She said: “I’m afraid that there were gaping holes in the answers we were given – some of the questions weren’t answered at all, others were not answered fully, and some of the answers we did get didn’t fill us with confidence.

“Residents’ overwhelming question when they left that meeting was how the CCG could be so sure that their plans will provide a better service when those plans still seems so vague.”

Of the lack of answers from health chiefs, veteran Labour councillor Terry Walker (Kings Chase) told today’s meeting: “We wonder about the competence of the Commissioning Group.”

Two Bristol city councillors – Lesley Alexander, deputy leader of the Conservative group, who represents Frome Vale, and Labour member Jenny Smith (Southmead) were at today’s meeting.

Cllr Alexander said that if the unit at Cossham was opened, it would only need a fraction of the number of staff to run it, compared to trialling it in GP surgeries. She also questioned the wisdom of increasing services in GP surgeries which are already under pressure.

And she and others were concerned about minor services provision for patients living in Bristol. Cossham is mainly used by South Glos residents but in fact it lies just over the boundary in Bristol.

Dr Ann Sephton, deputy clinical chair of the CCG, said: “Bristol CCG are aware of what we are doing. They have a different system but it is up to them to present their solutions.”

There were no representatives from Bristol CCG at today’s meeting.

Health Secretary Jeremy Hunt

Health Secretary Jeremy Hunt

As well as unanimously agreeing to refer the matter to the Secretary of State, the committee called on the CCG to reflect on the concerns raised and consider changing its plans before reporting back to the next scrutiny meeting on 21st January.

After the meeting Dr Jonathan Hayes, chairman of South Glos CCG, said: “We recognise the strength of feeling at today’s Public Health & Health Scrutiny Committee meeting and we will reflect on what we have heard.

“We are disappointed – but not surprised – with the decision at the meeting to refer this matter…we will cooperate fully with the process.

“We have been looking at the best way to provide urgent care services in South Gloucestershire, providing services for the whole population, closer to where they live. Patients and the public have told us they want better access to their GP and they want local access to minor injuries services.

“In common with other parts of the country, we are therefore looking at whether enhancing the provision and capacity for urgent care, including minor injuries services in GP surgeries, could fulfil these requirements.

“We are planning to pilot a scheme which will increase the availability of same day appointments at GP surgeries, including for minor injuries. We will then engage with patients and the public to gather feedback about how these services have worked and we will assess the clinical and cost effectiveness of this approach.

“If this approach works well, the services provided by a minor injuries unit would be available for patients through their GP surgery. Therefore the decision on whether to commission an MIU at Cossham will be made in 2015 once we have tested this alternative approach.

Dr Jonathan Hayes

Dr Jonathan Hayes

“We don’t anticipate that today’s decision will affect our plans to pilot minor injuries services in some local GP surgeries – as reflected by Public Health and Health Scrutiny Committee today.

“We recognise the frustration about reaching a decision on a minor injuries unit at Cossham. However, we have a duty to the population of the whole of South Gloucestershire to provide services that are equitable to all, evidence based, of high quality and which make the most effective use of the resources available.”

The wording of the motion unanimously supported by the scrutiny committee today:

“That the plans agreed on 22 October 2014 by the South Gloucestershire CCG for improving local urgent and emergency care services are a negative substantial variation of service as the plans agreed are not in the interests of the health service in our area and will provide inadequate provision for dealing with minor injuries.

“That notice hereby be given of the committee’s in principle decision to refer the matter to the Secretary of State for Heath. However, in the meantime the South Glos CCG be provided with an opportunity to reflect on the committee’s concerns and consider whether to amend/ameliorate its plans before it reports back to the next meeting of the committee on 21 January 2015.”