The temporary change, agreed for a period of six months by Hywel Dda University Health Board today will not affect the Acute Medical Assessment Unit. Very unwell medical patients will still be taken to Prince Philip Hospital, 24-hours a day, for assessment and treatment as they are now.
Adults and children with a minor injury will still be able to attend the Minor Injury Unit at the hospital between 8am and 8pm every day.
Overnight, from 8pm to 8am patients in the Llanelli area with minor injuries that cannot wait for treatment the following day, should use the NHS 111 Wales symptom checker available from 111.wales.nhs.uk; or, call NHS 111 for help, advice and signposting if urgent but not an emergency, or in a life-threatening emergency, call 999.
The temporary adjustment to the opening hours of the MIU is due to patient safety concerns, raised both by Healthcare Inspectorate Wales, seeking assurances following an inspection in June of last year, and from staff working at the unit. This is due to the frequent inability to find suitably qualified doctors to cover the GP led service, particularly in evening and overnight sessions.
This has led to the service being led instead by Emergency Nurse Practitioners who, whilst extremely skilled at dealing with minor injuries, are not able to provide suitable care to patients who require a GP.
Additionally, some patients attending the unit have more complex needs than can be managed by a GP, as they are considered major. This means they need to be stabilised and transferred onwards.
The urgent need to address this problem has been endorsed by medical staff at the hospital with growing concerns about the safety of the service and the patients it treats.
Prince Philip Hospital’s Minor Injury Unit Clinical Lead Jon Morris said:
“To ensure the safety and confidence of people attending the minor injury unit, we need to able to provide a fit-for-purpose service during all opening hours.
“The inability to consistently cover the rota, with suitably qualified doctors, particularly during the evenings and overnight, carries risk to our patients and our staff, with staff absences then compounding the problem.
“We considered whether we could move to an emergency nurse-led model overnight, but we have found that some presentations at the unit are more serious in nature than can be dealt with in a unit of this type. Therefore, we ruled out this option in the short term.
“Whilst this temporary change is in place, it is important to stress that Prince Philip Hospital continues to provide acute medical care for the local population.
“The Acute Medical Assessment Unit provides rapid investigations and treatments to unwell patients such as those who have potentially had a stroke, or with chronic diseases, or infections.
“These cases typically come into the unit via ambulance or via GP referral. We will work closely with GPs and the Welsh Ambulance Services Trust to ensure these patients continue to be seen in Prince Philip Hospital, as their closest hospital, during this temporary change to the Minor Injury Unit.”
The health board will now run an information and engagement campaign in the community and will seek to establish a stakeholder group with representatives of the community to build the future options for the service. This will both inform people about what care and treatment is provided from the Minor Injury Unit, what the temporary opening hours are, and seek to consider what the future of the service could look like.
After hearing the changes Nia Griffith MP for Llanelli said:
“I am very concerned at the proposals to close the Minor Injuries Unit (MIU) at Prince Philip Hospital overnight and have said so bluntly to the Chair and CEO of the Hywel Dda Board.
“Today I am attending the Board’s meeting in Carmarthen and I have asked the Board to explain why they are proposing to implement the closure on 1st November before starting a consultation on the future staffing of the MIU.
“I am asking them to keep the MIU open whilst they do much more to develop a sustainable staffing model to keep the MIU permanently open 24/7.”
