Minehead MIU to temporarily close overnight for four months

The Minor Injury Unit (MIU) located at Minehead Community Hospital will temporarily close overnight, from 9pm until 8am, for four months from Thursday 1 July. The service will remain open from 8am – 9pm, seven days a week, 365 days a year.

Dr Matt Hayman, Deputy Medical Director for Somerset NHS Foundation Trust, said: “The MIU in Minehead is one of seven across Somerset and they provide a valuable service in our county treating approximately 105,000 people a year. The Minehead MIU is the only one that is open overnight and we have concerns about the safety of the service which is why we have made the difficult decision to temporarily close the unit overnight for four months.

“We need to take the time to review the service and work with partners and patient and public representatives to look at how we address those safety concerns, quantify and meet the overnight needs of the local area within our available resources, and propose a way forward that is both safe and operationally robust. We will monitor the impact of the overnight closure monthly and report back on our progress to look at options for providing an alternative, safe and operationally robust service.”

During the daytime and evening hours (predominantly from 8am – 9pm) all of the MIUs in Somerset provide a full clinical service led by emergency nurse practitioners and supported by other clinicians such as specialist physiotherapists and paramedic practitioners. Working together they provide a full clinical service. 96% of those who seek treatment at an MIU in Somerset receive all the treatment, support and advice they need on their first visit and do not need to come back or be referred for treatment elsewhere.

The MIU in Minehead is the only one that is open overnight. From 9pm until 8am the service that is offered is different. It is staffed by one paramedic and one healthcare assistant. The overnight paramedic primarily acts as a care navigator, they are not a senior clinical decision maker and therefore unable to assess, treat and discharge patients independently.

This means that patients attending the Minehead MIU overnight receive appropriate first aid if that is needed and are advised to either return for a detailed assessment and treatment the following day or are referred to the Emergency Department at Musgrove Park Hospital. As a result, the majority of patients who attend the Minehead MIU overnight need to return the following day or are referred elsewhere.

While the MIU in Minehead provides a well-used service during the day, it is used much less overnight. The average number of patients seen overnight by a paramedic over the last 3-years is less than one patient a night (0.9) on average.

Dr Hayman said: “While this is not an optimal experience for our patients we are also concerned about the safety of the service. It can have serious consequences for patients if treatment for conditions like heart attacks, strokes, major trauma, asthma, sepsis and wounds is delayed. During the day, if a patient attends an MIU with one of these conditions, the senior clinicians working there are able to initiate a range of treatments before the patient is quickly transferred to an Emergency Department. Overnight at the Minehead MIU this is not the case and there have been three examples in the last three years when patient outcomes were compromised because of a delay in receiving treatment at an Emergency Department.”

The overnight service at the MIU in Minehead is also operationally fragile. Somerset NHS Foundation Trust employs two paramedics to run the service, but, because of the low number of staff, the unit is forced to close overnight at short notice when colleagues are ill or take annual leave, or  leave. It is very difficult to recruit to the overnight paramedic roles, partly because it is difficult for them to maintain their skills and competencies working in a service which sees such a small number of patients.

If you have a minor injury or you're unwell, NHS 111 will make sure you get the right help from the right service. For serious and life-threatening conditions, call 999.