Spotlight

Minor injuries unit in Minehead to close permanently overnight

The Trust Board of Somerset NHS Foundation Trust has taken the difficult decision to permanently reduce the hours of the Minor Injuries Unit located at Minehead Community Hospital by closing the overnight service.

The trust has taken this decision because of its concerns about the safety of the overnight service and because the service does not meet the overnight urgent care needs of the people in Minehead and the surrounding area. Somerset Clinical Commissioning Group (CCG) is leading work to look at how the local NHS can meet this need in a safe and sustainable way.

The MIU was temporarily closed overnight until 1 April and it will not now reopen overnight. The MIU service that is open during core hours from 8am – 9pm seven days a week, 365 days a year, will remain and there are no plans to change it.

Dr Dan Meron, Chief Medical Officer for Somerset NHS Foundation Trust, said: “We first closed the Minehead MIU temporarily overnight from 1 July 2021 because we had concerns about the safety of the overnight service – and those concerns remain.

“The Trust Board has taken the difficult decision to permanently reduce the hours of the MIU in Minehead because of those concerns and because the overnight service does not meet the needs of the local population. However, we have heard what local people have told us about access to urgent care services overnight and Somerset Clinical Commissioning Group is leading work to look at how the local NHS can meet this need in a safe and sustainable way.”

Dr Iain Chorlton, Associate Clinical Director Urgent and Emergency Care, Somerset Clinical Commissioning Group, said: We have listened to the concerns people have around suitable access to appropriate urgent and emergency care services in the area and appreciate that this announcement may cause concern. It is important that we understand the urgent and emergency needs of the local population, to create services which are both safe and sustainable. We would like to reassure local people that we are working closely with NHS partners across Somerset to understand how best to achieve this ambition."

The MIU in Minehead was the only MIU in Somerset that was open overnight. However, the overnight service was different from the service during core hours from 8am – 9pm seven days a week. During core hours the MIU is well used and provides 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.

Dr Dan Meron said: “The overnight service was different. It saw on average less than one patient (0.9) a night and was staffed by one paramedic and one healthcare assistant. The overnight paramedic primarily acted as a care navigator and did not assess, treat and discharge patients independently. This meant that patients attending the Minehead MIU overnight received appropriate first aid if needed and were advised to either return for a detailed assessment and treatment the following day or were referred to the Emergency Department at Musgrove Park Hospital.”

“This is not an optimal experience for our patients and we are concerned about the safety of this service. It can have serious consequences for patients if treatment for conditions like heart attacks, strokes, major trauma, asthma, sepsis and wounds is delayed.”

While the MIU was temporarily closed overnight, Somerset NHS Foundation Trust undertook to review the overnight service, work with partners and patient and public representatives to look at how we address our 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. As part of this it engaged with local people to understand the impact of the overnight closure on them and any concerns they have.

Dr Dan Meron said: “Many of those we communicated with talked about the travel distance to the nearest Accident and Emergency at Musgrove Park Hospital in Taunton and the difficulty in travelling there. Although the majority of those we spoke to had not used the overnight MIU service, it was often cited as a necessary ‘safety net’ for local people because of the perceived limited availability, access and responses from other health care services including primary care, NHS111 and 999 Ambulance services.”

Somerset NHS Foundation Trust monitored the impact of the overnight closure on other health services in Somerset. It found no discernable impact on overnight attendances at Musgrove Park Hospital’s Emergency Department, and overnight trips to the Emergency Department from Minehead postcodes; no impact on NHS 111 or the out of hours GP service in the Minehead area; and no discernable impact in attendances at Minehead MIU in the hour prior to closure or the first hour of the unit’s opening times while the overnight service has been closed.