Service Changes – Emergency Departments

Following yesterday’s meeting of the Governing Body of the Gloucestershire Clinical Commissioning Group, we will be implementing the proposed changes to our Emergency Service with effect from 29th July 2013.

The changes relate to services at Cheltenham General Hospital at night time only (8pm to 8am). Night time is the time when medical staffing levels are the most difficult to deliver and this change will result in bringing specialist emergency doctors together on one site.

As part of the proposal, the Emergency Care Centre (within the current Emergency Department) at Cheltenham General Hospital will be run at night by specially trained nursing staff (Emergency Nurse Practitioners) who are capable of treating the vast majority of walk-in patients.

Doctors (Acute Physicians) will continue to be on site at Cheltenham General Hospital to receive patients who had previously been reviewed by a GP.

However, patients with a critical illness and injury who need treatment from emergency medicine doctors will go to Gloucestershire Royal Hospital at night.

If a patient with a critical illness or injury arrives as a ‘walk-in’ at Cheltenham General Hospital, they will be assessed in the Emergency Care Centre, receive initial treatment and a decision will be made on whether they can be admitted in to hospital in Cheltenham under the care of an Acute Physician (Doctor) or transferred by ambulance to Gloucestershire Royal.

By bringing together specialist emergency medicine staff at Gloucestershire Royal Hospital at night time, we will be able to ensure early senior assessment and decision making, which will benefit the sickest patients and deliver more robust senior medical cover around the clock.

The reason for concentrating resources at Gloucestershire Royal at night rather than Cheltenham General is due to the critical links to other services which are based there, such as children’s services, high risk maternity services and stroke care.

With this change, the vast majority of patients will continue to access services in the way they do now.

Background to the service change

The Trust is facing increasing pressures as nationally, recruitment into emergency medicine remains extremely challenging.

Despite numerous attempts, the Trust has not been able to recruit the number of recommended doctors in emergency medicine (emergency care consultants and middle grade doctors) it needs in order to maintain services the way they are currently set up in the county.

From 29 July this year, with the new intake of junior doctors arriving at our hospitals, there is no guarantee that the Trust will have the number of doctors that they currently have, so have planned the service change responsibly to ensure patient safety.