Update on temporary overnight closure of A&E at Weston

On Tuesday 3 July 2018, the Board of Weston Area Health NHS Trust conducted its standard comprehensive monthly review of the impact and management of the temporary overnight closure of A&E. The A&E at Weston General Hospital is open as normal between 8am – 10pm, which is when the majority (80%) of our patients have always used it.

The temporary overnight closure of Weston’s A&E department which started on 4 July 2017, remains in place as it cannot reopen without safe and sustainable staffing levels in place throughout the night. We have worked hard to recruit the numbers of permanent doctors needed to safely staff A&E during the night and have made progress. There are now currently 6.7 out of 9 middle grade posts filled and 4.5 substantive consultant posts out of 8 filled.   We acknowledge, however, that recruiting to an area of medicine where there is a national shortage of staff remains an ongoing challenge and continues to be difficult to achieve, despite our ongoing efforts.

Patient safety remains our priority and we can confirm that the local NHS continues to manage well during the temporary overnight closure. The Trust Board and Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group Governing Body remain confident that plans to ensure patients needing emergency treatment during the night are treated safely at an alternative neighbouring A&E department are continuing to work well and patients are receiving safe care.

The number of people affected by the temporary overnight closure continue to remain in line with expectations:

• around 3-4  people per night have attended other A&E departments themselves,
• around 8-9 people per night have been taken by ambulance to other A&E departments
• around 5-6 patients per night have been admitted to either the Bristol Royal Infirmary, Southmead Hospital in Bristol or Musgrove Park Hospital in Taunton.

We would like to thank the many healthcare staff at Weston General Hospital and partner organisations for their ongoing commitment and hard work to deliver safe care to all patients during this time.

Patients needing urgent but not emergency care can continue to access the most appropriate care for them from out of hours community healthcare providers and the out-of-hours GP service by ringing 111.  Anyone with an immediate life-threatening condition should call 999, as they would now.

Direct admissions pathways in place

The Trust has changed how it works so that some patients can now be admitted directly to a ward at Weston General Hospital for treatment when the A&E department is closed overnight and no longer need to be taken to Bristol or Taunton. This includes patients being referred directly by their GP for certain medical conditions such as chest infections, and direct access for patients with suspected fractured or broken hips.

Long term future for A&E at Weston General Hospital

The long term future of A&E is being addressed as part of Healthy Weston: joining up services for better care in Weston, Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group’s work programme.  This is looking at alternative ways of offering care locally to patients traditionally seen in A&E, and at the types of urgent and emergency services best provided by Weston or by another hospital nearby that are clinically sustainable and affordable.

The work, which is being led by clinicians, is being informed by the evidence of how the system has coped, and continues to cope during the temporary overnight closure. Detailed proposals for the future of urgent and emergency services will be set out by the CCG over the coming months.

Our joint ambition is to create a sustainable acute hospital which remains at the heart of the community and provides the services it is best placed to do in order to meet the needs of the local people.  We remain committed to ensuring people in North Somerset have access to safe, high quality, sustainable urgent and emergency care services, as close to home as possible.

The overnight closure of Weston General Hospital’s A&E remains a temporary measure. No permanent changes to A&E services will be taken without a full public consultation.

 Julia Ross                                                        James Rimmer

Chief Executive, NHS Bristol,                        Chief Executive, Weston Area Health NHS Trust
North Somerset & South
Gloucestershire CCGs