Gloucestershire Hospitals have confirmed their intention to reinstate Cheltenham A&E to pre-COVID-19 arrangements (24/7 A&E – nurse led 8pm to 8am) no later than 1 July in response to the continued reduction in community transmission and falling hospital admissions.

The NHS presented their plans for a three month extension to a range of temporary service changes introduced in response to the pandemic at the County’s Health Overview and Scrutiny Committee on Tuesday 2 March 2021, as part of continued planning to ensure the safety of patients and staff.

Additionally, in response to the continued reduction in COVID hospital admissions, the Aveta Birth Centre at Cheltenham General Hospital will re-open next week. The centre was converted to a temporary surgical ward during the peak of the third wave to enable urgent cancer surgery to be continued.

Tewkesbury Minor Injury and Illness Unit (MIIU) will also reopen from April.

Clinical Chair of NHS Gloucestershire Clinical Commissioning Group, Dr Andy Seymour said:

“The COVID-19 pandemic has presented huge challenges to the NHS and local hospitals and these temporary emergency changes have played a crucial part in supporting provision of vital health services during these unprecedented times and keeping patients as safe as possible.

Despite the success of the on-going vaccination programme in Gloucestershire and the start of what we hope is a pattern of reduced COVID-19 related hospital admissions, we are not out of the woods by any means and the NHS still faces significant pressure.

We believe that this three month extension to a number of the temporary service changes is a pragmatic and proportionate step.”

Professor Mark Pietroni, Director of Safety and Medical Director at Gloucestershire Hospitals NHS Foundation Trust said:

“We know how well regarded the A&E service in Cheltenham is in the east of the county so this announcement will come as welcomed news.

Whilst we all hope that we have seen the back of the worst of the pandemic, we have to remain cautious particularly over the coming months.

In line with the Government’s own approach, plans will be guided by the evidence that changes are safe based on the rates of transmission (including any new variants of concern), hospital admissions rates and the continued success of the vaccination programme.

We know that the service changes which we implemented during the pandemic have reduced transmission among staff and patients as well as enabling us to provide planned care and cancer diagnosis and treatment, especially to those patients who are most vulnerable.

This has been demonstrated in our recent 62-day cancer performance standards where we have been one of the best performers in the country in seeing patients referred to us by their GP. Importantly these measures have also helped maintain public confidence in our hospitals.”

Dr Amjad Uppal, Medical Director at Gloucestershire Health and Care NHS Foundation Trust, said:

“As a county we have responded remarkably to the COVID-19 pandemic, both across the NHS and alongside partner organisations as a One Gloucestershire community.

We are now beginning to see real progress being made, but we cannot risk going backwards and increasing the rate of infection. These changes have worked so far and we think another few months will support us as health services look to recover from the pandemic. A cautious and well planned recovery is what I’m sure we all want to see.”

Under the temporary service changes, the following service provisions will be extended:

  • An extension of a further three months of the reconfiguration of Emergency General Surgery to Gloucestershire Royal Hospital (GRH) from Cheltenham General Hospital (CGH).

Under the plans, there will also be a further three month extension to a series of temporary service changes across the GRH and CGH sites:

  • CGH Emergency Department operating as a Minor Injury and Illness Unit, 7-days a week, 8am-8pm
  • All 999 and undifferentiated (uncertain diagnosis) GP referrals centralised at GRH, including centralisation of the Acute Medical Take (a consequence of which, given the clinical nature of COVID-19, has resulted in more acute respiratory care moving to GRH since June). It should be noted that a significant number of patients whose hospital care starts with assessment or admission at GRH then transfer to inpatient beds at CGH
  • Acute Stroke Unit (ASU) moved to CGH (Hyper Acute Stroke Unit – (HASU) remains at GRH). This change is complemented by the reallocation of beds at the Vale hospital, Dursley to support additional capacity in stroke rehabilitation care
  • Emergency and elective (planned) Vascular move to GRH (although as part of our winter plan more elective vascular activity will be delivered from CGH)
  • Emergency Urology pathway to GRH, planned pathways remain at CGH.

The countywide plans also include the following measures at community sites:

  • A further three month extension to the temporary reallocation of 6 general rehabilitation beds at the Vale hospital to provide additional capacity for stroke rehabilitation in the county
  • The continued temporary closure of the Dilke Memorial Hospital Minor Injury and Illness Unit, which was closed in March 2020 and will remain closed until the end of June 2021
  • The continued temporary closure of the Vale Community Hospital Minor Injury and Illness Unit, which was closed in December 2020 and will remain closed until the end of June 2021
  • The reopening of Tewkesbury Minor Injury and Illness Unit from 1 April 2021, with its usual opening hours of 8am to 8pm daily
  • The retention of the current opening hours at Lydney, Cirencester, Stroud and North Cotswolds Minor Injury and Illness Units (8am until 8pm). To assist with social distancing, telephone triage is becoming more common in MIIUs with bookable appointments available via the 111 phone service. Walk in treatment is still available, but demand has decreased during the COVID-19 pandemic and will be continually monitored.

The three month extensions will take effect from the end of March 2021.