Joint statement from: One Gloucestershire NHS partners – NHS Gloucestershire Clinical Commissioning Group, Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire Health and Care NHS Foundation Trust.

The local NHS has today updated the county’s Health Overview and Scrutiny Committee (HOSC) on plans relating to the existing temporary service changes with the aim of providing the very best care to local patients.

The changes were originally put in place in response to the unprecedented challenges of the COVID-19 pandemic, with some recent changes also linked to winter pressures and staffing considerations.

The majority of COVID-19 temporary changes came to an end in August 2021, with the exception of a small number of services; where the NHS felt there was potential to provide continuing benefits to patient care and to help manage current challenges (see below).

Stroke services

The NHS is planning to extend the acute stroke service temporary changes.

This includes keeping the *Hyper Acute Stroke Unit (HASU) at Cheltenham General Hospital. The change was originally made in early February 2022 and will be extended to March 2023.

The *Acute Stroke Unit (ASU) will also remain at Cheltenham General Hospital (Woodmancote ward) as a temporary change until March 2023. This was originally put in place in August 2020 as part of the local NHS’ response to the first wave of COVID-19.

This change has coincided with improvements in the Trust’s rating for stroke services as part of a national assessment programme (a B rating compared to the previous C rating).

Feedback from staff and patients is that Woodmancote ward at CGH is also much better suited to support acute stroke care and rehabilitation, in terms of both lay out and environment.

This extension of the temporary arrangements will give the NHS more time to monitor the full impact of the changes for patient care and carry out a full evaluation to develop potential solutions for the long-term development of stroke care in Gloucestershire.

In respect of the Community Stroke Rehabilitation bed numbers at Vale Community Hospital, the intention remains to reverse the temporary emergency change and return the Stroke Rehabilitation bed numbers to 14 (from 20 under the temporary change); to be completed at a time when this can be safely achieved.

This will require a time limited extension of the temporary service change.

High care Respiratory services

The NHS plans to keep high care Respiratory services at Gloucestershire Royal Hospital as a temporary service change until March 2023, to ensure they are responsive to any further ‘waves’ of COVID-19.

Due to the specialist staffing, equipment and infection control measures already installed at GRH, there is no realistic alternative location for COVID high care Respiratory services in the short to medium term.

Again, this will give the local NHS more time to carry out further analysis of the impact of the changes and consider potential changes to this service over the longer term.

Medical Day Unit (MDU)

Under the plans confirmed today, the MDU will remain at Cheltenham General Hospital.

The Medical Day Unit (MDU) is a nurse led service open 8am to 4pm, Monday to Saturday and provides a range of planned day case procedures (infusions, biopsies and treatments) for medical and surgical patients.

Given the wider positive benefits already identified by locating the MDU at CGH, both for patients who need to access services at the MDU and for patients accessing Emergency Department services at GRH, the NHS will:

  • Keep the Medical Day Unit at CGH as a temporary service change to March 2023 to minimise disruption to patients and staff whilst at the same time;
  • Work through the evidence to inform development of longer-term options for the MDU as part of the Fit for the Future programme.

Gloucestershire Health and Care NHS Foundation Trust – update on the Community Minor Injury and Illness Units and the MIIU at Dilke Memorial Hospital

Due to the restrictive space and environment at Dilke Memorial Hospital, the community MIIU will remain closed for a further period whilst healthcare social distancing measures remain in place.

Should these measures be relaxed, the NHS will review these timeframes in line with future guidance.

Opening hours at the other Units in the county will remain as they are now for the foreseeable future as the local NHS recovers from the pandemic, with the exception of Stroud MIIU which will revert to 8am to 8pm in May 2022, following completion of the refurbishment programme.

The local NHS has also highlighted the benefits brought by the recent introduction of a dedicated MIIU triage telephone service for the public which can provide advice and book appointments at the county’s MIIUs. People can also use the NHS 111 telephone service. These numbers are highlighted on local websites, Apps and campaign materials.

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

“We fully support these plans which represent a pragmatic and carefully considered response at this challenging time for local services.

As with all the temporary changes implemented over the last two years, service resilience, quality of care and health outcomes have been the guiding principles behind them.”

Medical Director at Gloucestershire Hospitals NHS Foundation Trust, Prof. Mark Pietroni said:

“Our challenge is to ensure that we balance the need to deliver the very best care in the short term as we emerge from the pandemic, whilst at the same time work with local people and communities to consider where more permanent changes could add real benefits over the longer term.

In terms of the temporary changes, we are not yet out of the woods in terms of the pandemic and other pressures and we feel they are both necessary and proportionate at this time.”

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

“There has been a collective will across One Gloucestershire NHS partners to work together to make the right decisions at the right time when it comes to temporary service changes. We continue to consider a range of factors including safety and staffing, health outcomes and access to services.”

Additional Information

Acute Stroke Services

*The majority of stroke patients are admitted directly to the Hyper Acute Stroke Unit (HASU) for up to 3 days. It provides highly specialist care to patients after suffering a suspected stroke or Transient Ischaemic Attack (mini stroke).

After this time, many patients who require on-going inpatient hospital care are transferred to the Acute Stroke Unit (ASU), which is currently on Woodmancote ward at the Cheltenham General Hospital site.

Further information can be found in the HOSC briefing papers (8 March) here.