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Letter on future of urgent care in Gloucestershire to Stroud newspapers

Thursday, 18 August 2016 12:59
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Dear Editor,

Let’s be clear: the reduction in opening hours of Stroud Minor Illness & Injuries Unit is a cut in service. It goes against the core NHS principles of universal, comprehensive, easy to access care.  

Already in Stroud we have fought unwise and expensive attempts to privatise our local district hospitals. Other local NHS services have been handed to private companies - non-emergency ambulances to Arriva; hospital pharmacy services to Lloyds. Cheltenham A&E was downgraded to a Minor Injuries Unit overnight. In 2014, Dursley’s Vale Hospital opening hours were reduced.  Susan Field (then Director of Service Transformation) said that cut was partly about “enabling us to keep the MIU service at Stroud General Hospital running 24 hours a day.”[1]  Now Stroud MIIU hours will be cut as well.

Unsurprisingly, Gloucestershire Hospitals NHS Trust has been missing the target to treat 95% of Accident & Emergency (A&E) patients within four hours every month for a year.

What have Gloucestershire Care Services and the Gloucestershire Clinical Commissioning Group done to assess the impact of changes to MIIU opening hours on Out Of Hours and urgent care services in Stroud and Gloucestershire? Local Out of Hours provision is already in turmoil as the NHS trust currently providing the service has said the constraints of their contract mean they cannot continue to do so effectively (with the service having been closed for 560 hours at The Dilke, and 195 hours here in Stroud in a single year).[2]  We need answers.

Of course, services must have sufficient staff to provide safe, high-quality care. Ultimately, attention must be directed to the national context of sustained government attacks on the NHS - including a pay freeze, cuts to training and the scrapping of nurse training bursaries, and the attacks on junior doctors - that are producing financial stress, constant re-organisation, privatisation of services, and demoralised doctors and nurses retiring early, leaving the profession, or emigrating. Nurse's pay, for instance, has fallen by at least 14% in real terms thanks to the government's public sector pay freeze. RCN Chief Executive, Janet Davies, says the current shortage of nurses was “a preventable crisis, caused by years of cuts to student nurse commissions and a lack of long-term workforce planning”.[3]

We fear for the future of local NHS services under the latest round of reorganisation:  Like other areas, Gloucestershire is currently working on a ‘Sustainability and Transformation Plan’ behind closed doors, to deliver its share of a £22bn cut in funding, that will involve “the consolidation of unsustainable services”
[4]. In other words, services will be closed - potentially soon. Nationally, 14 A&Es were closed or downgraded between May 2010 and October 2014.[5]  Last week Grantham A&E in Lincolnshire cut its opening time by 14 hours[6] for three months.

We need to ask, what makes these services ‘unsustainable’? Political decisions, wasting billions on a needless expensive system of markets and competition to give the private sector a toehold, and a destructive attack on the NHS’s most precious asset – it’s workers.

How can Neil Carmichael say he supports Stroud Hospital, whilst supporting all this?

We encourage anyone who can, to visit the Trust’s Information bus from 10-11.30am on Monday 22nd August on King St – and to sign the Labour Party’s online petition to “Ensure 24 hour, urgent care is provided at the Minor Injuries Unit at Stroud Hospital”, which can be found at goo.gl/4G4ihL.

Yours sincerely,

Stroud Against the Cuts



[2] SWAST said: “within the current contractual constraints, the trust does not have the resources to improve the service to a level that is satisfactory” - Patients faced with closures of out-of-hours GP services”, Gloucestershire Live

[4]Strengthening financial performance and accountability in 2016/17”, NHS Improvement, 21st July 2016 (page 10 of pdf linked on page)

[5] Dozens of maternity and A&E units shut”, The Telegraph, 26 October 2014. In June, two community hospitals in Derbyshire were earmarked for closure. Chorley Hospital in Lancashire was ‘temporarily’ downgraded in April, but recently announced it will not be reopening as an A&E as planned in August (“Chorley Hospital A&E unit to remain closed over doctor shortage”, BBC New Lancashire, 28th July 2016)

[6]Grantham A&E opening times slashed by more than 14 hours”, Lincolnshire Echo, 11th August 2016