Agenda item

(Dr A Russell, Chairman of the League of Friends of Edenbridge and District War Memorial Hospital, and Julian Ross, Director of Public Engagement and Sharon Jones, Director of Community Services, West Kent PCT, were in attendance for this item)

(1)       A petition from the League of Friends of Edenbridge and District War Memorial Hospital regarding the Minor Injuries Unit at the hospital (attached as Appendix 1 to these Minutes) was tabled, along with information supplied by West Kent PCT (attached as Appendix 2). The Chairman welcomed Dr Andrew Russell to the meeting and invited him to address the Committee.  Dr Russell made the following points:-

·              The Minor Injuries Unit at Edenbridge had been a nurse-led unit for the past nine years and had worked satisfactorily.

·              On 24 May the West Kent PCT at their Board meeting had decided, on safety grounds, that the unit should be renamed a “Treatment Clinic” with immediate effect.

·              A consultation period on the future of the Clinic was due to run from 2 July for three months and he expressed concern that the name change had occurred one month before the official consultation period had started.

·              The PCT had given the reason for the renaming as the low throughput of patients, which did not give staff adequate exposure to all types of case for the safety of patients.

·              He made the point that there had never been any question of poor safety; the unit had a 100% safety record, with no complaints.

·              He highlighted the important support given to the unit by Dr Julian Webb, the A&E consultant who covered this unit and others in the area. He audited the unit’s work regularly and visited the unit weekly to discuss the work with nurses; in the view of Dr Webb, the unit was safe.

·              The nurses at the unit rotated with colleagues at the Sevenoaks Hospital Minor Injuries Unit and, therefore, saw the same case-mix.

(2)       In conclusion, Dr Russell stated that he believed that the name change at this time, before a consultation on possible closure of the Unit, would lead people to believe that the Minor Injuries Unit had already ceased to exist.  This would prejudice the consultation that was about to take place and, therefore, was unfair.  He suggested that the question of the final closure of the Unit might be a subject for further consideration by the NHS Overview and Scrutiny Committee.

(3)       Ms J Ross was invited to speak and stated how disappointed she was that the good news in relation to community hospitals had been overshadowed by more minor issues.  She made the following points in relation to the Minor Injuries Unit at Edenbridge:-

·              The PCT had taken legal advice and they had the right to change the name of the unit.

·              Out of the 11 patients a day that were seen in the unit, 50% were sent by GPs for re-dressings or Electrocardiograms (ECGs). ECGs had actually already been paid for in the General Medical Services contract and did not need to be provided in a Minor Injuries Unit.

·              The issue was not the safety of the current service. Rather, there was a risk in retaining the name “Minor Injuries Unit” that, if a patient were to present with a serious injury, the service would not be able to cope, given that it was not used to such cases.  The name “Treatment Clinic” was a more accurate reflection of the service actually being provided.

·              The PCT would be going out to consultation on the future of the renamed Treatment Clinic.

·              The PCT had data from 2004 and the numbers using the unit had not changed. Although it had the support of the local community, it was not a well-used facility.

·              It should be noted that the outcome of the review of community hospitals was: to keep all six hospitals; to re-open those beds that had been closed in recent years; and to bid for national capital funding.  This new investment would include modernising the x-ray facilities at Edenbridge.

·              Another contentious issue that had arisen was the matter of possibly transferring the Renal Dialysis Unit to Tonbridge Cottage Hospital. This would be going out to consultation. On the whole, the outcome of the community hospitals review was very good news – and the controversy around the small changes at Edenbridge and Tonbridge should not be allowed to obscure this.

(4)       Ms S Jones stated that she had a clinical background and a passion for community hospitals.  She corrected the statement made by Dr Russell regarding Dr Webb, the A&E consultant. Dr Webb was not clinically in charge of the Minor Injuries Unit at Edenbridge: he only audited clinical notes, not the actual work of the unit.  Only 9–11 patients a day used the unit, and 50% of them attended to have their dressings changed; this was not a proper workload for qualified nurses. There was not the throughput of patients at Edenbridge to consolidate training and there were problems getting nurses to work there. She said, from a personal point of view, that if she were a Nurse Practitioner she would not stay in that unit.  There was actually only one member of staff who rotated between Edenbridge and Sevenoaks Hospital.  She stated that there was no one definition of a Minor injuries Unit. When the Healthcare Commission and PriceWaterhouseCooper had audited emergency units, they had broken them down into three types. Type 1 was a full A&E unit; Type 2 saw at least 20,000 patients a year; and Type 3 saw at least 10,000 patients a year.  Edenbridge was seeing just 3,000 patients a year and, as such, did not even count as a Type 3 facility.  In changing the name of the unit at Edenbridge, the PCT was merely calling it what it really was – which was a Treatment Clinic.

(5)       The Chairman stated that he welcomed the result of the community hospitals review overall.  Members made a number of points in response to what they had heard and Ms Ross responded.

(6)       RESOLVED that:-

(i)      the presentations and discussions be noted;

(ii)     the next meeting of the NHS Overview and Scrutiny Committee would consider West Kent PCT’s community hospitals review in its totality.