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Cheltenham A&E future uncertain as trial reduction in service begins

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22 Oct 2017


After several days’ rumour and conjecture about possible changes to the Accident and Emergency Unit at Cheltenham General Hospital, the NHS has issued notification that from the morning of 19 October all patients with bone injuries, or even suspected bone injuries, must be sent to the A&E Unit at Gloucester Royal Hospital. Cheltenham will run a twenty-four hour minor injuries unit, but its A&E facilities, open from 8am to 8pm only, can no longer offer a comprehensive emergency service.

Although this change has been introduced for a ‘trial period’ of five months, everybody in the county should be aware that, for the winter period as the very least, Gloucester Royal has the only fully functional A&E unit in the whole of Gloucestershire. Emergency personnel and hospital staff have expressed concerns about how the new arrangement will affect the efficiency of the 999 ambulance service, and the ability of emergency departments to cope with an altered influx of casualties.

Up until now all the county’s 999 ambulances have taken their night-time emergency cases to Gloucester Royal’s A&E Unit, due to the facilities at Cheltenham being restricted. This has resulted in acute pressure on bed-space at Gloucester, with the consequence that on most mornings the incoming casualties that normally would have been treated in Gloucester have to be diverted to Cheltenham.

This situation has increased the workload and mileage of the 999 ambulance service, but up until now it has at least ensured a balance of bed-occupancy between the two hospitals.

However, with Gloucester Royal from now on having the county’s only A&E accepting bone-injury casualties, many worry that with bed-space already a major issue, especially at night, the hospital will no longer be able to cope. There is a big question mark about what happens to orthopaedic patients who will have received initial treatment but for whom no beds can be found. Bed-space may well be found in other hospitals, but the 999 ambulance service is already frequently stretched beyond its capacity and the transfer of patients cannot be its priority.

The NHS has stated that the new arrangement at Cheltenham A&E is only to be in place for five months, to cover the winter period. The situation will then be reviewed. Many will remember a very similar explanation was given four years ago when Cheltenham A&E was put onto a daytime only basis. That temporary situation has become permanent.

Both members of the general public and many working within the NHS would welcome assurances that the changes at Cheltenham General Hospital are indeed only temporary, and that they are not part of a sequence of downgrades that will lead to its eventual closure. The Labour Party is also pressing health chiefs for answers on these matters as a matter of urgency. With winter approaching, can the future safety of patients actually be guaranteed?

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