2 Jun 2020, 4:48 p.m.

Temporary changes to services at Gloucestershire Royal and Cheltenham General Hospitals will help ensure better and safer care for patients as we move into the next phase of the pandemic, clinicians have said.

The Board of Gloucestershire Hospitals NHS Foundation Trust has given its support to temporary service changes proposed by its clinical teams, including changes to the way emergency care and other specialist services will be delivered throughout the next stage of the pandemic.

At the heart of these changes are the goals of minimising the risk of transmission of the virus to patients and staff, whilst remaining prepared for a second surge should it happen. Importantly, the changes will enable many of the services paused during the first phase of the pandemic such as planned surgery and specialist diagnostic services, to be resumed. This will be done by separating as much as possible services caring for COVID and non-COVID patients, at both hospitals.

In embracing the opportunity that comes from having two hospital sites for the county, the Board believes that these changes will promote public confidence in the safety of our hospitals, including for the most vulnerable who we know have stayed away in recent weeks. In reaching its decision the Board of Gloucestershire Hospitals NHS Foundation Trust considered a wide range of views from staff, members of the public and other partners.

Whilst these temporary changes are in place all 999 ambulances, and patients referred by their GP for likely admission, will be directed to GRH 24 hours a day where rapid COVID-19 testing will be available alongside separate COVID and non-COVID assessment and admission areas.

Cheltenham ED will become a Minor Injuries and Illness Unit (MIIU) from 8am to 8pm, 7 days a week and will be closed overnight during the temporary period. The ED will continue to be staffed by nurses and senior doctors to see patients with less serious conditions. An enhanced Ambulatory Emergency Care service (AEC), operating Monday to Friday from 8am to 6pm, will remain to see patients referred by their GP who require specialist review but are unlikely to require admission and also to enable previously discharged patients to be followed up in CGH. The changes are effective from Tuesday 9 June 2020.

Professor Steve Hams, Director of Quality and Chief Nurse, said: “The changes to our emergency departments have come about after much discussion. We have had to balance the temporary reduction in service for the small numbers of patients who attend Cheltenham ED overnight with the wider goal of ensuring staffing is safe and that our clinicans are not required to continue to work the additional hours that have characterised recent weeks. Maintaining staff wellbeing has never been more important.”

Professor Mark Pietroni, Director of Safety and Medical Director, said: “COVID-19 has caused a huge upheaval and in response to this pandemic all of us are having to find different ways of doing things whether in our professional working lives or personal lives.

“At our hospitals the challenge and the balance that we are striking is in finding the right way to increase vital services such as cancer surgery and specialist diagnostic tests while continuing to manage COVID-19 in the community and being prepared for a second surge.

“The layout of Gloucestershire Royal Emergency Department and its critical care unit means it is considerably easier to separate confirmed non-COVID patients from confirmed and suspected COVID patients.

“These changes allow us to establish a non-COVID critical care department and specialist imaging department at Cheltenham General Hospital thus enabling us to retain complex cancer surgery locally whilst enabling elderly and shielded patients to access diagnostic care, with minimal risk.”

A public information campaign to help raise awareness of the changes has now been launched ahead of the changes.

The service changes are being implemented as emergency (temporary) changes in line with the Memorandum of Understanding (MOU) agreed with Gloucestershire Health Overview and Scrutiny Committee (HOSC). Changes would be enacted on a three monthly basis, at which point the ongoing necessity would be reviewed, again in line with the requirements of the MOU.