Posted on: February 17, 2020 Posted by: grahamsmith Comments: 0

When Truro sneezes, the rest of Cornwall catches a cold. Get yourself to County Hall on 11th March and stand up for our National Health Service

By Pat Richens

The withdrawal of overnight NHS services at Stratton MIU for the second time in a year is a real blow to its 36,000 potential users in and around Bude.  For us, it’s much more than the nighttime closure of a minor injuries/minor illnesses unit. Stratton Community Treatment Centre – as the centre was called between 10pm and 8am – supplied the only emergency service within an hour’s drive of Bude.

Following the first closure in December 2018, local people were addressed by a panel of officers and Councillors from Cornwall Council and Cornwall NHS bodies at a Community Network Panel meeting. One of the reasons given for the closure was that too many patients were wrongly presenting at the MIU with a serious medical emergency, rather than a minor injury.

This should not be surprising.  Someone in Bude suffering an emergency in the middle of the night has few choices:

  1. phone 999 and wait hours for an ambulance (Cornwall has the 2nd worst ambulance response times in England) thus taking an ambulance out of use for other emergencies for a considerable length of time;
  2. persuade a friend/relative – anyone - to drive them to the nearest A&E at North Devon District Hospital – an hour’s drive on a good night along the difficult A39 (it’s worth noting that as I write, a large stretch of this road is closed overnight for drainage maintenance for at least a week);
  3. Call a taxi (around £90 each way – if you can get one);
  4. Phone 111, only to be told to do a), b) or c) above.

The overnight service at the MIU was a real refuge for some who were absolutely distraught in the middle of the night, seeking urgent medical care.  Although it was not their brief, staff there coped with a range of emergencies, from strokes to childbirth, giving advice, reassurance and treatment as necessary. They. Saved. Lives.

During the first closure, which lasted from 7th December 2018 to 28th August 2019, several of us got together to form a campaign group.

  • We set up a Facebook page – “Saving Stratton MIU overnight”. We got well over 1,000 members within a couple of weeks! Huge support.
  • We set up petitions both online and in local businesses and got well over thousand signatures. Real strength of feeling
  • We passed the signatures and the stories to relevant health chiefs and Cornwall Councillors.
  • After nearly nine months of closure, overnight services were reinstated! Yay!

This was not simply the reinstatement of the MIU, this was a new Community Treatment Centre – an innovative scheme to provide emergency healthcare via Cornwall CIC – who also manage Cornwall’s 111 service.  This would be a pilot, running for one year and, if successful, could be rolled out to other parts of Cornwall.  Ground-breaking stuff!

It closed on 2nd January 2020.  It had been open for just four months.

The reason for this, second closure was because The Royal Cornwall Hospital was at OPEL 4 (Operational Pressures Escalation Level 4), which is similar to the old “Black Alert”.  Staff were taken from Stratton to work at St Austell in order to take pressure off the hospital at Treliske. So ended overnight emergency cover for 36,000 people in and around Bude.  We have now been told “the plan is” to reopen nighttime services at the end of February. We have received no guarantee that it won’t be closed again under similar circumstances.

What now?

There is no doubt in my mind, and surely in the minds of anyone rather more au fait with NHS England’s procedures than me, that we have undergone a Change of Service at Stratton MIU. Under NHS England’s “s.244 Regulations”:

  • The NHS providers and commissioners should work with the local authority (Health and Adult Social Care) Oversight and Scrutiny Committee to decide whether the change is “substantial”.
  • If it is “substantial” (there is no legal definition for this – though the change feels pretty substantial from here, in Bude!) “it will trigger the duty to consult with the local authority”.
  • The consultation with the Local Authority can then “trigger a referral to the Secretary of State and the Independent Reconfiguration Panel”.

All of this needs to happen now.   It should have happened before now.  The reason given by our health chiefs for not following the procedure outlined above is that this closure, like others around Cornwall, has been labelled “temporary”. The get-out clause in the NHS s.244 Regulations is that “Changes can be made temporarily….because of a risk to safety or welfare of patients or staff”.

I guess this boils down to one’s definition of “temporarily  I’ve asked NHS England to provide me with their definition but, as with all NHS waiting times, a response may take longer than it should.

If the overnight services are not reinstated by the beginning of March 2020, I shall, for the 6th time,  undertake the 90 minute early morning drive to County Hall, Truro, to ask questions the Oversight and Scrutiny Committee at their meeting at 10am on 11th March. This time, I hope I shall not be alone.

 

 

 

 

 

 

 

 

 

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