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Minor Injuries Unit Consultation

Heron House
120 Grove Road
Fenton
Stoke-on-Trent
ST4 4LX
9 September 2014

Response to Cannock Hospital Minor Injuries Unit Consultation
I wish to make a formal response to the Minor Injuries Unit Consultation.
The complete loss of the Minor Injuries Unit (MIU) at Cannock Hospital as originally
proposed would have been a hammer blow to the local community and placed even
further pressures on our local health economy which is already undergoing huge
change.
As you will be aware, I have long campaigned to save Cannock Hospital from the
Administrators Axe and have consistently called for more, not less services to be
provided at the site. The MIU is valued by local people, especially parents with children
and as such any reduction in provision must be done so in proper consultation with local
people.
Whilst I am pleased that the initial plans to close the unit were dropped, I do not feel that
the new proposal to reduce the opening hours is a sustainable or acceptable long term
solution, particularly given the lack of diagnostic facilities at the site. In the short term
however, it will at least provide some provision for my constituents. Retaining a service
will also help prevent the diversion of minor injuries patients to already stretched A&E
departments.
Going forward I understand that it is the intention of the CCG to develop an Urgent Care
Centre in Cannock, in line with the Keogh recommendations - a move I would welcome.
However the current timeframe for completion of this work is estimated to be two years.
Given the importance of healthcare provision, I would request that this work is speeded
up as much as possible.
One very obvious way to improve the MIU service at Cannock is to add radiology
provision. In the options paper submitted to the Healthy Staffordshire Select Committee
on 11 August you state that the unit does not have access to diagnostic provision for
patients who need an x-ray or other test.
It goes on to say that nearly one in four of the patients who visit MIU are sent to another
NHS service because of this lack of diagnostics creating a two-step pathway. This, as
you make clear, is neither efficient nor cost effective.


Your own figures indicate that a significant number of people go to the unit with limb
issues. It therefore would seem sensible to look at bringing in diagnostic provision such
as an x-ray machine which most other MIUs across the country have. This would allow
quick diagnosis and relevant signposting and avoid sending those people identified has
having just sprains to already stretched acute hospitals units across the region.
In the options paper you say that discussions have taken place with the Royal
Wolverhampton NHS Trust about access to diagnostics, such as the X-ray facilities at
the site. I would be interested to find out the outcome of these discussions and if there is
any scope for patients from the MIU using these services?
If use of the existing X-ray machines is not possible, could the CCG and Royal
Wolverhampton NHS Trust not look at investing in an additional machine for joint use?
While I accept that this would come at a significant short term cost, it could save money
longer term with fewer admissions to Stafford and other local A&Es. Would access to
diagnostic provision also not be made easier if the unit was run by the Royal
Wolverhampton NHS Trust rather than the Staffordshire and Stoke-on-Trent Partnership
Trust?
I understand that discussions have taken place with Badger Medical Services (out of
hours provider) about enhancing current service to deal with minor injury between
6.30pm and midnight. Would you be able to publish the outcome of these discussions?
I do not feel it has been sufficiently explained in the consultation document how other
parts of the primary care system will pick up the slack with a reduced hours MIU. You
state that 40% of the activity undertaken by the MIU is for illness, not injury, and
therefore should be dealt with by local GPs. However your own options paper makes
clear that the preferred option will place extra pressure on already stretched GPs.
While I agree that it is often more appropriate that patients are seen by their own Doctor
or self-care at home, it is clear that many people go to MIU simply because they cant
get access to an appointment with their GP. While in the consultation paper you say are
looking at ways to address this access and capacity issue, I am still not clear as to what
specific support will be given to GPs to help them cope with this inevitable extra
demand? Will more GPs be employed to meet local primary care needs? Your own data
highlights very clearly those GP practices which have the largest number of registered
patients who attend the MIU unit and so this is a useful indicator as to what GP practices
may need extra support.
If the change to the opening hours at the MIU is to go ahead, it is vital that this is
coupled with an increase in GP and other primary care provision.
One of the risks identified from the reduced opening has been an increase in attendance
to local A&Es for minor illnesses. What discussions have been had with Royal
Wolverhampton, Walsall and UHNS Trusts about these risks and what plans, if any,


have been put in place to deal with them? A&E provision is already stretched across the
locality and the restricted opening hours at Stafford make this problem worse. Local
people need to be given assurances about access to an improved GP out of hours
service to avoid them visiting A&E unnecessarily.
If the changes to the MIU opening hours are to go ahead, it is also vital that local people
across the district are properly informed and educated about what local services are
available at any given time and which of these services is most appropriate for their
treatment. A variation of the Choose well leaflet in the consultation document is one
such example of literature that should be widely distributed.
As a side note, I would also like to express my disappointment at the poor scheduling of
the public consultation meetings arranged as part of this consultation. Two out of the
three public meetings set up occur during normal working hours which makes it very
difficult for local people to attend. Could I ask about the reasoning for arranging these
meetings at these times and urge that in any future consultations consideration is given
about the timing of such meetings.




Aidan Burley MP