Named – the ten Minor Injury Units in Cornwall due to close under Accountable Care
3rd January 2018
By Graham Smith
Cornwall’s network of minor injury units are under imminent threat of closure, according to an analysis of NHS plans. Ten sites, from Bude to Helston, would be scrapped.
Only Penzance, Camborne, Truro and Liskeard will survive – under a new designation of “Urgent Care Centre” – while all of the other current local minor injury facilities are due to close.
According to a government report last year, the NHS should where possible seek to sell its property to help finance patient care. This means that unless the ten sites most at risk have a viable alternative business case, they could be getting a visit from the estate agents very soon.
The Edward Hain hospital, at St Ives, does not have a minor injuries unit but has now been closed for nearly two years on disputed fire safety grounds, resulting in a significant loss in community beds.
The analysis of published NHS management reports has been carried out by academic Dr Peter Levin, who has published his findings on his Social Policy 4 Cornwall website.
The various NHS partners in Cornwall, and Cornwall Council, first suggested closing Cornwall’s minor injury units under the guise of the Sustainability and Transformation Plan (STP) Outline Business Case, first published in October 2016: “We propose to replace the current Minor Injury Units with a new model of strategically located Urgent Care Centres across the spine of Cornwall. The centres will provide enhanced, consistent and resilient clinical cover to meet the urgent care needs of all residents and visitors.”
Since then the NHS has declined to offer any information about where the Urgent Care Centres (UCCs) will be, because to do so would trigger a wave of protest everywhere else. But the SP4C analysis of emerging UCC specifications has found that only Penzance, Camborne, Truro and Liskeard meet the required cost-benefit targets, as the STP moves rapidly to become an Accountable Care Organisation (subsequently re-branded as an Accountable Care System.)
Cornwall Council’s cabinet is due to vote in favour of setting up an ACO (or ACS) on 7th February. There has been no public consultation.
This means that minor injury units at Bodmin, Falmouth, Fowey (currently “temporarily” closed), Helston, Launceston, Newquay, St Austell, Saltash (also “temporarily” closed), and Stratton, near Bude would all close.
Ten MIUs: disappearing from a hospital near you (unless the entire hospital has closed already)
As SP4C points out: “They treat sprains and strains, broken bones, traumatic wound infections (not surgical wounds), minor burns and scalds, head injuries (where the person has not been unconscious), insect and animal bites and stings, minor eye injuries, and cuts, bruising and grazes. They are open 7 days a week, mostly from 8am to 8 or 10pm. All but one is equipped with X-ray facilities, although these are not available during all the open hours. All the MIUs offer free car parking.”
SP4C also draws attention to the MIU run by GPs at the Stennack surgery, St Ives, which would not meet the new specifications of an Urgent Care Centre.
The SP4C analysis draws on a management report by Jackie Pendleton, of NHS Kernow, to a board meeting last month. The acronym appears to have changed from Urgent Care Centre to Urgent Treatment Centre (UTC), and says NHS Kernow has “made some progress in developing a draft service specification for a Cornwall UTC” which will be shared with groups like Healthwatch in February.
Ms Pendleton’s report goes on to identify Penzance, Camborne, Truro, and Liskeard as the only likely UTCs in Cornwall. The judgement to give Liskeard the nod over Launceston could be particularly controversial, as both offer X-ray facilities and Launceston has recently had a £440,000 facelift. The NHS Kernow report says: “The inclusion of Liskeard has the benefit of offering a more evenly geographical spread of designated sites, but should in no way be seen as pre-determining our future model of Urgent Treatment Centre locations.”
But according to SP4C it quickly becomes difficult for NHS and council officials to be seen to “change their minds,” even though the minor injury facilities in the relatively rural parts of Cornwall a recognised as relieving pressures on the already over-stretched Accident and Emergency departments at larger, general hospitals.