Firstly, I am not a health professional and all my research is in the public domain.
Frankly, if the proposals were such a good idea for the people of Dorset the CCG would have made their case such that it would have carried most of the public along with it.
They have not, and people’s fears and worries have expanded from the Kingfisher Ward to include A&E, Maternity and Paediatric provision, not to mention the wider political, money saving and privatisation.
Leaving aside issues of political influence and the current structure of the NHS there are, in my opinion, sensible initiative under-weigh to improve and to enable the service to cope into the future. Just to outline what I have discovered thus far.
Urgent Care is about those medical situations that you can’t just leave till the next day or week, but are not life threatening.
Current advice is as follows “If you have an illness that is not life threatening, contact your GP surgery first if possible. You can still call your GP outside normal surgery hours, but you will usually be directed to an out-of-hours service. The out-of-hours period is 6.30pm to 8am on weekdays, and all day at weekends and bank holidays.
You can also call NHS 111, which can give you advice or direct you to the best local service to treat you.
If your injury is not serious, you can get help from a minor injuries unit (MIU) or urgent care centre (UCC), rather than going to an A&E department. This will allow A&E staff to concentrate on people with serious, life-threatening conditions and will save you a potentially long wait.
There are there are around seven million attendances at type 3 A&E services (WiCs, UCCs and MIUs) in England. MIUs and urgent care centres are usually led by nurses and an appointment is notnecessary.”
Some MIUs, UCCs do not have facilities to treat young children. This depends on the capacity, resources or skilllevels available at the departments.
At the moment there are Minor Injury Units and Urgent Care Centres or type 3 centres around Dorset and elsewhere doing a great job treating and helping.
Minor injuries units and urgent care centres can treat:
· sprains and strains
· broken bones
· wound infections
· minor burns and scalds
· minor head injuries
· insect and animal bites
· minor eye injuries
· injuries to the back, shoulder and chest
If you are not sure, particularly for a child or for all serious life threatening injuries call 999 and follow their help and advice. They will direct as to what to do and will send an ambulance which will take you to the best A&E for your needs.
If they send an ambulance you will not simply be dumped in the back and carried off ‘blues and twos’ to hospital until the very highly skilled paramedic and team have fully assessed you and done everything to stabilise your condition, making you as comfortable as possible. If needed a specialist doctor may also attend where ever you are. This may take some time, but it will make your recovery so much the quicker and better. Once all that is done you will be transported to hospital.
Just one point -currently the average cost for each ambulance call out is £267.
The idea is to treat everyone as far as is possible where they are, but have got used to our A&E service being the place we rush to, better to ring NHS111 first or 999. The service has had its problems, but it is designed to be your first action rather than just turning up. It will take time to get used to and it isn’t simply a cost saving idea. Used properly it will make a real difference.
Now to the proposed A&E changes. As you will have gathered MIU & UCCs play an important role already, but they are restricted in what they can do. Dorset has access to three A&E departments ‘in county’ and with Exeter, Taunton, Yeovil and Salisbury available for those further out in the county. Similarly Royal Bournemouth and Christchurch Hospital serves a good number of people in Hampshire.
Leaving aside, for the moment, maternity and other issues this table looks at the towns that would be most affected – Shaftesbury and Sherborne for the most part would go out of county anyway.
Distance/transit times from the main towns in Dorset to the current Hospital A&E.
These figures were compiled using ViaMichelin for the best time with a family car.
Town |
Hospital |
Miles |
Time: mins |
Preferred |
Time difference |
Notes |
Lyme Regis |
||||||
DCH |
26 |
46 |
1 |
|||
Yeovil |
26 |
61 |
2 |
15 |
||
44 |
74 |
30 |
Via Dorchester |
|||
Taunton |
32 |
59 |
2 |
13 |
||
Exeter |
32 |
59 |
2 |
13 |
||
29 |
65 |
19 |
Via A3052 |
|||
|
||||||
Bridport |
DCH |
16 |
25 |
1 |
||
Yeovil |
21 |
51 |
2 |
26 |
||
33 |
53 |
2 |
28 |
Via Dorchester |
||
28 |
71 |
46 |
Via B3162 & A356 |
|||
Weymouth |
DCH |
9 |
19 |
1 |
||
Poole |
33 |
48 |
2 |
29 |
||
RBCH |
47 |
69 |
3 |
50 |
Via Spur Road |
|
Yeovil |
29 |
50 |
2 |
31 |
||
Dorchester |
DCH |
0 |
0 |
|||
Yeovil |
21 |
37 |
1 |
37 |
a) |
|
Poole |
24 |
36 |
2 |
36 |
||
|
RBCH |
34 |
55 |
3 |
55 |
|
|
||||||
Swanage |
Poole |
20 |
39 |
1 |
||
DCH |
26 |
51 |
2 |
12 |
||
RBCH |
28 |
66 |
3 |
27 |
||
Blandford |
Poole |
15 |
30 |
1 |
||
|
RBCH |
27 |
45 |
3 |
15 |
Via spur rd. Best time |
|
Salisbury |
23 |
39 |
2 |
9 |
|
|
||||||
Poole to |
Transfer |
8 |
27 |
27 |
b) Depending |
|
RBCH |
time |
9 |
43 |
43 |
on the chosen |
|
10 |
38 |
38 |
route. |
As you can see, Dorchester a) will potentially be hardest hit with the journey to Yeovil with Poole next b) and unexpectedly Swanage and Lyme Regis the least.
The biggest factor that will make a difference is the combined time – time to attend due to number and disposition of ambulances + the transit time to A&E.
The above figures are based on a family car driving in good, free conditions observing the speed limits etc. An ambulance should be quicker in ideal conditions which is not always the case.
I have yet to gather the data on numbers of actual journey times and distances for the current populations. It might take a while and several Freedom of Information Requests.
I will have the breakdown of potential numbers who may have used A&E against MIU and UCCs soon.
©John Daniels 2016