Concerns Raised Over Possible Reduction in Opening Hours of Llanelli’s Minor Injury Unit

CONCERN has been expressed that health chiefs in West Wales might be considering reducing the opening hours of a minor injury unit (MIU) in Llanelli.
The walk-in unit at Prince Philip Hospital is currently open 24 hours a day for seven days a week and treats a range of wounds, sprains, minor burns and limb fractures.
The Local Democracy Reporting Service understands that options that have been, or are being, looked at by Hywel Dda University Health Board include two which would result in fewer MIU opening hours at night.
Separately, Llanelli MP Dame Nia Griffith posted a message on Facebook on November 20 which said a reduction of night-time opening was being discussed by the health board. She said this was based on a conversation she’d had with its chief executive, Steve Moore. She urged Mr Moore to make every effort to maintain the current round-the-clock opening times.
“I told him that we in Llanelli are very concerned indeed at any reduction in opening times, and I stressed how important it is to have an easily accessible service available locally,” said the Labour MP.
Andrew Carruthers, director of operations at Hywel Dda University Health Board, said it was at the early stages of reviewing the MIU model at Prince Philip Hospital.
The unit was inspected in June by Healthcare Inspectorate Wales (HIW), which found that elderly and sometimes “acutely” unwell patients were stuck in it for up to five days because there weren’t enough beds for them in the main hospital.
Some MIU staff told inspectors that it felt more like an accident and emergency department staffed by nurses and GPs. The inspectors’ report, which identified improvements and immediate concerns, said: “Overall, we found the issues identified applied inappropriate pressures to the functionality of the MIU as a minor injury service.” The health board accepted the findings and put in place an improvement plan to address them.
Speaking on November 20, Mr Carruthers said its review of the MIU followed concerns raised by both staff and HIW regarding “the inappropriate use” of the service.
He said: “When the new service was agreed and implemented by the board in 2015, it was never intended that it would treat acutely unwell medical and surgical patients. Individuals requiring such care should be going to a fully functioning emergency department.
“The recent Health Inspectorate Wales report highlighted a range of concerns that we must address. These challenges are made worse when our clinical teams are regularly called upon to treat conditions and medical emergencies that should been seen elsewhere within our system.
“These challenges mean that our service is becoming increasingly unsafe, and so we are looking at options that will ensure the safety of all patients accessing the service at Prince Philip Hospital. Before any change is put in place, we will continue to speak with staff and local stakeholders, and to ensure that we have understood the impact and managed the effects of any change for the local community.”
There is concern that any reduction in opening hours at Prince Philip Hospital’s MIU would result in more patients attending already over-stretched accident and emergency departments at Glangwili Hospital, Carmarthen, or Morriston Hospital, Swansea.
Prince Philip Hospital no longer has an A&E department, but does have an “acute medical assessment unit” which deals with emergency medical cases arriving by ambulance, but not emergency trauma or surgical ones. The unit also handles GP referrals.
Llanelli Town Council has pledged to fight any reduction in opening hours at the unit.  Town council leader David Darkin said: “Llanelli people deserve to have access to vital medical aid on a 24-hour basis seven days a week. Anything less would be disastrous.” He added: “We need more services in what is Carmarthenshire’s industrial heartland, not less.”
The health board runs A&E departments at Withybush Hospital, Haverfordwest, and Bronglais Hospital, Aberystwyth, as well as Glangwili. These three hospitals also have minor injuries units but they’re not open 24/7, according to the hospital’s website.  There is also a minor injury unit in Cardigan – open Monday to Fridays 8am to 6.30pm – and a nurse-led walk-in centre in Tenby, open Monday to Friday 10am to 5pm.
All health boards in Wales are under pressure to make additional savings in order to rein in growing budget overspends caused by rising staff, energy and drug costs, ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​