1. Background

Nevill Hall hospital in Abergavenny provides care to residents of Gwent and South Powys, and currently offers a 24 hour, seven days a week, nurse-led Minor Injury Unit.

In September 2023 Aneurin Bevan University Health Board announced a “12-week Engagement” on the provision of Minor Injury Unit (MIU) services. The health board’s briefing document says a recent evaluation of MIU demand identified key patterns of activity across sites, and “highlighted a significant imbalance between opening hours and patient demand across the MIUs”. It found that very few patients attend Nevill Hall hospital (NHH) MIU between 1.00am and 7.00am:

Between 1 April 2022 and 31 March 2023, there were 400 attendances to NHH MIU (approximately one patient per night) during these hours. By contrast, there were 1,530 attendances to RGH MIU (approximately four patients per night) during the same hours

The health board says in response to these findings, it has considered a number of options for future service provision, with the aim “to ensure optimal matching of capacity to demand and develop the most robust and sustainable model for the future”.

The health board’s preferred option is to make permanent the current temporary opening hours at Ysbyty Ystrad Fawr (YTT) (7.00am to 1.00am, seven days per week), and to introduce the same opening hours pattern at NHH. If adopted, MIU service provision would be:

· Royal Gwent Hospital - Open 24 hours, seven days per week

· NHH - Open 18 hours from 7.00am to 1.00am seven days per week

· YYF - Open 18 hours from 7.00am to 1.00am seven days per week

· Ysbyty Aneurin Bevan (YAB) - Open from 9.00am to 7.00pm Monday to Friday (excluding bank holidays)

The engagement period runs until 5.00pm on Friday 1 December 2023. Responses will be collated into an engagement report which will be shared with the Llais Gwent Region (the body that has replaced Community Health Councils) to identify whether a final decision can be made or whether further actions are required.

The health board says subject to further discussions with Llais, it may wish to enter a period of formal consultation, in which case it would once again invite views.

2. Welsh Parliament action

In Plenary on 18 October 2023, Peredur Owen Griffiths MS raised the issue with the Minister for Health and Services about the proposed changes and asked:

Given that minor injury units are seen as a key component in a strategy to ease pressure on A&E departments, is it not a retrograde step, and will this make the Grange University Hospital an even longer and more frustrating experience for anyone visiting their A&E department and heap more pressure on the staff working there?

The Minister answered:

[…] it's obviously something that I know the health board has considered very seriously. But the fact is, in relation in particular to the Abergavenny minor injury unit, on average, there was one patient there overnight. Now, in these financial pressurised situations, it's very difficult to justify that on the basis of value for money. And that is one of the reasons why, certainly, they have moved to close that facility, and to move people to and encourage people to go to the new Grange hospital, where in fact we've put significant investment, and will be making significant additional investment in future years. We've put an extra £3.5 million capital funding to establish a same day emergency care centre, for example, in the Grange.

3. Welsh Government response

The Minister for Health and Social Services noted in her response to the petition that the health board is responsible for the planning and delivery of healthcare services on behalf of its local population.

The Minister said she’s aware that following a recent evaluation of minor injury unit (MIU) services, the health board identified an imbalance between opening hours and patient demand across the units, and:

In recognition of the low overnight patient demand at some sites (on average one patient between 1am and 7am at Nevill Hall Hospital), the health board is seeking to ensure that this valuable staff resource is used as effectively as possible and that clinical teams can maintain their skills.

The Minister said she would encourage all interested parties to engage in the process and that no decision will be made by the health board until after the formal public engagement process has concluded in December.

Every effort is made to ensure that the information contained in this briefing is correct at the time of publication. Readers should be aware that these briefings are not necessarily updated or otherwise amended to reflect subsequent changes.