HEALTH bosses have revealed the long-term future of two county minor injury units hangs in the balance as they explained the extent of winter pressure facing the A&E department in Hereford.

Wye Valley NHS Trust, which controls Herefordshire hospitals, decided to temporarily close the units at Ross-on-Wye and Leominster community hospitals from November.

They say there is a shortage of emergency nurse practitioners who run the service in the county.

These health workers also play a vital role in the A&E department and hospital bosses say they are desperately needed in Hereford.

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And this is the third year running in which hospital bosses have had to relocate staff to Hereford, but this time residents have not been told when the units will reopen.

Health chiefs say the MIUs will remain closed until it is safe to relocate staff back to the towns.

However, they hope to conduct a review and consultation into the MIUs around February and may replace the service with one similar to that in Kington where GP surgery staff provide the service.

Managing director Jane Ives told Ross town council tonight (December 18) that they took the difficult decision to temporarily focus resources where they are needed to save lives.

She said the 240-bed county hospital received 92 ambulances last Tuesday.

“My primary role is to make sure that care is safe for patients and to improve the outcomes for them whether they are in the community or the hospital,” she said.

“What we’ve seen on the acute side is across the acute site is that we’ve seen a very significant increase in demand for urgent care in Hereford.

“We haven’t seen that in the minor injuries unit where it is broadly very flat.

“This year over the last year, we’ve had 5,000 more A&E attendances altogether and a 13% increase in emergency admissions.

“On Tuesday of this week, we had 92 ambulances, that’s the most we’ve ever seen.

“We have to manage that demand because what’s dangerous in A&E is that if it becomes very congested the staff can’t see the wood for the trees.

“And so we have to try and make sure we keep the flow going.”

Ms Ives said there weren’t enough emergency nurse practitioners and they take a long time to train.

“Our response to keep patients who are critically ill safe is to keep the main A&E department as least congested as we can,” she said.

She said the average for the Ross MIU was for the nurse to see one patient an hour while in the main A&E department it is between three and four.

Residents at the meeting at the Corn Exchange asked when the service would reopen.

“We haven’t set an end date,” Ms Ives said.

“Last year we set a date and tried to make sure we kept to it.

“So our rationale around this is when it’s safe to reopen, we will reopen it.”

Herefordshire clinical commissioning group managing director Joanne Alner admitted that it was unsatisfactory for them to close the MIUs every winter.

“We have made the decision jointly with the trust around doing it again this winter on a temporary basis,” she said.

“But during that time, we’ve been really looking at what would be a better solution locally for the populations of Ross and Leominster to provide a more responsive service that the MIU currently provides to you.

“We are hoping if all the ducks line up we will be able to come out to talk to you properly in a consultation process in February.”

Health bosses also said that while they could never completely rule out a hospital closure, they said they have no plans to permanently close the community hospitals in Leominster or Ross.

They say their focus is to change the way health services are provided more efficiently locally and achieve better outcomes.