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Minor injuries service in Faversham - Frequently asked questions

User AvatarPosted by Beatrice Liddell at 07/02/2014 15:42:35

Last updated: 29 January 2014.

On the 11 November 2013 NHS Canterbury and Coastal Clinical Commissioning Group (CCG) announced it had been unable to find a provider to continue running the minor injuries service in Faversham. As a result, the CCG announced that the minor injuries service would need to close at the end of March 2014.

It has since been agreed that the service will continue until September 2014. This will allow time for a detailed review of the process used last year to find a new provider for the minor injuries service.  

The CCG has received a number of questions from members of the public regarding the minor injuries service in Faversham. This page sets out the CCG’s response to those frequently asked questions.

We hope you will find the answer to your question below, if not, please contact us.

Where is the minor injuries service in Faversham?

The minor injuries service is based in Faversham Cottage Hospital, Stone Street, Faversham. The building is owned by NHS Property Services which leases some of the space to the minor injuries service.

How big is the minor injuries service?

The minor injuries service has a space in Faversham Cottage Hospital that is around 34m2. That’s just over three per cent of Faversham Cottage Hospital’s floor space.

Who runs the current service?

NHS Canterbury and Coastal CCG commissions (plans and pays for) the majority of healthcare services in the area. The CCG currently commissions IC24 (previously called South East Health Ltd) to run the minor injuries service.

What are the opening hours of the current service and what type of injuries and illnesses can be treated?  

The current service is open 8am to 8pm, 7 days a week. The unit is led by nurses and can help people with injuries such as sprains, minor burns or scalds, animal bites and minor eye injuries.

Unlike other minor injuries services across the area, there is no X-ray available on site.

Minor Injuries Units (MIUs) should not be used if patients have a ‘life-threatening’ illness. If, for example, someone has difficulty breathing, symptoms of a stroke or severe blood loss they should call 999 or be taken to the nearest Accident & Emergency (A&E) department immediately.

Why is the service closing?

The current contract was due to end in January 2014 so the CCG needed to renew it. A procurement process to find someone to run the service started in July 2013.

One bid for the contract was submitted but it was decided that the bid could not be taken forward at the CCG’s November governing body meeting. The decision was taken based on clinical and financial grounds.

The bidder proposed transporting patients needing an X-ray to an alternative site, which did not meet the clinical specification. This arrangement was proposed by the bidder because of a lack of suitable space to install an X-ray unit on the current site, the cost of staffing, and low activity levels.

The bidder was also unable to deliver the minor injuries service within the budget available (set nationally).

How was the specification for the minor injuries service developed?

NHS Canterbury and Coastal CCG wanted to commission a minor injuries service in line with, and to the same standard as, others in the area.

To develop the specification the CCG met patient representatives, local GPs, and a representative from the voluntary community sector. It was agreed the specification for the service would include an X-ray service in line with the opening hours (8am to 8pm).

What happened during the procurement process?

The contract was advertised on Supply2Health.

The contract and subsequent bidders’ event highlighted The Friends of the Faversham Cottage Hospital’s offer to provide funding for X-ray equipment (but not staff).

Bidders were also made aware that there had been a 12 per cent increase in attendances since 2011-12. A patient representative was on the evaluation panel and took part in the bidder interview.

Overall, we had 19 expressions of interest, eight providers attended a bidders’ event but only one provider submitted a bid.

Why doesn’t the CCG go out to procurement again?

The procurement process that was undertaken was a thorough and rigorous one. We are undertaking a review of the process which will look at:

  • How the service specification was developed
  • The process that the CCG used to try to find a new provider
  • The feasibility of providing X-ray services.

Each area of the review will involve members from the steering group and a report will be produced. This report will be presented to Kent County Council’s Health Overview and Scrutiny Committee (KCC’s HOSC) at the end of April and used to help decide on the next steps.

When will the minor injuries service close?

The service was due to close in January 2014 but it was agreed with the current provider to extend the contract until the end of March 2014.  

This has now been extended further, until September 2014.  This will allow time for a detailed review of the process used last year to find a new provider for the minor injuries service.  

If the CCG can extend the contract for a few months, why doesn’t it just keep extending it indefinitely?

The CCG has agreed to extend the contract to provide plenty of time to make people aware of the likely closure, suitable alternatives and to carry out a detailed review of the process undertaken last year in seeking a new provider. We want to speak to as many people as possible, to work through any issues or concerns and see what we can do to minimise any potential impacts should the service come to a close.

As the current service does not provide X-ray it does not meet the clinical requirements for minor injuries services set out by the CCG. The current service is also paid for on a block contract – this means we pay the provider a set amount, regardless of the number of patients who are seen. Minor injuries services under the national Payment by Results guidance mean we now need to set up contracts on a ‘per patient basis’. If we continued paying for the service on a block contract we could be open to legal challenge. 

Where will I need to go for minor injuries services should the minor injuries service close?

Minor injuries services are provided in Sittingbourne Memorial Hospital and Estuary View, Whitstable as well as Kent and Canterbury Hospital’s Emergency Care Centre. It is also important to remember that there is overlap between the services an MIU can provide and those available at GP practices and pharmacies. Pharmacists can also provide health advice and guidance on self-care and common illnesses such as colds, flu, vomiting, and diarrhoea.

All 22 GP practices across the Canterbury, Faversham, Herne Bay, Whitstable, Sandwich and Ash areas are signed up to the ‘Professional Standards for Urgent Care’. This means that patients requiring urgent attention should always be offered the most appropriate type of same day appointment with a doctor or nurse, either face-to-face, over the phone or at home.

The CCG is also looking at rolling out an ‘enhanced patient offer’ which would mean all practices will have the opportunity to provide a dressings and nursing service for their patients.

How many people use the minor injuries service in Faversham?

Around 800 people per month use the service. Of those, around 300 attend for a minor injury and 500 attend with a minor illness or for a treatment such as dressings or injections (services which can be provided by a GP practice, pharmacy or through NHS 111).

Data indicates that on average, around 400 Faversham patients per month already use minor injuries services elsewhere, for example Sittingbourne MIU, Estuary View and KCH Emergency Care Centre.

How does this compare with other minor injuries services in other areas?

Almost 17,000 per year attend Estuary View and 21,000 attend Sittingbourne MIU. 

Is this just a cost-cutting exercise?

No. It was our intention to improve the quality of care and ensure we were providing a best value for money minor injuries service. We have done everything to try to find a provider that can provide us with an affordable service within the national tariff.

Will the closure of the minor injuries service impact on other services provided out of Faversham Cottage Hospital?

No. Other services provided at the hospital are not affected by the closure of the minor injuries service.

How can this decision be made when you haven’t completed the community services review?

The community services review is a project to look at the best possible way of organising and delivering community-based services for the future.  This is a wide-ranging review looking at services delivered in people's homes, GP practices and community hospitals.  

Are you consulting on the closure of the minor injuries service?

Faversham’s minor injuries service has been a topic of consultation for a number of years. Before the Primary Care Trust (PCT) was abolished a lot of work was carried out with patients and local organisations to explore options for the service.

We publicised that we needed to find a new provider for the minor injuries service and that we went out to tender.

Following the governing body’s decision that it could not take forward the bid, we have started consulting people and local organisations to understand what we can do to lessen the potential impacts of the closure. This has included speaking to local GPs, trustees of the hospital, Faversham town councillors, Swale Borough Council and MPs.

Following discussion with Kent County Council’s Health Overview and Scrutiny Committee (HOSC) and representatives from Swale Borough Council, the CCG has agreed to carry out a review the process used last year to find a new provider for the minor injuries service.

A steering group has been created to help carry out the review. This includes representatives from Faversham GPs, The Friends of Faversham Cottage Hospital and Community Health Centres, Faversham Town Council, Faversham patients, Swale Borough Council, Kent County Council and Healthwatch.

The review will include:

  • How the service specification was developed
  • The process that the CCG used to try to find a new provider
  • The feasibility of providing X-ray services.

Each area of the review will involve members from the steering group and a report will be produced. This report will be presented to Kent County Council’s Health Overview and Scrutiny Committee (KCC’s HOSC) at the end of April and used to help decide on the next steps.

I have a question that isn’t answered here, who should I get in touch with?

If anyone has any comments or concerns they would like to discuss with NHS Canterbury and Coastal Clinical Commissioning Group they can call 01227 791359, email c4.ccg@nhs.net or write to the CCG: NHS Canterbury and Coastal CCG, Brook House, John Wilson Business Park, Reeves Way, Chestfield, Whitstable, CT5 3DD.

People can also join in the discussion on Twitter using #CCGMIU.

I would like to submit a formal complaint, who should I contact?

If you would like to make a complaint about the closure of the minor injuries service at Faversham Cottage Hospital, please contact Kent and Medway Commissioning Support (KMCS), which handles complaints on behalf of NHS Canterbury and Coastal Clinical Commissioning Group.

Telephone: 03000 42 42 44 (Monday to Friday, 8.30am to 5pm)
Email: complaints.kmcs@nhs.net  
Write to: KMCS, Complaints Team, Kent House, 81 Station Road, Ashford, TN23 1PP.