Queen Mary’s will also shut down minor injuries unit

St George’s University Hospitals NHS Foundation Trust is shutting down the minor injuries unit at Queen Mary’s Hospital in Roehampton. This comes on top of closing four operating theatres at the same site this week.

The closures mean thousands of local people will have to travel much further – to St George’s Hospital in Tooting – for treatment they could previously get close to home.

Staff found out about the closure in the worst possible way – from co-workers in a different department rather than their own managers. The hospital trust, which is over £100 million in debt and under pressure to cut costs, hasn’t publicly announced either closure.

A popular, effective service under threat

The minor injuries unit at Queen Mary’s Enhanced Primary Care Hub was very efficient when operating as a walk-in service and could see about 60, 70, sometimes 80 patients in the 12 hours that it was open.

After COVID, it became an appointment-only system with just 44 slots per day, despite staff stating they could easily handle more. The service treats anyone over two years old for injuries ranging from serious dislocations to minor ailments like infections and rashes. Many elderly patients rely on it for regular wound care.

As a walk-in unit, the minor injuries unit only reached two-hour waits – as opposed to four or six hours common in other hospitals. The unit also consistently receives five-star feedback through the NHS Friends & Family system.

Suspect decision-making

Staff are concerned that the closure stems from misleading statistics rather than genuine lack of demand. Management recently made two key changes that reduced the unit’s apparent effectiveness.

First, they stopped routine wound dressing services that came to the unit because most practice nurses work part-time and so there isn’t always one available at a practice. When wound dressing was stopped, attendances fell and the appointments were filled up with more injury and illness. But depending on what period of time the ICB took their statistics from, it could be that decisions about effectiveness are being made at transition points rather than reflecting true demand.

The switch from walk-in to appointments also had a crucial impact on statistics: as a walk-in unit, the hospital’s figures and reputation – particularly A&E – were boosted by its activities. But when it became an appointment system, the figures didn’t count towards the statistics.

The decision to close an efficient, busy service – albeit one that has been on a rolling six-month pilot for several years – has led to suspicions that these changes were made in order to make it easier to cut the service and so meet broader demands to reduce costs across the NHS.

Poor communication and management failures

What has particularly concerning is how the decision to close the unit was relayed.

Those impacted by the decision were reportedly told by other hospital staff rather than by their managers, with managers claiming not to have known about the decision until the day it was announced.

If true, that strongly suggests that managers don’t attend or directly inform the meetings of the Integrated Care Board where such decisions are made, resulting in critical patient care decisions being made without input from clinicians who understand the service’s real value.

Impact on the community

The closure will force residents from a wide area to make longer journeys for treatment. Staff have been told they still have jobs but must transfer to St George’s Hospital in Tooting – the same distance most patients will also have to travel. St George’s main hospital is known for having much longer wait times – sometimes up to six-hours.

Other options include a walk-in centre at Teddington Memorial Hospital and at Parsons Green but they don’t offer the same comprehensive service due to a lack of facilities. The closure is likely to particularly impact vulnerable patients, with elderly people needing regular wound care will face long journeys to access basic healthcare.

Local GP surgeries will also feel the impact: those who previously visited the service are likely to clog up the GP system.

In essence, the decision only makes sense if viewed through the lens of being able to cut costs easily and quickly, despite the impact on patient care and NHS efficiency.

Uncertain timeline

No official timeline for the closure has been announced and there will still need to be an internal consultation but rumours are that the unit is set to close in January.

There remains a glimmer of hope: public pressure.

Strong support from the public and patients has been known to result in a re-evaluation of services, especially if the decision is made without an understanding of the full picture.

Those impacted or affected by the proposed closure can contact local Roehampton councillor Graeme Henderson at cllr.g.henderson@wandsworth.gov.uk, who is a former Department of Health official and sits on the South West London Integrated Care Partnership, or Putney MP Fleur Anderson at fleur.anderson.mp@parliament.uk to express their concern.

The St George’s Trust is facing a deficit of over £150 million and looking to cut services. This reflects a wider crisis across the NHS, with over 40% of trusts now running deficits totalling over £1 billion nationally.

St George’s response

When contacted for comment, St George’s Trust told Putney.news on background there were no plans to close the Enhanced Primary Care Hub at Queen Mary’s’ and no plans to cease access to primary care.

The minor injuries was run on a rolling pilot status.

However, the Trust confirmed that the function and scope of the Enhanced Primary Care Hub is under review and cited the need to ‘live within our means’ while reviewing all services — a reference to its significant debt and pressure from the government to cut costs.

The Trust did not specifically address the future of the minor injuries unit within the hub or comment on concerns raised about how the decision was made, or how it handled by management.

Interested in a long read about what is going on behind the scenes at the NHS Trust that oversees Queen Mary’s? Then you will enjoy this long read.

Update. Wed 6 August: We have removed and replaced several quotes in the original story following requests from those quoted. The details were and remain accurate.