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Practices to take on minor injuries work as plans for specialist unit are shelved

GPs in South Gloucestershire are likely to deal with minor injuries including minor fractures, minor burns and scalds as part of a pilot scheme, after the health secretary vetoed plans for a minor injury unit in a local hospital.

NHS South Gloucestershire CCG said that, under its proposals, ‘additional staffing and resources will be put in place to provide the necessary extra capacity’ so minor injuries services could be delivered by practice-based nurses supported by GPs.

It comes after Jeremy Hunt decided in June that a proposed unit at the Cossham Hospital would not be built, despite 18,000 residents signing a petition in favour of it, and 250 people demonstrating at the council offices in Kingswood.

The CCG announced the plans this week, which would see practices treating injuries including sprains and strains, cuts and grazes, minor fractures, minor burns and scalds, bites, minor eye injuries and minor head injuries.

It would not treat those needing plastering or crutches, or experiencing severe breathlessness, severe abdominal paint, severe chest pain or strokes.

The services would be available within normal GP opening hours, from 8.30am to 6.30pm Monday to Friday, though the CCG is considering extending the service to outside of these hours.

NHS South Gloucestershire CCG will make a formal decision on whether to proceed with the pilot in September.

Dr Ann Sephton, deputy clinical chair and lead for emergency and urgent care at NHS South Gloucestershire CCG, said: ‘People have told us they want better access to their GP practices and better access to urgent care services in the community. This new service aims to deliver both – through a GP practice-based model delivered at surgeries throughout South Gloucestershire.

‘We believe our proposal is the best and most cost-effective option for improving local access to minor injury services in South Gloucestershire.’

Readers' comments (17)

  • How many GP's have the capacity, the training or the skills do this? ZERO. What a load of b%^&*$cks. And when something goes wrong, the GMC/CQC/NHSE/The magistrate will all ask "so doctor, what skills did you have to provide this service? none you say? so why were you doing it? I was forced to is not an excuse. There goes your license/your livlihood/your childrens future".

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  • Hopefully CCG or Mr.Hunt is paying their medical indemnity!
    Next we can do appendicitis, tonsillectomy, hernia etc in the GP surgery.
    One practice where i worked in had pictures of the GP ( pre NHS days) performing a tonsillectomy in the surgery for Quinsy!
    Well Hunt has managed to send NHS care 1 century back in time. Maybe he can patent the time machine.

    Soon there won't be any GP's to see patients on NHS for common problems.
    Then patients will start doing Minor Injuries work themselves as there is no one else who can!

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  • 'No decision about me without me'. Ahem

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  • Which bit of "minor" do these commentators have difficulty in understanding? Frankly if the nurse/GP combination suggested has any difficulty in dealing with these (including knowing when to refer onwards to A&E) they need to consider their competence to do anything. The problems I see are nothing to do with clinical abilities but signposting and access.

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  • There speaks a typical manager - as if nothing 'minor' was ever 'major' in disguise. And of course the diagnostic facilities which would have been available in the MIU (X-ray, phlebotomy, etc) will be set up in each GP surgery? Thought not!

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  • Hi totally ridiculous. You try to phone your GP with a bleeding hand and can't get through. You attend your local GP bleeding over the carpet but can't be seen as the GP is seeing patients with appointments in clinic. GPs cannot do everything at the same time. I'll thought through and setting up GPs to fail.

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  • We manage very successfully to do most minor injuries here at the surgery. Typically we get a 1-2 walk-ins (or phone calls) each day. They are managed pretty quickly. About 15% are forwarded to A+E or a specialist team because they need an x-ray or expert treatment.

    Having said that we only agree to do them because we are paid significant amounts of money to do so. We are one of the areas that successfully came through the PMS/GMS renegotiation. I understand GMS practices are paid through a LES - which most of the time is underfunded.

    I would say a reasonable amount for minor injuries is 5 pounds per patient on the list.

    I would encourage any practice considering this LES to think before hand what they think is a good figure (either per patient on the list, figure for the whole practice or figure per minor injury seen). Then after look at the figure being offered.

    If it is less (I suspect it will be) then just say no.

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  • I'm an ENP/ANP with 14yrs experience in 3 countries working A&E, remote outback, trauma, GP surgeries, OOH & MIUs - including XR & interpretation slit lamp examination/eye management, intricate suturing etc etc (it's a long list of expertise that we have). GP surgeries do what they do best and MIUs the same. We're highly trained & experienced to assess/diagnose/manage minor injuries and know what/when/where to refer and/or follow-up as appropriate. Not all so-called "minor" injuries turn out to be minor and without the appropriate training missing something apparently "minor" can potentially lead to serious consequences for the patient. I suggest leave us all do do what we do best, GP surgeries have more than enough pressures to deal with and in my experience a large % of patients struggle to access their surgery because of the ever-increasing work load. Look at the MIUs and UCCs around the country - attendance numbers alone should prove their value - not to mention appropriate management and referrals to secondary care/follow- reduce the ever-burdened EDs. Good luck South Gloucestershire, I think you'll need it.

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  • As an Emergency Nurse Practitioner working in a busy Minor Injury Unit I strongly agree with the concerns of the GP Partner writing at 6.50am and fear the ill-informed comment of the NHS Manager at 10.55am. Work in this unit involves a host of skills that neither a Practice Nurse or a GP would usually undertake examples include interpreting x-rays, manipulating dislocations, plastering, removing foreign bodies from eyes and ears, closing wounds with sutures. We liaise with Plastics, Opthalmology, Trauma, Burns and other teams prior to referral and do not simply assess and refer to A and E , most treatment is completed in the unit. These units are able to provide considerably more treatment than a First Aid Unit.
    Patients often misjudge the severity of their injury, particularly head injuries, and require stabilisation prior to hospital transfer. We are trained in Immediate Life Support and it is difficult to see how adequately trained staff can be provided in a small GP Surgery.
    I never cease to be amazed by the knowledge, experience, stamina and bravery expected of GP's and Practice Nurses by Mr Hunt and Health Service Managers. These arrangements may well leave the Practice Nurses and the GP's ' supporting them ' in a very vulnerable position unless there is considerable time and money invested in retraining everyone and providing x-ray facilities. Is this really just a means to redirect everyone to large, and often overloaded, A and E centres?

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  • Oh dear, when, where an how are GP's going to fit this in to their days work?
    Over worked GP's make mistakes.
    So what is it the this pleb Hunt wants GP's to do ... work in A&E, help paramedics, help ambulance crews, see routine patients, perform minor surgery etc. etc. etc.
    As a patient my real concern is that having taken part in all these additional tasks,is the GP mentally and physically fit to undertake all these additional tasks. I don't want to see a GP that is struggling to keep his eyes open!

    Can someone tell Jeremy Hunt that GP's are mere human beings like the rest of us and unfortunately they need time to eat and sleep, not forgetting occasionally spending time with their famliy.

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