REACH has written to Gloucestershire Hospitals NHS Foundation Trust to raise a number of urgent points for the Trust Board to consider at their Board Meeting on Tuesday. The questions relate to temporary service change proposals to create a COVID-free site in Cheltenham to restart planned surgery and to treat emergencies, potential COVID cases and some non COVID patients at Gloucester.

The points raised by REACH are:
1. Asking the Trust to confirm all service moves are temporary and that all changes will be fully reversed.
2. Asking the Trust to confirm the Cheltenham A&E Department will be restored to a fully supported Type 1 facility, when NHS England has decided the COVID crisis is over.
3. Asking the Trust to confirm the “temporary” transfer of Acute Medicine and Emergency General Surgery from Cheltenham General Hospital to Gloucestershire Royal Hospital will be reversed when NHSE has decided that the COVID crisis is over.
4. Asking why the Trust is planning to keep some planned surgery (such as colorectal and upper GI) at GRH and not transfer all planned surgery onto the “COVID-free” site in CGH, if the service changes are designed to separate COVID from non-COVID patients.
5. Asking the Trust to clarify “temporary” proposals to move part of or all of vascular surgery and/or urology from CGH to GRH, and whether these will be fully reversed.
6. Asking the Trust to advise if these changes have the consensus of all staff in affected services.
7. REACH opposes the Trust’s preferred option to close the downgraded CGH A&E at night between 20.00hrs and 08.00hrs

Chairman of REACH Michael Ratcliffe commented:
“We understand the need for temporary service changes to separate COVID and non-COVID patients. We are concerned that this situation must not be used as a means to introduce permanent changes, which is why we have written to the Trust to seek clarification on these key points. After being contacted by a number of local NHS staff, we are also keen to ensure that staff should be properly consulted on these changes”.

Editor’s Notes

1. Full text of email from Michael Ratcliffe MBE Chairman of REACH to Simon Lanceley, Director of Strategy and Transformation, Gloucestershire Hospitals NHS Foundation Trust sent 3.21pm 28th May 2020:

Dear Simon
Thank you for your email of 23 May.
I schedule below the primary questions that the REACH Board would like to ask:
(1) Please confirm that all service moves are temporary and that all the changes will be reversed (irrespective of the duration of the COVID crisis), as per your media statement on 14 May 2020.
(2) Please confirm the A&E Department will be restored to a fully supported Type 1 facility when NHSE has decided the COVID crisis is over.
(3) Please confirm the transfer of Acute Medicine and Emergency General Surgery from CGH to GRH, which has been labelled as an “emergency temporary measure”, will be reversed when NHSE has decided that the COVID crisis is over.
(4) If the service moves are designed to concentrate the risk of C19 patients and cross infection risk into one site at GRH, why is the Trust planning to keep elective surgery (such as colorectal and upper GI) at GRH and not transfer all elective surgery onto the Green site in CGH, in order to provide physical separation of patient cohorts as per NHS recommendations.
(5) The Trust has stated that it is considering proposals to move part of or all of vascular surgery and/or urology from CGH to GRH during the COVID crisis, will the Trust please clarify these options and confirm that the Trust will undertake to reverse these emergency temporary moves when NHSE has decided that the COVID crisis is over.
(6) Please advise the level of consensus among all the clinical staff on both sites with regard to these proposals. How has clinical opinion been generated and what further discussions with all of the clinical staff is proposed.
(7) It is understood one of the possible options being considered is the closure of a downgraded CGH A&E at night between 20.00hrs and 08.00hrs. If this is correct then clearly it would be absolutely unacceptable to REACH, Cheltenham and Tewkesbury Borough Councils, the local MPs and virtually 100% of the Parish Councils in North and East Gloucestershire i.e. a populace of circa 260,000, which constitutes almost 50% of the County’s population
I await a comprehensive response to the above in early course.
Kind regards
Michael