Proposal to close St Damian’s Surgery in Melksham

Increased demands on healthcare services and the national shortage of GPs are having an impact on primary care across the UK and in Wiltshire. The Bradford on Avon and Melksham Health Partnership (BoAMHP) have been unable to recruit enough clinicians following the retirement of three full-time GP partners and have sought approval to close St Damian’s Surgery in Melksham.

Dr Richard Sandford-Hill, NHS Wiltshire Clinical Commissioning Group Chair said:
“We understand the challenges facing primary care, particularly around recruitment of clinical staff. BoAMHP has sought approval to close its branch surgery in Melksham because, despite their best efforts, the partners feel unable to maintain a full range of patient services at all of their sites.”
Dr Janice Patrick, Senior Partner at Bradford on Avon and Melksham Health Partnership said:
“This has been a very difficult decision for us to take. Over the past year we have put a lot of measures in place to try and maintain the surgery at St Damian’s, but we find ourselves in a position where we cannot continue to provide a service in Melksham with the resources we have available to us.

“BoAMHP is keen to continue to provide services to as many of the St Damian’s registered patients as wish to stay with their current GP, should our proposal to close the surgery at St Damian’s be approved. We are writing to all St Damian’s patients to explain to them what the proposed closure would mean for them.”

St Damian’s patients who want to continue to see a GP in Melksham would need to register with Giffords Surgery or Spa Medical Centre after the decision is made about the practice closure, in the New Year.

Patients who have questions or would like further information about the proposed closure should contact St Damian’s Surgery.

Transforming Maternity Services Together

A proposal to transform maternity services across Bath and North East Somerset (BANES), Swindon and Wiltshire has been shared with the general public for their consideration today, Monday 12 November.

The proposal has been developed after listening to the views of women, families and staff over the last two years by all the NHS organisations that plan and buy health services as well as those that provide or manage maternity services across Bath and North East Somerset, Swindon and Wiltshire. Together these organisations make up the Local Maternity System.

Lucy Baker, Acting Director for Maternity Services at Wiltshire Clinical Commissioning Group
and Lead Director for the project said:
“Our proposal is the result of feedback gained from listening to over 2,000 women and families, staff, midwives, obstetricians and others with an interest in maternity services to look at ways we can improve the services we provide to mothers and families across the region. To do that, we need to make some changes to how we currently do things”.
Lucy added:
“Our proposal would allow us to provide more choice for more women across our area about where and how they are supported before, during and after the birth of their baby, and allows us to make more efficient use of our resources and workforce so we can further improve our antenatal and post-natal and birthing services. We also want to ensure we are delivering the services that can meet the changing needs of our local women and families both now and in the future.

“Despite the financial pressures facing the NHS locally and nationally, we are not planning to reduce how much we spend on maternity services, nor are we proposing to reduce the amount of staff we have or to close any buildings.”

The proposal addresses the issues posed by changes to the population. The average age of a woman giving birth in the UK is now 35. More and more women are experiencing high risk pregnancies (for example, because of high blood pressure, obesity or diabetes) which means they need to be supported in a hospital setting with an expert medical team available. The combination of these factors means there is vastly increased pressure on services at the Obstetric Units at the Royal United Hospital in Bath, Great Western Hospital in Swindon and Salisbury District Hospital.  

In addition, many women with a low risk pregnancy are choosing to have their babies in an Obstetric Unit because they are worried about having to move by ambulance to another site during or after their labour if they need the help of a doctor. Women need a safe, convenient alternative so staff at the three obstetric units at Bath, Salisbury and Swindon hospitals can focus on mothers who really need their care.

Sarah Merritt, Head of Nursing and Midwifery at Royal United Hospital, Bath, said:
“Some of the changes we are proposing are because, particularly at the RUH, certain services are underused and we are often staffing empty buildings and beds. 85% of women give birth in one of the three Obstetric Units with fewer than 6% giving birth across our four Freestanding Midwifery Units in Chippenham, Trowbridge, Paulton and Frome.

“We believe we have the right number and mix of staff but they’re not based in the right locations to ensure efficient use of our resources and provide women with the services they need.

“In our Freestanding Midwifery Units – particularly at night – staff are covering areas even when there are no or very few births. On average only one baby is delivered every two or three days in each of these units but they need to be staffed to support births 24 hours a day seven days a week.”

The plans have been developed to ensure services are efficient and sustainable to support future population growth, changes in housing policy, and the repatriation of military personnel to South Wiltshire from April 2019.

The proposal offers the following:

  • To continue to support births in two, rather than four, of our Freestanding Midwifery Units across Bath and North East Somerset, Wiltshire and Swindon. Women will still be able to have their baby in Chippenham and Frome Freestanding Midwifery Units, and antenatal and postnatal clinics will continue to be provided in all four – at Chippenham, Frome, Paulton and Trowbridge as well as all other current locations e.g. GP practices. A detailed travel impact analysis was undertaken to inform our proposal to continue supporting births in two of the Freestanding Midwifery Units.
  • To create two new Alongside Midwifery Units, one at Salisbury District Hospital and one at the Royal United Hospital, which will provide more women with the opportunity to have a midwife-led birth. These two units will be in addition to the White Horse Birth Centre that already exists at the Great Western Hospital in Swindon.
  • To improve the range of antenatal and postnatal services, for example by providing more breastfeeding support to women in their own homes. We also want to support more women to give birth at home if this is their preferred choice.
  • To replace the nine community postnatal beds (four at Chippenham and five at Paulton Freestanding Midwifery Units) with support closer to or in women’s homes. Women who need to be admitted for medical treatment after giving birth would be treated in their local Obstetric Unit at one of our acute hospitals in Bath, Salisbury and Swindon.
  • 95% of the time post-natal beds in our Freestanding Midwifery Units are empty as women rarely need to stay in a community hospital after giving birth.
  • 89 antenatal or post-natal beds are available at our Obstetric Units for women who need them

Once the public consultation has closed, the responses will be carefully and independently analysed and the results used to help the Governing Bodies of Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Groups make a final decision by Spring 2019.

Lucy Baker said:
“Our proposal is just that – a proposal. It addresses what women and staff have told us they think will work, but we want to hear people’s views and encourage them to have their say.

“The consultation will run from 12 November 2018 until 24 February 2019, to enable plenty of time for people to give their views.

“We will make the consultation results available to the public and explain how their feedback has helped shape our plans. We are aiming to make our final decision in Spring 2019.”

Find out more on our consultation webpage.

All the consultation information and documents, including ways to get involved and to provide feedback will be available online from Monday 12 November, at: www.transformingmaternity.org.uk

Helping each other to stay well this winter

Today is the start of Self Care Week and Wiltshire Council and NHS Wiltshire Clinical Commissioning Group are encouraging people to be well-prepared ahead of winter by taking simple steps to look after themselves and helping their families, friends and neighbours to do the same.
 

This year, the theme for Self Care Week is ‘Choose Self Care for Life’ and preparing now for the winter ahead will help people, particularly those who are elderly or vulnerable, to stay as well as possible.

This means trying to stay active even when the weather is colder, and eating a balanced diet. Wiltshire Council’s health trainers can help people every step of the way – the service is for people aged 18 + and is free. They can also help you find other services and activities to keep you healthy and well over winter.

For more information visit www.wiltshire.gov.uk/public-health-trainers or call 0300 003 4566.

There are also benefits and grants available to help with energy efficiency, such as cavity wall insulation to help keep homes warm. Call Warm & Safe Wiltshire on 0800 038 5722 or visit www.warmandsafewiltshire.org.uk for more information.

Jerry Wickham, Wiltshire Council cabinet member for public health, said:
“It’s also sensible to check on vulnerable neighbours and relatives and ensure they have everything they need to stay safe and warm. Sometimes, simply offering to do the shopping for someone can make a big difference.

“There is a lot of support available to help people to stay safe, healthy, warm and out of hospital this winter and beyond.”

NHS Wiltshire CCG has created an easy-to-use eight-step guide, to help people know what simple steps they can take to help keep themselves well over the winter months.

S – see your pharmacist at first sign of illness

E – eat plenty of fruit and vegetables

L – learn more about around the clock healthcare services in Wiltshire

F – find out if you’re eligible for a free flu vaccine

C – check in on your neighbours

A – arrange to pick up your prescription

R – restock your medicine cabinet 

E – ensure you stay warm

Dr Andrew Girdher, GP at Box Surgery, explains:
“We’re encouraging people to be proactive with their own self-care, to help them stay as healthy as possible and to know where to go if they do need health care advice.

“Healthcare services are put under enormous pressure over the winter months and by doing what you can to look after yourself where you can, helps to free up valuable practitioner time to see those people who really need to be seen.”