BNSSG Healthier Together

Healthy Weston: Phase Two FAQs

Weston General Hospital is developing into a thriving hospital at the heart of the community.
Over 5,000 patients, public and staff have shaped plans to make sure Weston General Hospital provides more of the care people need most often, now and in the future.

Questions about Weston’s bright future

What’s planned?

On top of routine, ongoing service development at the Hospital, there is a particular focus on three areas. The Hospital will:

  • become a centre of surgical excellence. This means thousands more planned operations for adults of all ages will be carried out at Weston General Hospital
  • become a centre of excellence for older people’s care. This means the Hospital will provide more specialised care for older people, as well as a wide range of services for people of all ages
  • help more people go home quickly after going to hospital in an emergency. The Hospital will have a dedicated unit for assessing and treating people quickly

The Hospital will continue to provide A&E services from 8am to 10pm, exactly the same as for the last five years.

Other services at the Hospital (including outpatient appointments, maternity care, children’s services, cancer care, intensive care, emergency surgery and stroke rehabilitation) will continue to be provided, and improved, for people of all ages.

People with stroke, heart attack and major trauma already go straight to a hospital with specialist services. This will stay the same. Ambulances will take everyone else to Weston General Hospital to be assessed and get immediate care as usual.

The majority of people who arrive at Weston General Hospital in an emergency will still receive their care at Weston General Hospital. A small number of people who need longer specialist, medical inpatient care (for more than 24 hours) for specific things like lung and stomach problems will be transferred to a hospital with the required specialist staff and equipment. They will get the best care for their needs so they can go home quicker.

Why do services need to change? Is this about saving money?

These plans are part of a programme of improvements and development to make sure Weston General Hospital remains a thriving hospital at the heart of the community. We are not saving money or reducing budgets. We are investing in a strong and stable hospital with a clear long-term future.

The reasons that we need to keep developing Weston General Hospital are:

  • We need to keep up with local people’s health needs. There are more houses being built and the population is growing. Local people are getting older and living with more complex health conditions. Our plans mean that Weston General Hospital can provide thousands more operations a year close to home and keep up with all the services that people use most, like outpatient appointments and children’s services.
  • All services need to stay safe and strong. The whole country has a shortage of healthcare staff. There are not enough specialist staff in some departments at Weston General Hospital, even though we have tried for years to recruit more. This makes it hard for some services at Weston General Hospital to always meet national and local standards. Our plans mean services can continue for the long-term.
  • Local people want Weston General Hospital to stay strong. Over 5,000 members of the public and staff have helped shaped plans. In a recent survey of almost 900 people, 9 out of 10 said services at Weston General Hospital need to change (85%). People know that if we make these changes, Weston General Hospital will have a secure future.
  • Our plans will help services and teams work together. Weston General Hospital will work even more closely with general practices, community services and social care to care for people close to home. Trusts from Weston and Bristol merged to work closely together.
  • We can make best use of resources. The NHS has limited staff, money and other resources. The COVID-19 pandemic put even more pressure on services. Our plans will help get the best result for every pound of NHS money spent.

Questions about who will be affected

How many people will be affected?

Most of the people who use Weston General Hospital’s services will not be affected. Outpatient appointments, maternity care, children’s services, cancer care, diagnostic tests intensive care, emergency surgery, stroke rehabilitation and pharmacy will all continue as usual.

Weston General Hospital will continue to provide A&E services from 8am to 10pm, exactly the same as for the last 5 years. The Hospital will continue to provide an urgent care centre for children.

We want to keep improving services for everybody who uses the hospital and there will be particularly positive impacts in the areas of planned care, care of the elderly and same-day emergency care.

  • Thousands more adults each year, of any age, could have a planned operation at Weston General Hospital for things like hip, knee and cataract surgery. We will do between 20 and 114 more planned operations every day. This will benefit people living in and near Weston, who will not need to travel to other hospitals.
  • Thousands more older people each year will benefit from Weston General Hospital’s focus on caring for older people, with special clinics and wards to help frail, older people who are less likely to bounce back after being unwell.
  • Thousands of people of any age will be able to go home quicker after an emergency due to same day emergency care. A small number of people who need ongoing specialist inpatient medical care for conditions such as heart, lung or stomach problems, will be transferred to a hospital with the required specialist staff and equipment. They will get the best care for their needs so they can get home quicker. We estimate about eight people per day will be transferred in this way.

Why is there so much focus on older people’s services?

Weston General Hospital is providing care for people of all ages, not solely older people.

The hospital will continue to provide general hospital services and A&E for all ages.

There is lots of new housing for families in the area. Weston General Hospital is already providing better children’s services, as a result of the first phase of Healthy Weston, and will continue providing current maternity services.

The hospital will continue to provide outpatient appointments and diagnostics to people of all ages.

We plan to create a surgical centre of excellence which will increase the amount and type of planned operations at Weston General Hospital. This will serve adults of all ages.

We know that a lot of local people are older than 65 years. Weston General Hospital must be able to meet older people’s needs too. This is why we plan to make Weston a centre of excellence for the care of older people. Health and social care professionals who are experts in older people’s care will work together to help people remain as independent as possible for as long as possible. We are doing this as well as continuing to provide a wide range of care to all ages.

Questions about travel and transport

Will ambulances still go to Weston General Hospital?

Yes. Ambulances will keep bringing people to Weston General Hospital in an emergency, exactly as they do now. Staff at Weston General Hospital will assess people and start their care.

Ambulances already take people who have a stroke, heart attack or major trauma directly to neighbouring specialist hospitals and this will not change.

Will it be safe to transfer people between hospitals if they need specialist ongoing care?

Most people, including older adults who are frail and those who have had emergency surgery, will continue to receive all their ongoing care at Weston. A small number who need longer inpatient medical care (for longer than 24 hours) for specific things like lung and stomach problems will be transferred to a hospital with the required specialist staff and equipment. They will get the best care for their needs so they can get home quicker.

We will only take people to another hospital if they are medically stable. There are safe and reliable processes in place to transfer patients who need more specialist care than Weston General Hospital can provide. People will not have to make their own way — we will take them.

Will the ambulance service be able to cope?

Yes. We will have a separate Patient Transport Service to transfer patients between hospitals, not the ambulance service.

How will you help patients and visitors who need to travel?

Our plans mean most people will travel less. Weston General Hospital will provide thousands more planned operations each year, so fewer people will need to travel to other hospitals for surgery, or for outpatient appointments before and afterwards, or to visit people having surgery in another hospital.

Three groups of people may have to travel further:

  1. people who need longer medical inpatient care for specific conditions like lung and stomach problems (estimated at about eight people per day)
  2. people coming from around Bristol for planned operations at Weston General Hospital
  3. people visiting either of these two groups

We know that travel is important to people and in our public engagement exercise (20 June to 14 August) we are asking for your advice about what we could do to help people with this.

The health service does not have control over public transport and cannot pay for visitor travel, so we need practical ideas for things we could do to help.

Things we are already doing to reduce the impact are:

  • reducing the number of people who need to be admitted to hospital by strengthening our community service and same day emergency care
  • providing a patient transport service to neighbouring hospitals for those who need to transfer
  • signposting visitors to help with travel and transport to hospital if they are eligible.
  • considering ways to help people stay in touch if people cannot visit. For example, we could provide laptops or tablets to help people in hospital speak with loved ones on video.
  • meeting with transport providers and local authorities to discuss bus routes and timetables
  • making sure that people who are transferred to other hospitals can come back to Weston General Hospital after their specialist care, so they can finish their inpatient stay closer to home if possible.

Questions about staff and resources

Will you be able to recruit enough staff?

Having clear plans for Weston General Hospital will help us recruit and keep the right mix of staff. The plans will address our staffing challenges because:

  • Hospitals that have a secure future with clear plans find it easier to keep staff and recruit new staff. We have already recruited new staff to Weston in a short space of time.
  • Staff will have opportunities to develop more skills in our centres of excellence for planned surgery and older people’s care. There will also be new roles supporting same day / short stay care, different clinics and digital technologies. This will make Weston General Hospital an attractive place to work and give staff more job satisfaction.
  • We will streamline medical staff into a smaller number of clinical areas. This will improve care and reduce the number of sub-specialities that the Hospital is trying to recruit into.
  • We will create more joint positions working between hospitals in Weston and Bristol. This will give people more variety in their roles.

Will you reduce the number of staff or have redundancies?

No. Weston General Hospital has dedicated and hardworking staff. We want to attract and keep more staff, not reduce numbers.

We plan to change the way that Weston General Hospital delivers services. This may include changes to wards and specialities, so some staff may be asked to work in different ways. We would formally consult with individual staff if this were the case.

Will there be enough money to make the changes?

Most of the planned changes are possible within our existing budget. We need funds for building works and equipment to create a centre of surgical excellence. We are discussing funding with national and local sources.

Do neighbouring hospitals have enough space to take more patients?
We are working closely with hospitals across Bristol, Somerset and South Gloucestershire on these plans, to make sureother hospitals have enough space to cope. The impact on other hospitals is small. For example, around 3.5% more people will go to the Bristol Royal Infirmary after an emergency.

We will be reducing the number of people who need to stay in hospital overall, by providing more same day and short stay care.

Weston General Hospital will also be providing more planned operations for people from across North Somerset, Somerset, Bristol and South Gloucestershire. That means Weston General Hospital would serve people who would otherwise be having planned surgery at another hospital.

Changes would begin from 2023/24 so there is time to prepare.

Questions about A&E

Will you close or change A&E at Weston General Hospital?

No. Weston General Hospital will continue A&E services from 8am to 10pm, exactly the same as for the last five years. The Hospital will continue to provide children urgent care.

Why can’t A&E be open 24 hours?

For the past five years Weston General Hospital A&E has been open from 8am to 10pm. This is working well.

This started temporarily from July 2017 as there were not enough senior staff to supervise junior staff and keep the A&E open. The shortage of senior staff was affecting the hospital’s ability to deliver safe care that met national standards. Following detailed consideration of the hospital’s options, and a public consultation, the arrangement became permanent from October 2019. Having a 24-hour A&E would require more senior staff and resources to cover overnight surgery rotas, transport and extra diagnostics. There remains a national shortage of staff and not enough people use A&E overnight in Weston.

Senior local doctors and other experts agree that providing urgent and emergency care services 14 hours a day, seven days a week like now is the right approach for Weston General Hospital.

The current opening hours mean Weston General Hospital can keep a safe, stable and sustainable A&E for local people seven days a week. This gives local people and staff confidence that the services we have are secure for the long term.

Questions about involving people

Are you engaging with people about these plans?

Yes. The plans were developed by senior doctors, nurses and other professionals working with patients and members of the public. More than 5,000 people have influenced the plans.

The plans were reviewed by:

  • a local authority committee responsible for checking that the NHS engages properly (North Somerset Health Overview and Scrutiny Panel)
  • a panel of senior clinicians who review proposed changes to health services (South West Clinical Senate)
  • senior people in the NHS (NHS England and NHS Improvement)

The partners decided that the plans are a development of existing services, rather than a ‘substantial variation’ to services. They stated that there is no legal requirement for a formal public consultation.

Engaging with local people and staff continues to be important to us. We are not consulting people formally, but we are spending two months, from 20 June to 14 August, asking for advice about how to make the plans stronger and how to get the message out about what is happening.

How have patients and staff been involved?

The plans were developed by senior doctors, nurses and other professionals working with patients and members of the public.

Over the past four years, we received 5,635 pieces of feedback about the Healthy Weston programme. People have taken part in meetings, workshops, completed surveys and written letters and emails. We published independent summaries of all the feedback and used the feedback to shape the plans.

A Patient and Public Reference Group and a Staff Reference Group provide regular feedback. A Citizen’s Panel also contributes.

In March 2022, we surveyed people about the latest plans. About 900 staff and members of the public responded. Some 85% agreed that Weston General Hospital services need to change, 68% supported transferring patients to neighbouring hospitals after an emergency and 91% supported same day emergency care at A&E.

What happens next? How and when will decisions be made?

We are continuing to refine plans, based on feedback from staff, members of the public and other groups. Later in 2022 an independent team, separate to the NHS, will summarise all the feedback we receive between June and August 2022. We will use people’s practical ideas to plan how we communicate about next steps and how we support people affected by the changes.

Towards the end of 2022, NHS decision-makers will review the plans and make sure we have considered people’s feedback. The aim is to begin turning the plans into reality from 2023. Some of the new services will take a few years to build up. We will continue to ask for people’s advice as we move forward.