The overnight closure of Weston Hospital's A&E department has officially been made permanent.
It means - at night - patients will continue to be sent to Taunton's Musgrove Park or Bristol instead.
The change was approved by the Clinical Commissioning Group last night, who say they will now strengthen local GP services as a result.
They also plan to invest in children's urgent care, which will be extended from five to seven days a week
A recent consultation on the closure - which was over staffing level concerns and originally supposed to just be temporary - found 69 per cent of responders opposed it.
A spokesperson for the Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group’s Governing Body said: "The plans - supported by senior doctors across the region, alongside national regulators and the Boards of both Weston Area Health NHS Trust and University Hospitals Bristol NHS Foundation Trust - will establish permanent opening hours of 8am - 10pm at Weston A&E 7 days a week.
"These are the opening hours that operate currently, and which have been in place since July 2017 when the department was temporarily closed overnight due to patient safety concerns.
"Under the agreed proposals, 24/7 urgent care access will be bolstered by an increase in the number of hospital admissions being made directly onto wards overnight - bypassing the need for A&E altogether. GP services in the area will also be strengthened.
"On average, around eight people per night currently attend neighbouring hospitals for emergency care, and this number will reduce to around five with the introduction of direct admissions. Referrals directly onto wards will be made by GPs and paramedics."
The additional recommendations are:
- To make specialist children’s urgent care provision available 7 days a week instead of 5, and extending the mid-week opening hours at the Seashore Centre to match those of A&E. This means around 1,100 more children in need of emergency care will be treated at Weston Hospital each year; and a further 570 will receive their planned care at Weston instead of travelling further afield.
- Continue to provide emergency surgery at Weston Hospital 7 days a week, closing theatres from 8pm-8am. Patients needing emergency surgery overnight will be stabilised at Weston and transferred to neighbouring specialist hospitals for treatment, affecting around 80 people a year.
- Continue to provide up to Level 3 critical care for people who need single organ support at Weston Hospital. People requiring critical care for two or more organs at Level 2 or 3 - or people who will benefit from highly specialist clinical services - will be transferred to Bristol for treatment then brought back to Weston to continue their recovery locally. As a result of the public consultation process, a dedicated transfer team will be set up for these patients - reflecting the importance of travel to the public. The change is expected to affect around 130 people a year.
- The developments will see around 2, 000 more people treated locally at Weston each year, the majority of them children benefiting from the extended paediatric hours. They are supported by a raft of wider improvements already in progress, which include:
- The introduction of an integrated frailty service which will provide more joined-up care for the area’s growing population of older people.
- A new mental health crisis and recovery centre in the centre of Weston which will open in early 2020.
- Strengthened primary care services, with GP practices working together at scale to improve access and care for local people.
Dr Martin Jones, Medical Director at BNSSG CCG, said: "The proposals agreed today are a big step forward for Weston Hospital, the population it serves, and the staff who work there. The hospital will be much better able to achieve national clinical quality standards with these changes in place, as well as attract and retain the staff it needs.
"Clinicians across our area are clear that ‘doing nothing’ is not an option for Weston. Similarly, 8 in 10 respondents to our public consultation recognised the need to do things differently.
"Despite the best efforts of skilled and committed hospital staff, the way we organise services has simply not kept up with changing health needs over the years.
"The approved proposals will stabilise urgent care, improve quality, and ensure that the hospital is better able to expand the services that local people need most often - such as frailty support, paediatrics and planned care."
Dr Peter Collins, Medical Director at Weston Area Health Trust, said: "We welcome the CCG Governing Body’s decision and the clarity and certainty this brings to our staff and those who need our services.
"We are committed to working with our commissioning colleagues to ensure that Weston General Hospital remains a dynamic hospital at the heart of the community, and our priority now is to work with our skilled and dedicated clinical teams to implement the proposals and make this a reality."
A phased implementation of the recommendations will run until April 2021.
You can read the full Decision-Making Business Case for Healthy Weston here