Agenda item

The Chair welcomed those present to the meeting.

Ms Lesley Watts, Chief Executive at The Hillingdon Hospitals NHS Foundation Trust (THH), noted that she had previously spoken to the Committee about the Minor Injuries Unit (MIU) at Mount Vernon Hospital. She advised that health services in Hillingdon, specifically the acute trust, had a history of overspending and not achieving great performance standards. Action was needed in relation to elective recovery whilst also looking after existing staff, attracting and developing new staff and building a new hospital, all within budget.

Discussions had been undertaken in relation to processes and the proposal had been considered by the Board in July 2025 where it had been agreed to transfer the MIU work from Mount Vernon Hospital to Hillingdon Hospital. Engagement had been undertaken with a range of people including colleagues in Hertfordshire and Berkshire, as well as residents associations and MPs. A meeting with residents had been held on Friday which had also been attended by the local MP and a consultation was currently underway with staff.

Dr Alan McGlennan, Chief Medical Officer and Managing Director at THH, advised that around 35-45 patients were seen each day at the MIU at Mount Vernon Hospital, whereas there were around 200 per day at the Urgent Treatment Centre at Hillingdon Hospital. Around 50% of the patients seen at the MIU were not Hillingdon residents and a large number of the presentations were minor illnesses or wound management issues which should be dealt with through primary care, social care or pharmacy care. It was anticipated that the move would initially see an additional 30 patients per day at Hillingdon Hospital but that this would reduce over time and productivity would increase.

Members queried how the MIU proposals would fit in with the NHS 10 year plan to shift more care into the community and whether the Pembroke Centre Hub in Ruislip would be able to cope with the resultant increase in demand. Dr McGlennan advised that around half of the patients presenting at the MIU needed an x-ray (for example, for a fractured finger or twisted ankle). A shuttle bus would still be available but half of the patients currently seen at the MIU could go to their GP. The proposals would fit in with the NHS 10 year plan.

The Ruislip Hub had been initiated and was still growing. Its availability had been well received by residents as it put the right care in the right place. Injuries requiring an x-ray would always need to be seen at Hillingdon Hospital but minor illnesses previously seen at the MIU should be going to their GP. Patient with things like urinary tract infections should go to their local pharmacy and chronic wounds and infections should be dealt with by the GPs. The Hubs would be developed so that they could deal with urgent care and some diagnostics.

Patients currently called NHS 111 and were given options on the places that they could attend. The MIU was not the only option given to patients when they called NHS 111 and MIU appointments tended to be the next day. Dr McGlennan was confident that there would be sufficient capacity within the system, with 98% of patients being seen, treated and discharged from Hillingdon within 4 hours. Ms Watts advised that Hillingdon Hospital performance was currently very good and one of the best in London. The need for change was about moving staff around to make best use of the resources available.

Concern was expressed that no consideration appeared to have been given to options 1 and 2 and it was queried whether the decision would be reversed if the pressure on other services became too high as a result. Dr McGlennan noted that the decision had been made in response to a deficit in healthcare in Hillingdon – there were no concessions and reviews were undertaken to resolve problems. It was recognised that the proposals would save the Trust around £1m but that Hillingdon’s Emergency Department’s (ED) performance was not good so the resources could be used to rebalance that. Currently, agency and bank staff were regularly used in the ED and moving the MIU staff to Hillingdon would help to reduce that reliance. Performance would be reviewed in April 2026 to establish whether or not there had been any improvements.

THH had not been operating within its means for a long time but the Trust had been on budget over the last couple of months. This performance needed to be sustainable but there was never going to be a good time to move the MIU. Hillingdon needed to invest in providing a good ED and being able to deal with patients with minor illnesses and injuries. Patients were also waiting too long for surgery. Hillingdon had well developed community working and the £1m would be able to underpin the work being undertaken in the acute units.

Ms Watts advised that it was important to address inequality of provision and resources and effort needed to be concentrated where it would have the biggest impact. Some of Hillingdon’s most deprived residents did not get the good service that they wanted. As part of the process, THH had liaised with hospitals in neighbouring boroughs to talk about the possible impact on them.

A decision on this matter had not been made previously. A number of ideas had been put forward and this was one of 2-3 that were being taken forward. Although the residents using the MIU at Mount Vernon Hospital would not be happy with the change, there were a lot of people who did not use the MIU that would benefit from the change.

It had been proposed that the 9FTE MIU staff would transfer to Hillingdon Hospital. Ms Watts advised that this was part of a routine process of moving resources to where they were most needed and that a formal consultation was currently underway with the MIU staff. Decisions needed to be made about patient care but the staff involved would get to make their own decisions about the transfer. Ms Watts advised that a wider formal consultation would not be undertaken but that THH had engaged with various organisations over the proposals and had held an adjournment debate at the request of the local MP.

The MIU had been used by families booking online for their children or by pupils sent by schools. Dr McGlennan noted that consideration would be given to moving the equipment from Mount Vernon to Hillingdon Hospital. He recognised that people had preconceived ideas about the ED but reassured Members that Hillingdon’s ED had been zoned and that the paediatric ED was secure and had a separate waiting area. Adults would be triaged on arrival and moved to another area if their injury was minor.

Ms Watts noted that work was currently underway to introduce a mobile diagnostics service which would also reduce the impact on the ED. Having been seen at Hillingdon Hospital, follow up clinics and physiotherapy would still be available from Mount Vernon. It was noted that the transfer of resources would take place at the end of September 2025 and that the Board would continuously review the resultant ED performance.

RESOLVED: That the discussion be noted.