Minor Injuries Unit (Consultation closed) (MIU)

Cromer and District Hospital - Minor Injuries Unit

In 2004 we formally consulted on a proposal to change the opening hours of the Minor Injuries Unit (MIU) at Cromer & District Hospital and to staff the unit solely with Emergency Nurse Practitioners (ENPs).

The MIU was open 24 hours a day, seven days a week. However an audit of patients who used the MIU at night-time, between January and November 2003, showed that, on average, less than one person a night used the service.

On that basis, we proposed in January 2004 that the unit be open seven days a week but from 8am to 10pm, rather than 24 hours a day.

We also consulted on how the public would feel about the MIU becoming a totally nurse led service as 98 per cent of our MIU patients are currently treated by ENPs.

It was proposed that these changes would start from December 23, 2004 following a three month consultation period that ended on April 2, 2004.

How we consulted the public

The consultation leaflet was made available in the hospital's MIU reception, at local GP surgeries, opticians, and chemists. In addition, 12,000 copies of the leaflet were inserted into and distributed via the North Norfolk News, a local weekly newspaper. 

All the responses were logged and fed back to the hospital's managers. Any member of the public who raised a specific question also received a letter of response. 

Consultation results

The full consultation results can be seen by clicking here

In summary,  of the 12,000 leaflets distributed, 120 were returned (response rate 1%). Of those:

Proposed closure of the unit overnight

• 41.6%            (50)            were opposed to the change in hours
• 29.1%            (35)            agreed with the change in hours
• 11.6%            (14)            agreed, but with extended opening hours in summer
• 17.5%            (21)            did not express a view about the proposals, but raised a separate issue relating to the NHS, or stated that they did not know the service existed (6)

Of the 41.6% who were opposed to the proposal, it is clear from their comments that many of the respondents did not understand the role of a minor injuries unit, or indeed the limited nature of ‘emergency’ services that can be provided in a hospital with the staffing and facilities of Cromer, as distinct from the Norfolk and Norwich University Hospital. 

Proposal to make MIU an Emergency Nurse Practitioner-led service

Only two respondents referred to this issue.  One was in favour, and the second was in favour, as long as there was access to a doctor.

Conclusions

In light of the feedback on moving to a nurse-led service, it was resolved we should  move to making the Minor Injuries Unit an ENP-led service.  Many of the concerns about reducing the hours were strongly influenced by a lack of understanding of what the MIU can actually treat i.e. that it would be irresponsible to reduce an emergency service. However the MIU has not and never will offer an emergency service. 

The consultation confirmed some people were unclear about the nature of the service and what it can deal with. A number of people also said they were unaware of the service or exactly when it operated.

As a result of that feedback, we have commited to undertake a public information campaign to promote awareness.  

Decision-making process 

• the results of the public consultation were presented to our Trust Board on April 21 and considered 
• the results of the public consultation were presented to North Norfolk Primary Care Trust Board on May 13 2004 and considered
• the results of the consultation were discussed with the North Norfolk and NNUH PPI Fora on July 1 2004
• we published the results of the consultation on July 27 2004, including answering the queries raised by respondents, and giving clear information about the Minor Injuries Unit and its appropriate use
• we agreed a timescale for making changes with staff concerned
• we introduced the new opening hours for the MIU from December 23 2004
• we produced public information for North Norfolk residents and holidaymakers and distributed it in February/March 2006