STRUCTURE: A shortage of accident and emergency consultants is driving the reconfiguration of accident and emergency services in Gloucestershire, board papers reveal.

Under plans approved by Gloucestershire Clinical Commissioning Group last week, the accident and emergency unit at Cheltenham General Hospital will stop accepting 999 emergency cases between 8pm and 8am from 29 July.

Instead patients will be transported to Gloucester Royal Hospital. Both hospitals are run by Gloucestershire Hospitals Foundation Trust.

A report to the meeting said the changes were being driven by the national shortage of A&E consultants. Currently there are 11 consultants and 7.5 middle grade doctors working across both sites; the College of Emergency Medicine recommends each site should have 10 consultants and eight middle grade doctors.

The Severn Deanery has given the trust until 1 August to address the issue or risk losing trainee doctors to other providers.

The document noted recruitment of A&E doctors was difficult nationally, as highlighted by a Commons health committee report this week, but said the problems were particularly “acute” in Gloucestershire. It said the “significant challenge” in recruiting was the “key” reason for the changes.

Emergency medicine consultant Tom Llewellyn said: “The proposals for change were developed for service quality and safety related reasons, which includes the availability of experienced emergency medicine doctors.

“The proposals were subject to rigorous scrutiny and review by both the National Clinical Advisory Team (NCAT) and the county’s health and care overview and scrutiny committee, who understand and appreciate that the present arrangements for emergency care are unsustainable.”

Gloucestershire County Council’s health overview and scrutiny committee has backed the planned changes subject to regular reporting of the impact and an agreement to review the changes if outcomes do not improve as expected.

The trust also plans to concentrate the majority of beds for planned gastroenterology and hepatology at Cheltenham along with treatment for long term respiratory conditions. The cardiac intervention unit will also be expanded and a dedicated paediatric day-case unit created at Gloucester.

The report said changes to paediatric services were driven by the “shortage of specialist doctors and nurses to care for children”.

Local Conservative MP Geoffrey Clifton-Brown has publicly backed the changes. In a statement on his website he said: “As an individual I would prefer one superb accident and emergency service available to me, rather than two less efficient services.”