APPENDIX ONE : Community Hospitals - Overview

The Trust manages seven community hospitals across the county, namely:

Hospital;  North Cotswolds Hospital;  General Hospital;  Vale Community Hospital;  Community Hospital;  Dilke Memorial Hospital;  Lydney and District Hospital.

Additionally, the Trust provides services within and .

These community hospitals provide access to six categories of service as illustrated in the table below, and more detailed thereafter:

Inpatient Out- Day Day Assessment Minor wards patients case case and Rehab Injuries (non- (theatre) Units and Illness theatre) Unit Cirencester      

Dilke Memorial   x x  

Fairford x  x x x x

Lydney and District     x 

North Cotswolds   x x x  Stroud General      

Tewkesbury Community   x   

Vale Community   x x x 

Winchcombe   x x x x

1 Care Services NHS Trust Community hospital overview 1. Inpatient wards Adult inpatient services currently have capacity across twelve bedded units and eight sites.

The number of inpatient admissions to these hospitals over the 12 month period July 2014 to June 2015 is illustrated below (excluding Winchcombe):

100

90

80

70 Cirencester 60 Dilke Lydney 50 North Cots Stroud 40 Tewkesbury 30 Vale

20

10

0 Jul-14 Aug-14Sep-14Oct-14Nov-14Dec-14Jan-15 Feb-15Mar-15Apr-15May-15Jun-15 2. Outpatients Adult and children’s outpatient services are provided in all the Trust’s community hospitals – these are planned consultations which may include diagnostic tests such as x-ray where applicable. Specialties that are provided in an outpatient setting include Audiology, Back Pain Clinic, Continence, Stoma and Diabetic Nurse.

Additionally, service users have access to specialists in Dermatology, Diabetes, Dietetics, Dermatology, ECG Clinic, ENT, Elderly Care, Gastroenterology, General Medicine, General Surgery, Gynaecology, Heart Failure Service, Menopause Clinic, Midwifery, Multiple Sclerosis, Nephrology, Smoking Cessation, Oncology, Ophthalmology, Optometrist, Orthotics, Orthopaedics, Pain Clinic, Paediatrics, Podiatry Rheumatology, Speech Therapy, Substance Misuse, Thoracic, Trauma and Orthopaedics including Fracture Clinic and Urology.

Outpatient services are provided either directly by Trust clinicians, or by external clinicians (ostensibly, clinicians from Gloucestershire Hospitals NHS Foundation Trust) using Trust services and facilities.

2 Gloucestershire Care Services NHS Trust Community hospital overview The number of outpatients appointments in community hospitals over the 12 month period July 2014 to June 2015 is illustrated below (excluding Winchcombe):

700

600

500

Cirencester Dilke 400 Lydney North Cots Stroud 300 Tewkesbury Vale Fairford 200

100

0 3. Adult Jul-14day Aug-14case Sep-14servicesOct-14 notNov-14 performedDec-14Jan-15 inFeb-15 theatreMar-15Apr-15 May-15Jun-15 These are predominantly endoscopy services, which are provided by Gloucestershire Hospitals NHS Foundation Trust using Trust services and facilities.

4. Adult day case services performed in theatre These are services which are performed under either local or general anaesthetic. They are also provided by Gloucestershire Hospitals NHS Foundation Trust using Trust services and facilities. Surgery undertaken includes gynaecology, oral surgery, orthopaedics, plastic surgery, podiatric surgery etc.

5. Assessment and rehabilitation units The ARUs house occupational therapy teams and physiotherapists, and also offer access to gyms for treatment and to enable rehabilitation.

6. Minor Injuries and Illness Units

3 Gloucestershire Care Services NHS Trust Community hospital overview Minor Injuries and Illness Units (MIiUs) treat a range of less serious conditions and ailments such as sprains, simple fractures that may need x-rays and plastering, wounds that may need stitches, minor burns etc.

The number of MIiU attendances over the 12 month period July 2014 to June 2015 is illustrated below:

1900

1700

1500

1300 Cirencester Dilke Lydney 1100 North Cots Stroud 900 Tewkesbury Vale

700

500

300 Jul-14Aug-14Sep-14Oct-14Nov-14Dec-14Jan-15Feb-15Mar-15Apr-15May-15Jun-15

4 Gloucestershire Care Services NHS Trust Community hospital overview