NHS directive ends walk-in access to Swanage minor injuries unit

Swanage Hospital, along with all the other minor injuries units (MIUs) in Dorset are now asking people not to turn up for treatment but to ring an NHS helpline 111 and book an appointment first.

This is the result of a change to national NHS policy made on Tuesday 1st December 2020, when the ‘NHS 111 First’ scheme was introduced, although no NHS England news release was issued at the time to communicate the decision.


This was at the end of the second lockdown and just before the second UK wave of Covid infection.

Call NHS 111 first for assessment

As the name implies, this requires all patients who do not have life threatening emergencies to call NHS 111 first for assessment before attending emergency departments or urgent care centres. It has now been extended to all minor injuries units in Dorset including Swanage.

At the start of the pandemic, patients were asked to ring the local number for reception at Swanage Hospital before entering the building to prevent more people than necessary congregating in waiting rooms. As restrictions eased, the expectation was that people would be able to resume walk-in access to the MIU.

Swanage Hospital sign

The sign outside Swanage Hospital

“Ensure they get directed to the right service”

Now, Dorset Healthcare University NHS Foundation Trust has announced that from Monday 21st June 2021 people are being asked to ring 111 for an appointment and should only attend the MIU at their allotted time.

It says this will ensure people won’t have unnecessary waits and will help to avoid crowded waiting rooms. It will also mean some patients can be treated remotely and will not need to make an unnecessary journey.

A spokesperson for Dorset Healthcare University NHS Foundation Trust said:

“If people have a minor injury or ailment they should call 111 first for a telephone assessment. This will ensure they get directed to the right service, and could also save them travelling or waiting unnecessarily.

“The pre-booked appointment system has been working well throughout the pandemic. In the event of a more serious injury, people should call 999 as usual.”

As well as Swanage Hospital, this change in policy affects MIUs at:

  • Blandford Hospital
  • Bridport Hospital
  • Portland Hospital
  • Westminster Memorial Hospital, Shaftesbury
  • The Yeatman Hospital, Sherborne
  • Weymouth Hospital (Urgent Treatment Centre)
  • The Victoria Hospital, Wimborne

It was Swanage Medical Practice that first alerted residents to the change. On a social media post it said:

“We thought we should let you know that we’ve been advised this morning that as of this week, to get support from the MIU (Minor Injury Unit) you now need to phone 111; (the old number 01929 557563, also re-directs patients to 111).”

Exterior of Swanage Hospital

The minor injuries unit at Swanage Hospital

“It is an unnecessary inconvenience”

Responding to the information, local residents voiced their concern.

Gemma Walbridge said:

“A friend of mine spent over 30 mins on the phone trying to get an appointment through 111 yesterday for her child. The MIU wouldn’t allow her into the hospital even though she was outside desperate to see someone.

“This isn’t providing a service, it is an unnecessary inconvenience. Our MIU nurses are all lovely and kind and I’m afraid I think this service will have a negative effect on them through no fault of theirs.

“I have in the past often shot up to the hospital with my boys and been seen pretty much straight away. Having to phone 111 will delay patients being seen. The questions my friend was asked on the phone by 111 were very time consuming.”

“It will make more people use 999”

Another resident Suzanne Lucas said:

“I thought the idea was that if you had a minor injury you could walk-in, pre covid of course. Now you may wait a few hours for 111 to call back. It will make more people use 999. Just another way of trying to close it down.”

“111 can take hours to get the answers you need!”

Swanage local, Stephanie Cole added:

“I have always found the Swanage MIU very helpful and to be fair, without them my husband probably wouldn’t be alive now. The joy of having a unit like this is the speed you are seen. Even in these times when my son recently scolded himself, I was able to phone them and be seen within 30 minutes – 111 can take hours to get the answers you need!”

“Clinical risk increases when triage does not happen face to face”

Writing in December 2020 in the medical journal, BMJ, two GPs said that before ‘NHS 111 First’ was rolled out nationally, more data was needed from more extensive and longer term pilots. Simon Hodes and Neena Jha said:

“The overarching concern expressed by healthcare professionals about NHS 111 First is patient safety. Triaging patients takes time, can add unnecessary delays, is complex, and is not without medical risk. Clinical risk increases when triage does not happen face to face. When directing patients to different services, there must be an understanding by call handlers of what those services entail.

“There are no set entry requirements to become an emergency medical dispatcher or call handler. All trusts require applicants to be aged 18 or over, and most require a GCSE in Maths and English at Grade C/4 level or above. Given the limited healthcare experience of call handlers it is imperative that the algorithm is risk-averse, which in itself may lead to increased attendances.”

Anyone attending with an immediate need to be seen, will be seen by the team

The Friends of Swanage Hospital committee say they understand that the appointment system that’s been operating throughout the pandemic has now been formalised by a national directive that says all referrals go through 111.

Now every call that comes to Swanage Hospital has to go through 111 and callers to the hospital are being advised of this. However they added that obviously anyone attending with an immediate need to be seen, will be seen by the team.

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