The Hillingdon Health & Social Care Select Committee met this week to discuss the future of the Mount Vernon Minor Injuries Unit. It is being closed, and its services being transferred to the existing Urgent Treatment Centre (UTC) at Hillingdon Hospital.
The decision, and perhaps more specifically, the decision making process, has become a bit of a political hot potato – leaving the actual details of what is happening and why… a little more difficult to follow. So, what’s actually happening?
What is (was) Mt Vernon's Minor Injuries Unit for?
Minor injuries might include cuts, grazes and bruising, minor burns, animal bites and simple broken bones. This service is not a ‘walk-in’ clinic; patients are triaged and appointments, if required, are booked via NHS 111 online or by calling 111.
What would appointments be made for?
The service treats minor injuries and illnesses that require urgent treatment.
- minor illnesses
- cuts and grazes
- minor scalds and burns
- strains and sprains
- bites and stings
- minor head injuries
- ear and throat infections
- minor skin infections / rashes
- minor eye conditions / infections
- suspected fractures.
During the meeting, making the point that the patients attending the Mount Vernon unit with minor injuries are generally mobile (and that going to a pharmacist or even to Hillingdon hospital is possible, Dr. McGlennan said: “Remember that people who are going there don’t have fractured hips, they have fractured fingers or twisted ankles.”
In Summary
The hospital leadership defended their board’s decision to close the Minor Injuries Unit at Mount Vernon Hospital and consolidate services at Hillingdon Hospital, with the change set to take place at the end of September. Lesley Watts, the Trust’s CEO, explained the move is necessary to address the hospital’s long-standing financial deficit, stating it will create a recurrent saving of £1 million annually.
Dr. Alan McGlennan, the Chief Medical Officer, added that the decision is clinically driven, aiming to create a more resilient service, reduce reliance on expensive agency staff at Hillingdon’s Urgent Treatment Centre (UTC), and better serve the borough’s more deprived populations who live closer to Hillingdon Hospital.
He clarified that Mount Vernon’s Minor Injuries unit sees about 35-40 patients per day, mostly if not exclusively after being referred there by 111 with an appointment for the following day. He expects only half of those (the ones requiring an X-ray) would need to travel to Hillingdon, which has the capacity to see them.
For comparison, Hillingdon’s whole Emergency Department sees 400-450 patients per day, with about 200 of those in the Urgent Treatment Centre – and it’s there that the 20-30 or so patients who would’ve gone to Mt Vernon would be going instead. Others would be directed by 111 to a GP, even if not their own, the new Hub in Ruislip Manor (and, eventually, two others which are to be opened too), or a pharmacist.
Discussions at the meeting
Councillors raised significant concerns on behalf of residents, focusing on the lack of a formal public consultation, the negative impact on access for those in the north of the borough, and the current capacity of community services to handle redirected patients. Hospital leadership confirmed no formal public consultation was held and stated one would not be conducted, asserting their stakeholder engagement was sufficient. In response to concerns about the patient experience, Dr. McGlennan gave assurances that Hillingdon Hospital has a completely separate and secure Paediatric Emergency Department for children. He also confirmed that crucial follow-up services, such as physiotherapy, will remain at Mount Vernon Hospital, meaning patients would not need to travel to Hillingdon for their rehabilitation appointments.
Lesley Watts (Hillingdon Hospital Chief Executive)
Lesley Watts outlined the strategic reasons for the decision and addressed the process and financial implications.
- Rationale for Change: She explained the proposal was driven by the Trust’s history of financial overspending, subpar emergency department performance, and the need to improve services for the sickest patients while living within its means.
- Process Followed: She confirmed the Trust’s board had already approved the decision in July. She detailed the engagement process with MPs, councillors, residents’ associations, and surrounding health authorities, but confirmed no formal public consultation was held, stating it was not deemed necessary after taking advice from the Integrated Care Board (ICB).
- Financial Impact: The consolidation will save £1 million per year. She stated this money is not available for reinvestment in other community services but is essential to make the hospital’s finances sustainable and support core services like elective surgery.
- Staff Impact: She acknowledged that the 9.4 full-time equivalent staff at Mount Vernon would prefer to stay but said the decision was about “putting the patients first.” She expressed hope that they would all move to Hillingdon.
- Timeline: The transfer of services is scheduled to take place at the end of September.
Dr. Alan McGlennan (Chief Medical Officer & Managing Director)
Dr. McGlennan provided the clinical and operational details to support the consolidation.
- Patient Numbers & Activity: He clarified that Mount Vernon sees 35-40 patients per day, while Hillingdon’s UTC sees around 200. (Hillingdon’s entire emergency department, which includes the UTC, sees 400-450 patients per day). He argued that much of Mount Vernon’s work isn’t for acute minor injuries but for minor illnesses (coughs, colds) and wound management, which are better suited for primary care (GPs) and pharmacies.
- Impact on Patients: He estimated that about 50% of Mount Vernon’s patients (those needing an X-ray) would have to travel to Hillingdon. The other 50% should be redirected to primary care (GPs or pharmacists). He noted that Hillingdon UTC has the capacity to absorb these patients and that its performance is strong, seeing 98% of patients within four hours.
- Patient Experience: In response to concerns, he assured the committee that Hillingdon Hospital has a completely separate and secure Paediatric Emergency Department, so children with minor injuries would not be mixed with critically ill adults. He also confirmed that follow-up services like physiotherapy will remain at Mount Vernon.
- Monitoring: He stated the Trust will continuously review the impact of the change on performance and staff, with a key review planned for April as part of the normal business cycle.
Questions raised, and topics covered by Councillors on the Health & Social Care Select Committee
Nick Denys (Chair, Conservative, Eastcote)
How does this move align with the NHS plan to shift care closer to communities?
- Dr. Alan McGlennan explained that the move supports the plan by ensuring complex minor injuries requiring hospital diagnostics (like X-rays) are seen in a fully equipped hospital, while very minor illnesses (like coughs, colds, or urinary infections) are correctly redirected to community services like GPs and pharmacies, which is where they belong. 1 The development of integrated care hubs is the long-term strategy for enhancing this community-based care.
Is there enough capacity in local services right now to handle the patients who won’t go to Hillingdon Hospital?
- Yes. Dr. McGlennan stated that Hillingdon Hospital has the physical capacity to absorb the extra ~30 patients per day who need hospital care. He also said that the minor illnesses that were being seen at Mount Vernon should already be handled within the “general practice offering,” which has sufficient capacity.
Where will the £1 million annual saving go? Will it be reinvested locally?
- No. Lesley Watts stated the money will not be reinvested into other community services. It is required to address the hospital’s long-term financial deficit and ensure its core services (like elective surgery and emergency care) are sustainable.
Cllr Kelly Martin (Conservative, Hillingdon East)
Was the decision to close the Mount Vernon unit the goal all along?
- No. Lesley Watts stated the decision “genuinely wasn’t” predetermined. The proposal was one of several options presented by clinical teams during the annual business planning process, and other proposed changes were not taken forward.
What specific metrics would trigger a reversal of the decision?
- Dr. McGlennan said they would monitor key performance indicators. A reversal would be considered if performance at the Hillingdon UTC worsened from its current average (which is about a two-hour wait time, but on the day of the meeting he said that they had been running at only 90 minutes) or if there were negative impacts on staff retention. He said they would conduct a formal review in April, which he described as standard practice for any major service change.
Cllr Reeta Chamdal (Conservative, Hillingdon West)
Has a formal public consultation been carried out?
- No. Lesley Watts confirmed, “No, we haven’t.” She said the Trust took advice from the Integrated Care Board (ICB) and believed that the extensive engagement they had already conducted with stakeholders was sufficient. When asked if they would consider running one, she replied, “we won’t.”
Cllr Becky Haggard (Conservative, Eastcote)
Will there be a separate area at Hillingdon Hospital for children with minor injuries?
- Yes. Dr. McGlennan assured the committee that Hillingdon has a “completely separate” and secure Paediatric Emergency Department with its own waiting area. Adults with minor injuries are also streamed away from critically ill patients into the Urgent Treatment Centre.
What will happen to follow-up appointments like physiotherapy?
- These services will remain at Mount Vernon Hospital. Both Lesley Watts and Dr. McGlennan confirmed that follow-up clinics and physiotherapy will not be moved.
Sital Punja (Labour, Yiewsley)
How will the gap in provision be managed while the new community hubs are still developing?
- Dr. McGlennan explained there isn’t a “gap.” The service is being moved, not closed. Patients with injuries needing an X-ray will go to Hillingdon Hospital immediately. Patients with minor illnesses who were inappropriately going to Mount Vernon will be redirected to existing GP and pharmacy services, which already have the capacity to manage them.
What is the expected capacity growth at Hillingdon Hospital?
- The hospital expects to see about 30 more patients per day initially. Dr. McGlennan stated that with the experienced nursing staff also moving from Mount Vernon, the “productivity” would increase, and patients should be seen within the same timeframe as they are now.
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