WALES’ newest hospital has been operating without full planning permission for its accident and emergency department since opening three years ago, it has been revealed.
The Grange University Hospital in Llanfrechfa, Cwmbran has only had permission to treat patients at its A&E department who had been brought there either by ambulance or transferred from another hospital.
Health chiefs had never imagined people would take themselves to the A&E at the £358 million hospital when they were granted planning permission for the 450 bed critical care facility in 2013.
As a result the planning permission only covered “triaged patients” that is those who have been assessed, in some form, by health professionals and taken to the hospital either by ambulance or helicopter, or transferred from another health facility.
The Aneurin Bevan University Health Board has now been given permission to vary the planning permission so that it does allow the A&E to treat “walk in” patients. It was also given permission to keep a car park it has already developed, without permission, to provide for the “walk in” patients and create a two-storey extension to the emergency department.
However, Torfaen Borough Council’s planning committee, which approved the two applications in a special meeting, heard concerns there could be increased demand on the hospital due to the board’s own proposal to close the Minor Injuries Unit at Abergavenny’s Nevill Hall Hospital overnight.
Torfaen council planning consultant Duncan Smith told the committee: “The hospital originally had planning permission to deal with triage patients. Since coming into operation people have basically come up to the door to use the hospital as walk in patients, that hasn’t got permission.”
He added: “The majority (of walk in patients) arrive by car. The unauthorised use has been in place since 2020 and this application seeks to authorise that use.”
It was also confirmed there are no plans for additional staff to work at the hospital. The approved extension will have seating capacity for at least 78 patients on the ground floor, new patient assessment rooms and an additional electrocardiogram room. Staff rooms would be on the first floor and a partial second floor would house a plant room.
The current emergency department only has waiting capacity for 38 patients and the board has reported there are often more than 70 waiting while Health Inspectorate Wales has said action to increase capacity is an “urgent requirement”.
The original planning permission also only had 22 parking spaces for the emergency department but the board has since developed an 11 space car park next to it, where it also has portable diagnostic assessment centres, which are to be moved to another part of the site, and a 58 space car park to the north of the unit.
Mr Smith said the “key issue” to consider was the impact on traffic but he said a transport assessment showed there shouldn’t be any increased queuing at the Caerleon Road roundabout, at the entrance to the hospital, or the Turnpike roundabout on the A4042, and there are no objections from the highways department or Welsh Government trunk road agency.
Blaenavon independent councillor Janet Jones said she was concerned at the potential impact should the Minor Injuries Unit at Nevill Hall close overnight. She said: “That will put more pressure on the traffic down to the hospital.”
Mr Smith said he wasn’t aware of those proposals but said traffic has been “considerably lower”, overall, than had been anticipated when the hospital was being planned in 2012.
Information published by the health board has said it doesn’t anticipate any impact from the overnight closure at Nevill Hall on the Grange as it says patients attending between 1am and 7am are around one per night and it anticipates they would go to the minor injuries unit at Newport’s Royal Gwent instead.
Labour councillor for Llanfrechfa and Ponthir, Karl Gauden, said local residents already had a number of concerns over parking at the hospital and “hospital staff using Crown Road as a rat run”.
The trade union official also said when he visits the hospital he “very often struggles to park” and described the roundabout at the entrance to the hospital as “poorly designed”.
He said: “Quite frankly residents in Llanfrechfa have had a guts full of people parking on their street.”
Cwmbran Pontnewydd Labour councillor Stuart Ashley said pedestrian access is “horrible” and said: “I think a quarter or a third of people in this borough do not own a car and have to find a way to get there, normally a neighbour or a taxi.”
He also complained that the health board hadn’t put in a bus shelter: “If you get stuck in a rainstorm you get soaking wet. If it was a council property we would have put a shelter up there.”
Both applications were approved unanimously.
The health board is currently running an eight week consultation on its minor injuries unit proposals.