Patients may be forced to make an appointment before being treated at the minor injuries unit at St Albans City Hospital.

The existing walk-in facility, which is designed to treat patients with broken bones, wounds and minor burns, could be replaced as part of a review of urgent care services.

The unit was temporarily closed in April 2020, when staff were redeployed to support the response to the pandemic – and has remained closed to keep the hospital site Covid-free, allowing surgery can take place there more safely.

But now health bosses at Herts Valleys Clinical Commissioning Group (HVCCG) are looking at reviewing urgent care services at the site, which are expected to re-start next spring.

Four options under consideration include re-opening the minor injuries unit – or not re-opening it at all.

There is an option to replace it with an urgent treatment centre offering both walk-in and pre-booked appointments.

But the CCG’s preferred option is for a new nurse-led integrated urgent care hub model which would provide same-day urgent care through a booked appointment system.

According to the proposal, patients would be able to access appointments through their GP surgery, NHS 111, the ambulance service or by other routes, such as pharmacies.

Nurses at the new facility – which would open for nine hours a day – would offer advice and treatment or refer patients on to another service.

The review was outlined last week to members of the county’s Health Scrutiny Committee, which includes councillors from the county council, the district and borough councils and organisations such as Healthwatch.

Ian Armitage, programme director for urgent care at HVCCG, told the committee the temporary closure of the existing unit had offered the opportunity to look at what services could be provided.

He said that the national strategy was to have urgent treatment centres rather than minor injury units.

But he said the preferred model for St Albans would be the integrated urgent care hub model.

He said the nurse-led service wouldn’t require GPs on site – and because appointments were pre-booked there would be no triage required. This would make the best use of the workforce, allow for appointments to be spread across the day, cut waiting times – and offer a better patient experience.

Consultation on the plans is already underway, with an online survey already counting around 3,000 responses.

A decision on the options is expected by the end of the year – with a service in place at the hospital next spring.

But at the meeting Mr Armitage accepted that if the public consultation was strongly opposed to the plans a redesign may be built in.

Lib Dem county councillor and St Albans district council leader Chris White accepted there were residents who would see the loss of a walk-in facility as a “deterioration”.

But backing the move, he said: “In my view a booked service – which is actually same day – is a massive step forward from what you can get from local GPs. And therefore this seems to be a good compromise...

“I think this is the way forward but comms are going to be absolutely key – both now and when it hopefully opens, as is planned.”

Mr Armitage was challenged by Cllr Colette Wyatt-Lowe to ensure the service would be effective and would cater for patients needs.

And Cllr Roma Mills, also a member of St Albans district council, said she hoped the options to re-open and to close the existing minor injuries unit would be quickly discounted.

She suggested that people would continue to try to walk-in to the service, and there could be a view that St Albans – which no longer has an A&E department – should have a walk-in facility.