GWENT health bosses will ask the body responsible for overseeing doctors’ training in Wales for more time to reshape night staffing at the area’s newest hospital, to allay fears that they might have to close part of its emergency centre overnight.

The £172 million Ysbyty Ystrad Fawr, in Ystrad Mynach, which opened almost three years ago, runs a 24/7 emergency centre comprising a medical assessment unit (MAU), minor injuries unit, and GP out-of-hours service.

But the MAU, a key part of the centre, may have to close at night, with the hospital unable to admit patients from 8pm-8am from February, because the Wales Deanery - which has already removed some junior doctors from out-of-hours on-call work at the hospital – wants to remove more from February.

Aneurin Bevan University Health Board warns that will make keeping the emergency centre as a whole open during the night “totally unsustainable.”

The Deanery first intervened earlier this year, ordering that Core Medical Training (CMT) doctors undertake their out-of-hours on-call training at a busier hospital, in this case the Royal Gwent in Newport.

There were, and remain, concerns too that junior doctors have difficulty accessing teaching and do not get enough on-the-job consultant support.

The health board has already reorganised rotas at Ysbyty Ystrad Fawr to deal with the first set of junior doctor withdrawals, costing an extra £227,000 this year, and a similar amount next year.

It is working toward longer term changes based on enhanced consultant input and support, but may now be forced to try to implement these in a matter of months to keep the MAU operating 24/7, with all the challenges of funding - the complete programme may cost around £1m - and recruitment that will bring.

Medical director Dr Paul Buss said evidence from pilot schemes in England based on similar changes to staff rotas is that such systems work well, and he is confident a better service will result. But the issue is the timescale.

“It is the pace rather than direction. We would have liked some more time. We have asked to meet the Deanery and hope to discuss the possibility of putting this in place incrementally rather than quickly.

“But first and foremost we must have a sustainable service for patients.

Dr Chris Callander, Wales Deanery sub Dean for quality and governance, said it initially recommended that, from August 2014, junior doctors on training contracts should undertake their out-of-hours duties at other sites in the health board, in order to meet their training needs.

“This recommendation was confirmed on April 3 2014. In subsequent discussions, on May 21 with the health board chief executive, it was jointly agreed to stagger this change in out-of-hours junior doctor allocation, with four moving in August and the remainder in February 2015,” he said.

“This will still leave three more experienced junior doctor training posts, together with a number of non-training posts available for out-of-hours duties at Ysbyty Ystrad Fawr beyond February.”