Suffering an injury, then having to endure a long journey into Oxford along the A40, followed by a perhaps even longer wait in the John Radcliffe Hospital's casualty department - it's the stuff of nightmares, writes Penny Studdy.

But those living in and around Witney have, since last summer, been spared all that, thanks to the flagship Minor Injuries Unit. The unit, which is the first of its kind in Oxfordshire, was threatened with closure just nine months after it opened. But, thanks to the good work that the unit does and a campaign spearheaded by the Witney Gazette, the small casualty department received a last-minute reprieve. The health authority last month gave a 200,000 lifeline to keep it going for another year. Bricklayer Mr Charles Metcalf, of Mount Owen Road, Lew, attended the unit with an eye injury, having been unsuccessful in obtaining an immediate appointment at his local surgery.

Mr Metcalf said: "I didn't know this place existed until the surgery told me. Now I know it's here, I would definitely come back. It's a great service and right on the doorstep."

Mrs Janette Sallis, of Blakes Avenue, Witney, came to the unit with severe bruising, having trapped her foot under a warehouse work truck.

She reflects the opinion of the vast majority who use the unit: "I am most impressed with the service and would not hesitate to recommend it to others. I have had to wait about half an hour to be seen, but that certainly beats going to the John Radcliffe. It's a much cosier and less intimidating environment too."

The mayor of Witney, Mr Steve Haywood, said: "I am obviously delighted that the unit has been saved. It is doing sterling work and has become a most valuable asset to the town. "I am, however, very disappointed that the funds are only guaranteed for 12 months."

In the first year that it has been opened the unit, which is housed in a purpose-built extension to the town's community hospital, has almost doubled its expected number of patients, with 10,000 people receiving treatment.

The unit's project co-ordinator, Mrs Sarah Bright, said: "The department provides a drop-in service to residents of Witney and its surrounding villages for the treatment of minor injuries such as bumps to the head, broken bones, burns and cuts. We would, however, never turn anyone away wherever they are from - we've treated people visiting the area from London and even a tourist from Canada. "It is, of course, ideal for the elderly and for those without transport because it is so local. We can also give advice over the telephone. People do not have to see their GPs first, although of course we would write to their doctors to give them details of the treatment we administered.

"The unit was set up with the aim of reducing the pressure on the John Radcliffe's accident and emergency department and this has certainly been achieved with a noticeable decline in patient attendance from West Oxfordshire. Witney is very fortunate to have this pioneering unit which hasn't directly resulted from somewhere else closing."

Operating seven days a week 10am to 11pm, the department is run by an emergency nurse practitioner and a healthcare assistant. Twelve senior nurses, who without exception have numerous years of accident and emergency experience, work out of the John Radcliffe casualty department and take two-week turns to man the Witney unit. Mrs Bright said: "Most of the injuries we see are trauma-related such as fractures, sprains and cuts and, in addition, we provide emergency contraception. We are, however, unable to see people with minor illnesses such as coughs and colds."

Epitomising the cliche small is beautiful, the unit has three examination cubicles, a stitcher/plaster room and x-ray facilities. A radiographer, whose remit is limited to X-raying from the elbows and knees downwards, is available from 10am to 9pm.

Emergency nurse practitioner, Ms Julie Stockbridge, said: "As we are generally speaking not dealing with the seriously ill, it means we have more time to give to the patient and advise on long term care of the medical complaint."

That is not to say, however, that the job doesn't present its own stresses. Ms Stockbridge explained: "As there is only one nurse working at any one time, it means you are very much on your own. There are periods in the day when it can become quite hectic and people do have to wait to be seen." While there are no doctors in the unit, the emergency nurse is aided by the tele-medicine link - via a video camera, an accident and emergency consultant is able to give advice.

Ms Stockbridge added: "Even if we are unable to treat the patient in the unit, we will be able to assess them and if necessary get an ambulance to the John Radcliffe where they will be fast-tracked in the system as far as possible to see a senior doctor."

While a heart attack and stroke do not constitute a minor injury, the unit is equipped with an ECG and defibrillator. Life-saving treatments are started and the patient stabilised before referral to a more appropriate healthcare facility.

Two recent surveys show that patient satisfaction is extremely high.

Mr Daniel Sutton of Blenheim Way, Southmoor, went to the hospital with a painful hand after a bad fall when push-starting a friend's motorbike. An X-ray confirmed that he had broken a finger and the nurse put it in plaster. As with all breaks, he was then referred to a fracture clinic at the John Radcliffe to be seen within 24 hours. Mr Sutton said: "It's much more convenient to come here and of course it's free to park. The experience has been made as pleasant as possible."

The Minor Injuries Unit can be found at Witney Community Hospital, Welch Way, telephone (01993) 602966/602968, and is open seven days a week from 10am to 11pm.

**This feature first appeared in the Witney Gazette, May 10, 2000