25th January, 2017
IW CCG is seeking views from the public on theimpact of changes tothe IW Urgent Care Service, Walk-in AccessMonday-Friday
The Isle of Wight (IW) Clinical Commissioning Group (CCG) is engaging with the public to seek their views onthe impact of changes to theWalk-in Access to GP Urgent Care Service based at St. Mary’s Hospital, during weekdays.
The decision is to close walk-in access to the service during routine working hours during the week,(8 am - 8:30 pm) when GP Practices are open.
The current access to the GP Out-of-Hours services, including Walk-in Access during daytime hours at weekends will remain.
The proposal does not change access for emergency care inthe Emergency Department at St. Mary’s Hospital.
The survey is open until 22nd February, 2017.
To clarify:
Urgent care – typically non-life threatening but may be time sensitive in that delays in delivering it may result in a deterioration in the person’s health and wellbeing.
Emergency care –is delivered for an unexpected illness or injury or accident which is life threatening and without which the patient would suffer serious harm, or death.
Current Services
The Urgent Care Service which was previously called the Beacon Centre, for the provision of primary care medical services 24/7, including urgent and non-urgent “walk-in”care was set up seven years ago under an agreement which ended on 30th September 2016. A number of challenges had become apparent in running the service including recruitment of GPs to the service, and their availability to cover the number of shifts required; a reduction in numbers of people using the service; and, financial implications of rising premium costs in securing GP cover.
Staffing both the original walk in primary care service at the hospital and General Practice in the community is becoming increasingly difficult and this is reflected in the Primary Care Strategy consultation which is open for public consultation (posted 23rd December on the CCG website and communicated island-wide).
In addition, the quality of care delivered on a walk-in basis can be limited by lack of continuity and consistency of management, compared to that delivered by a patient’s registered GP, Nurse Prescriber or Nurse Practitioner.
The IW CCG and IW NHS Trust worked together to ensure that a safe, ongoing service for provision of GP Out-of-Hours services from 1st October 2016 would be in place. As part of continuing to secure Out Of Hours services, the Beacon Centre became the Urgent Care Service. IW residents were urged to consider accessing the redesigned service only if signposted by a health professional, or through the NHS 111 service.
The Urgent Care Service was also redesigned to make most effective use of scarce GP time so that, depending on need, those attending the service could be seen by a nurse, community practitioner or a GP.
Case for Change
The Urgent Care Service implemented on 1st October 2016,was a response to lack of GPs and the unsustainable cost of continuing to provide a service which wasduplicating what is already being offered by GP practices and community pharmacistsin daytime hours, during the working week. The Walk-in Service, which was originally put in place in 2009, does not reflect what NHS England now requires local systems to provide in terms of access to urgent care.
Over the last year, walk in attendance rates into the Urgent Care Service have begun to reduce through the increased use of the NHS 111 service and people are being directed to other healthcare professionals instead. Patients wait for up to four hours to be seen following a walk-in attendanceand a patient’s need can be more quickly met if signposted via 111 to a more convenient or appropriate service.
Daytime - Monday to Friday, the Urgent Care Service now sees an average of 29Walk-in Access patients each day, when the Walk-in Access is open – a reduction of 42% compared to a year ago.
The costs for running this service have not reduced over this period and are now considered to represent relatively poor value for money, especially where other services are available to support the urgent care needs of patients. Given the continued pressure to identify savings across all services funded by the CCG, the next stage of the Urgent Care Service future vision for the Island is to reduce the walk-in element of the weekday Urgent Care Service when GP practices are normally open, and ensure that other services are in place so patients can be signposted to a more appropriate service.
In the evenings during weekdays, access to the GP Out-of-Hours service will continue to operate as it has donesince 1st October 2016, based at the Urgent Care Service at St. Mary’s, with access via the 111 phone number, from 6.30p.m. – 8.00am.
At weekends, the GP Out-of-Hours service operates from 6.30p.m.Friday through to 8.00a.m.Monday, and all day Bank Holidays.The walk-in access to the service during the daytimeduring the weekend (8:00 am – 6:30 pm) will not be changed as a result of this proposal.
By 1st April 2017, IW residents and those visiting the Island requiring urgent, non-emergency care will be asked to do the following:
- Call 111 if you need urgent medical advice, or if you are unsure which service can best help you
- For visitors to the IW, the first point of contact at all times is to ring the NHS 111 service
- If calling 111, it is possible that you will be asked to contact a local community pharmacist or other community healthcare services
People who require emergency treatment for a serious/life-threatening injury or illness should call 999, or attend the Emergency Department immediately. This proposal does not change the walk-in access to the Emergency Department (Accident and Emergency).
SUPPLEMENTARY INFORMATION on next page
Definitions:
Urgent care – typically non-life threatening but may be time sensitive in that delays in delivering it may result in a deterioration in the persons health and wellbeing.
Emergency care –is delivered for an unexpected illness or injury or accident which is life threatening and without which the patient would suffer serious harm, or death.
Despite this it is recognised that demand for urgent on the day access to medical services is defined by patient expectation, experience and level of understanding of conditions and services.
Urgent Care Service - provides help for a minor illness or injury at times you can't wait to see your GP, or another healthcare professional.
GP Out of Hours service - the period that GP practices are closed to patients. This is between 18:30 and 08:00 on weekdays and from 18:30 on Friday night until 08:00 on Monday morning. GP practices are also closed on Bank Holidays.
Walk in - the ability to access to a service without first booking an appointment.
Emergency Department (A & E) – 24/7 response for emergency care.
Advice and Urgent Care is now provided in a range of services and locations including:•Online e.g. , , Isle Find It (and see mental healthbelow)
•Telephone advice e.g. 111, Parentline , Isle Help, Action on Hearing Loss, Healthwatch IW, People MatterTravel Advice Line, Alcoholics Anonymous, British Red Cross, Age UK, Carers IW, Disablement Information and Advice Line (DIAL), Cruse Bereavement Care, Dental Advice, Frank, The Silver Line, etc. (and see mental health below).
- Pharmacy – there are about 30 across the Island open longer hours than GP practices with a minimum of 8 open each day at weekends. Under the Pharmacy First scheme you don’t need to get a prescription from your GP for some conditions.
•Dentists and the emergency dental service – for problems with teeth
•Opticians – for problems with eyes
•Mental Health - mental health crisis line, IAPT (Improving access to Psychological Therapies), Silver Cloud, Positive Mental Health, Big White Wall
This survey seeks views on how to manage the impact of the proposed closure of all walk in access to the Urgent Care Service during week days.
Consultation Questions
We want to hear from people who feel they may be adversely affected by the decision, detailing why and whether there are alternative solutions for meeting their needs.
- Which of the following applies to you? Please tick each relevant statement.
I am a resident of the Isle of Wight, responding for myself
I am a resident of the Isle of Wight, responding on behalf of an adult
I am a resident on the Isle of Wight, and am responding on behalf of a child
I am a visitor to the Isle of Wight, and I do not have a GP practice on the Island
- Do you currently use Walk-in Access to the Urgent Care Service (ex Beacon Centre) during the day (8 am – 18:30) Monday to Friday?Please circle the relevant answer.
YES / NO
If Yes: How often in a year?- Why have you used the Walk-in Access at the Urgent Care Service during these times? Please write in your comments below.
- How could you have had your health needs met in another way?
Please write in your comments below.
- Do you feel you would be affected by this proposal? Please circle the relevant answer.
YES / NO
If Yes: Why?If you run out of space please add at the end of the survey.- Please add any additional suggestions/comments in the box below.
You do not need to fill in this section if you don’t want to, however we would appreciate it if you would provide some information about yourself. We use this information for our equality impact analysis to ensure that all parts of our community have been considered in this consultation process.
Please tell us in the box below:
Your age
Your gender
Your ethic origin
If you have a disability
Your religion or belief
How would you describe your sexual orientation
If you would like to receive the results by email or by post, please write your relevant contact information here.
Please email or post your questionnaire to the:
Isle of WightClinical Commissioning Group (CCG), Building A
The APEX, St. Cross Business Park, Newport, Isle of Wight, PO30 5XW
Email:
If you would like a copy of the report by post as you are unable to access the CCG internet:
Please write in your address in capitals below:
Thank you very much for taking the time to complete this survey. Your comments are greatly appreciated and will be compiled with other responses. Your contact details will not be used for any other purpose.
Please use this space below if you run out of room in any of the boxes.
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