Welcome

Dudley Borough Healthcare Forum

Tuesday 24th September 2013

In this session we will

Explain what we mean by urgent care

Look at why we are thinking of making the changes

Look at the issues within urgent care

What is Urgent Care?

A&E

Your GP Practice

Primary care out of hours service

The 111 telephone system

The ambulance service

Why Urgent Care needs to change

It is not meeting the needs of our patients, carers, public and community

There is a new financial environment

The system is complicated and confusing to navigate

People do not know where to go for help when they need it

Why look at making changes now? Our contract for the Walk In Centre (WIC) ends next year so it is a

good time to look at how the service works and whether it needs to stay the same, change or be improved

Our contract for primary care out of hours service ends next year too, so again it is a good time to look at how the service works and whether it needs to change, stay the same or be improved

Our local hospital (Russells Hall) is struggling to see people within the national standard of 4 hours in A&E

The 111 telephone service is now provided by the West Midlands Ambulance Service as NHS Direct have told us they can no longer provide the service. This gives us an opportunity to help shape the service when it is recommissioned

Urgent Care in Dudley Borough If you go the Walk In Centre (WIC), you are twice as likely to be sent to A&E

than if you saw your own GP

If you go the Walk in Centre (WIC), the GP there will not be able to see any of your medical history – they can only go on what you tell them

The Walk In Centre (WIC) opens from 8am until 8pm, 7 days a week, is based at

Holly Hall Clinic and sees 47,000 patients a year

The primary care out of hours is based at Holly Hall Clinic and manages about 22,000 cases a year – of these about 7300 patients receive advice or guidance over the telephone, 1000 patients are sent directly to A&E, 4300 patients receive a home visit from a GP and 9200 attend the clinic to see a GP

About 32,000 people attend A&E with minor conditions which could have been treated in primary care

About 66,000 people attend A&E for major conditions

Urgent Care in Dudley BoroughWhen patients attend A&E: 38.4% of patients are discharged immediately without treatment.

Half of these are sent back to their GP 24.7% are admitted to a ward The rest either have immediate treatment or are referred to another

service

The costs are: Walk in centre - £35 GP same day appointment - £25 A&E attendance (no treatment) - £58 Seen by primary care out of hours doctor service - £73 Ambulance 999 - £208 Emergency admission - £1,739 (average)

What you have told us already

The urgent care system is too complicated and needs simplifying If you need to see a GP, you would rather visit your own practice You would like it to be easier to make and get an appointment with

your practice You would like more appointments to be available especially outside

of ‘routine’ hours Sometimes you just need reassurance from a medical person You have not got much confidence or trust in the 111 telephone

service You would rather be treated at home than have to go into hospital That if people go to A&E, it needs to be for a real emergency That if people really aren’t that poorly – they should make use of

other services but need the help and information to make the right choices

You still need somewhere to go/or someone to speak to get help

What GPs have said

They would rather see their own patients in their own surgery

They recognise that if the Walk In Centre was taken away, there would have to be additional capacity in primary care

That they would like people to stay at home and be treated rather than be admitted to hospital

We need to maintain existing resource for primary care in Dudley borough

Urgent Care Map

What could the future look like?

We believe that your own GP is the best ‘navigator’ to your health needs and care

An effective triage system in Accident & Emergency so that we challenge people in the right way if they turn up and it’s not an emergency but we still give people the right help and in the right way

More appointments available in primary care including extended hours

A primary care out of hours service that meets the needs of our local people

A 111 telephone service which gains trust and confidence from you

What are we proposing?

Close the Walk In Centre at Holly Hall and improve access to your own GP during routine hours

Redesigning access to urgent care through a single point of access

1. As a group can you think about advantages and disadvantages of the proposals

2. Identify solutions that might help overcome any concerns

3. In 2 years time what would perfect look like to you?

We would like you to help us shape the public consultation