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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