Consultation on Options
for delivery of Walk-in
Service for Urgent Primary
Care (GP) in the Future
Consultation to inform commissioning decisions regarding GP Walk-In Service
from July 2017 onwards. The service is currently provided by IMH Malling
located in the grounds of Princess Royal Hospital
Consultation Period April 18th 2016 to June 10th 2016
NHS Telford and Wrekin Clinical Commissioning Group (CCG) is the name for the local
General Practitioner led organisation who purchase Healthcare on behalf of the population
of Telford and Wrekin.
If you live or work in the Telford and Wrekin area
and have an interest in health services then
please take the time to:
•
•
•
•
We want to engage with as many people as
possible about our proposal and we would really
like to hear from you or talk it through with you.
Your feedback is invaluable and will help inform
our final decision. We are communicating about
this consultation using a range of media
including newspapers, through our partners, our
website and through our face to face pop up
meetings.
Read this consultation document
Speak to us at one of our pop up stands
Complete our survey
Comment on our options in writing to our
Freepost address below or via email and
phone.
Contents
• Let us know what
you think
• Support and advice
• Welcome
• What this consultation
is about
• What people have told
us so far
• Equality and
Diversity
• Potential Options
for Future
Provision
• How you can share
your views
• Planned meetings
• What happens next?
Let Us
Support
Know
and
What You Advice
Think
Let us know what you
think about our
options by completing
the response form at
the back of the
document.
Or you can complete the response
form on-line at our website
http://www.telfordccg.nhs.uk/
You can also attend one of our
p o p u p events – see further
details on page 11.
Write to:
Freepost NHS T & W CCG
Email your response to:
twccg.patientservices@nhs.net
For more information you can
also call Patient Services
Team
01952 580478
2
If you want to talk to someone
about these options or if you
would like a representative from the
CCG to come to a meeting to
discuss our proposals please call
Sharon Smith at Telford and
Wrekin CCG on 01952 580478
Healthwatch Telford and Wrekin
are the independent consumer
champion for health and social
care in this area. If you wanted to
comment on the proposals
contained within this document,
but did not want to provide
feedback directly to the CCG, you
could contribute to the
consultation via Healthwatch.
Please contact Healthwatch on
01952 739540 or email
info@healthwatchtelfordand
wrekin.co.uk
If you need any support in
completing the response form, or
if you would like this information
in a different format, such as
large print, Braille, audio or in a
different language please contact
us.
Welcome
Welcome to our consultation
document on potential options
regarding the future of Walk-in
Service for Primary Care in Telford
and Wrekin. We really want to hear
your comments and value any
feedback you can give us on our
proposed options.
Walk-in Centre Malling Wrekin PRH SITE
Walk-in centres were introduced in Telford and
Wrekin in 2009 as part of a national drive to
improve access to Primary Care. They were
developed to allow patients to access urgent care
from a GP or a nurse with no need to register or
to pre-book an appointment.
Why are we consulting on the future of the
GP Walk-In Service?
The type of contracts that were used for
commissioning the walk-in service are known
as Alternative Provider Medical Services (APMS)
Contracts. These are slightly different to the
standard General Medical Services (GMS)
contract which the majority of GP Practices work
to. One key feature is that these APMS contracts
were time limited and had an end date.
The centres were designed to be open for longer
hours than a typical GP practice including later
into the evening and at weekends.
The GP walk-in service is aimed at:


Improving patient access to Primary
Care
Modernising the NHS to be more
responsive to patients’ busy lifestyles
The current walk-in service provided on the site of
the Princess Royal Hospital is due to end in July
2017. The contract also includes regular GP
services; however these are not being included in
this consultation. The contract for the Town centre
site was ended by mutual agreement between the
CCG and the provider IMH Malling.
and

Offering more patient choice.
The CCG wishes to consider the options for
providing walk-in urgent GP services for the future.
The CCG would like you to share your views by
contributing to this consultation process. These
views will be part of the information that Nicky
Wilde, the Deputy Executive for Primary Care
uses to present to the CCG Governing Board to
decide how to provide this type of service going
forward.
Dr Jo Leahy - Chair CCG
Dr Johnny McMahon
Nicky Wilde - Deputy
Chair
Executive for Primary Care
C Chase CCG
Commissioning and
Planning
Chief
Officer
CCG
3
What this consultation is about?
The CCG has identified that the reverse was
happening and if patients are not able to have
immediate access to an appointment, they go
across to A&E because it is so close by.
What are walk-in centres?
Walk-in Centres were designed to provide
urgent access to advice and treatment for
Primary Care conditions, if patients are unable
to access their own GP. Primary Care
conditions are those that you would normally go
to see a GP or a nurse at a GP Surgery for.
The CCG is currently addressing the overall
increased demand at A&E and has placed a
“streaming service” at the front door of A&E
whereby nurses triage and send suitable primary
care patients to the Malling walk-in centre.
Walk-in centres are not for medical emergencies
and are not for conditions where diagnostics
such as x-rays may be required
Why did the CCG not consult about the
closure of the Town Centre Walk-in
Facility?
The CCG would recommend that where
possible people should attend their normal GP
practice where they are registered to receive
Primary Care Services.
The population of Telford and Wrekin will know that
there were originally 2 walk-in centres in Telford. It
was mutually agreed to end the service at the Telford
Town Centre.
Why the need to change?
It had a very small registered list size, the walk-in
service was under-utilised and because the premises
were very small, it made them unable to provide the
range of services the CCG would expect local GP
Practices to provide.
The Walk-in Centres in Telford and Wrekin were
set up in 2009. Primary Care Services and other
urgent care services have undergone changes
since that time.
The CCG want to understand whether the
current walk-in service is providing the best
solution to walk-in Urgent Primary Care.
The walk-in service closed at the end of March 2016
and all registered patients will need to re-register at a
new GP Practice in Telford and Wrekin by the end of
July 2016. Registered patients will be contacted in
the near future to be advised of the action they need
to take to find a new GP Practice.
Malling Wrekin GP Element
There are around 7,500 patients registered
patients.
Walk-in facilities are still available at the Malling
Wrekin Site located in the grounds of Princess Royal
Hospital. The capacity has been increased to
accommodate the closure in the Town centre.
The services is based in a temporary building
and consists of four consulting rooms and two
nurse treatment rooms.
In addition the opening times at the walk-in centre at
Malling Wrekin (Princess Royal Hospital) site have
been extended from 8am to 8pm to 8am to 10pm.
It is located on the Princess Royal Hospital site
with temporary planning permission.
The premises are not deemed to be fit for
purpose to provide future Primary Care in line
with the Five Year Forward View (a national plan
to improve Primary Care).
Walk-in facilities are seven days per week 365 days a
year.
The closure of the Town centre site does not mean
the CCG will not consider this geographical location
as a base for future services .The issue of location
will be considered according to the final option for
delivery.
Malling Wrekin Walk-In Element
It was originally believed that having a walk-in
centre at Princess Royal Site would mean
people would choose to go there rather than the
Emergency Department.
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What people have
told us so far:
We have already talked with 100 patients who used either
Malling Telford or Malling Wrekin. We did this across the
opening hours including weekends.
Of those people asked we found that:


80% of people travel to walk-in centres by car (own or friends)

The most common reason for attending the walk-in service was because people
could not get an appointment at their own GP practice, followed closely by the
convenience of being seen the same day.

Only 3% of those attending the walk-in said they came there because it was near
or on the way to their work.

If there was no walk-in provision, the top three responses for what people would
have done on that occasion were
I.
Attend A and E
II.
Wait and get an appointment with own GP
III.
Go to the Pharmacy
However when asked if access to appointments at their own practice was
improved would they prefer to go there, the majority said yes
People were also asked about their preferred option for walk-in in the future
Initial Views about Future Walk-in Centres
I think having one place for walk-in centres is better
I think it would be better option to work with GP so people can get appointments with their
regular practice
it would be better if more GPs had walk-in so there was more choice about where people go
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In addition people also commented that they thought

Having slots outside normal working hours was important so they could attend
after work

Having slots at the weekend was important
because their own GP was closed.

It would be better if they did not have to wait so long to see someone especially
when children were involved

More Practices offering the service would not only provide more choice but
importantly increase availability
We want to hear your
thoughts - see page 11
Whilst the CCG welcomes the improvements in access to Primary care that walk-in
centres provide through extended opening hours, across the weekend, into the
evenings and on bank holidays, we also believe that it is important that this
accessibility is available for all patients in Telford and Wrekin.
The CCG is concerned that there may be a wider gap opening in inequality of access
for patients in Telford and Wrekin. This is due to the high percentage of the walk-in
appointments being used for the registered patients of Malling Health and not for the
wider population.
The purpose of our consultation is to allow for more local people, patients and
stakeholders in the Telford and Wrekin area the opportunity to comment on the
potential options that the CCG has identified to provide the GP walk-in service in the
future.
Equality and Diversity
The CCG commissions services to be inclusive in all respects, with no individual being
denied access on the basis of their protected characteristic. Protected characteristics are
grounds upon which discrimination is unlawful. The characteristics are age, disability,
gender reassignment, marriage and civil partnership, pregnancy and maternity, race,
religion or belief, sex and sexual orientation. To help us with this we have included equality
monitoring data as part of the survey.
In addition, the CCG will seek to understand the views of members of these groups through
conducting targeted equality listening events.
The CCG are also keen to understand how it can provide primary care services to those
members of society who are not registered with a GP or have difficulties accessing a GP
traditionally believed to be members of traveller communities, people of no fixed abode and
young adults with substance misuse issues.
6
Potential Options for Future
Provision
1.
Single site in Telford and Wrekin for patients to receive urgent GP
walk-in appointments – not attached to a registered list GP Practice
8am to 8pm.
2.
Single site in Telford and Wrekin for patients to receive urgent GP
walk-in appointments – attached to a registered list GP Practice
8am to 8pm
3.
Single site in Telford and Wrekin for patients to receive urgent GP
walk-in appointments when GP Practices are normally closed- i.e.
6.30pm – 10pm / weekends and bank holiday 8am – 10pm
4.
Develop two or three sites for urgent GP walk-in appointments
based in existing surgeries during normal working hours 8.00am –
6.30 pm Monday to Friday
5.
Develop two or three sites for urgent GP walk-in appointments
based in existing surgeries when GP Practices are normally closedi.e. 6.30 pm – 10pm / weekends and bank holiday 8.00am –
10.00pm
6.
Improve GP Access at all GP practices to enable walk-in provision 5
days a week Monday to Friday 8.00 to 6.30pm
7.
Not to have access to GP walk-in appointments
Remember: GP walk-in services are for conditions you
would normally visit your own GP surgery for.
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In this section we set out our proposed options in more detail.
Option 1
Single site in Telford and Wrekin for patients to receive
urgent GP walk-in appointments – not attached to a
registered list GP Practice 8am to 8pm
Pros This option encourages more equal access for everyone as there will be no
registered patient list. The location would need to be accessible by private and public
transport. This would be the same hours as the current walk-in service provision.
Cons There will only be one location, some people may feel they are disadvantaged
in accessing it.
Option 2
Single site in Telford and Wrekin for patients to receive
Urgent GP walk-in appointments –attached to a registered
list GP Practice 8am to 8pm
Pros The location would need to be accessible by private and public transport. This
would be the same hours as the current walk-in service provision
Cons Like Option One, due to a single site location, some people may feel they are
disadvantaged in getting to it .There is potential with this option that appointment slots
may be taken up with registered patients. This means there would not be equal access
for everyone.
Option 3
Single site in Telford and Wrekin for patients to receive urgent
GP walk-in appointments when GP Practices are normally
closed- i.e. 6.30 pm –10pm / weekends and bank holidays
8am - 10pm. No registered GP list.
Pros This option like Option One encourages more equal access for everyone as no
patients will be registered with the walk-in service.
It gives the potential for more slots to be available in the out of hours’ period. This
may be of benefit to people who work during GP core opening hours.
Cons As with all one location options some people may feel they are
disadvantaged in getting to it. People have identified that they cannot always get
access to their GP in normal working hours, so people may use other services such
as A&E inside normal GP hours if no walk-in service was available.
8
Option 4
Develop two or three sites for urgent GP walk-in
appointmentsCurrent
based in existing
surgeries
during normal working
Access
to Services
hours 8am – 6.30 pm Monday to Friday
6amHow
8am
2am
10am
12pm
2pm
4pm
6pm
8pm
10pm
Midnight
Pros Multiple locations may improve the ease with which people can access
the service. The CCG would aim to provide sites in different geographical
locations.
Cons There is potential for the practices own registered patients to be
booked into the walk-in slots in the same way they are currently. People have
identified that they cannot always get access to their GP in normal working
hours, so people may use other services such as A&E outside these opening
hours if no walk-in service was available. There would be no weekend
provision or bank holiday cover.
Option 5
Develop two or three sites for urgent GP walk-in
appointments based in existing surgeries when GP Practices are
normally closed- i.e. 6.30 pm – 10pm / weekends and bank holidays
8am – 10pm
Pros Multiple locations may improve the ease with which people can access the
service. The CCG would aim to provide sites in different geographical locations.
People are telling us that they value access to GP services in these times.
Cons
The current usage of walk-in appointments is such that the workforce
may not be available over multiple sites for the number of patients wanting to use
the service in these time periods.
We are asking you to share your thoughts of these
options 1st through to 7th see page 11
9
Option 6
Improve GP Access at all GP practices to enable walk-In
Provision 5 days a week Monday to Friday 8.30 am to 6pm.
Pros If access was improved across all practices, this may be more equitable.
People have expressed preferences to be seen by their regular GP practice .This
option allows people to use their local/normal practice and places no additional
transport barriers. Each practice would offer walk-in slots.
Cons No weekend or bank holiday service provision may place additional
demands on other services. However the concept is that there would be greater
availability in the core hours so less people should have unmet demand for GP
type of appointments.
This option would require arrangements to be clear for non-registered and out of
area patients who wished to use the walk-in slots.
We have option 7 because some people may prefer that resources are not spent on this
type of service.
Option 7
Not to have access to GP walk-in appointments
In this option walk-in slots at either a specific site or delivered at one or more GP
practices would no longer be offered.
Registered Patients would be able to book into regular appointment slots, urgent
or planned as they currently do. The CCG would continue its work with practices
to improve access in line with the Five Year Forward View.
The CCG would need to plan services to provide urgent access to Primary Care
to unregistered patients and those from out of area when required
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How you can share your views
Come and talk to CCG staff at our pop up stands
Wednesday 20th April – Meeting Point House
10am – 4pm
Thursday 21st April – Southwater Building
10am – 12.30pm
th
Monday 25 April – Southwater Building
10am – 12.30pm
th
Wednesday 4 May – Southwater Building
10am – 4pm
Thursday 12th May – Meeting Point House
10am – 4pm
th
Friday 20 May –
Southwater Building
10am – 12.30pm
rd
Monday 23 May – Meeting Point House
Smith
Engagement
YouSharon
can also
fill inPatient
our on-line
survey Lead
via our website at INSERT
10am – 4pm
Have Your Say
We really want to hear your views
Our consultation runs from 18th April to 10th June 2016. Please complete
this form and send it back to us by 5.00pm on 10th June. We will review
all your feedback and share our key findings with you in July.
You can also email your feedback to: twccg.patientservices@nhs.net
Access the link to answer the survey
http://tinyurl.com/twccg-wic-consultsurvey-2016
11
What
happens
next?
We can provide information in other languages and
format on request if you need them. This includes: braille,
large print, audio CD or tape, other languages.
We will take into
account all the views
expressed and
comments received.
These will be presented in a
report alongside other
information to NHS Telford and
Wrekin Clinical Commissioning
Group’s Governance Board who
will then make a decision on
which option will be chosen to
deliver GP walk-in services post
July 2017.We will of course
publicise when the decision will
be made, once the consultation
has finished.
The analysis of the responses will
be carried out by the Deputy
Executive for Quality and
Engagement who does not have
any involvement in the final
decision making process.
We will compile a summary of
the consultation showing how
these responses and views have
been taken into consideration
The summary will also be posted
on our website
www.telfordccg.nhs.uk
Alternatively you can request a
hard copy from
twccg.patientservices@nhs.net
Or
Patient Services Team on
Call 01952 580478
We are bound by the rules of the
Freedom of Information Act (2000).
This means that we may publish
or release all the information
contained within your response. If
you ask us to keep information you
give us as confidential we can only
do so in line with obligations
under the Act.
Write to:
Freepost NHS T & W CCG
Email twccg.patientservices@nhs.net Phone 01952 580478
Want to be more involved in Health Locally?
Join “Our NHS”
Everyone registered with a GP in Telford and Wrekin is entitled to join
the patient membership scheme, known as “Our NHS”.
Members regularly receive information about local health
developments.
Become a member by; completing our online membership form at
http://www.telfordccg.nhs.uk/become-a-member
or
Contact Julie Beevor Tel: 0300 404 2999 ext: 6595 email:
julie.beevor@staffordshirecss.nhs.uk.
12