Walk In Centre Review

Board Papers Now Live

The Board approved the review of Stapleford and Ashfield Walk in Centres (WIC) at its meeting in October 2010. A formal public consultation about the future of both WICs was carried out between 1 November 2010 and 9 February 2011. Information from the consultation has been used to inform the business case. Click here to view them.

Public Consultation Closed

The public consultation of the Wak in centres review ended at midnight 9 February 2011. Please keep checking these pages for updates.

Background

This consultation is only about the Walk-in Centres themselves. There are other facilities in the buildings where the centres are based. That will not change. The buildings will remain open. The GP practices and other services provided will not be affected by this review. You have from 1 November 2010 until 9 February 2011 to tell us what you think.

Find out all you need to know about a review and public consultation on the future of Walk-in Centres in Ashfield and Stapleford. The review is led and supported by doctors.

The review is part of work to ensure that healthcare services in Nottinghamshire are of the highest quality and offer the best possible value for money

Your local NHS needs to become more efficient to meet the challenges it faces. That includes avoiding duplication of services, and helping patients to make the right choices to get the 'right care, first time'.

There are three main reasons why they are being reviewed.

Find out what they are

Walk In Centres Review Film

What and where are the Walk In Centres?

The Walk-in Centres in Nottinghamshire were part of a national initiative to provide convenient access to basic primary care services without the need for an appointment.

The services are high-quality and are delivered by dedicated and skilled staff. They include general health advice, treatment for minor ailments, plus information about the NHS and social services.

More than 85% of patients who attend a Walk-in Centre complete their needed treatment at that visit.

The centres were not designed to provide an appointment based service. For further care, patients have to go to other appropriate settings.

The centres operate as their name suggests. Patients can ‘walk in’ and see a health professional without the need for an appointment.

Many patients have used the service more than once over the last 12 months.

The Reasons for Change

The review is inspired by the key principles of value for money and high-quality care.

The reasons are explained in detail here

Who's behind the consultation?

 

This consultation is being led by NHS Nottinghamshire County. As a Primary Care Trust (PCT), we plan and pay for health services for 660,000 people in Ashfield, Broxtowe, Gedling, Mansfield, Newark and Sherwood, and Rushcliffe.

We spend a billion pounds a year on healthcare. Our other main roles are to:

• Improve people’s length and quality of life.
• Encourage everyone to live healthily.
• Monitor services to keep them high-quality and safe.
• Ensure the local NHS gives best value for money.
• Give people a say in what the local NHS does

Read more: Who's behind the consultation?

Assessment for service change

Last Updated on Friday, 20 May 2011 09:14

The Secretary of State for Health has four tests that must be met by NHS organisations when they are considering any change to health services. NHS organisations are assessed against each of the four tests:

1.      Support from GP Commissioners

2.      Strengthened Patient and Public Involvement

3.      Clarity on the clinical evidence base

4.      Consistency with current and prospective patient choice

1. Support from GP commissioners

The GP Commissioners within High Point Health (Ashfield and Mansfield) and Nottingham West (Stapleford) supported the review. The Nottingham West Board submitted a response stating ‘Clinically, the Nottingham West Consortium is supportive of the preferred option of relocation of the service to be adjacent to the Emergency Department (ED) at the Queens Medical Centre for the following reasons:

• Patients are being seen at Accident & Emergency (A&E) who could be more appropriately treated in primary care
• The service would be available longer than current hours
• The advanced clinical skills of the current staff would be more effectively used in the A&E setting

High Point Health Board: ‘agreed that the Consortia wish to commission a Primary Care Streaming service at the front door of the Emergency Department to direct walk-in patients to the most appropriate clinician, within a multi-disciplinary team, for their clinical presentation.’

Lead GP Clinicians from both GP Commissioning Consortia were members of the Steering Group and Task and Finish Groups which were instrumental in developing and driving the review.

2. Strengthened public and patient engagement

The formal consultation process was preceded by a period of approximately one month pre-engagement and this included the development of a Review Advisory Panel consisting of Lay Advisers and voluntary sector representatives. They were instrumental in reviewing and challenging the review and consultation document before it was signed off for the formal consultation process. The Panel met throughout the consultation and will continue to shape the messages following the Board’s decision.

Extensive stakeholder mapping was carried out and over 1,500 groups and individuals were included on the consultation database and sent consultation information and offers of individual presentations. Both groups associated with the Walk-in Centres (Stapleford Patient Participation Panel and Friends of Ashfield Community Hospital) were engaged before and during the consultation as specific interest groups.

Over 1,900 individual and stakeholder responses were received to the consultation from across Nottinghamshire. New channels of engagement were employed, including using the Nottinghamshire Listens Citizens Panel to gain a county-wide perspective.

3. Clarity on the clinical evidence base

The review was led by clinicians with full evidence developed and presented within the consultation document. This included input from GP commissioners, Walk-in Centre staff and ED professionals. ED clinicians supported the closure of the service but requested further evidence with regard to primary care activity. A full criteria assessment was completed by the steering group and key clinicians and the reasons were clearly stated in the consultation document.

An extensive review of the literature was undertaken and shared with all clinical stakeholders.  The literature found that walk in centres have not reduced health inequalities or impacted on access to General Practice.

The National Clinical Advisory Team (NCAT) undertook a desktop review of the proposals and provided an opinion on the clinical evidence base. They concluded:

‘There is no clinical concern with a proposal to decommission the existing walk in centres. The issue will be about capacity and design of A&E services and urgent care in primary care.’

‘The proposals meet the Secretary of State’s criteria for a clinical evidence base and demonstrating clinical engagement. NHS Nottinghamshire County will need to ensure that the other 3 criteria are fully met.’

4. Consistency with current and prospective patient choice

The current model does not offer seamless care for patients, who may have to visit more than one location. Overwhelmingly, the responses from those preferring integration preferred one location to remove confusion, whilst maintaining the relationship with their GP as the first port of call for primary care. The Emergency Department is more accessible to more people, is known and understood and the seamless integration of primary and secondary care will improve the patient experience by removing confusion and multiple layers.