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News

2019

Hammersmith Urgent Care Centre and Weekend Plus Hubs decision making business case: the summary

In April and May 2019 Hammersmith and Fulham CCG ran a public consultation called 'Hearing your views on urgent care centre opening times and location of GP ‘hubs’ in Hammersmith and Fulham'. This summary provides an overview of the outcome following the consultation.

Summary: Decisions made by Hammersmith and Fulham CCG Governing Body on 16 July 2019:

  1. No changes will be made this year to the three GP practices in Hammersmith and Fulham offering evening and weekend appointments (Park View Practice, Brook Green Medical Centre and Cassidy Medical Centre).
  2. Hammersmith Urgent Treatment Centre[1] (HHUTC) will close overnight between the hours of 12am and 8am.
  3. The CCG will take a number of actions to address local people’s concerns, including a communications campaign about local services and installing a telephone to call NHS 111 outside Hammersmith Urgent Care Centre.

The CCG would like to thank everyone who took the time to get involved the engagement and consultation activities which helped to inform these decisions.

What do these changes mean for local people?

The only thing that will change is that HHUTC will no longer be open between the hours of 12 midnight and 8am. There will be a communications campaign providing information on the alternative primary and urgent care services available to you in the borough. You will continue to receive the best and clinically safest healthcare from your local NHS. The other local urgent treatment centres are confident that they can manage the demand for services.

When are the changes at the HHUTC going to take place?

The HHUTC changes will take effect from 1 November 2019. It is felt that this will provide time to undertake the mitigations and other actions that need to be taken before the changes can be implemented.

Why make any changes?

In January 2019 the CCG Governing Body considered a paper which set out details of how the urgent care centres at Hammersmith and Charing Cross hospitals were being used overnight and how often people were attending the GP weekend hubs.  The paper concluded that the CCG was not getting value for money from the services at HHUTC or the GP hubs.  The HHUTC was providing care to, on average, five patients a night the vast majority of whom could have been seen within primary care. The weekend hubs were only utilising 72% of the available appointments.  For these reasons the CCG Governing Body decided that it should consult the public on whether to close the HHUTC over night between 12 midnight and 8am and reduce the number of GP hubs.

How did we engage and consult?

The CCG started discussing our ideas with local people in August 2018 to ensure that we heard from people using the current services and any potential new service users. We proactively reached out to a diverse range of groups both before and during the consultation. The formal consultation started on 8 April and finished on 24 May. We reviewed the demographics of survey respondents weekly so that we could work out which groups we were not hearing from and target our outreach work accordingly. We consulted with BAME, LGBT, older resident, and youth groups. The wide audiences attending our outreach events and focus groups proved invaluable to our consultation, ensuring that the demographics of our survey respondents was as richly diverse as our local borough population. In total 2,669 surveys were received by the CCG, the CCG attended 55 public facing events, met with over 1,260 individuals and distributed 1,120 surveys. 

What did we decide?

Having considered consultation feedback at a meeting on 16 July 2019 the CCG Governing Body took the decision to approve the closure of the HHUTC overnight and to keep the three current GP hubs as they are. The decisions also took into account low utilisation of the HHUTC overnight, other local services saying that they would be able to cope with the small number of additional cases that would attend other services.

What did people tell us during the consultation?

Of the 2669 survey’s completed a total of 48% of people indicated that they did not support the proposed overnight closure of the HHUTC with 27% agreeing with the proposal. The remaining respondents to the survey did not express a preference. A total of 78% of respondents wanted the CCG to retain the current three weekend hubs with only 5% wanting a single hub.

What were the key issues identified and how are we addressing these concerns?

Concerns about the impact of closing the Hammersmith Hospital Urgent Care Centre (HHUC) on other services.

 

Communicating the assurance we have received from other services that they have the capacity to manage additional demand.

Perceptions that it was a lack of knowledge about the current HHUTC leading to the current underutilisation.

 

The specific issues of higher levels of deprivation in the north of the borough.

 

Publicising the range of services that are available to people locally and provide information on how they can be accessed. Ensuring campaign reaches people in north of borough. Working with Healthwatch Local Committee to produce these communications.

Accessing other services at night when travelling was more difficult.

The potential increased cost of having to travel to another urgent care centre.

Providing telephone access that goes straight through to NHS 111 for patients attending the HHUTC so that they can get quick advice if they attend during closing hours.

Difficulties in accessing primary care services

Working with the newly established Primary Care Networks to ensure that concerns raised about access to primary care are being considered.

What is going to stay the same?

The GP weekend hubs will not be changing.  This is predominantly based on the feedback received regarding the difficulties people say they experience in accessing primary care appointments. Additionally, as there are changes to the delivery of primary care services and extended access as part of delivery of the NHS Long Term Plan that will come into effect over the next 12-18 months in line with the national agenda, it was felt that it would be inappropriate to initiate change at this time. There are no changes to the proposal to close the HHUTC overnight.

Who are we?

NHS Hammersmith and Fulham Clinical Commissioning Group (CCG) is the GP-led organisation responsible for planning and buying health services for the people living in the borough of Hammersmith and Fulham. We are made up of 29 GP practices serving a registered patient population of 252,357. We are committed to improving patient care, reducing health inequalities and raising the quality and standards of GP practices whilst achieving a financial balance.

For more information, please contact: hafccg.engagement@nhs.net / 020 3350 4303