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Consultations and events

Find out more about our proposals

This page provides:
*An introduction to the public consultation
*Information about Hammersmith urgent care centre
*Information about GP 'hubs;
*A summary of what we have already heard
*Our next steps
*Where you can download our public information materials


INTRODUCTION TO THE PUBLIC CONSULTATION

Dear resident,

Making any changes to healthcare services is always hard but when money is tight those decisions become even more difficult. Our job is to provide you all with the best possible healthcare in the borough but also to stay within our budget.

This public consultation is about the opening hours of the urgent care centre at Hammersmith Hospital and also the number of GP ‘hubs’ we have that allow anyone registered in the borough to see a GP or nurse in the evening or weekend.

This consultation document is to tell you about what our plans are. It gives you information about the current services and talks about the impact of the proposed changes. We also set out how you can let us know what you think of the plans.

We are proposing the following:

1. To change the hours of the urgent care centre at Hammersmith Hospital from 24 hours a day 7 days a week, to 8am-midnight 7 days a week (closed overnight).

2. To change the number of GP ‘hubs’ that allow anyone in Hammersmith and Fulham to access an evening or weekend GP or nurse appointment.

It is really important that we hear what you think. We are very grateful to all the members of the public and our staff who have already provided their feedback and helped us develop the plans that we are now suggesting. Over the next few weeks, we will be out and about in the borough listening to your views. We hope that many of you will be able to take the time to come along to our events or send us your thoughts.

We look forward to hearing your views.

Dr Tim Spicer                                                    Janet Cree

GP                                                                   Managing Director

Chair of NHS Hammersmith & Fulham CCG          NHS Hammersmith & Fulham CCG

 

ABOUT HAMMERSMITH URGENT CARE CENTRE

PROPOSED CHANGE: Change the hours of the urgent care centre at Hammersmith Hospital from 24 hours a day 7 days a week to opening at 8am and closing at midnight each day.  A 24/7 urgent care centre would still be available in the borough at Charing Cross Hospital.

What is an urgent care centre?

  • Urgent care centres are for minor illnesses and injuries that are urgent but not life threatening.
  • You can just walk in. You do not need an appointment.
  • They are run by GPs and nurses.
  • In Hammersmith and Fulham there are two urgent care centres - one at Charing Cross Hospital - one at Hammersmith Hospital. Both are currently 24/7.

Hammersmith & Fulham is the only borough in North West London to have two urgent care centres and they are two miles apart.

Hammersmith urgent care centre is in the north of the borough at Hammersmith Hospital. The hospital does not have an A&E so anyone who arrives and needs A&E treatment, is transferred to another hospital.

Key facts about Hammersmith urgent care centre:

  • Nearly 33,000 patients were seen at Hammersmith urgent care centre last year
  • Just 48 people a week came in between midnight and 8am last year
  • In 2017/18 the busiest night saw 18 patients - the quietest saw 1 patient
  • Around 9 out of 10 patients at night are sent home with no investigations. Most people were only given advice or simple medication
  • On average, 4 patients a week overnight need investigation or treatment compared to 85 patients a week in the day
  • Doctors feel that the appropriate care for over 60% would have been to contact their GP the next day
  • There are 4 members of staff employed overnight
  • No one arrived by ambulance over night
  • 80% of those attending overnight are aged between 20 and 64, with the majority aged under 44
  • Overnight around seven people a week are referred to an A&E for further assessment by a specialist hospital doctor
  • It costs around £600,000 a year to open the urgent care centre between midnight and 8am 

What would this proposal mean for patients?

  • Hammersmith urgent care centre would no longer be open 24/7. It would be open from 8am-midnight, 7 days a week. This means it would be closed overnight.
  • The majority of people currently attending at night do not need to be seen at an urgent care centre so could seek advice through 111, a pharmacy or by arranging a GP appointment. 
  • For patients who need to go to an urgent care centre. The nearest would be Charing Cross, Central Middlesex or St Mary’s. See below for travel options to these locations at night. 
  • The London Clinical Senate – the leading group of health professionals in London – has told us that it believes this proposal is safe for patients.

Overnight travel

Charing Cross is the closest alternative urgent care centre and is 2.4 miles by road from Hammersmith urgent care centre.

Charing Cross urgent care centre is 2.4miles away

  • By car, it takes approximately 9-16 minutes (at 2am based on data from google maps).
  • By public transport, both the 72 and 220 buses run between the two hospitals overnight.  Using TfL data, and assuming average waiting times and slower walking speeds, transport time at 2am varies from 16-35 minutes.

Central Middlesex urgent care centre is 2.6miles away

  • By car, it takes approximately 10-12 minutes (at 2am based on data from google maps).
  • There are no easy public transport links between the two hospitals

St Mary’s Hospital urgent care centre is 3.1miles away

  • By car, it takes approximately 9-12 minutes (at 2am based on data from google maps).
  • The N7 takes 21 minutes to get to St Mary’s at night from Hammersmith Hospital.


ABOUT GP 'HUBS'

PROPOSED CHANGE: To reduce the number of GP ‘hubs’ in the borough.   We will continue to provide evening and weekend appointments to anyone registered with a GP in the borough and we will make sure the number of appointments available meets the current demand.

What is a hub?

  • A hub is a GP practice that offers bookable appointments, at certain times, to any patients who are registered with any GP in the borough.

Many of our GP practices already offer GP and nurse appointments in the evenings and at weekends, but not all do.

We feel it is essential that everyone has access to out of hours appointments regardless of what their own GP practice provides.

In Hammersmith and Fulham, we’ve made sure anyone registered in the borough can make an evening or weekend appointment with a GP or nurse at one of our ‘hubs’.

Currently we have three practices which operate as hubs. These practices provide bookable evening and weekend appointments to patients from any GP practice in the borough.  You can book by calling your own GP practice or by calling 111.

Only 72% of the out of hours appointments are used.

Graphic For Consultation 2

OPTION A – No change.  Keep three hubs and 357 appointments per week

  • Three hubs would be evenly distributed across the borough
  • There would be spare appointments but we are wasting money by paying for unused appointments (only 257 appointments used)
  • No financial savings made

OPTION B – Have two hubs and 270 appointments per week

  • Financial savings of approximately £220,000 per year
  • Appointments would match demand
  • Fewer locations mean some people will have to travel further for an appointment at a hub

OPTION C – Have one hub and 270 appointments per week

  • Financial savings of approximately £265,000 per year
  • Appointments would match demand
  • Single location mean some people will have to travel further for an appointment at the hub

Hammersmith and Fulham CCG prefer option C – moving to a single hub location - as we believe it provides the best balance between financial savings and providing the right level of care for our residents. By having a single hub, we can still provide enough appointments to meet the current demand for any patients registered in the borough to have an out of hours appointment at a hub, but we can also make the maximum financial savings.

What would this proposal mean for patients?

  • We would still be offering appointments from 8am-8pm seven days a week at a hub for anyone registered with a GP in the borough
  • We would meet current demand for those appointments
  • If there were a reduced number of hubs, this would mean some people would have further to travel for an appointment at a hub.

Current number of appointments available: 357

Current number of appointment used: 257

Proposed number of appointments: 270


WHAT WE HAVE ALREADY HEARD

To help develop our ideas, we have been talking to people across the borough. We have heard from residents, the council, patient representatives, Healthwatch, the Health and Wellbeing Board, the London Clinical Senate, NHS England, local GP practice staff and many more. We heard a range of views about GP appointments, urgent care centres and how we should consult the public. This has all fed into our work.

You can read more about what we have already heard in the pre-consultation business case.


NEXT STEPS

The consultation closed on 24 May 2019

Now that the consultation is closed we will bring all the feedback together and take time to listen to everything we have heard.

The results of the consultation, along with our final proposals will go to the NHS Hammersmith and Fulham CCG Governing Body meeting on July 16 2019. This meeting is taking place in the Newbigin Room, St Paul's Centre, Queen Charlotte Street, W6 9PJ and will start at 3pm.  Members of the public can attend this meeting and listen to the discussion.

DOWNLOAD CONSULTATION MATERIALS