Ahead of the Future Fit reorganisation of health services, should that go ahead, the Clinical Commissioning Groups are consulting on the renewal of the urgent care contract. This provides non-emergency treatments at the Royal Shrewsbury Hospital and Princes Royal Hospital in Telford 12 hours a day.
In a survey launched without fanfare on 1 February, the Shropshire and Telford Clinical Commissioning Groups (CCGs) are asking for views on providing urgent care treatment to the hours of 9am to 9pm. They are also asking if it would be helpful to pre-book appointments.
I had missed the survey until emailed about it yesterday. It was slipped out in a low-key announcement on the Shropshire CCG website a couple of days after the Future Fit decision. There is no information on the Telford and Wrekin CCG website. No background papers are provided but a paper on the retendering was considered by the Joint Health Scrutiny Committee in January.
The survey is open for just 11 full days. (I understand that the survey was initially password locked so the actual period will be shorter.) It closes on Tuesday 12 February. It has been launched in the context of the retendering of the CCGs’ urgent care contract in October for a futher three years.
The CCG survey clarifies the difference between an A&E and Urgent Treatment Centre (UTC) – which is the national NHS name for urgent treatment facilities. In the A&E, patients will be assessed by a consultant.
“Urgent needs (a condition that needs same day medical attention) are treated by a GP-led team and emergency needs (a potentially life-threatening condition) are treated by specialist emergency consultants and their teams.”
But not if you have an urgent need overnight, you’ll have wait until the next day or go to A&E as at present. The consultation states:
“It is proposed the Urgent Treatment Centres would be open from 9am – 9pm each day to support the busiest times in the Emergency Department.”
That change will increase the opening hours for urgent treatment at the Princes Royal Hospital from 11 to 12 hours.
The survey also asks:
“If you could book an appointment time is that something you would choose to do rather than wait?”
Patients who walk-in will receive a rapid initial clinical assessment within 15 minutes of arrival. They will then get an appointment not more than two hours after arrival. Patients who have a pre-booked appointment through NHS 111 will be seen and treated within 30 minutes of their appointment time.
Previously, the two walk-in services had operated to different standards under different providers. The plan is for the centres to be standardised under one contractor and for them to meet the national standard of Urgent Treatment Centres.
This is not a Future Fit change. It comes from the need to retender under national rules and the requirement to implement a new national Urgent Treatment Centre standard. But I am disappointed that the CCGs are not moving more quickly towards having urgent care centres open 24×7. There are often long waiting times in A&E of people who could be assessed and treated in an Urgent Treatment Centre.
Only 66% of patients arriving at A&E were seen within Shrewsbury and Telford Hospital Trust were seen within four hours. Only one hospital trust in England had a worse performance. Whatever the outcome of Future Fit, it makes sense to extend urgent care quickly. We can’t keep on waiting for adequate health care in this country. Perhaps we are only supposed to be ill between 9am and 9pm.
It is also time that we stopped tendering vital health services to parties that soak up NHS cash for their shareholders’ profit.