Reviewing urgent care in Newcastle

In Newcastle, urgent care is mostly provided by the patient’s GP practice, alongside three GP-led walk-in centres at Westgate Road, Molineux Street in Byker and Ponteland Road, plus a nurse-led service which operates 14 hours per week at the Lemington Resource Centre. [As at September 2020, the centres at Byker and Westgate Road remain closed due to Covid-19.]

These services work alongside the NHS 111 telephone service and local pharmacists to support patients with urgent care needs.

A range of changes then took place in late 2019, with the three walk-in centres upgraded to become Urgent Treatment Centres.

These are GP-led, staffed by GPs, nurses and other clinicians and provide a consistent level of service across the city. Opening hours were extended, with centres now opening 8am to 10pm. They offer a mix of booked and walk-in appointments with access to simple diagnostics, like urinalysis, ECG and X-rays, as well as treating children under two.

These services work alongside the NHS 111 telephone service and local pharmacists to support patients with urgent care needs.

In addition, we listened to the views of local people in Lemington and the surrounding area, where a service operating 14 hours per week from Lemington Resource Centre would not be able to meet the national requirements to be an Urgent Treatment Centre, but is nevertheless highly valued by patients.

When we met with local people, the majority of people felt that the biggest issue in Lemington is access to GP services, rather than urgent care or walk-in provision. There is no GP practice based in Lemington, although the Newburn practice delivers some sessions at the Lemington Centre.

The CCG therefore decided to maintain and improve access to services in Lemington by providing access to a GP as well as nurses, and offering booked appointments, instead of a walk-in facility, to make the best possible use of the GP’s time.

This means an improved service for most people, making it much easier to get a same-day appointment with a GP in Lemington.

At a time when the NHS is facing financial and staffing pressures, this will make better use of our resources as well as helping more people to get the care they need within their local area.

These changes were widely publicised in print and online, including a Newcastle-wide urgent care leaflet, a similar one to remind people in Gateshead how to use their urgent care services, and bespoke information for Lemington, Newburn and Throckley.

At an earlier stage, the CCG also shared its findings at a series of local events, and published a report summarising all the comments that were made. For further details, click on the ‘Your comments’ tab above.

Between November 2017 and January 2018, we held a listening exercise to gather people’s views and experiences of urgent care services.

Urgent care is for minor injuries or illnesses which need medical attention the same day, but are not serious enough for the Emergency Department.

Between July 2018 and September 2018, we ran a second exercise to feed back the findings of the previous work and to introduce and gather views on some planned changes to urgent care services, particularly around walk-in centres  changing to Urgent Treatment Centres.

Below is a summary of the comments we received, as described at the time:

During focus groups and listening events, you told us…

• You were very happy that the CCG had taken the time to listen to you, involve you and tell you about future changes
• You were happy that there has been an improvement in urgent care services for patients and that changes are being implemented
• You also recognised that there had been an improvement in NHS 111 services
• You fed back on the quality and were happy with this

From December 2019, walk-in centres with be known as Urgent Treatment Centres. You supported these plans because:

• Children under 2 could be seen and you can see a GP
• We will use current sites, which are well known and accessed
• They will be GP-led, staffed by GPs, nurses and other clinicians with access to simple diagnosis
• All sites would have access to x-ray facilities
• They will provide a consistent route to urgent appointments booked through NHS 111 and your general practice as well as some appointments for patients who walk in

Information and awareness about urgent care services

You said:

• There is a lack of awareness around what urgent care services are available and when to use
• There is a lack of understanding around the changes that are being made to walk-in centres; how they will operate, what treatments will be available, whether appointments will be prioritised and whether UTCs will have access to patient records

Barriers to accessing urgent care services

You said:

• There is a lack of awareness around how to access interpreters when calling NHS 111 or 999
• That access to Westgate Walk-in Centre can be time consuming and costly  for people who live in Lemington and the outer west of the city
• It can be difficult accessing same-day appointments and attending a GP practice when offered early morning appointments
• That NHS 111 ask too many questions and the service is always busy and they have to wait on hold

From what you told us, the following points were considered

You said

• A lack of awareness of urgent care services in Newcastle
• The development of Urgent Treatment Centres
• Changes to the way urgent primary care support at the Lemington Centre is accessed
• In addition to mainstream media platforms, the voluntary and community sector should be used to get messages out
• Any materials developed should also be distributed to the organisations and groups who took part in this engagement activity
• All plans should also ensure that information is provided in an accessible way, including information in different languages and formats

We considered

• All of the above points and plan to have in place by December 2019 a robust communications plan along with an focus on how this will be distributed to those who need the information most; this will include working with partners and stakeholders to engage with wider community and producing the documents in accessible, easy read formats including different languages via the NGCCG website

You said

• The new service at Lemington should be monitored in its initial stages to ensure it is still able to meet the needs of the area. This should include:
• Who is using the service and for what
• Gathering feedback from both service users and local residents after the new service has been in operation for six months

We considered and are now doing

• These points are now being addressed currently to ensure the needs of those living in Lemington are met

You said

• Explore people’s awareness of accessing interpreters and as part of the communications plan ensure that people understand what they actually do and say to get access to an interpreter, signer, or have information in another format such as large print, braille or easy read

We will

• Make sure this is part of the larger communication plan ready by December 2019

If you would like the full report or have any further questions, please contact our involvement team.

After considering people’s comments carefully, the changes to urgent care in Newcastle took place in late 2019.

Local people’s comments influenced our decisions in a number of ways, from the decision to maintain all three centres (at Westgate Road, Molineux Street in Byker and Ponteland Road) to the large-scale promotion campaign to help people understand how to choose the right service for their needs.

In Lemington, it was clear that people value the 14 hours-per-week urgent care service at Lemington Resource Centre highly, because of limited access to GP services in the area.

We therefore decided to improve the service by providing access to a GP as well as nurses, and offering booked appointments. As a result, it’s now easier to get a same-day appointment with a GP in Lemington.

The three walk-in centres were upgraded to become Urgent Treatment Centres, which are led by GPs, working alongside nurses and other clinicians, and now provide a consistent level of service across the city. Opening hours were extended, with centres now opening 8am to 10pm. They offer a mix of booked and walk-in appointments with access to simple diagnostics, like urinalysis, ECG and X-rays, as well as treating children under two.

These services work alongside the NHS 111 telephone service and local pharmacists to support patients with urgent care needs.

The part-time urgent care service at the Lemington Centre CCG now offers access to a GP as well as nurses, with booked appointments rather than a walk-in option, to make the best use of the GP’s time.

This means an improved service for most people, making it much easier to get a same-day appointment with a GP in Lemington.

These changes were widely publicised in print and online, including a Newcastle-wide urgent care leaflet, a similar one to remind people in Gateshead how to use their urgent care services, and bespoke information for Lemington, Newburn and Throckley.