By Brian WheelerPolitical reporter, BBC News | 28 June 2012
Walk-in centres are rapidly becoming a casualty of the tougher financial climate in the NHS in England.
The centres – which treat minor ailments without an appointment – were a flagship policy of the previous Labour government.
They are popular with patients but critics say they’re not cost-effective.
Figures suggest a quarter have closed in the past year but the government say the services they offered have not been cut.
The centres were meant to relieve pressure on A&E departments by providing easy access to treatment for minor ailments.
The government says these services are still available when the centres are relocated to hospitals – but critics say patients have to join long queues at A&E or make an appointment rather than simply being able to walk in off the street and see a nurse or doctor.
The Department of Health says it does not have data on how many walk-in centres have been closed, but analysis of weekly NHS hospital activity statistics show there were 75 non-hospital providers of emergency care in June 2012, which could also include urgent care units.
That is 26 fewer than in the same month last year – a reduction of 25%.
‘Not being cut’
Health Minister Simon Burns said: “More people than ever are being treated in these units, almost 20,000 more compared to last year.
“Some of these services have recently been taken over by hospital trusts, whilst others have been integrated into local urgent care services, so while the number of organisations might appear to have fallen, this has not affected access to urgent care services, in fact people using them has increased.”
Labour MP Gloria De Piero, earlier this month asked Prime Minister David Cameron why the “popular” walk-in centre in her Ashfield constituency and “similar walk-in centres are closing all over the country”.
Mr Cameron said it was “certainly not because the money in the NHS is being cut, because it is not being cut” but decisions need to be “taken locally” about how “money in the NHS is spent to deliver better health outcomes”.
The Department of Health said the Ashfield walk-in centre – one of two to be closed in Nottinghamshire – has been replaced by a 24-hour unit at the nearby King’s Mill hospital.
But – in a letter to Health Secretary Andrew Lansley – Ms De Piero says people in need of primary care services now “either have to first present themselves at A&E or make an appointment” and “no longer had the ability to walk-in directly”.
Walk-in centres have been closing down across England for the past two years. Among those to go in recent weeks is a facility in Tooting, in South London, which has been incorporated into the A&E department at nearby St George’s hospital.
“The relocation next to the minor injuries section within A&E is designed to help deliver care to patients in the most appropriate place and improve patient experience,” the hospital said.
A privately-run centre in Victoria, central London closed its doors in December. It was commissioned by the Department of Health but when its five year contract ran out the local Primary Care Trust decided not to keep it open, to save money.
Walk-in centres were used by more than three million people last year and they “have proved to be a successful complementary service to traditional GP and A&E services”, according to the NHS Choices website.
But the Department of Health says they are not a “nationally mandated” policy and GP commissioning groups will be free to shut them down when they take over from Primary Care Trusts as part of the government’s NHS shake-up.
Critics of walk-in centres say they have failed to relieve pressure on A&E services in the way Labour planned and that the cost of treating each patient has gone up from an average of £36 in 2008-09 to £39 in 2010-11.
But patient groups say they remain highly popular with those that use them.
Katherine Murphy, chief executive of the Patients Association, said: “Despite the many promises of patients having choice within the NHS, this is yet another example of having those very choices removed in the name of efficiency savings.
“Walk-in-centres provide a vital function for those who are unable to access their GPs, due to excessive waits and those who do not want to bother the already heavily burdened A&E staff.
“Our helpline regularly hears from callers who have had a range of issues with GPs and hospitals, but we hear almost universally about just how popular walk-in-centres are.”Read Full Post | Make a Comment ( None so far )
A serious loophole in APMS contracts allows GP practices to become a ‘commodity traded in the private market’, an enquiry into the closure of a London practice run by a private company has found.
Camden Council’s Health Scrutiny Panel of Enquiry report into the closure of the Camden Road Surgery in north London, due to be discussed at a council meeting tonight, is urging the NHS Commissioning Board (NCB) to take ‘prompt action’ to prevent a repeat of the incident.
The panel hit out at private companies involved in running the surgery for failing to provide evidence to the enquiry, and called for greater transparency on deals with private firms involved in running NHS services.
Private healthcare firm United Health won a five-year contract to run the Camden Road Surgery in 2008, but then transferred the contract to another provider, The Practice plc, in April 2011.
A year later, in April 2012, the surgery was shut down when its premises lease ran out, forcing its 4,700 patients to register elsewhere.
The report reads: ‘There appears to be a serious loophole in the national contract for alternative providers, which allowed United Health to transfer the contract.
‘The panel were of the view that this was a serious loophole. In our view, primary care by GPs should not be a commodity traded in the private market and prompt action should be taken by the NHS Commissioning Board, which will be responsible for commissioning primary care, to remedy this.’
Minimise use of locums
The panel said it would welcome further discussions with NHS North Central London and with the NCB on how contract specifications can best ensure continuity of care and to minimise the use of locums.
Its report reads: ‘Contracts should promote the long-term commitment to continuity of GP care, to counter the concerns expressed in evidence that large private providers have less commitment to a local population.’
The enquiry said it welcomed the prospect that from next April councils’ health and scrutiny committees will have enhanced power to require private health providers and GP practices to go before them.
It said: ‘A regrettable aspect of this enquiry was the failure of United Health or The Practice to provide any evidence whatsoever.
‘We welcome the decision of the Information Commissioner’s Office to order Camden PCT to disclose details of the contract with United Health, including the pricing, and believe further consideration needs to be given by the NHS Commissioning Board to the transparency of contractual arrangements as the market for alternative providers increases.
‘The Panel were concerned that there does not appear to be an open and transparent protocol for monitoring performance in primary care, which is understood by the public and public agencies.’
The report added: ‘In the absence of any evidence to the contrary we have no reason not to believe that the reason for United Health UK’s decision [to transfer the Camden Road contract to The Practice plc] was their desire to concentrate on providing services to the GP commissioner consortia being set up under the National Health and Social Care Act 2012.’
Spokespeople for the United Health UK and the Practice plc were unavailable to comment.Read Full Post | Make a Comment ( None so far )
A private company is pulling out of running a city GP surgery after protests from patients about poor service.
The Practice plc made the announcement as patients threatened to demonstrate outside the Brandon Street surgery, in Belgrave, and take their protest to local health bosses.
They said they were fed up that nothing was being done to sort out a catalogue of problems at the surgery, which moved from Cross Street, in Belgrave, to the newly-built Belgrave Health Centre, in Brandon Street, last year. Problems included concerns over the number of locum doctors being used, as well as difficulties getting through on the telephone and in getting an appointment after The Practice plc took over the running of the surgery in 2010.
It was part of a £5 million deal to run this and three other city surgeries for five years.
Ved Dhiman, chairman of the patients’ participation group at the surgery, said: “We were promised services would get better but the surgery has been run by locum doctors and patients have had constant problems in getting medication.
“We kept asking the primary care trust (PCT), NHS Leicester City, to do something about it and had meetings with The Practice, but nothing much changed. We were getting so fed up we were planning to demonstrate outside the surgery to let people know about our frustrations.”
The group was also planning to publicly demonstrate outside the PCT headquarters in Enderby.
However, on Monday evening bosses at The Practice said they were pulling out.
Dr Jeremy Rose, clinical director of The Practice plc, said: “We have had great difficulty in recruiting permanent GPs to maintain continuity of care for this group of patients – something that is very important to us.
“It is with regret that, by mutual agreement with the PCT, we have decided to release this contract for re-tender.”
The Practice will carry on providing services for the 4,800 patients registered at the surgery until the end of the year.
Mr Dhiman said: “I am very pleased this company is leaving and the patient participation group is sorry it has taken so long for people to listen to our complaints.”
Professor Azhar Farooqi, a city GP and chairman of the Leicester City clinical commissioning group, which will take on responsibility for providing health care in April, said: “Although we are not responsible for the contract, the most important thing for us is patients experience continuity of care.”
Lesley Harrison, associate director for primary care contracting at the PCT, said health bosses would be talking to patients to make sure a suitable provider is found.
Zuffar Haq, a spokesman for the Leicester Mercury Patients’ Panel, said: “It is about time the PCT got its act together for the people in this area. Things need to change.”Read Full Post | Make a Comment ( None so far )
NHS Peterborough’s unpopular plan to close one GP practice and merge six others in order to save money has been given the go ahead by its board.
The PCT-preferred third option, now accepted by the board, will close two practices – the Alma Road walk-in clinic and the Burghley Road surgery, merge the Lincoln Road and North Street practices into one, and merge four other practices into one new health centre in Dogsthorpe.
According to the board, the plans will release savings of over £1m a year which will be reinvested into other health services in Peterborough.
Due to the strength of public feeling about the plans during the public consultation, the proposals were modified to ensure that the Alma Road clinic will remain open until a new urgent care service is up and running, the PCT said.
When the public consultation was announced, 3Well Medical, a GP-led company which owns the Alma Road medical centre, submitted a 14-page response to the PCT’s consultation, detailing its objections.
It said that reducing the number of GP practices in the area and closing the walk-in centre would ‘lead to further large increases in A&E attendances’.
The plans were also subjected to an investigation by the cooperation and competition panel (CCP) following a complaint from 3Well Medical that the plans would have an adverse effect on patient choice and competition in primary and urgent care services.
The panel found that the involvement of two GPs in the process ‘was not appropriate in circumstances where those clinicians were associated with providers that would be directly affected, and might gain, from the process itself’.
In order to remedy the situation the CCP said it would be appropriate for either the RCGP or the NHS clinical commissioning community to appoint a panel of independent clinicians to review the process.
The RCGP suggested that the Collingham Healthcare Education Centre (CHEC) in Nottinghamshire might be in a position to convene a suitable panel on its behalf. A CHEC review carried out by Professor Mike Pringle, Dr Christine Johnson, Miss Julie Reid and Ms Jacqui Smith was presented to NHS Peterborough in March.
The group concluded that: ‘The three options were fairly expressed and based on clinical logic…but that either the original or the recently revised option 3 (the recommended change) would be clinically desirable and appropriate.’
Chief executive of NHS Cambridgeshire and NHS Peterborough Dr Sushil Jathanna said: ‘The redesigned urgent care services and the four new health centres are important steps forward in ensuring the NHS in Peterborough meets the changing needs of our growing population.
‘The vast majority of urgent minor health problems are managed by GP surgeries. This strategy makes sure GPs have the facilities to enable them to provide these and many other patient services.’Read Full Post | Make a Comment ( None so far )
Exclusive: GPs are being warned they are likely to face a series of challenges to commissioning decisions they make under the Government’s NHS reforms after a competition watchdog ruled being a GP partner at a practice was a significant conflict of interest.
The Co-operation and Competition Panel (CCP) found a PCT had breached conflict of interest rules by involving GP commissioners in a consultation on the closure of a Darzi centre – on the grounds their practices and other provider interests stood to benefit from the decision.
The case was brought after 3Well Medical, the GP-led limited company that runs the Darzi centre, alleged Dr Mike Caskey, chair of NHS Peterborough’s GP commissioning committee, was one of two clinicians involved in the consultation with ‘vested financial interests’ in the centre’s closure as his own practice could benefit.
But lawyers have warned the ruling has opened the door to legal challenges to GPs’ attempts to restructure care on the grounds clinical commissioning group board members’ practices could gain.
Ross Clark, a partner at solicitor Hempsons, said his firm’s procurement team already spent half of its time ‘challenging procurement processes’.
He added: ‘This is an indication of the break-up of the NHS family into separate components. Those freestanding bits will do whatever they can to stay alive and will therefore challenge decisions like this.’
Michael Rourke, associate solicitor at Lockharts Solicitors, said: ‘More cases could go to the competition panel or the High Court. I think there will be judicial reviews looking to get decisions quashed, and people going to the panel where they feel decisions have been reached infringing the principles set out in co-operation and competition guidance.’
The CCP ruling stated: ‘The commissioner’s actions were not consistent with the principles and rules [of competition] because of the involvement of two lead clinicians who had associations with primary and/or urgent care providers that might gain from the consultation process.’
But the CCP said NHS Peterborough ‘did not appear to discriminate’ against Alma Road.
Dr Rupert Bankhart, 3Well medical director and a GP in
Peterborough, said: ‘We welcome the CCP’s conclusion that there was a conflict of interest.’
He added 3Well Medical looked forward to working with local GPs on ‘correcting the impact’ of the decision.
Dr Sushil Jathanna, chief executive of NHS Peterborough, said the PCT ‘supported’ the panel’s recommendation that the consultation was reviewed by independent clinicians.
He added: ‘It is important to state we do not believe there has been any actual conflict of interest.’
Dr Amit Bhargava, a GP in Crawley, Sussex, and chair of the Crawley Commissioning Consortium, said: ‘Because [commissioning] is localised and we are talking about localism, then almost every local person has a conflict of interest in almost every local decision.
‘Whether it’s a GP, a nurse, a lay person or a manager who lives in the region, they will all be impacted by a decision, whether gaining or losing.’
But he added: ‘If we are clear about the vote structure and the transparency in which decisions are made and people
declare conflicts of interests at the beginning of discussions, then the pooling of decision making and intelligence will make sure the right decision is made.’
GPs on CCGs could face challenges if their own practices are seen to benefit from the closure of Darzi centres or walk-in centres.
GP commissioners will be responsible for commissioning urgent care, but many practices will be involved in out-of-hours co-ops.
CCGs will commission LESs, meaning their own practices could benefit or lose out from the decisions.
CCG members’ practices may be part of LLPs or provider services offering diagnostics.
Exclusive: GP practices in north London have been told they must absorb 4,700 patients in the next two months after the leading private health provider The Practice Plc announced it will close a high-profile GP practice less than a year after taking over the service.
The Camden Road Surgery – a long-standing GP practice which has been at the centre of the NHS privatisation debate ever since it was taken over by US health giant UnitedHealth in 2008 – will close its doors in April, with plans in place for a ‘mutual termination’ of its APMS contract with NHS North Central London.
NHS managers said the decision to close the surgery, which was broken to GPs on Friday, was forced by a decision by the surgery’s landlord to refuse an extension for the premises lease beyond April.
The Practice’s contract to run the surgery had been due to expire in March 2013, but NHS North Central London said that the early ‘mutual termination’ of the contract would not involve any compensation payouts to the private provider.
In recent years the Camden Road Surgery has been at the centre of controversy over the private sector’s role in general practice. The Practice Plc took on ownership of the practice last April after taking over the contract from UnitedHealth. The decision to award the original APMS contract to UnitedHealth in 2008 attracted vehement opposition from anti-privatisation campaigners, after NHS managers snubbed rival bids by local GPs to run the surgery despite them being judged to offer superior core services.
LMC leaders and leading GPs warned that the move to close Camden Road surgery at such short notice would be ‘hugely disruptive’ to patients and GPs.
Dr Paddy Glackin, medical director at Londonwide LMCs and a GP in Islington, North London, said: ‘The patients, who have had long-term relationships and have come to depend on a practice despite all the changes in management, are now going to have their practice taken away from them without having even been asked. We would like to have seen a meaningful consultation with patients and looking at actual alternatives to closing the practice down and dispersing the patients.’
‘They should look at some potential solution generated by the GPs and the patients, rather than this which has been imposed on them from without.’
RCGP chair Dr Clare Gerada said: ‘This is hugely disruptive for patients. They had the new provider not long ago, and before that UnitedHealth. The patients themselves need to feel that they have a GP who is there to look after them and that they trust. For the last year we’ve focused so much on GPs as a commissioner but we have to remember that GPs as providers is our most important role.’
NHS North Central London said it will be contacting local GPs to see how many patients they can take on and will be consulting with patients who will be given the option of choosing a new surgery or being allocated to a new practice.
A spokesperson said: ‘We are absolutely confident that there is capacity in the system for other Camden GPs to take on these patients. We are in the process of contacting them to discuss how many they can take at which practice and this will depend to some extent on the outcome of the allocation/dispersal consultation we are undertaking.’
A spokesperson for The Practice said: ‘It is with regret that The Practice can confirm that it is currently in the process of closing its surgery on Camden Road.’
‘The lease on the property expires in April and although the PCT and The Practice have both worked tirelessly to negotiate an extension to this lease, unfortunately the landlord has decided not to grant an extension . Working with the PCT we are currently in consultation with our patients in order to ensure they will continue to be looked after within the area once the surgery has closed. We remain at all times committed to our patients and their best interests and will do our very best to ensure a smooth transition.’
An under threat Darzi centre has been given a stay of execution, after the NHS competition watchdog ruled that PCT bosses breached conflict of interest rules by enlisting GPs with ‘vested interests’ – including the local CCG chair – to lead a consultation on the centre’s possible closure.
The Cooperation and Competition Panel ruled that NHS Peterborough’s consultation recommending the closure of the Alma Road surgery fell foul of conflict of interest rules.
The CCP ruled that the PCT had acted inappropriately by involving two GPs with links to surgeries and urgent care services that could benefit from the centre’s closure to act as ‘lead clinicians’ for the consultation.
The case was brought after 3 Well Medical, the GP-led limited company that runs the Darzi centre, alleged that Dr Mike Caskey, chair of NHS Peterborough’s GP commissioning committee and Dr Harshad Mistry, NHS Peterborough’s urgent care commissioning lead, had ‘vested financial interests in the closure of Alma Road’, as their own local practices could benefit from the change.
The CCP report stated: ‘The commissioner’s actions were not consistent with the Principles and Rules [of competition] because of the involvement of two lead clinicians in the commissioner’s consultation process that had associations with primary and/or urgent care providers that would be directly affected by and might gain from the consultation process.’
But the CCP said NHS Peterborough ‘did not appear to discriminate’ against Alma Road, and found it’s consultation did not restrict patient choice.
The watchdog is set to recommend to health secretary Andrew Lansley that an independent body of clinicians review the consultation responses. Mr Lansley will decide how to act on the CCP’s advice in mid-February at the earliest.
Dr Sushil Jathanna, chief executive at NHS Peterborough and NHS Cambridgeshire said the PCT ‘supported’ the CCP’s recommendation that the consultation was reviewed by independent clinicians.
He said: ‘We have reflected on the processes and feel that we managed potential conflicts of interest appropriately, but accept that the CCP has recommended we work further to engage independent clinicians outside the Peterborough area to provide further assurance.’
‘It is important to state that we do not believe that there has been any actual conflict of interest and that the clinicians we involved in answering questions from the public have not profited in any way from this process and no evidence was found to the contrary. The PCT drew on their expertise as local clinicians in helping explain how systems work. They were not involved in developing the proposals, nor would they have been involved in making final decisions about the consultation.’
A WALK-IN centre for NHS patients in Leeds is set to close this month as part of moves to save cash.
The Department of Health has decided not to renew a contract for the walk-in centre in the Light shopping centre in Leeds which opened five years ago and yesterday it was announced that it will now close at the end of November.
Last night NHS Leeds said the Department of Health did not intend to continue delivering services from commuter walk-in centres and this means the Leeds centre will close. Centres in Manchester, Newcastle and London have already been axed.
It will shutdown on November 30 and is the latest service in West Yorkshire to be hit by cuts. Already opening hours have been cut at other centres in Halifax, Todmorden and Dewsbury.
The surgeries were set up to give patients quick access to GPs.
The walk-in centre in Leeds opened under a national Department of Health programme to improve care to commuters which is being axed to save money. Only a fifth of its users were commuters, with most of the remainder registered with practices in Leeds.
In an earlier report, NHS Leeds said nearly 300 people had responded to an exercise asking for public views on the closure. Most said they would instead go to their own GP in future although many used the walk-in service because they found it difficult getting a convenient appointment.
Officials said the findings would be fed into a review of urgent care services and shared with GPs to help drive service development.
A survey by the Yorkshire Post last year found half the access centres in the region were seeing at least double the number of walk-in patients expected.
Last night Philomena Corrigan, director of delivery and service transformation for NHS Airedale, Bradford and Leeds, said: “The centre was commissioned by the Department of Health to have a focus on commuters, but only 22 per cent of users in the year October 2009 to September 2010 were categorised as commuters.
“Our Clinical Commissioning Executive (CCE), whose membership includes local GP commissioners, agreed that the most appropriate course of action is to ensure that the needs of patients are met within the rest of the services provided in Leeds.“
To assist this process NHS Leeds conducted a twelve-week consultation; including sending out 30,000 leaflets, to find out where Leeds residents would like to receive appropriate care once the Commuter Walk-in Centre has closed.
Health bosses claim that since the centre opened in 2005 there have been significant improvements to local health services in Leeds include: promoting the West Yorkshire Urgent Care Services telephone service, 0345 605 99 99 that people with an unexpected health problem can call to be assessed quickly and directed to the most appropriate service.
The Shakespeare Medical Practice, a walk-in centre, has also been developed, there have been extended opening hours provided at the city’s two minor injury units – St George’s Centre Minor Injuries Unit, Middleton Leeds and Wharfedale Minor Injuries Unit, Newall Carr Road, Otley and some GP practices in Leeds are providing evening and weekend appointments.
The GP practice in The Light is unaffected by the closure and is welcoming new registrations, as are all other GP practices within the city. People can contact West Yorkshire Central Services Agency on 0113 295 2500 or visit http://www.nhs.uk if they would like further information about which GP practice you can register with.
Walk-in services were designed for patients with minor ailments to take pressure off A&E and for those with urgent problems who were unable to get a quick appointment with their own practice who could then register with the surgery for future appointments.
Exclusive PCTs have begun paying out undisclosed figures in compensation for the early termination of Darzi centre contracts, as more centres across England close their doors due to financial pressures, Pulse can reveal.
One trust has admitted shelling out compensation to a provider after terminating their GP-led health centre contract ahead of time, while others are refusing to disclose whether or not they paying off providers after cancelling their contracts.
Another PCT told Pulse it was re-procuring its contract to reduce daytime walk-in hours in response to low demand.
The investigation shows the centres – rolled out in every PCT under the directive of former Labour health minister Lord Ara Darzi – but branded expensive white elephants by GP leaders – are increasingly being targeted for closure as cash-strapped PCTs try to bring their finances under control.
Of 68 PCTs to provide information to Pulse on the contractual status of their Darzi centre, more than one in eight (13%) have either terminated their contract or are planning to imminently, with many others renegotiating deals for financial reasons.
NHS Stockport revealed that it had paid out-of-hours provider Mastercall – the provider for its Darzi centre that was the first to close its doors last year due to duplication of service – had been paid compensation after the contract was terminated ahead of time, but refused to disclose financial details.
A spokeswoman said: ‘The contract holder has been compensated in accordance with contractual terms. Termination costs are confidential between NHS Stockport and our provider.’
Among those which refused to disclose whether they had shelled out compensation was NHS Barnsley, which recently closed its Darzi centre run by private firm Primecare due to over-use of its walk-in service. ‘The termination agreement between the two parties is confidential,’ said a spokesman.
NHS Sandwell, which is due to terminate its contract in December 2011, refused to disclose whether it paid compensation to Kent-based provider Malling Health, saying: ‘We believe the release of this information would prejudice our ability as a trust to operate contracts appropriately.’
NHS Calderdale said it was re-procuring its Darzi centre contract after ‘mutual agreement to terminate’ with private provider Care UK. A PCT spokeswoman said: ‘We have re-negotiated the contract to reduce the hours of the walk-in service only and this was in response to low demand at certain times of the day.’
Dr Nigel Watson, chair of the GPC commissioning and service development subcommittee, and a GP in the New Forest, said: ‘My understanding is there would need to be compensation paid if a contract is terminated early. It’s a really good example of central directive wasting money at a local level.’
Dr John Pickard, chair of the Plymouth subcommittee of Devon LMC, and a GP in Plymouth, where the PCT closed its Darzi centre in February this year, said it was ‘a luxury we couldn’t afford’. ‘I don’t know if they were given compensation but I would be concerned if they were – in these cash strapped times, we can’t afford it.’
GPC negotiator Dr Chaand Nagpaul said: ‘We predicted this scenario of the Darzi centres being superfluous to need. It clearly reiterates the huge waste of money. It seems a tragedy that so much has been invested, only to find contracts are being terminated.’
PCTs which have terminated or plan to terminate Darzi centre contracts
4. Heywood, Middleton and Rochdale
A WALK-IN centre for NHS patients in Yorkshire is set to close and the hours of another will be cut under moves to save cash.
The Department of Health decided early this year not to renew a contract for the walk-in centre in the Light shopping centre in Leeds which opened five years ago.
Health bosses in Leeds will tomorrow discuss a survey detailing public reaction to the shutdown after reaching agreement no alternative services will be opened following the closure at the end of November.
In a separate move, NHS bosses will today agree to cut the hours at the walk-in centre in Barkerend, Bradford, which was the first to open under a national flagship Labour initiative to improve access to GP services.
The surgery will be the latest in the region to see hours reduced. Already the walk-in service in Barnsley has been closed and opening hours have been cut at other centres in Halifax, Todmorden and Dewsbury.
The walk-in centre in Leeds opened under a national Department of Health programme to improve care to commuters which is being axed to save money. Only a fifth of its users were commuters, with most of the remainder registered with practices in Leeds.
In a report, NHS Leeds said nearly 300 people had responded to an exercise asking for public views on the closure. Most said they would instead go to their own GP in future although many used the walk-in service because they found it difficult getting a convenient appointment.
Officials said the findings would be fed into a review of urgent care services and shared with GPs to help drive service development.
In Bradford, officials are expected to agree to cut the morning opening hours of the Hillside Bridge centre which has seen demand four times that expected, with 23,500 people using it in 2009-10, significantly driving up costs.
The centre was designed for the most deprived people in the area but checks showed few were using it. More than a third of walk-in patients were those at other GP practices, some of whom were seeking a second opinion, leaving the NHS to pay double for the same service.
A public consultation found patients using the service said it was because there were no appointments at their own practice, they needed help outside normal working hours or because it was more convenient, claiming they would instead go to A&E at Bradford Royal Infirmary.
A survey by the Yorkshire Post last year found half the access centres in the region were seeing at least double the number of walk-in patients expected, with the surgery in Bridlington seeing a seven-fold increase.
Walk-in health centres are closing or having their opening hours reduced because they have proved so popular they are becoming unaffordable.
Most of the centres opened less than three years ago under a flagship Labour scheme aimed at improving access to primary care and reducing demand on A&E services.
But instead of being used by people not registered with a doctor, the walk-in centres have also proved extremely attractive to patients unable to get timely or convenient appointments with their own GPs.
This has meant demand for the services has often been far higher than anticipated and now primary care trusts (PCTs), many of which are struggling to balance their books, are being forced to cut opening hours, or even close the centres.
Flawed thinking over policy
Research by the Bureau has identified 18 centres across the country that have been closed, are under threat of closure or have substantially reduced their opening hours.
Instead of unregistered patients, most of those seen at walk-in centres are people that have been unable to get a convenient appointment at their GP surgery.
In Yorkshire Bradford’s Hillside Bridge centre, which was opened in 2008 by then health secretary Alan Johnson, was expected to provide care for 540 walk-in patients by 2013. By December last year it was already seeing 1,530 patients, with no corresponding fall in A&E admissions registered in local hospitals. The centre’s opening hours are currently under review.
This April a centre in Bedford had its opening hours cut by an hour and a half a day because excess demand meant it was running £100,000 over budget.
A walk-in service in Barnsley closed last October after being overwhelmed by four times theexpected number of patients. And in Calderdale, West Yorkshire health bosses are reviewing the future of two walk-in centres where demand has put huge pressure on the facilities. Their hours have already been cut.
Health chiefs in many areas incorrectly predicted the centres would mainly attract patients not already registered with family doctors, and they expected A&E attendances to plummet as a result. However there is little evidence that this has been the case. Instead many of the patients seen at walk-in centres are people that have been unable to get a convenient appointment at their GP surgery.
NHS Calderdale medical director Matt Walsh told the Yorkshire Post the centres were unaffordable: “The level of demand is much higher than we commissioned. The majority of patients using the walk-in are doing so with non-urgent conditions in core hours when they could be seen by their own GP practice,” he said. “There has been no reduction in A&E attendances and patients have not chosen to register with the practice.”
Closures across the country
Other areas where centres have closed or are closing despite their popularity include Salford andNottingham which have each closed two walk-in centres, Manchester, which is closing three, andStockport, whose centre is closing during GP opening hours. NHS chiefs are considering closing a further centre in Peterborough.
In the South East, Haringey PCT axed a walk-in centre in March after deciding it was “not an appropriate use of resources”. And last year NHS Bromley blamed its entire primary care deficit on its walk-in centres contract, which it claimed had created “artificial” demand for services.
In some areas local pressure has forced PCTs to rethink their plans. In Southampton, a walk-in centre has been reprieved after former health secretary John Denham declared it was “too important to close” but its opening hours are to be slashed. Two centres in Derby will also be kept open for a further two years following a local outcry over plans to close them.
GPs have complained that the centres are paid far more per patient than their own surgeries receive.
In February 2011 the Government announced the NHS Commissioning Board would review all GP-led health centre contracts once they had expired. It said it would be up to GP consortia to decide whether they wanted to re-commission the “open access” parts of the centres.
GPs have complained that the walk-in centres are paid far more per patient than their own surgeries receive.
NHS Partners Network, which represents private providers of NHS services, said it would challenge the decision to review the contracts under competition law if it became the basis for a nationwide round of closures.
Research by the Bureau earlier this year found six privately run commuter health centres based at railways (three in London, and one each in Leeds, Manchester and Newcastle stations) were also being closed. However unlike the general walk-in GP surgeries, the commuter centreswere failing to attract enough patients.
In 2010 the flagship commuter centre in Manchester’s Piccadilly run by Atos Healthcare shut, a contract for a centre in Liverpool Street was not renewed, and Newcastle’s commuter centre (Care UK) closed in April 2011. This month the NHS confirmed that the Leeds’ centre would also close.Read Full Post | Make a Comment ( None so far )
A PATIENT liaison officer at a health centre spoke out against a panel of NHS chiefs considering its closure.
Amy Fry, who works at the Alma Road NHS Primary Care Centre, spoke passionately about its role for the Millfield community at the Central and North Neighbourhood Committee meeting on Thursday.
She spoke to the gathering at the Gladstone Park Community Centre after hearing representatives from NHS Peterborough discussing health options for the city, which include the permanent closure of the centre in Alma Road.
Ms Fry said: “The board has not done its research in this area.
“There is a high population density here – on some addresses we have up to 10 people living in a property.
“That is not taken into account and the people here need this surgery.”
NHS Peterborough was represented at the meeting by Peter Wightman, interim director for primary care, and Dr Mike Caskey, GP commissioning lead.
They discussed plans to switch to a system with fewer but larger health facilities across the city.
Dr Steve Watson, who runs a surgery in Lincoln Road, told the meeting he believes his surgery could absorb Alma Road’s 2,000 patients.
He said: “We have 11,250 patients – we could keep up with anything Alma Road does but they could not keep up with ours.
“If nothing changes we will not see the next decade in. We have problems with the building.”Read Full Post | Make a Comment ( 2 so far )
Yorkshire Evening Post | By Katie Baldwin
Published on Thursday 16 June 2011 07:22
A WALK-in centre tailored to provide NHS health care to commuters in Leeds city centre is to shut – because it wasn’t used by enough of them.
The facility at The Light shopping centre on the Headrow will close later this year after the Government decided not to renew the contract of the company running it.
Six commuter walk-in centres, run by private firms providing NHS care, opened across the country between 2005 and 2007 – four are now shut.
The Leeds centre, operated by BMI Healthcare, opened in 2007. It will close when its contract runs out in November. It was open every weekday and aimed at those working in the city centre but figures showed only 22 per cent of users were actually commuters.
NHS Leeds bosses said a panel of experts, including GPs, had agreed to ensure there were enough healthcare services available elsewhere following its closure.
Philomena Corrigan, executive director of strategy and commissioning at NHS Leeds, said the contract for the centre was with the Department of Health but NHS Leeds managed it.
“The Department of Health does not intend to continue delivering services from commuter walk-in centres and this means the Leeds centre will close on November 30. The walk-in centre was commissioned to have a focus on commuters but they have not been the primary users.
“In fact, only 22 per cent of users in the year October 2009 to September 2010 were categorised as commuters with the other 78 per cent of users being from the local area.”
She added that since the centre opened, other services had expanded, including the creation of West Yorkshire Urgent Care Services, a walk-in centre and GP practice at Burmantofts Health Centre had opened and opening hours had been extended at other NHS walk-in centres at Middleton and Wharfedale Hospital in Otley as well as at some GP surgeries.
There is also a GP practice in the Light which is run separately and will be unaffected.
A patient watchdog group said it was important to ensure there were adequate health services.
Maureen Idle, of Leeds Hospital Alert, said: “Although we were opposed to private providers in the health service, if they are shutting the centre and even a small number of people have been using it, what are they putting in place for them?”
A Department of Health spokesman confirmed they were no longer contracting services from any commuter walk-in centres – based in London, Manchester and Newcastle as well as Leeds – apart from possibly one in the capital.
The spokesman said: “The Government is moving away from the type of contract that ties the NHS into spending money unnecessarily. Any decision to re-let a contract for such a centre is entirely a matter for local commissioners.”Read Full Post | Make a Comment ( 2 so far )
The opening hours of the country’s first walk-in health centre are set to be cut because so many patients are abusing the system that costs have soared.
The GP-led health centre – Hillside Bridge, in Butler Street, Barkerend, Bradford – was designed to improve access to healthcare for some of the most socially-excluded members of the community.
However, a damning new report reveals the vast majority of patients using the service are in fact those already registered with local GPs and who are seeking a second opinion, treatment for minor ailments or an appointment during the day when they could be seen by their own doctor.
This means the primary care trust, NHS Bradford and Airedale, is paying twice for their care, the report says.
And, in a further blow, the study reveals the walk-in centre has failed to show any demonstrable improvements in health outcomes for the local population.
The report by Dr Andy McElligott, medical director of NHS Bradford and Airedale, says: “Whilst the service has been useful to individual patients, it has not resulted in demonstrable improvements in health outcomes or cost benefits, and has actually increased demand for urgent-care services.
“We have found that a proportion of patients have been using the GP-led health centre for a second opinion when they have already been given appropriate advice by their own GP.
“The service provided by the GP-led health centre for non-registered patients is therefore a duplication of service provision.”
The report will be discussed at a board meeting of NHS Bradford and Airedale tomorrow at 1pm at Douglas Mill, Bradford.Read Full Post | Make a Comment ( None so far )
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