Over the summer we ran public events focussing on the provision of urgent care in Medway.

At these events we discussed our proposals to create a new urgent care centre at Medway Maritime Hospital. So many of you came out to give us your views and we appreciate the time you have all taken to fill in our surveys around urgent care.

Improving Urgent and Emergency Care Services in Medway

Public Engagement 2017: Your Views and the Medway Clinical Commissioning Group’s response

 

Improving urgent and emergency care services

NHS Medway Clinical Commissioning Group (CCG) has been reviewing existing urgent care services, to ensure that people can access high quality urgent care when and where their families need it most. Key to this review has been the proposal to relocate services currently provided at the Walk-in Centre in Balmoral Gardens, Gillingham, into a new Urgent Care Centre (UCC) with other urgent care services, near the A&E Department at Medway Maritime Hospital.

What we did to engage people

During the summer of 2017 Medway CCG engaged widely with the people of Medway to help us decide on how we would develop urgent care service. We wanted to know whether people agreed with our proposal to develop an integrated urgent care centre at Medway Maritime Hospital and which services people wished to see at the centre.

  • 458 people responded to questions on their priorities for urgent care as part of the Medway Citizens’ Panel
  • 209 members of the public responded to a survey about the options for the new urgent care centre
  • 27 clinicians filled in a survey about their views on the new centre
  • 119 local people took part in focus groups and discussions in local community settings
  • GPs and their staff and community group leaders also attended meetings with the CCG to give their views
  • 145 people attended three public meetings on the proposals

We asked independent agency Public Engagement Agency (PEA) to analyse the findings and report back to us. We started working on your views immediately and have set out below how we are responding.

A full report of the findings can be found here 

What you said

There was general agreement that something needed to be done to relieve the pressure on A&E – people told us early on that their priorities for urgent care was to be seen by a professional face:face, that urgent care services needed to be made simpler and accessible 7 days a week.

Most of the people we spoke to or who responded to our surveys agreed with the proposal to bring together a wide range of health and care services, within a dedicated urgent care centre at Medway Hospital. You told us it would be less confusing to have triage, treatment and a range of other services available in one place, that people would get more easily and quickly to the right place. You thought this would reduce pressure on A&E, that it should reduce waiting times and would hopefully lead to less pressures on GP services.

However, not everyone agreed with our proposals. During the engagement there were some common issues raised. You were concerned about there being enough parking at the hospital and about access to the site by public transport, particularly from some parts of Medway such as the Hoo Peninsula. You also told us that the hospital site was too full, that it could not accommodate more services. Many of you were concerned about staffing – you told us that you could see the pressures on current staffing levels and wanted to be assured that there would be enough staff for the new centre and urgent care going forward.

You also stressed the importance of including mental health services in the plans for urgent care In Medway.

The full report of what you told us can be found here.

Thank you

Medway CCG would like to thank all those who took time to come along to meetings and workshop discussions and to fill in the survey on improving urgent care services in Medway. Your feedback has fed directly into our planning and we have already started to implement what you told us.

Support for a dedicated Urgent Treatment Centre at Medway Maritime Hospital

Most people who gave us their views supported our proposed urgent treatment centre.

Given the views that an integrated service would work better, and taking into account the additional pressure on urgent care we expect to see over the winter period, we have been able to start implementing some of the ideas. From early January the way patients access urgent and emergency care at the hospital will change. This is to make better use of the services available in A&E and ensure that patients access the most appropriate clinician/service for their need. There will still be a fully functioning Emergency Department for patients needing emergency care at Medway Foundation Trust, but for patients with urgent care needs we are improving access to primary care professionals.

These changes will not affect access to the Walk-in Centre at Balmoral Gardens which will remain open until the entire new urgent care centre comes into place in 2019.

Your concerns about parking

We are aware that parking at Medway Maritime hospital can be difficult at certain times of the day and concerns were raised that there may be an increase patient attendance at the site because of the consolidation of urgent care activity.

The modelling process has incorporated this as a potential challenge however a number of longer term developments will decrease patient attendance at the site including moving some outpatient appointments off site. By April 2019 there will be extended GP access – 7 days a week, and 8am-8pm Monday to Friday which meaning patients can access primary care at a practice nearer to your own home so there will be less need to travel to the hospital site. The CCG has started to establish minor illness clinics to provide additional primary care access during the week.

Your views on access to the hospital

Many of you highlighted access to the hospital site as a challenge, particularly for those not having access to a car and are reliant on public transport. The CCG are in discussion with the bus companies in Medway to review options for improving public transport access to the hospital site for the longer term.

As part of our Medway Model development, and in line with the rest of Kent, we are working to move some services out of hospital and closer to people’s homes. Many of these plans will be in place by April 2019 and the CCG is committed to ensuring that patients are seen as quickly as possible by the right healthcare professionals for their need.

Your concerns about future staffing

The other key concern raised was around staffing and how the services will continue to deliver given the national challenge of a decreasing clinical workforce. The core aim of redesigning urgent care services is to make better use of the workforce that we have available and that patients are accessing the most appropriate clinician/service for their need. This includes incorporating a wider range of clinicians into urgent and emergency care services.

Kent and Medway has a longer term strategy to ensure that we develop and retain a local clinical workforce. As part of this endeavour, the CCG is working closely with its healthcare providers to support initiatives that look to train and develop clinicians through local apprenticeship and training schemes with local Colleges and Universities as well identifying clear career pathways for clinicians to support retention and progression of local clinicians within Medway health services.

What happens next

Once the initial simplification of urgent care services has taken place we will continue with our plans to establish an integrated urgent care centre at Medway Maritime Hospital. This will be opened in the spring of 2019. At this point people in Medway will also be able to get an appointment at a GP practice near to your home.

We are confident that our plans will mean that you will be able to access the most appropriate clinicians in a timely manner making the best use of skilled staff.

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