Agenda item

The Cabinet is asked to note any announcements made by Members of the Cabinet.

Urgent Care Review: Proposed Changes to Urgent Care (out of hospital services) across North East Essex: Future of the Walk-In Centre and Minor Injuries Units

Councillor McWilliams (Portfolio Holder for Leisure, Health and Well-being) informed Cabinet that, assisted by Officers, she intended to submit a formal letter, on behalf of the Council, in response to the public consultation on the above.

The contents of the proposed letter were as follows:

“I write in response to your Urgent Care Review consultation and would like my comments to be considered as my formal submission for consultation.

My concerns are specifically around the Potential Approaches proposed for the Walk-In Centre in Colchester and the Minor Injuries Units in Clacton and Harwich.

I believe Potential Approach 1 would be in the best interests of Tendring residents – To continue to commission a Walk-in Centre (WIC) service in Colchester also the Minor Injuries Units (MIU’s) in Clacton and Harwich is the correct approach to continue with at this time.

The reasons are that any changes to these services would be premature, particularly when Tendring is in the process of increasing the number of houses in the district. Major developments are already under way with many more on the horizon, bringing with them a significant increase in the population of Tendring over the next five to ten years.

The geographical make up of our district also poses a problem as large parts of our district are rural communities that can be isolated with very limited access to public transport.

If the Harwich MIU was closed there are difficulties for Harwich residents to access the Clacton MIU, this is due to a lack of good road infrastructure and available transport across that part of the district; the alternative route is to attend the Colchester WIC because of its more direct route along the A120; it would though be a long journey to make.

Without adequate public transport and limited road infrastructure there are many people who will find it difficult to travel to where they will receive the medical care they need. For this reason, there is a need to be able to offer appropriate primary care services to people within a reasonable distance from their homes.

The Secretary of State for Health’s figure of 30% of cases at A&E are non-emergencies are of concern, and we know that GP surgeries in the district are under tremendous pressure and recruiting more practitioners to the area is notoriously difficult which must surely mean that Potential Approach 1 should be the choice for Tendring to prevent further pressure on A&E and GP Surgeries.

However as future housing developments materialise, the makeup of Tendring is likely to change quite considerably. It may be the case that as the district evolves Harwich and Clacton medical services become unsustainable as they currently exist and could end up being not best placed to serve the whole district. An alternative, more central medical centre, may need to be considered.

            I do understand and agree that we need to think differently about how services are delivered and there is a need for a certain level of ‘culture change’ in our residents/ patients. I have picked up on a point made by Bernard Jenkin MP about the need to triage patients in a way that is closely linked to the WIC and MIU’s. We need to consider that there may be a better way to treat people who develop mild, short term illness or suffer minor injury and the service available needs to be properly tailored to that need.

• We have spoken and it has been highlighted more recently to use the services of pharmacists more frequently than has been in recent years. In order to do this, perhaps one of the options to be considered is a trial triage service involving pharmacists. Pharmacists could be based at the WIC and MIU’s. The first person the patient sees is a medical professional (pharmacist) who can quickly assess the person and, where appropriate, deliver a first aid level of treatment or health advice. Anyone who cannot be treated by the pharmacist is then offered an appointment with a nurse or doctor (whichever is appropriate). In this way, patients are receiving a faster, more accessible level of medical attention and over stretched doctors are only seeing patients who need their expertise.  

• It may be that by presenting pharmacists at the point of contact with the WIC and MIU’s and intervening in a triage/ early treatment capacity, we start to see a reduction in demand on GP surgeries and associated services; and to encourage people to start changing behaviours with the first step they make being a visit to their local pharmacist instead of calling their local doctors surgery or turning to the MIU or A&E.

• Lack of transport is an issue and a review would be needed, especially with the expected increase in housing. Alternatively, and without wishing to revert to ‘the old way of doing things’, there was a time when we didn’t always have a fully equipped ambulance response to transporting every patient to A&E or a medical centre. Perhaps a similar fleet of vehicles equipped with a basic level of medical equipment and trained staff could be made available to transport patients with a low level need a reasonable distance (i.e. within the district) to receive treatment. 

• There is a concern that many people, especially the younger generation do not know basic First Aid. Is this another area that people could be encouraged to change their behaviour through guidance on First Aid.

• In order to optimise the MIUs I believe that rather than consider reducing services one of the options should be in relation to increasing and maximising the use of the MIUs. They could provide the opportunity for expanded minor surgical and clinical delivery at a local level. This expansion of the service would reduce the pressure on Colchester Hospital and be a much better outcome for patients. We know that Tendring has an above average number of people who are not registered with a doctor and therefore to leave Colchester Hospital as their first port of call and not retain the MIUs and the walk-in centre would be a false economy.

In conclusion, I believe we must continue with the Clacton and Harwich MIU’s and Colchester’s WIC. Serious consideration needs to be given to: -

·         the public transport network in our district and means by which patients can travel to access medical facilities

·         the future population growth that will come with the major housing developments that have been agreed by our planning department

·         a need for alternative ways of delivering patient care closer to people’s homes.

I hope that the CCG will have the opportunity to show some creativity in its thinking rather than sticking solely to options that centre around the financial constraints of keeping a facility open in its current form. People need accessible primary care facilities and I hope that you can be willing and open to working with other stakeholders in the area to come up with some more creative, and practical options.”

Members of the Cabinet, together with the Leader of the Labour Group and the Leader of the UKIP Group, expressed their support for such representations being made.

It was agreed that the proposed letter would be sent to all Members of the Council in order that they too could express their support.