News

Improving care for you when you need NHS help urgently

Wednesday 18th April, 2018

We want to make it as easy as possible for people to know where to turn when you need healthcare quickly.

It could be a weekend sporting injury, DIY at home, or a fall while out at the park with the grandchildren – would you know where to go if any of these happened today? What about at the weekend?

We hear from people across Coastal West Sussex that NHS services are currently confusing and that it isn’t easy to know where to go, especially in the evenings and at weekends.

We want to make some changes to make it simpler and easier for people to get the care they need, and make sure that everyone who needs an urgent appointment can see a health professional within 24 hours.

There are no changes to emergency or planned care as part of this work.

This week we launch a new campaign to make urgent care services work better in Coastal West Sussex.

Today we want to share what we have heard from local people and how these views have helped to shape our work so far.

Over the past two years we have been talking to people across Coastal West Sussex about urgent care services, where you go when you need help, and how we could improve them.

When we talk about ‘urgent care’, we mean treatment for a sudden healthcare problem that needs attention within 24 hours but is not life threatening. This includes urgent care for both physical and mental health, including minor injuries and illnesses.

We have carried out a large Primary and Urgent Care Survey and received more than 6,000 replies, which is a fantastic response, and the feedback has been central to the work since then.

Nearly half of the people who replied had used urgent care services in the past year either for themselves or someone they cared for, and everyone had a view on how services could be improved.

What you told us

People said they want services that:

  • are easily accessible,
  • are relatively close to where they live,
  • provide quick access to appointments,
  • give confidence in the care being provided and the people providing that help.

In terms of the detail, over half of those that responded had used a GP practice during opening hours and 42% had attended A&E. One third had called NHS 111.  

A small proportion (15%) had gone to a pharmacist for an unexpected health condition and a similar number had seen an out of hours doctor.

We asked people why they chose the service that they went to, and excluding those taken by ambulance or recommended by health professionals, most people choose it because they thought it was the best place, followed by it was the nearest. 

National evidence shows that around 1 in 4 people who go to A&E could have been treated more appropriately by an alternative service.

When we asked people about this, a number of people said they went to A&E because it was felt that it would be the quickest way to get the help they needed.

For example, people told us that they sometimes resort to A&E because they cannot get a GP appointment quickly enough. If there had been easy access to alternatives, they would have been happy to be treated elsewhere.

So is it clear for people to know where to go? 

The simple answer is no.

Most people knew about the range of options available

  • NHS 111,
  • pharmacies,
  • out of hours doctors, and
  • minor injury units

but many didn’t know when they were open or when they should use that particular service.

There was also lower awareness of A&E in Chichester, the Bognor Regis Minor Injuries Unit and the Minor Illness Assessment and Minor Injury clinics across the area.

Time of day was also really important. Nearly everyone we spoke to would consider calling NHS 111, going to a pharmacy or their GP practice during opening hours if they needed urgent care. There was less awareness about what to do out of hours and when GP practices are closed.

“Give me a clear concise plan of what to do when I have a sudden health problem and it is out of hours of normal GP surgery time, other than using hospital A&E.”

In terms of the information available about the range of services and when to use them, three quarters of those that replied told us they did feel they had enough information about where to go for treatment. One in four were not sure or said they didn’t have enough information.

Many told us that even though they had information they didn’t feel there were suitable alternatives to A&E for urgent concerns, especially out of hours and at weekends.

“We need more clarity about minor injury services. We don’t know where to go on a Saturday or a Sunday if we need to see a doctor. We know it isn’t an emergency but there isn’t anywhere else to go apart from A&E.”

What we have learned

We recognise that we need to consider the range of services, and provide simpler services for people to access in and out of hours.

In particular, if we have easy to access urgent treatment services, people will have an alternative to A&E and we can make sure that local people can be treated in the most appropriate place by the most appropriate health professionals, saving A&E for saving lives.

We also recognise that if we can improve access to GP services, this will help to reduce some of the pressures on A&E.

Importantly this is about GP appointments in the evenings and at weekends – not just in normal working hours.

To do this we are going to have to work differently. Every GP practice will not be able to provide appointments like this, but working collectively, or in partnerships, then GP appointments will be able to be offered beyond normal opening hours across our patch.

Two thirds of those that spoke to us said they would use GP appointments outside of normal working hours. Of those, nearly 40% said they would use evening and Saturday appointments.

A higher proportion of younger people, carers of children and working age people with long term conditions were interested in extended hours.

“I work 12 hour shifts for the NHS hospital so it’s hard to get an appointment to see my doctor as I don’t finish work till 8pm at night.”

As part of our new plans we are considering GP access hubs, based across the Coastal West Sussex area, that will provide appointments in the evening and at weekends.

As we developed these plans we have had at the centre of our work what local people have said to us, in particular what is most important to them.

The most important priority for people choosing urgent care services is the confidence that staff can treat the condition appropriately with nearly 80% ranking that in the top three reasons why they choose a service, and 41% saying it is the most important to them.

Knowing it is open, how close it is to home and the shortest waiting time were equal after that with nearly half of people ranking them in the top three.

Ease of access by car or public transport and having used it before were not prioritised highly.

So what next?

This year we are working to develop a new way for the services you use when you need help urgently to work.

This is going to mean there is a joined up service that includes urgent treatment centres in Coastal West Sussex, GP access hubs and a visiting service out of hours.

We want to make services easier and simpler for local residents, and these changes will help us to make this real.

National guidance is also reinforcing the need to change how we deliver urgent care, not just in Coastal West Sussex, but across the country as a whole.

New requirements have been issued for clinical commissioning groups to introduce urgent treatment centres and there are also national recommendations that GP practices work together to help to meet the needs of their local communities.

We have taken what we have heard from local people, spoken to the health professionals working in these services, and considered the national guidance and developed a new way for these services to work which we believe will improve care for you when you need help urgently.

Next week we will share these plans, what they mean for you, how you will be able to use them, and how you can have your say.

How to contact the communications team

You can reach our communication team by:

  • Calling – 01903 707447
  • Emailing – contactus.coastal@nhs.net
  • Writing to – Communications Team, NHS Coastal West Sussex CCG, 1 The Causeway, Goring-by-Sea, West Sussex, BN12 6BT