Statement from Urgent Health UK, Federation of Social Enterprise Primary Care Providers Re Winter Pressures

Submitted by Sarah Fletcher on Fri, 05/01/2018 - 10:59

UHUK asked its members to comment on how the Christmas and New Year Bank Holiday period worked for their patients. Members providing Urgent Primary Care for about 4.5 million patients in England provided information.  Integration of Health Services means that pressures on one service will have a direct impact on other services. As well as looking at the services provided by our members we also asked what sort of pressures other services were under, including 111, the Ambulance services, Emergency Departments and Acute Hospitals. The survey was carried out via email and sent out on Tuesday 2nd January.

As background, for most of the year, in-hours General Practice covers the working days from 8am to 6.30pm, that is 52.5 hours per week.  The Out of Hours Services cover the remaining 115.5 hours - nights and weekends – about 2/3 of the week, with many local General Practitioners providing the clinical service. The Christmas and New Year Break is a time when the percentage of General Practice cover swings heavily over to the Out of Hours services. From Friday evening the 22nd December to Tuesday morning the 2nd January, in-Hours provided 31.5 hours and the Out of Hours provided 229.5 hours. In summary, the proportion changed from 1/3 In-Hours and 2/3 Out of Hours for most of the year, to nearly 90% provided by Out of Hours in the Winter Bank Holiday Period. In addition, in common with many people GPs like to take holiday during this period adding to the challenges of providing effective and safe urgent primary care services.

Members reported that they were busier than last year; some reporting increased activity of a few percent, others 8% and one 29%. Members generally considered they were under considerable pressure but were able to cope however there were times when workload became intense. Several Members reported providing additional services to support the joint winter planning including: a Professionals line for Paramedics on scene and the Clinical Desk, appointment slots for patients to be transferred from Emergency Departments. Another member provided comfort calling to patients who were expected to wait a while when low priority; to better manage workflow one member identified lower priority patients who could safely wait longer before receiving their clinical care and managed requests for repeat medication separately to the urgent care service.

Recruiting GPs to cover sessions continues to be challenging with all members saying it was harder than last year. One mentioned that the additional funding provided to support Medical Indemnity Costs had been helpful for recruitment. Paradoxically, one organisation is concerned that when that funding stops at the end of March recruitment will become more difficult.

Messages about 111 services were about being under pressure. One member had to take back direct patient calls, whereas the purpose of 111 is to take all calls from patients; another reported high rates of call abandonment by patients and delays in passing calls to the Out of Hours Services; one member questioned whether there were any clinicians supporting the 111 service for two days. Several reported that the strain on 111 services felt as though it was being transferred to Out of Hours Services. 

Ambulance services were described as under pressure and not coping as well as last year.

Emergency Departments were described as having a mixed experience, at times very difficult and under pressure. One member mentioned that despite one Emergency Department being funded to have GPs on site they still sent the same number of patients to the Primary Care Centre as last year.

Added pre-bookable appointments were a late request coming from NHS England via CCGs from 22nd December to 8th January.

Comment from Dr Simon Abrams, Chair of Urgent Health UK:

“Pressure on health services has been intense this winter especially over the bank holidays. Urgent Primary Care Providers, the Out of Hours services have worked hard to provide urgent GP care for patients. They make an important contribution to health care throughout the year but especially at this time, keeping patients out of hospital and supporting other urgent care services”.

 

Notes to Editors

  1. If you would like any further information, please contact Simon Abrams, Chair of UHUK on Simon.abrams@nhs.net mob: 07966 203130
  2. Urgent Health UK is the federation of Social Enterprise Unscheduled Primary and Community Care Providers committed to providing the highest quality of care for patients.
  3. Through its members UHUK represent 47% of the medical out-of-hours services market and also provide many other services including urgent care centres, emergency and community dental services and a wide range of community based health and social care services.
  4. For more information, access the UHUK website www.urgenthealthuk.com