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GPs go forth

Walk-in service scrapped as GPs are asked to refer to 'overflow hub'

An urgent care centre in Corby is replacing their walk-in service with an appointment-only GP hub service from March 2019, allowing GPs to refer there when they have no free appointments, Pulse can reveal.

NHS Corby CCG has approved plans to set up a new system, which will see patients ring their GP practice and speak to a ‘trained navigator’ who will book them into same-day appointments at their GP practice or a ‘same day access hub’ run via an APMS contract if no appointments are available elsewhere.

This appointment-only system will replace the local urgent care centre – a type 3 A&E – which currently only accepts walk-ins.

GP leaders welcomed the move, after the BMA GP Committee suggested CCGs commission 'overflow hubs' where GPs can send patients with urgent problems when they have no appointments.

According to board papers, the new model will see patients ‘triaged and navigated to the clinically most appropriate service by trained care navigators’ based in the hub and in practices over the phone.

The CCG said that to make sure there is enough capacity to meet the needs of patients, commissioners plan to procure an APMS contract to deliver same-day appointments between 8am and 8pm, seven days a week.

The CCG plans to commission an additional 12,000 appointments for the new model ‘to meet the full planning challenge raised by the GPFV’.

Dr Simon Abrams, chair of out-of-hours services representitive body UHUK, said that he is 'not specifically aware of other services' taking on this model but said triaging patients by telephone 'makes sense'.

However, he added: 'Primary care will require resources to enable this positive step to work. The workforce will need to expand. Not everyone need be seen by a GP. Advanced nurse practitioners, pharmacists, paramedics and physician associates are all capable of providing care to the right patient groups.

'If it is going to work, and I don’t see another alternative, then funding must move to primary care.'

The board papers added the current system of delivering primary care support to patients at the A&E department at Kettering General Hospital and the urgent care centre is ‘unaffordable’.

It said: ‘The 59,200 episodes of care identified, if delivered under GMS conditions where care episodes could be completed, would cost in the range of £1.2m.

‘The price for this care in the current service configuration would be £3.7m there would also be additional costs associated with the costs of incomplete episodes of care appearing in other care settings.’

Dr Richard Vautrey, chair of the BMA's GP committee, said: 'We have repeatedly questioned both the clinical value and value for money of the walk-in centre model of working. A move to triage patients before attendance may make better use of the service for both patients and the provider.'

Dr Joanne Watt, clinical chair of the CCG, said: ‘We are now continuing our conversation with people to ask them to help us ensure access to the ‘Hub’ works for them. Our team will again be out and about in public places, as well as visiting community groups and workplaces.’

The new appointment system will be subject to public consultation between 12 February and 8 April.

Readers' comments (14)

  • 'Re-arranging the deckchairs'
    'figures don't add up'

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  • What happens when the hub appointments are full?

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  • "What happens when the hub appointments are full?"
    - People die, but that does not matter as long as the holder of the APMS contract has met the KPIs.

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  • Same old thing under a different name to keep the administrators and managers in their jobs. The system is broken. There cannot be unlimited funding and so neither can there be unlimited appointments. NHS free at the point of use needs a rethink and it will be self limiting.

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  • Though a good initiative this is simply an example of meeting endless demand. When are we going to think about solving problem from its root. NHS doesnot have bottomless pockets. Leaders need to think outside box and make some radical changes. Its high time we give up on age old ethos of free for all at the point of delivery

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  • What a mess.

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  • Walk in Centres are mainly APMS Contractors and cost more than the proletarian GPs in Hubs who will work for a pittance- it's enough to toss a penny, a flavoured carrot and tell them what an honourable deed they are doing and hurrah you have a dirt cheap service.
    Yes, question remains. How long will GPs in Hubs take to get wiser and what happens when the service is full as Obi - above- mentions?

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  • Hubs are a waste of time and fill up in no time with patients left nowhere other than A&E to go. People go to A&E as timings are odd/places are other than their own surgery or if they want to be seen quickly where walk in service was not available. The non registered and out of area people will still go to A&E as hubs cater only local surgeries. The hubs take long time to kick in diverting huge resources in already cash starved NHS. Obviously it is to match government rhetoric without any evidence that it does anything effective.

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  • Just seems awfully expensive 1,200,000 for 59,200 episodes is £20 an episode. If each episode is given 10mins of a GP's time that would be £120 an hour. (even with overheads this would be expensive?)

    Surely they just need more GPs ...

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  • Decorumest- just what I was going to write.
    Much energy rearranging the deckchairs; relabelling etc etc
    Sigh .......

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