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Community urgent care

Community urgent care services – engagement

We want to make improvements to community urgent care services to improve patient experience and the quality of these services. 

Community urgent care services provide urgent same-day care and advice for people with urgent, but not life-threatening physical and mental health issues. They include our GP hubs, walk-in services and the GP out-of-hours service. 

Our case for change (July 2017) identified key issues that we need to address when we look at changes.  In March 2018, we wanted to test some of the ideas we are considering for a new model of care for community urgent care services. We wanted to explore these in more detail with groups of local people that we know a higher or more frequent users of these services to inform our planning. 

We commissioned the Healthwatch organisations in our three boroughs (Barking and Dagenham, Havering and Redbridge) to undertake engagement on:

  • Providing more bookable appointments when you have an urgent health care concern or need
  • NHS 111 (the free 24/7 telephone health advice service)
  • Making urgent care more accessible through digital channels (online booking, digital apps and resources)

Based on our data of current use of services and the feedback from our 2016 research study, we identified priority research groups as:

  • Parents of young children (especially those aged 0 to 5 Years)
  • Older people (those aged 60+)
  • Young adults (15 to 25/30)

Follow this link to a summary report. You can also read the borough-specific reports for Barking and DagenhamHavering and Redbridge.

Right care, right place, first time - public consultation

Feedback from the above Healthwatch engagement informed the planning of two proposed options for a new model of care. From 29 May to 4 September 2018 we undertook a public consultation where we sought feedback on the two options.

We consulted local residents and community groups about the two options, holding 12 public drop in sessions and delivering 25 presentations to local community groups. A document explaining the proposals was produced for both consultations, along with a survey. In total, over 1,062 survey responses were received.

The Joint Committee of the BHR CCGs met in public following the consultation (on 8 November) and agreed that Option 1 of the proposals should become the future community urgent care pathway for our area.

Follow these links to read the Right care, right place, first time consultation report and decision making business case and for more information on the consultation

Spending NHS money wisely (1 & 2)

BHR CCGs face a significant financial challenge which means that we have to make some very difficult decisions about how best to spend our limited budget. This has become increasingly important as there is rising demand for local NHS services and we are seeing more patients with complex health issues than ever before.

During two public consultations (held from March to May and September to November 2017) we consulted on 48 proposals to change the way we spend local NHS money. These included proposals to stop funding:

  • Some over the counter medicines, such as anti-malarials, gluten-free products, sunscreens and probiotic supplements
  • A range of cosmetic procedures
  • Earwax removal (via aural micro suction)
  • Some injections for back pain
  • Osteopathy
  • Podiatry
  • Cataract surgery
  • Male and female sterilisation
  • IVF or reduce the number of cycles we offer
  • Weight loss surgery.

We consulted local residents and community groups about the 48 proposals, holding 12 public drop in sessions and delivering 49 presentations to local community groups. A document explaining the proposals was produced for both consultations, along with a survey. In total, over 1,420 survey responses and 26 letters/emails were received.

The governing bodies of BHR CCGs met in public following each consultation (on 29 June and 14 December 2017) and agreed to no longer fund certain treatments and procedures. Not all the proposals consulted on were agreed. Following recommendations, the governing bodies opted not to stop some cosmetic procedures. IVF will continue to be offered locally, but reduced to one cycle.

The changes came into effect from 10 July 2017 (SMW1) and 8 January 2018 (SMW2).

Follow these links to read the Spending NHS money wisely 1 and 2 – summary of decisions reached and for more information on the consultations.

Improving urgent and emergency care

In March 2016, Barking and Dagenham, Havering and Redbridge CCGs, on behalf of the BHR Integrated Care Partnership, undertook the biggest piece of market research on urgent and emergency care ever carried out in our area. We talked to more than 4,000 people who live in Barking and Dagenham, Havering and Redbridge to understand how they make decisions about where to go when they need urgent and emergency care (UEC).

The research study was co-designed by our three local Healthwatch organisations and funded by the national Vanguard Programme.

Key findings include:

  • Local people are very aware of alternative services, but go to A&E due to confusion about choices
  • A&E is seen as a reliable, same-day service for urgent care needs and long waits are not a deterrent. People are prepared to wait as they believe they will be seen and treated – even though they understand it’s not always the appropriate place to go
  • People are more than twice as likely to use their GP than go to A&E
  • GPs are the most commonly used service (72%) followed by pharmacy/chemist (69%) – with A&E third most commonly used at 31%
  • Of those attending A&E
    • 39% sought no advice before attending A&E
    • 37% had seen their GP with the same issue
    • 26% had been to A&E before with same issue.
  • People tend to follow the professional healthcare advice they are given.

This research is already shaping our ambitious programme of change for UEC services in our area. We continue to listen to local people and take their feedback and experiences on board to help us transform UEC services across Barking and Dagenham, Havering and Redbridge.

 Download the summary of the research report and supporting documents.

Community urgent care – patient, public and stakeholder engagement workshop

Following on from the UEC research study and engagement work in spring 2016, health and social care partners wanted to engage further with local people, clinicians and staff as we continued our work to develop a new model of care for urgent care services in our area.

More than 70 people from all three boroughs joined a workshop on October 7. It was an opportunity to explore the key themes that emerged from the work earlier in the year.

At the session, we agreed with participants to focus on two themes:

  • Tackling the confusion around what local urgent care services are and how to best use them
  • Building trust and confidence in local services.

The report provides a summary of the points raised, focusing on key shared themes, as well as details of how we plan to address these.

Page last updated 08 October 2019