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Update: Eastham Clinic Walk in Centre

In response to concerns about patient safety within the Wirral Urgent and Emergency Care system a decision was taken to reallocate clinical staff from the Eastham Walk in Centre (WIC) to the Walk in Centre at Arrowe Park Hospital to bring forward the introduction of front door clinical streaming at Arrowe Park Hospital’s Accident and Emergency Department. Since this action was commenced on 4th September 2017 we have seen a stabilisation of the local urgent and emergency care system and as such we have been working with the provider of the Eastham WIC, Wirral Community NHS Foundation Trust to plan for the resumption of the service at Eastham.

The Governing Body of NHS Wirral Clinical Commissioning Group (CCG) met in public on the 7th November 2017 and received representation from Eastham residents and Alison McGovern MP.  The Governing Body subsequently reviewed the position for the resumption of the Eastham WIC and decided to write to Wirral Community NHS Foundation Trust.  Given the significant public interest in this issue we are providing you with the content of this letter sent to Karen Howell, Chief Executive, Wirral Community NHS Foundation Trust as follows:


‘Temporary Closure of Walk In Centre service at Eastham Clinic

I am writing regarding the recent decision to temporarily suspend the Walk in Centre (WIC) service at the Eastham Clinic to facilitate a joint system wide response to the urgent patient safety concerns at the Arrowe Park Hospital Emergency Department including the early introduction of clinical streaming.  I am grateful to your organisation for being responsive to the needs of the wider health and care system in supporting this action.  I am also grateful for your personal support on this issue, particularly at the meeting of the Adult Health and Care Overview and Scrutiny Committee on 13th September 2017. 

The decision was taken for valid clinical reasons and we have subsequently seen a stabilisation of the urgent care system.  In addition to the staffing resource redeployed by the Trust, NHS Wirral CCG, through the Better Care Fund (BCF), has also provided temporary additional funding for 1.6 whole time equivalent (wte) Advanced Nurse Practitioner (ANP) staff to enable the Wirral system to implement at pace clinical streaming at the front door, in order to meet the mandated NHS England national requirements.  Although there remains considerable work to be done to ensure that we achieve the NHS Constitutional Standard for the system.

The decision that was taken to support the system has been controversial and we have to be responsive to the resulting concerns and feedback received from Eastham residents and their elected representatives.  The intention remains that this is a temporary measure and there has been a commitment made in public that the service will resume as soon as possible. 

NHS Wirral Clinical Commissioning Group’s (CCG) Governing Body discussed the Eastham Clinic WIC service yesterday at our meeting in public, at which we again received representation from local residents and also Alison McGovern MP.  The Governing Body agreed that, just over two months after the suspension of the WIC service, we need to have a plan with Wirral Community NHS Foundation Trust to resume the provision of the Eastham WIC services as a matter of urgency, whilst also maintaining clinical streaming at Arrowe Park. 

NHS Wirral CCG has recently received a written proposal from the Trust relating to 0-19 provision at the Eastham Clinic.  NHS Wirral CCG has fed back to the Trust that this proposal does not meet with commissioner requirements as it does not reinstate the core Eastham WIC service offer for the residents of Eastham and other users of the service.

NHS Wirral CCG acknowledges that there will be challenges in resuming the WIC service at Eastham Clinic, whilst also maintaining the clinical streaming at Arrowe Park, particularly in regard to a potential lack of availability of appropriately qualified staff.  NHS Wirral CCG is committed to be supportive in terms of taking a flexible approach to service delivery whilst meeting the needs of the population and we are happy to support the Trust in this regard. 

NHS Wirral CCG’s Governing Body is clear that the Eastham WIC service must resume as soon as possible.  We are now 3 weeks away from the commencement of the Urgent Care consultation and it is imperative that we move at pace to lift the suspension of Eastham WIC service.  NHS Wirral CCG has a 2 year block contract in place with the Trust that includes the delivery of WICs at 3 sites including the Eastham WIC service.  It is therefore of mutual interest that the Eastham WIC service is reinstated. 

On behalf of NHS Wirral CCG’s Governing Body, I am therefore writing to you to ask that the Trust submits a plan to reinstate the Eastham WIC service to NHS Wirral CCG by 5.00pm on Friday 17th November 2017.  To facilitate this I will ensure that the appropriate members of our team liaise with the Trust to ensure that our commissioning requirements are understood.  On this basis I am confident that NHS Wirral CCG can work with Wirral Community NHS Foundation Trust to develop a flexible solution to re-instating the Eastham WIC service. 

Given that this decision is of significant public interest we will also be sharing the contents of this letter in the form of a briefing note with our local stakeholders including MPs and elected members of Wirral Council and Cheshire West and Chester Council.  We will include you in these communications.’

NHS Wirral CCG remains committed to working with its partners including the current provider of the Eastham WIC to see the resumption of the service.

 

Wirral health partners have taken the decision to accelerate a programme to improve urgent and emergency care services for people in Wirral.  Urgent and Emergency Care in the NHS is a national priority and in March NHS England signalled a national commitment to introduce front door streaming services in all Accident and Emergency Departments to help deal with increasing demand and the pressure this creates on clinical services.

This demand is similar in Wirral and we have decided to take immediate steps to make improvements as quickly as possible to ensure that the resources we have available are best placed as we move towards the winter months.

A new ‘front door streaming’ service will be in place at the Emergency Department at Arrowe Park Hospital from 4th September 2017. In future people attending the Emergency Department will be assessed at the front door and in some cases will be directed to the adjacent Walk in Centre, this will be for patients who have minor injuries or illnesses. This new service will help to ensure that people with serious or life threatening conditions are seen and treated more quickly in the Emergency Department which will improve the safety and quality of services and overall performance.

In order to make this happen, we have decided to increase the number of clinical staff working at the Arrowe Park Walk in Centre by reallocating staff from the current Walk in Centre located at the Eastham Clinic.

This means that the Walk in Centre service at the Eastham Clinic will be unavailable from 4th September 2017 Walk in Centre services will continue to be provided at Victoria Central Health Centre and the Walk in Centre on the Arrowe Park Hospital site. Eastham Clinic will continue to provide a wide range of other clinical services including blood testing and the dressings clinic. The CCG is committed to ensuring that the clinic remains an essential part of the local community. For more information on NHS services at the Eastham Clinic please click here.

We are taking this immediate action now because we have concerns about patient safety as the winter approaches. The CCG is in the process of reviewing Urgent Care across Wirral as a whole and will present proposed models for consultation in November 2017. Therefore the action we are taking now is in lieu of this wider review and is a short term measure to deal with an immediate patient safety issue.

All Wirral residents will have the opportunity to express their views on the way Urgent Care should be provided in the future when the CCG publishes its proposed models for consultation.

We have written a letter to stakeholders explaining the full reasons for this action at this time.

A Frequently Asked Questions (FAQ's) sheet has been developed to help explain these important changes: