Urgent Care Review & Consultation Report April 2019 Report by: URGENT CARE REVIEW AND CONSULTATION - 2019 01 Executive Summary 4 1.1 Background to the consultation 4 1.2 The proposal for Urgent Care on Wirral 4 1.3 The consultation process 5 1.4 Findings 6 02 List of Abbreviations 11 03 Introduction: About the consultation 12 3.1 Background to the consultation 12 3.2 The proposal for Urgent Care on Wirral 13 3.2.1 Option 1 13 3.2.2 Option 2 13 3.3 The consultation process 13 3.4 Analysing the responses 20 3.4.1 Quantitative Analysis 20 3.4.2 Qualitative Analysis 20 3.4.3 Data Protection 21 04 Online Public and Easy Read Surveys 22 4.1 Online public survey 22 4.1.1 Respondent characteristics 22 4.1.2 Preference of Urgent Care proposed options 24 4.1.3 Proposed changes to children’s services 37 4.1.4 Proposed changes to wound care and dressing appointments 42 4.1.5 Importance of factors being considered in siting new services 48 4.1.6 Participants’ alternative suggestions 51 4.1.7 Any other comments, concerns or ideas shared 54 4.2 Easy-to-read survey 55 4.2.1 What participants liked about the proposed options 55 4.2.2 What participants disliked about the proposed options 56 05 Public meetings, letters, and emails 57 5.1 What participants liked about the proposals 57 5.2 What participants disliked about the proposals 57 06 Medical & Healthcare professionals 68 6.1 Who provided feedback? 68 6.2 What participants liked about the proposals 69 6.3 What participants disliked about the proposals 70 2 Wirral Clinical Commissioning Group URGENT CARE REVIEW AND CONSULTATION - 2019 07 Voluntary and Community Sector Organisations 74 7.1 Who provided feedback? 74 7.2 What participants liked about the proposals 74 7.3 What participants disliked about the proposals 75 08 Public bodies 77 8.1 What participants liked about the proposals 77 8.2 What participants disliked about the proposals 77 09 Elected members 80 9.1 Local Councillors 80 9.2 Members of Parliament 81 9.2.1 Angela Eagle MP 81 9.2.2 Alison McGovern MP 81 9.2.3 Frank Field MP 81 10 Opposing Campaign Activity 93 10.1 Letters from Wirral GP Federation and GP practices 93 10.2 Letters from patient groups 94 10.3 Correspondence received by the ‘Save Our MIU’ campaign 94 10.4 Petitions 95 10.6 YouTube presentations 104 11 Appendix One: Consultation Document 105 12 Appendix Two: Public Consultation Questionnaire 125 13 Appendix Three: Easy Read consultation document 134 14 Appendix Four: Preference for Option 1 or 2 144 by available demographic information 15 Appendix Five: Full stratified analysis output of 145 age-related preference by locality 16 Appendix Six: Constituency Letter from Frank Field 146 3 Wirral Clinical Commissioning Group URGENT CARE REVIEW AND CONSULTATION - 2019 EXECUTIVE 01 SUMMARY: 1.1 BACKGROUND TO THE CONSULTATION Urgent Care (UC) refers to same-day medical need for urgent, but non-life threatening, illnesses or injuries. The introduction of a new Urgent Treatment Centre (UTC) on Wirral is a national requirement. It will provide a higher and more consistent level of clinical service than the current Walk-in Centres (WICs) and Minor Injuries/Illness Units (MIUs) and will be led by GPs. It is the intention to locate the UTC for Wirral on the Arrowe Park Hospital (APH) site by developing the existing Walk-in Centre located next to the A&E department. NHS Wirral Clinical Commissioning Group’s (CCG) public consultation on Urgent Care took place between 20th September and 12th December 2018. The consultation was completed as part of a wider transformation programme in relation to urgent care services in Wirral and reflected mandated requirements from NHS England including the introduction of Urgent Treatment Centres across England. 1.2 THE PROPOSAL FOR URGENT CARE ON WIRRAL The Wirral CCG proposal can be summarised as below: • Introduction of an Urgent Treatment practice is often the first point of contact Centre: The Walk in Centre based on the when someone is unwell, therefore more Arrowe Park Hospital site will be developed urgent GP and nurse appointments would into an Urgent Treatment Centre for Wirral be available for people who need them. in line with national policy. • Making more use of Pharmacists: More • An improved Integrated NHS 111 service: pharmacists will be able to prescribe simple The NHS 111 service is being developed to medication to patients as well as offering offer more clinical assessments by doctors advice and information. and nurses. NHS 111 will continue to act as the point of contact for people who • Changing where adults go to for minor need to use the GP Out of Hours service illnesses and injuries: The current walk in and they will also be able to book urgent centres and minor injuries units would be appointments with a GP or nurse. replaced with more access to GP and nurse appointments. • More promotion of self-care, ‘helping people to look after themselves’: Giving • A dedicated walk in service for children people more information and help about (0-19) in South Wirral, West Wirral, their own healthcare needs to give them Birkenhead and Wallasey. the skills and knowledge to manage minor healthcare issues themselves. • A dressings (wound care) service accessed by a booked appointment in South Wirral, • Making more GP appointments available: West Wirral, Birkenhead and Wallasey. GP practices across Wirral provide the vast majority of healthcare to people. The GP 4 Wirral Clinical Commissioning Group URGENT CARE REVIEW AND CONSULTATION - 2019 Two options for how the UTC will operate Practitioners, Practice Managers, Dentists, in Wirral were presented for wider public Optometrists and Pharmacists. The results of consultation: the Listening Exercise were published on the CCG website. Option 1 will offer a UTC that is open 24 hours a day, seven days a week, giving help to During the options development phase and people all the time. NHS England Service Change Assurance Process a stakeholder group has included This means the ability to offer same day representation from Healthwatch Wirral (including walk-in) urgent care for children and the CCG lay member for Patient (0-19-yrs) and a bookable dressings (wound Engagement. The CCG has an established care) service for up to 8 hours a day in four Patient and Public Advisory Group whose different places across Wirral. members have been independently appointed and this group received regular briefings Option 2 is that the UTC would be available on the overall development process, the for 15 hours, (for example 7am-10pm or 8am- communications and engagement plan and 11pm), seven days a week. informed the development of the consultation communication materials. When the UTC is closed, patients would need to go to A&E, where they would be seen Consultation engagement commenced on within four hours. However, during busier the 20th September 2018 with the issuing times, waiting times may be longer. of notification letters to stakeholders and the launch of a dedicated website for the This means the ability to offer same-day consultation materials. (including walk-in) urgent care for children (0-19-yrs) and a bookable dressings (wound The specific methods used for engagement care) service for up to 12 hours a day in four during the consultation period are as follows: different places across Wirral. • A consultation survey outlining the main proposals; this was provided online and was 1.3 THE CONSULTATION PROCESS also available in paper format. Easy read versions were also provided; Engagement in relation to urgent care services had commenced as early as 2009 • A consultation document which detailed and continued until the completion of the context for the consultation, the Value Stream Analysis workshops in 2016 current position of urgent care services which signalled the commencement of the in Wirral and the proposed options for transformation programme. consultation. This also included patient stories to demonstrate the new model of In February 2018, the CCG sought to quantify care; earlier engagement by opening a pre consultation Listening Exercise. This included • A dedicated website for the consultation an online survey, focus groups, stakeholder which included all consultation resources engagement meetings, and visits to urgent and the online survey; care locations to speak with people using services during this period. Stakeholder • Animated ‘explainer’ videos to describe the engagement included a dedicated briefing current situation and the proposed model session with councillors from Wirral Council of care; and attended by councillors and officers from Cheshire West and Chester Council. This • Social media boosting to raise awareness methodology was replicated with colleagues and participation; from Primary Care including General 5 Wirral Clinical Commissioning Group URGENT CARE REVIEW AND CONSULTATION - 2019 • Proactive media with • Visits to further education • Focus groups with regional TV and local radio; colleges; people with protected characteristics including • Proactive media with • Visits to NHS locations the Wirral Multicultural local online and published including all current urgent Organisation, Together publications; care locations; all are Able (Learning Disability self-advocacy • A ‘postcard’ drop to every • Staff meetings with all group), Wirral Ways to household in Wirral to current NHS providers; Recovery, Wirral Change, highlight the consultation; and Tomorrows Women; • Professional group • Public meetings in all meetings including the • Statutory meeting with the constituency areas which Local Medical Committee Wirral Council Overview also included out of area and Local Pharmaceutical and Scrutiny Committee meetings in Ellesmere Port Committee; (combined Adult Care and and Neston; Health and Children’s); and • Meetings with GP members • Visits to supermarkets and and practice managers; • Statutory Joint Overview shopping centres; and Scrutiny Committee between Wirral Council and Chester and Cheshire West Council.