GP OUT OF HOURS SERVICE

GP OUT-OF-HOURS SERVICE

The GP Out of Hours (OOHs) service operates between the hours of:

• 6.30pm and 8.00am Monday Friday • 6.30pm on Friday evening until 8.00am on Monday morning • Plus all bank holidays

 The GP Out of Hours service receives high levels of patient demand with more than 60,000 patients being seen each year

GP OUT OF-HOURS SERVICE  There are four primary care centres where patients with urgent medical problems can be seen

 Prince Charles Hospital  Royal Glamorgan Hospital  Ysbyty Cwm Rhondda  Ysbyty Cwm Cynon

 Mobile doctors undertake home visits – mostly to patients in nursing homes, housebound and palliative care patients.

 A summary of the patient’s contact with the service is sent to the patients registered GP by 8am the following morning

GP OUT-OF-HOURS SERVICE

 The GPs who deliver the service are all sessional and self employed

 The service fills more than 85 shifts per week

 The service requires more than 22,000 hours of GP time per year GP SHIFTS IN YSBYTY CWM RHONDDA TOTAL GP NUMBER MONTH % UNFILLED SHIFTS UNFILLED April 2015 30 9 30% May 2015 31 10 32% June 2015 30 7 23%

NO OF PATIENTS SEEN AT PRIMARY CARE CENTRES ROYAL YSBYTY CWM MONTH GLAMORGAN RHONDDA HOSPITAL April 2015 1,008 208 May 2015 1,123 278 June 2015 947 184 GP OUT-OF-HOURS SERVICE Challenges:

Cwm Taf’s GP Out-of-Hours service is finding it increasingly difficult to recruit sufficient GPs to deliver the service.

The GP Out-of-Hours recruitment challenge is not unique to Cwm Taf as other Out-of- Hours services across and the UK have similar experiences.

GP OUT-OF-HOURS SERVICE

Challenges:

 Due to the short supply of GPs to deliver the service, there are times when one or more of the four centres where patients are seen have been closed (usually Ysbyty Cwm Cynon and Ysbyty Cwm Rhondda).

 At these times, the GP Out-of-Hours service is centralised at the Royal Glamorgan and Prince Charles Hospitals to ensure we can continue to provide the very best and safest service possible.

GP OUT-OF-HOURS SERVICE Urgent Action:

 We are continuing to do everything possible to increase the number of GPs but our immediate priority is to provide safe and effective access to GP Out-of-Hours services across Cwm Taf

 We now need to ensure that the GP Out-of- Hours service is able to meet the needs of patients and is sustainable for the future

GP OUT-OF-HOURS SERVICE Service Redesign and Investment:

 In order to address these challenges the GP Out-of- Hours’ service we want to re-design and operate from two rather than four centres.

 The new service to be co-located at Prince Charles Hospital and Royal Glamorgan Hospitals.

 This means that a GP Out-of-Hours service would operate separately but close to the A&E departments at both District General Hospitals. GP OUT-OF-HOURS SERVICE Improved Service for Patients:

 Co-location of the GP Out-of-Hours service will provide a more streamlined service for patients.

 Being located at the District General Hospitals will mean that for those patients who may need a specialist assessment or access to diagnostic tests, for example, x-rays or blood tests, these can be organised much more quickly.

GP OUT-OF-HOURS SERVICE

From October 2015:

 Accessing the GP Out-of-Hours service will remain unchanged.

 Patients who need to see a GP during the out of hours period will still be required to telephone the service.

 Patients will then undergo a telephone assessment (telephone triage) by a doctor and they will be directed to the most appropriate service to meet their needs.

GP OUT-OF-HOURS SERVICE  As is currently the case, patients may be advised to:

• Attend a GP Out of Hours Centre to see a GP (RGH or PCH) • Self care • Attend a pharmacy for advice or for treatment under the minor ailments service • Attend an optician or dentist • Make an appointment with their own GP • Receive a home visit if clinically indicated.

 Transport to appointments will continue to be provided if the patient is eligible (we are increasing this resource).

GP OUT-OF-HOURS SERVICE

The new model will provide:

 Patients with a safe, effective, streamlined and sustainable service for the future.

 Doctors with a more clinically supportive environment which will, in turn, help to attract more doctors to work for the service in the long term (investing in hard to fill shifts).

 A wider team of nurses, paramedics and pharmacists to work with GPs (investing in other professions).

 More Doctors doing more shifts.

 An investment from the Health Board of £500k.

 Engaging now and then looking to test August/September, full implementation September/October.

GP OUT-OF-HOURS SERVICE  When the patient contacts the service a call taker will record the patient’s personal details, for example, name, age, address, registered GP, and the reason for calling

 A doctor will telephone the patient back to make a clinical assessment

 At any stage emergencies can be diverted to 999 ambulance

GP Out-of-Hours Service - Accessing the Service  If a patient has an urgent health need during the out of hours period which cannot wait until their GP surgery is next open they can contact the GP Out of Hours Service. Tel: 0300 123 50 60.

 If a patient rings their own GP practice during the out of hours period they will be given the telephone number or be automatically redirected to the GP Out-of-Hours service.