Urgent Care at Pontefract Hospital 2017 Nichola Esmond Chief Executive Officer September 2017 This report and information in it can be used or reproduced however please ensure the information used is credited to Healthwatch Wakefield. Contents Pontefract Hospital emergency care provision since 2011 .......................................................................................... 4 Purpose of the engagement ......................................................................................................................................... 5 Next steps ..................................................................................................................................................................... 5 Key Findings .................................................................................................................................................................. 6 What happens currently across Wakefield District? .................................................................................................... 8 National Guidance about urgent care .......................................................................................................................... 8 The difference between A&E (or Emergency Department) and Urgent Treatment Centre .................................... 8 Responsibilities of the CCG, including legal requirements ........................................................................................... 9 Legal requirements ................................................................................................................................................... 9 Healthwatch Wakefield Statement of Independence ................................................................................................ 11 Our Vision ............................................................................................................................................................... 11 Our values and behaviours ..................................................................................................................................... 11 Retaining our independence when doing externally funded work ........................................................................ 11 Statutory functions of local Healthwatch ............................................................................................................... 11 Methodology .............................................................................................................................................................. 13 Survey Design ......................................................................................................................................................... 13 Interpreting the data .............................................................................................................................................. 13 The engagement process ........................................................................................................................................ 13 Online and media promotion ................................................................................................................................. 14 Community outreach .............................................................................................................................................. 14 Under represented communities ........................................................................................................................... 17 CCG engagement activity........................................................................................................................................ 17 The Campaign Company telephone survey ............................................................................................................ 18 Findings ....................................................................................................................................................................... 19 How people currently use healthcare services ...................................................................................................... 19 What people currently know about the services that are provided at Pontefract Hospital .................................. 25 What other services people think could be provided at Pontefract Hospital ........................................................ 27 Easy Read Survey .................................................................................................................................................... 31 Conclusion .................................................................................................................................................................. 32 Appendices ................................................................................................................................................................. 33 Demographics: people profile ................................................................................................................................ 33 Survey ..................................................................................................................................................................... 33 Pontefract Hospital emergency care provision since 2011 When the new hospitals at Pinderfields and Pontefract were opened in 2011, it was agreed that Pinderfields would be the main centre for people needing acute and complex care for the district but that Pontefract would continue to have a full Accident & Emergency (A&E) Department, with specialist doctors and equipment on site during the day and available to support patient care around the clock. This was delivered by Mid Yorkshire Hospitals NHS Trust as part of their contract. From 1 November 2011, due to a shortage of emergency doctors and concerns about safety the board at Mid Yorkshire Hospitals NHS Trust took the decision to close the emergency department at Pontefract Hospital temporarily between 10pm and 8am. The emergency department was fully re-opened on 3 September 2012 with an external provider covering the overnight service. In 2013, as part of a large scale hospital improvement programme to address the significant challenges facing the local NHS (called Meeting the Challenge) the roles of our three local hospitals (Dewsbury, Pinderfields and Pontefract), were reviewed. The review was in line with national guidance from NHS England that describes different types of urgent care services and how they should be organised to help people get to the right place for their medical needs. This guidance was developed to enable the local NHS to create systems which make routes for care easier, so patients use the appropriate service for their need, and urgent and emergency care services are freed up to support patients who are in greatest need. A detailed Integrated Impact Assessment of the Meeting the Challenge proposals was completed in 20131 that supported the local case for change. For many years the A&E service at Pontefract has been operating as more of an Urgent Treatment Centre (see definition on page 7) than a fully functioning A&E. This means the vast majority of people who are taken to hospital by ambulance from the east of our district are taken to Pinderfields to receive specialist emergency care. People arriving at Pontefract A&E who need admission to hospital are stabilised and transferred to Pinderfields. Both Dewsbury and Pontefract Hospitals provide consultant-led emergency care from a team of doctors and advanced nurse practitioners. There is a consultant present in the hospital during the day and available for advice out-of-hours, as well as full resuscitation facilities available. All three hospitals deal with urgent illnesses, injuries and conditions that can be seen without patients having to stay in hospital; these include cuts, sprains, broken bones, head injuries, eye problems and skin infections. 1 http://www.meetingthechallenge.co.uk/documents/making-the-case-for-change-evidence/ Healthwatch Wakefield Engagement on Urgent Care at Pontefract Hospital 2017 Page | 4 Purpose of the engagement The contract to deliver urgent care at Pontefract Hospital is due for renewal in 2018 so NHS Wakefield Clinical Commissioning Group (CCG) has taken this opportunity to review the service to ensure that it serves our population as well as it can. The CCG commissioned Healthwatch Wakefield to lead on the engagement with local people. The questions in the survey were designed to help find out: 1. How people currently use healthcare services 2. What people currently know about the services that are provided at Pontefract Hospital 3. What other services people think could be provided at Pontefract Hospital Next steps No decisions have been made yet about urgent care at Pontefract Hospital, as the CCG believes the public should help shape the service. This report summarises public views on the issue so that they can be considered alongside independent clinical advice on safety and sustainability of services at Pontefract Hospital. If changes are needed that affect the way people currently use services, the CCG will consult with the public on the options they might consider. The CCG tells us that Pontefract Hospital is central to the current and future plans for healthcare for Wakefield district. As an example, from October 2017 there is an extended hours GP service at Pontefract Hospital offering