GP led Walk-in Centre in Sheffield and Rotherham; Another way of urgent health care provision
GP led Walk-in Centre in Sheffield and Rotherham; Another way of urgent health care provision by: Dr Mubashir Arain Prof Jon Nicholl Prof Mike Campbell School of Health & Related Research (ScHARR) The University of Sheffield United Kingdom
Contents• Background• Aims and objectives• Methods• Results• Conclusion• References
Background• Resources are limited & it is important to allocate them efficiently for the health care services• It is evident that Accident and Emergency (A&E) departments are over loaded with patients• The increasing load of unnecessary visits to A&E not only causes delay in urgent care provision but also increases the overall cost
Background cont...• The Government started a number of urgent care services to compliment A&E in the last decade Nurse led Walk in Centre Minor Injuries Unit GP out of hour service Urgent Dental Service NHS Direct Late night pharmacies Eye Casualty (Adults) Asylum Seeker Service
Background cont...• In 2009, another Walk-in service started, where GPs, along with trained nurses, provide urgent care service, called GP Led walk-in centre• It was assumed that, in the presence of GPs and longer opening hours, these centre will help in diverting patients with minor health problems from A & E
Aims & objectives Primary• How efficiently the GP led walk-in centre services are working in Sheffield and Rotherham (under or over utilized, patients’ satisfaction, convenience of location etc) Secondary• Effect on other NHS urgent care services in Sheffield & Rotherham (determined by how many patients use other services after using the walk-in centre, for the same problem)
Methods Design:• The Cross sectional survey of patients was conducted in Sept and Oct, 2011 Study settings: Sheffield GP-led walk in centre Rotherham GP-led walk in centre• Previously validated questionnaire was used with modification• Questionnaire included characteristic of patients, patients choice of service and patients’’ satisfaction and consent to participate in a POST-VISIT survey
Rotherham GP led Walk-in centre The centre is located near the heart of the city (away from the main hospital) 1-2 GPs and 1-2 consultant Nurses are present most of the time at the centre On average 80 – 100 patients are seen every day by a GP or a nurse Centre is opened 8:00am till 9:00pm, 365days/year
Sheffield GP led Walk-in Centre The Sheffield Centre is located a little away from the city centre & main hospital, near the University of Sheffield in students’ area 2-3 GPs and 2-3 consultant Nurses at the centre Opened 8:00am to 10:00pm, 365days/year 120-130 patients turn over everyday
Survey Results• We were able to distribute 1821 questionnaires• 1030 questionnaires were returned (response rate 57%), 64% at Rotherham and 51% at Sheffield• According to the centre routine data estimates, around 30% received the questionnaire• We compared some demographics of patients participated in the survey with routine data• Mean age of patients in years was 30.66 in routine data and 32.1 in the survey data
Comparison of Age of the patients Routine data Survey dataMinimum age= 0 yr Minimum age= 0 yrMax = 93 yrs Max = 84 yrs 8
Results (Waiting time in minutes)Waiting time was significantly higher in SheffieldSheffield• Mean waiting time = 74.2 (SD=49)• Minimum 1 min ; Maximum 270 minsRotherham• Mean waiting time = 40 (SD=32.3)• Minimum 3mins ; Maximum 240 mins
Results cont… Overall satisfaction is significantly higher in Rotherham Centre as compared to Sheffield centre
Results cont…Able to look after problem yourself after the visit?
Intention to use other NHS serviceafter visiting the centre
Results from the Post visit survey (4 weeks after the visit) N= 260538 agreed to receive questionnaire (63% agreeing rate) and 260 responded (response rate 48%)
Other services used after visitingWalk-in Centre
Conclusion• Most of the patients are satisfied with the quality of service provided at these centres• These centres have increased accessibility to health care service through longer opening hour• High proportion of patients (40%) reported they used another service• The next step of project is to evaluate the impact on A & E by looking at routine data of patients
AcknowledgementWe highly acknowledge the support of all receptionists and staff for helping in data collection &Data analyst for providing routine data sets &The centre manager for making it possible to conduct this study at the centre!!
Key References• O´Cathain A, Coster J, Salisbury C, Pearson T, Maheswaran R, Nicholl J. Do walk-in centres for commuters work? A mixed methods evaluation. British Journal of General Practice 2009;59:934-939.• Salisbury C, Munro J. Walk-in centres in primary care: a review of the international literature. Br J Gen Pract 2003; 53 (486): 53-9.• Maheswaran R, Pearson T, Munro J, Jiwa M, Campbell MJ, Nicholl J. Impact of NHS walk-in centres on primary care access times: ecological study. BMJ 2007; 334 (7598): 838.