What are people's experiences of urgent care?
The pressure on urgent and emergency care services continues to make the news, with significant press coverage of ambulance delays and long waits in accident and emergency departments (A&E).
This is backed up by the official performance statistics, which paint a grim picture as we head into winter. 819,000 operations, procedures and appointments in England have been postponed, adding to the 7.5 million people waiting to start routine hospital treatment.
Understanding your experiences
To understand how the pressures have affected patients, we looked back at the experiences of urgent care services people shared with us this year.
We worked with Healthwatch York to speak with people about their experiences at four urgent treatment centres - York, Scarborough, Selby and Malton.
This work expanded on previous research. It highlighted issues such as limited GP access, lack of consistent care, travel challenges, confusion about urgent care options, and the need for better communication.
Your suggestions for improvements
- better information about waiting times and any pressures that could increase these
- clarity on service availability, particularly x-rays which are available for shorter time than urgent treatment centre opening hours
- increasing staff available to help reduce waiting times
Has anything changed?
In our research this year, we found that some of the themes outlined above still remain, particularly issues with accessing same day GP services and concerns about communication.
- Patients are often referred to urgent treatment centres when unable to contact their GP, leading to increased use as the default option for urgent care.
- The demand for urgent care exceeds the supply, leading to individuals being directed to urgent care centres or not being offered same day appointments.
- More people are using urgent care centres as a default for urgent care and exploring alternative options such as NHS 111.
- Communication issues persist regarding available services, waiting times at urgent treatment centres and coordination between services.
- Continuity of care and travel concerns were mentioned but not as significant.
- Navigating urgent care is still challenging for people. Patients often choose urgent treatment centres for prompt GP care and are understanding of waiting times (within reason!).
"There is a lack of communication between NHS urgent treatment centres."
Where are we now?
People are very grateful to be able to access same day urgent healthcare and there was almost universal praise for the quality, kindness and skill of NHS healthcare professionals and reception staff.
However, demand for urgent care remains high and people appreciate same-day support, despite wait times. However, challenges still include difficulties in obtaining GP appointments, a lack of communication, little information about waiting times, and inadequate coordination between urgent care centres.
Some individuals are using urgent care inappropriately, indicating a need for improved way of dealing with them when they first make contact and offering alternative options. Clearer ways forward and effective signposting are necessary. People are open to using digital solutions for non-injury related urgent issues. Feedback on urgent care services is mostly positive, with most individuals ending up at urgent care or the emergency department.
Urgent treatment centres and NHS 111 are vital to provide advice and care for people with urgent health needs. There is still work to do to raise awareness of the role that pharmacies can play in urgent care. The plans for pharmacies to be able to prescribe some medications could significantly help if this is promoted effectively.
Response from the NHS
The Healthwatch urgent care report highlighted patient struggles with navigating the disjointed system. They are now implementing a fully integrated urgent care service in York, Scarborough, Malton, Whitby, Selby, and Bridlington. The first step is blending local hospital and GP services, with local GPs (NimbusCare) managing out-of-hours care and York Hospital overseeing urgent treatment centres.
Both services also now share the same system to record patient care electronically (your health records) for improved cooperation and communication. York Hospital is working closely with local GPs to jointly staff the urgent treatment centre.
With the new services operating only since 1 April, its early days but early feedback indicates significant improvements since working together this way.
