1 st July Patient Engagement Activity at Chorley and South Ribble Hospital Urgent Care Centre

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1 Patient Engagement Activity at Chorley and South Ribble Hospital Urgent Care Centre 1 st July 2016 Contact details: Chorley and South Ribble Hospital Lancashire Teaching Hospitals NHS Foundation Trust Preston Rd, Chorley, Lancashire PR7 1PP Dates and times of visit: Friday 1 st July am-1pm Healthwatch Lancashire representatives: Amanda Higgins (Project Officer) Becky Willshaw (Project Officer) Beverly Evans (Volunteer)

2 Introduction Healthwatch Lancashire is committed to listening to patients and members of the public in Lancashire and making sure their views and experiences are heard by those who provide, plan and regulate health and social care services. Since Monday 18th April 2016 the Accident and Emergency Department at Chorley and South Ribble Hospital has been temporarily replaced with an Urgent Care Centre. On Friday 1 st July 2016, two project officers and one volunteer from Healthwatch Lancashire gathered survey responses from patients at Chorley and South Ribble Hospital s Urgent Care Centre. The aim of the visit was to obtain the views of people using the service and to observe the environment to evaluate any impact of the changes at Chorley and South Ribble Hospital. The Urgent Care Centre operates between the hours of 8am 8pm, 7 days a week and treats minor injuries and illnesses. Outside the Urgent Care Centre s opening hours patients are directed to phone the NHS 111 service for advice, attend their nearest emergency department, or call 999 if they need urgent help for serious and life-threatening injuries and conditions. The nearest A&E departments are Royal Preston Hospital and Royal Albert Edward Infirmary in Wigan. This report summarises reviews from 22 patients and one member of staff who were present within the Urgent Care Centre at Chorley and South Ribble Hospital on the morning of our visit. DISCLAIMER This report relates only to the service viewed at the time of the visit, and is only representative of the views of the patients who met members of the Patient Engagement Day team on the date and time of the visit. 2

3 Healthwatch Lancashire Patient Engagement Report General Information Chorley Urgent Care Centre replaced the Accident and Emergency Department at Chorley and South Ribble Hospital on Monday 18th April due to staff shortages. Below is a statement released by Stuart Heys, the Chairman of Lancashire Teaching Hospitals NHS Foundation Trust: The board, and all our staff, along with partner agencies, are absolutely committed to reinstating the emergency department at Chorley as soon as we have the sufficient staff to ensure we can provide a safe and sustainable service, and we are all working hard to make this happen. We need at least 14 doctors to safely staff the departments across both hospitals, and currently have a gap of six. Currently we have potentially secured three of the doctors we need, and there are further potential candidates we are actively pursuing. Until we are in a position where we can reinstate the emergency department we are doing everything possible to make sure effective interim arrangements are in place so patients in both Chorley and Preston areas receive prompt and safe care - and those arrangements are currently working well. Acknowledgements Healthwatch Lancashire would like to thank the patients for taking part in the surveys. We would also like to thank the staff on the department, for making us feel so welcome during the visit. Methodology This visit to Chorley Urgent Care Centre was arranged due to the recent changes at Chorley and South Ribble Hospital. The focus of this Patient Engagement Activity was to gather patients views on the accessibility of the department. We also gathered views on the quality of care provided and the awareness and impact of the changes. The team of project officers and volunteers interviewed patients in the waiting room and recorded their feedback. The team also collated their observations during the visit. The team compile a report reflecting these observations and feedback. The report is sent to the provider of the facility for validation of the facts. Any response from the provider is included with the final version of the report which is published on the Healthwatch Lancashire website at: healthwatchlancashire.co.uk/reports 3

4 Patient Engagement Day Observations Location Chorley Urgent Care is situated on the hospital site where the Accident and Emergency Department had previously been. External Environment The external environment is pleasant and there was adequate parking on the hospital car park with payment due upon exit. The Urgent Care Centre is clearly signposted. Internal Environment-First Impressions The Urgent Care Centre opens onto a bright, clean and spacious area with a large reception desk occupied by several members of staff. The waiting area has a small number of seats and vending machines to buy drinks and snacks. There is a separate children s waiting room through a door on the right with toys and games available. Information about the changes to A&E There are posters on display throughout the hospital informing people about the temporary changes to the department. (See photograph of a poster on display within the hospital.) The staff at reception told the Healthwatch Lancashire team that there had previously been leaflets to give patients which gave details of the care you can receive at the Urgent Care Centre, however these had run out and they had difficulty sourcing more. Waiting times We spoke to patients as they arrived at the department and were waiting to be seen. Patients who arrived earlier in the morning were not experiencing waiting times. Later in the morning there became a waiting times extended in line with increased footfall, however they didn t appear to be more than 1-2 hours. 4

5 The Patient Engagement Activity at Chorley and South Ribble Hospital Urgent Care Centre took place on Friday 1 st July patients shared their views. 1. We asked: Which town do you live in? Chorley Preston Leyland Lostock Hall Bolton Whittlelewoods Clayton Brook Much Hoole From the 22 respondents there were 7 patients who travelled from Preston. When asked why they had come to Chorley and South Ribble Hospital from Preston, 4 people said that it was because Chorley and South Ribble Hospital was more convenient to access, 2 patients said they had come from work which was closer to this hospital and 1 patient said that the nurse had told them to come to Chorley because of long waiting times at Royal Preston Hospital A&E. 2. We asked: How did you get here? Car Walk Taxi Ambulance Bike Public Other Transport We asked: Was Chorley Urgent Care Centre convenient to access? 100 % said Yes 0 % said No All respondents thought that the hospital was easy to access, 5 patients commented: It is near to my work which is where I have come from now. I came here from work which is in Buckshaw. I came to Chorley as Preston is too busy and I'm not urgent enough for A&E.I need an X-ray so I know my GP would only send me here. I work here next to the hospital and have come from there. It would be two buses to get to Bolton A&E. It is quicker than getting to Preston. 4. We asked: Did you speak to anyone before coming here? 5

6 GP NHS 111 Pharmacy Nurse Other Didn t speak to anyone Those who had spoken to someone other than the people listed above had spoken to the following people: A first aider. I rang here to see what facilities were available. I wasn't quite sure if it had closed. I had heard about a closure. I spoke to staff at my daughter s school where she had her fall. I had an operation down South and I have come back to this area for two weeks so I am here for Primary After Care. I spoke to a friend that works for the NHS to check if I could come here. 5. We asked: If answered yes to Q4, did they advise you to come here? 93% said Yes 7% said No Comments: I rang a nurse as my cast is rubbing and causing infection so the nurse told me to come here. I rang my GP to ask them if I should come here or Preston A&E. The staff at my daughter s school said her hand probably needs stitching so I came straight here with her. I spoke to my GP this morning and he told me to come for an x-ray. They didn't have a slot for me to see someone at my GP to get a tetanus shot so they told me to come here. My friend who works in the NHS said if it was anything non-life threatening then I should come here to Urgent Care. My GP told me this morning to go to Preston A&E which we did but then Preston said to come here to Chorley because it would take 4 hours to be seen. The GP rang the hospital and the hospital said to come here straight away. 6. We asked: Do you feel that Chorley Urgent Care was the right place to come to? 90% said Yes 5% said No 5% said Unsure I can get an X-ray here which I can't get at the GP. 7. We asked: Do you feel well informed about the changes to Chorley A&E? 6

7 43% said Yes 57% said No Those who said No, commented: "What do you do if you have an accident after 8pm? I didn't know about any changes. I didn't know. I thought it had shut from what I heard in local newspapers and television. I didn't know you could still come here. I don t really feel informed. I thought it had closed completely. It was only when I spoke to the doctors this morning and he told me to come here that I knew it was still open. I had heard it was closed through word of mouth and I saw it on the news. I wasn't aware of it at all. I thought this was still Chorley A&E. I had heard through word of mouth and Facebook. I wouldn't know what to come here for and what to go to Preston for and I didn't know the opening times until today or anything like that. I'm still not sure what I should come here for as a result of the closure. I know it's been on Facebook and in the Chorley Guardian but I forget. We were only told about the changes and what we could go to Chorley for when we were at Preston A&E. I'm following some groups on Facebook but the changes happened over night and they could have prepared the public more. They are not thinking about the public but the cost and the costs are only moved elsewhere. The services on offer here are on display in the GP surgery but there is always a lack of information about services for the public. Those who said Yes, commented: It is only from news and local gossip. Yes but I feel the info in the media is biased and not entirely true. I heard through Facebook because of all the petitions and protests. I've heard by word of mouth. I found out about it a month ago by seeing it on the news. I've only just moved up here but my Auntie who brought me today told me of all the problems with the hospital and how A&E has shut and Preston A&E can't cope. It's been well advertised on Social Media. I'm aware of it so I knew of the closure. I saw it in the press and I drive past the hospital often. We've read some information and I think I understand what I go to each place for. I only heard when I went to Preston Hospital when I went with my son, they gave me a leaflet listing the issues I could come here for. I'd only come here really because it's close. 8. If answered no to Q12, how do you think this could be improved? 7

8 I would have been more involved with protests if I had known more and hadn't been at work. Informing people through the local paper and leaflets would have meant people were more informed. Nothing came through the door; people are confused about what they can come here for. We should have factual information given with the real reasons for closure and if it is temporary or permanent. I've not had anything through the post and I live in Astley Village. I wouldn't have known about it, I heard only recently through someone at work. People would have been more informed if it had been covered in local news and radio. 9. We asked: Do you have any concerns about accessing your local A&E department? 66% said Yes 24% said No One respondent who said No, commented: No, because I'm not expecting to come very often the distance isn't much of a concern. I don t have any concerns personally as I can use Bolton but for those who live in Chorley its closure will have a big impact as they'll have to use Preston. Chorley is a big town with lots of people who will all have to use other hospitals. 8

9 Those who said Yes, commented: The people who live in this area will now have to go to Preston. I had to go to Preston A&E recently and it was very busy. The nurse said to come here today because Preston will be busy, especially over the weekend. The lack of it is disastrous. It would be a disaster if it closed permanently as Preston can't cope now with the numbers. It will increase pressure for both patients and staff. When you're not well you don't need to extra pressure. The ambulances are struggling with ferrying people here, there and everywhere. I think it's bad management to have a Doctor shortage, if that's the real reason for the closure. I have two children so I'd much prefer to have an A&E close to me in Chorley. If it closes we'd have to go to Preston or Wigan which isn't convenient and parking isn't good. At the moment ambulances are having to take people from Chorley to other A&E's which takes longer and takes them away from transporting more patients. I live in Preston but it is easier for me to come to Chorley. I have been to this A&E department before and the care has been excellent. It would be a big worry to me if they closed it completely as Preston is so busy. They shouldn't shut it as Preston can't cope. The NHS needs more money to sort it out and to keep it open for people who live here like my Auntie. I don't know any information about when I can come here or when I should go to Preston A&E. To get all the way to Preston it's about 45 minutes to an hour. It's a worry especially when you have kids and grandchildren. We all pay taxes so we should all be close to an A&E. We've been previously to Preston A&E and were told to go home and come back tomorrow because it was so busy. Preston A&E is too far away (25 minutes away without traffic). I wouldn't go to Preston A&E because it's just too busy. People are unsure where to go. The waiting room is heaving so I didn't go yesterday. I think it would be better if it reopens because it will be putting pressure on Preston A&E. We live about the same distance from both Preston A&E and Chorley so the distance isn't a problem but I have heard that the waiting times are very long now at Preston A&E. It takes longer to get to Preston A&E than to get to Chorley. Preston is further away, at least 15 minutes without traffic. 9

10 Comments and stories The following comments were provided by respondents: 1 I had been aware of the changes at Chorley Hospital and knew that the Accident and Emergency Department was now running as an Urgent Care Centre. My cast from a recent operation was rubbing into my leg and causing a sore which seems to be getting infected. I live in Preston and had rung a nurse to see where I should go for my cast to be refitted. The nurse had told me to come to Chorley Urgent Care before the weekend as she said that Preston Accident and Emergency would be very busy and I might have to wait a long time. I asked my mum for a lift here to Chorley as I can t drive and she came in with me. I registered at reception and told them why I had come and they asked me to wait to see someone. My mum waited with me for a little while but then she had to get back home and I was to ring my dad when I had finished who would then come and pick me up and take me back home. Once I had been called in to be seen I was told there is no Plaster Technician here and I need to go to Preston Accident and Emergency. I have to wait for my mum or dad to come and get me now and take me all the way back. The receptionists could have told me that they had no plaster technician when I came in so I didn't have to wait all this time to find out after seeing the doctor. I have driven from Preston to here, my mum has dropped me off and left me and now I need picking back up and taking to Preston. 2 I live in Preston but it is closer to Chorley. I spoke to my GP before coming here. He told me to go to Preston A&E which we did but then Preston said to come here to Chorley because it would take 4 hours to be seen there. Being told to come to Chorley straight away would have improved our experience as Chorley are more than capable of managing my treatment today. I don t feel well informed about the changes here. We were only told about the changes and what we could go to Chorley for when we were at Preston A&E. 10

11 Comments from staff We spoke to one member of staff at the service who shared their views on the impact of the temporary changes to Chorley and South Ribble A&E department: The member of staff commented; There has been a lot less people visiting this department since the changes and a lot of people are calling to see if the department is closed. We are trying to spread the message about what services are still available here. I have tried to call the local newspaper to inform local people but the lady on the other end didn t believe it wasn t closed completely. We still have our doors open from 8am and 8pm. Out of hours we have a phone system available for advice and there is a phone on the outside of the building if anyone is to show here and need advice on where to go. 11

12 Healthwatch Lancashire Summary of Findings Here is a summary of findings from the visits to Chorley Urgent Care Centre: The Healthwatch Lancashire team observed that the Urgent Care Centre was quiet at the time of our visit and that it got busier within the later hours of the morning. All respondents found Chorley Urgent Care Centre convenient to access. Many people we spoke to on the day were unsure about what services were available to them during the temporary changes to Chorley A&E. Most patients had spoken to someone else to get advice about where to go, before they came to the Urgent Care Centre. More than half of the respondents felt they had not been well informed about the recent and temporary changes to Chorley A&E. Most of the patients we spoke to had concerns about accessing their local A&E department following the changes. The team observed a general lack of information from member of the public about the changes to the A&E department. We have included the information below taken from the Lancashire Teaching Hospital NHS Foundation Trust website about which conditions can be treated at the Urgent Care Centre at Chorley and South Ribble Hospital between the hours of 8am-8pm: 12

13 Response from provider No. Issues raised by patients 1. Lack of information leaflets available 2. Public awareness 3. Public Awareness (Preston) 4. Issue with plaster technician Response or action from provider Uptake of the leaflets have been popular and stocks ran out but more have been ordered from publishers. Communications regarding the Chorley situation have been extensive through various forms of physical and social media, GP surgeries etc. Posters were placed in supermarkets in Chorley and in other public institutions, describing appropriate circumstances/conditions that could be treated at Chorley. Communications updates will continue through local news and media outlets and through the Trust and CCG website. Information will be provided on the Preston ED desk describing services and facilities at Chorley Hospital to clarify to ED users at Preston who may have cause to present at ED in the future. This issue is being investigated as this service is available at CDH. To be addressed by September 2016 Ongoing September September Name of manager responsible C Lawrenson L Kelly C Lawrenson C Lawrenson Additional questions: 1. Is the report factually accurate? If not, please state what needs to be changed and why Both reports are factually accurate as far as we are able to determine. 2. Have you learnt anything new about the experiences of your patients as a result of this exercise? Preston patients appear uninformed about the temporary closure of Chorley ED. 13

14 It is interesting that only 13% of Preston patients contacted NHS 111 (and that all were advised to attend ED). There may be some scope to increase public awareness/confidence in NHS 111 s services, especially since 36% of patients were unsure or did not feel Preston ED was the right place to come for treatment (compared to only 10% at Chorley). It is reassuring to see that all patients who attended Preston were happy with the care they received. We are aware that waiting times at Preston are challenging and we are actively trying to address this. Waiting times for Chorley Urgent Care Centre appear to be much shorter by comparison. 3. What was your impression of Healthwatch Lancashire during this exercise? Do you think they could have done anything better? As usual, the team behaved professionally, providing balanced reports. We do not think they could have done better. info@healthwatchlancashire.co.uk Facebook: facebook.com/lancshealthwatch 14