Sarah Fletcher

This week, health bosses agreed to close the Lincoln Walk-In-Centre on Monks Road for good at the end of February. Sarah Fletcher is CEO of Healthwatch Lincolnshire, the local watchdog created to gather views of the public and get the best out of their care services. She offered the following analysis when contacted by The Lincolnite.

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It is such early days since West CCG and local Primary Care Providers have introduced any additional services or improvements in access to GP appointments or Out of Hours services, that Healthwatch Lincolnshire feel it is too soon to understand what if any real changes have happened.

Whilst we have been given updates from reports produced by the CCG, for Healthwatch reports only tell part of the story. The proof will come from the patients using these services whether or not the impact of this closure has any long term affects.

Healthwatch Lincolnshire like many other organisations in Lincolnshire is concerned that the decision to close the walk-in-centre has been made at this time, whilst there will never be a ‘right time’ current pressures on the system suggests the impact could be felt much wider.

At present we are told that West CCG have completed a full review and analysis of the current provision and most importantly, what new provision is required to cover the gaps following the closure of the walk-in-centre.

If West CCG have not done all their homework properly, then it will become apparent very quickly that any additionally provided services will not meet demand.

However, we would agree that patients have a range of services available that should be considered including talking to a pharmacist. The concern comes when patients feel they are being forced to make ‘self-diagnosis and treatments’ rather than going to visit their GP, believing the messages are suggesting this.

Self-care will be a big message for all patients in the future, for more information about self-care, Lincolnshire residents can visit www.lincolnshire.nhs.uk.

Healthwatch Lincolnshire agree that for some patients, over the counter medication is the right course of action but if someone’s symptoms have been getting worse, or prolonged then they must either make an appointment to see a doctor, Nurse Practitioner or Practice Nurse or phone NHS 111 or in an emergency 999.

It is hard to know at this minute in time what impact this closure will have. Within the system NHS organisations such as the hospital have been aware for some time of the possibility the walk-in-centre will close, this doesn’t mean they can prepare any differently but they will recognise the fact that they may see increase in patient numbers once the centre has fully closed.

We all need to remember that A&E really is for emergencies, life threatening conditions or situations that require 999.

It appears that a significant number of the public and patients in Lincoln are aware of the walk-in-centre’s imminent closure. However, the concern is really for those people that are just not aware it has closed, which often tends to be those most vulnerable in our society, and end up going to the walk-in-centre when they need help, possibly wasting valuable time.

We will be asking West CCG to make sure there are large notices outside the walk-in-centre signposting patients to alternative services.

At this moment in time we do not believe there is any chance the decision to close the walk-in-centre can be altered.

The serious funding issues the four CCGs in Lincolnshire are facing, coupled with the fact that organisations such as United Lincolnshire Hospital Trust are facing significant funding crisis, has been one of the main reasons West CCG has made the decision to close.

We would encourage patients to contact Healthwatch Lincolnshire if they are not able to access the services they need as a result of the closure of the Walk in Centre and we will then be raising these concerns with West CCG.

Healthwatch Lincolnshire strongly considers that patient and service user experiences must be at the heart of any changes. To date there is no real evidence of this happening. At this time we are not reassured that patients, carers and service users’ experiences have been placed at the ‘heart’ of future plans.

It is our view that Lincolnshire Health and Care and any sustainability and transformation plans should include patient and service user experiences at its core. There are many ways local patient voices can be heard; patient participation groups, self-help health support groups, community groups, patient councils, Healthwatch Lincolnshire and most importantly through frontline services.

How often is the patient journey followed from start to finish, and by finish I mean when the patient has fully recovered, not on the day they leave hospital or a specialist service?

For the past three years Healthwatch Lincolnshire has observed the developments of Lincolnshire Health and Care and the more recent Sustainability and Transformation Plan for Lincolnshire.

During this period we have read blueprints which looked at how services might integrate; attended many meetings where current and future services have been discussed and read carefully the many public messages that have been shared.

However, three years on and having spent a great deal of time and money, our health and care system leaders have left Healthwatch Lincolnshire concerned that there is still much more work to do.

Going forward there are some public messages that we recognise will be difficult for many people to hear. The significant financial constraints on all health and care services in Lincolnshire will result in very difficult decisions concerning current services, and this is perhaps overall the most challenging message.

The people of Lincolnshire will need help from their GP, hospital doctors, nurses, consultants and other NHS staff in understanding what the implications of these changes will be. For instance, if specific services need to consolidate for them to provide the best outcome for patients, this needs to be properly explained and suitable evidence provided.

Also, for some people, they will need to have more support with travel to their appointments across, and at times ‘out of the county’ to enable them to access specialist services, and understand why they will need to travel further to access the right health care for their own or a member of their family’s needs.

We fully support the overall plan to deliver services as close to home as possible, keeping people out of hospital for as long as possible and integrating health and care services to work closer together. These plans offer a much more positive outcome, particularly for those most vulnerable.

Whilst we acknowledge that over the past two years there have been some public engagement activities and communication messages shared, these have been broadly concerned with the fact that ‘changes are coming’.

Lincolnshire people have not been given any indication as to what these changes are.

To consult the public later in the year with ‘Hobson’s Choice’ options, does not demonstrate real commitment to the people our NHS health and local authority care services are here to serve.

The sooner the plans are on the table for proper discussion, scrutiny and consultation the better.