In March 2009, Hemel’s Accident & Emergency department was closed, and replaced with the current Urgent Care Centre, along with what is now West Herts Medical Centre (which takes registered patients by appointment, as well as more minor walk in issues from anyone). In the last two years, we have seen the opening hours for the Urgent Care Centre reduced from 24 hours a day, to 8am-10pm. This has caused issues where many patients have had to attend Watford or Luton A&E department instead, despite it not being a life-threatening issue, as the illness or injury was not safe to wait until the next day.
Herts Valleys Clinical Commissioning Group is now deciding how best to provide services for Hemel Hempstead and the surrounding areas in the future, in relation to both the Urgent Care Centre and the West Herts Medical Centre. The provider that runs West Herts Medical Centre has a contract that is due for renewal in October 2018, so they have decided to take a public consultation process on the options going forward.
During April-November 2016 12.5% of patients attended the Urgent Care Centre between the hours of 10pm and 8am (the hours that are no longer utilised currently). At a rate of 85 patients a day on average, this makes almost 4,000 patients every year, who needed to attend at hours that are no longer available.
For the Urgent Care Centre, they are considering three different options. The first is to keep the hours the same at 8am-10pm, because this would be easier on current staff levels, however this runs the very real risk of patients attending A&E out of hours for non-life-threatening issues. Given that Watford A&E department is already having struggles with waiting times, this is a risky strategy in my opinion.
The second option they are looking at is increasing the opening hours by two hours to become 8am-midnight. This will capture the 4.4% of patients who attended during these hours, however that still leaves a significant number of patients with having to attend A&E if they need medical care.
The last option they are looking at, is bringing back a full 24-hour service. This would obviously be best for patients in theory, however continued GP shortages could make this difficult in practice and ad hoc closures due to inability to fill shifts could cause more of an issue for patients turning up, only to find they then need to travel to go home or travel to Watford A&E.
Regarding the West Herts Medical Centre, there are two options that are being looked at. The first would be that there would be no Medical Centre in practice. The Urgent Care Centre GP’s would still take walk in patients, however the 2,000 registered patients at West Herts Medical Centre would have to register at other practices throughout the town.
I know from talking to friends and family, that a lot of these surgeries have their own difficulties getting patients appointments in a reasonable timeframe. For example, I have had a look at the online booking system for my GP surgery just now, and there are no appointments for two weeks. Now, obviously if there is an emergency, then you can call (and must wait on hold for a long time) on the day, but what constitutes an emergency for a same day appointment is very vague, and many people are not aware.
The alternate option, is to put the running of the service out for commercial, competitive procurement. The new contract would start from November 2018, and again be limited to 5 years, and a decision would need to be looked at again at the end of that time. The 2,000 patients that West Herts Medical Centre has, is quite small compared to your average GP surgery with 9,000 patients and this might make it harder to recruit and retain GP’s for the surgery.
You can have your say from now until 28th March 2018, via their survey https://www.surveygizmo.eu/s3/90065917/NHS-Herts-Valleys-CCG-consultation
There is a public consultation meeting on Wednesday 21st February from 7-9pm at the South Hill Centre, Cemetery Hill, HP1 1JF They are asking that people confirm their planned attendance if possible by email to email@example.com. I urge people to attend to make their views known on this important issue.