Public Meeting Planned

Date: March 22nd 2018

Time: 7pm

Where: Putnoe Height Church, Putnoe Heights, MK41 8EB

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Closure of Putnoe Walk in Centre: Statement on new models of care for Bedford

When we attended the BCCG meeting in public a number of questions were submitted from HOBH, it’s participants and other members of the public. This is the response:

Closure of Putnoe Walk in Centre: New models of care for Bedford
Following news of the closure of Putnoe Walk in Centre, BCCG has received a number of
written questions, which have been collated and responded to in the questions and answers
below.
Q. Will the new facility be operated by VirginCare, as VirginCare operate the GPs at
Cauldwell?
A. No decisions have been made.
Q. What will be the success criteria that will demonstrate comparable or better care
will be available when the Urgent Treatment Centre and the Extended Hours process
have been implemented?
A. A series of Key Performance Indicators will be agreed with the provider and patient
experience will be monitored to ensure patients receive a good service.
Q. What are the plans for the parking situation?
A. We recognise that parking is an issue at the Bedford Hospital site. Given the introduction
of our Extended GP service and our Out of Hospital Strategy, which is designed to reduce
pressure on the Hospital, we expect that parking will not adversely affect residents.
Q. Where was the public consultation on the closure of the walk in facility?
A. The Urgent Treatment Centre is a nationally mandated service requirement, which means
that the Cauldwell Site is the only place where the requirements of the mandate can be
delivered. However, we need to look at the models of care for extended GP access and we
plan to do this in co-design with local people.
Q. Is this because it is a private contract and not run by CCG and there is no
requirement for consultation?
A. The Walk in Centre is not a private contract. It is managed by NHS England and
commissioner’s contract with GP partners, who are part of the NHS family.
Q. Why wasn’t a replacement service sought and prepared for implementation at
March 2018?
A. NHS England have, over time extended the contract for the Walk in Centre many times.
Unfortunately, the current contract has exceeded the number of extensions that can be
undertaken. Bedfordshire CCG has established a new contract with Partners at Putnoe
Medical Centre to continue to deliver walk in services until 30 September 2018, when
extended GP access and the new Urgent Treatment Centre will be introduced.
Q. Who was responsible for overseeing this situation and at what point was it known
that failure was going to happen?
A. Bedfordshire CCG is currently working to blend national policy with the needs of our local
population. This is a complex process that needs careful consideration. The CCG has been
working on this since last year and as part of the process have been involved in complex
and commercially sensitive discussions to secure walk in services for local people, pending
further discussions with the public on new models of care for our GP extended access.
Q. The walk in centre is popular, easy to use, child friendly accessible and parking is
free.
A. We recognise that this is an important consideration for local people.
Q. It is suggested by the press that a replacement service will be the Urgent
Treatment Centre at Bedford Hospital.
A. The nationally mandated Urgent Treatment Centre will be based at Cauldwell Medical
Centre, to ensure it is close to Bedford Hospital for use of diagnostics. This is not a
replacement for the Walk in Centre, but walk in services are a key requirement.
Q. Have you ever tried to park at Bedford Hospital? Cars are all over the place and
parked outside marked bays. It is expensive to park at the Hospital. Have you
considered pensioners, people on low wages or the unemployed? They will have
travel problems accessing an Urgent Treatment Centre.
A. We recognise that this is a difficult issue. The site is however on a bus route, with good
access to public transport.
Q. It is reported that the Urgent Treatment Centre will not be operating for at least six
months. What sort of planning is that? What are the users of the walk in centre going
to use in that time period, presumably join the queue at A&E?
A. The Walk in Centre at Putnoe will continue to operate until 30 September 2018, when the
Urgent Treatment Centre and GP Extended Hours service will be introduced.
Q. What is the implication for the A&E service in Bedford in the future with the
opening of an Urgent Treatment Centre next door?
A. The Urgent Treatment Centre will perform a different function to the emergency
department. The centre will treat minor illness and injury and reduce pressure on the over
stretched A&E department.
Q. What is happening to the staff at Putnoe Walk in Centre and where are the new
staff coming from for the Urgent Treatment Centre?
A. The staff at Putnoe will continue to work for the surgery and deliver a six day service to
registered patients. Once a provider has been selected for the Urgent Treatment Centre, we
will work to develop the workforce for the new UTC.
Q. Your strategic objective is “to support local people and stakeholders to influence
local services and ensure that decisions are informed and shaped by local views”.
Can you explain how your decision to close Putnoe Walk in Centre meets this
strategic objective?
A. Last year, NHS England issued a national mandate to all CCGs to establish a new Urgent
Treatment Centre, which would provide diagnostics for patients and reduce pressure on A&E
departments.
With the contract for Putnoe Walk in Centre set to expire at the end of March 2018, and the
new surgery gearing up to deliver a new service for its registered patients Cauldwell Medical
Centre – on the Bedford Hospital site is the only place where this could be provided.
However, in October, we will introduce an Extended GP Hours service, which means people
can access walk in appointments. We plan to involve local communities in the co-design of
this new model of care.
Q. How can you justify your decision for Cauldwell Medical Centre to be your location
of an Urgent Treatment Centre after the CCG only consulted 1300 residents?
A. The survey we undertook was to see if local people wanted to access extended GP
hours. This did not relate to the closure of Putnoe, but it did help to inform how local people
want to access services in Bedford. The Cauldwell Medical Centre is the only place that can
provide the nationally mandated Urgent Treatment Centre – in line with the specification.
Q. Why have you chosen an already over capacity health site to open an Urgent
Treatment Centre?
A. We are nationally mandated to provide an Urgent Treatment Centre that is close to
diagnostics and a workforce that will be able to deliver urgent treatment. It is the only option
for the CCG in Bedford.
Q. How do you expect residents from Bedford Borough to access Health Care
Services at a singular site that is already full to capability in relation to parking?
A. Our figures show that about 60 people a day use the Walk in Centre at Putnoe and some
of those patients are registered at the Putnoe practice. We recognise that there are
limitations to the site but the Extended Hours GP service will mean that patients can access
appointments elsewhere, so not all of the patients that currently use the walk in centre will go
to the Cauldwell Medical Centre.
Q. Can you explain why members, councillors who represent residents in their wards,
have not been communicated with when you promised that they would be? Instead
they have been put in a difficult position of finding out proposals which you have
publicly published for the CCG meeting dated 25 January 2018.
A. We did meet with Councillors and the Mayor in September and October as part of our preengagement
to talk to them about the national mandate and the plans we have in place.
Since then, we have been working hard on the new models of care and undertaking
confidential commercial discussions. We recognise however, that we should have continued
to talk to the councillors in the intervening months, as our plans evolved.
Q. Can the CCG explain their decision to publish their intentions publicly before
speaking to members of Bedford Borough Council’s Overview and Scrutiny
Committee, as promised in October 2017?
A. We were aware that the closure of the walk in centre and plans for the Urgent Treatment
Centre were causing concern locally, so we took the decision to share our plans as soon as
we could. We will continue to work closely with the Overview and Scrutiny Committee and
ensure they have visibility of our engagement plans.
Q. Do you acknowledge that this is a mess?
A. We recognise this has caused some concern locally. We have spoken to residents and
elected members as soon as we are able to do so.
Q. Will you commit today to maintaining walk-in care at Putnoe Walk-in Centre after 31
March?
A. Yes. The CCG’s new contract with the partners of the Putnoe Medical Practice will run
from 1 April – 30 September 2018. In the meantime, we will work closely with residents to
develop the new model of care for the Extended GP Hours service.
Q. The ‘Governing Body Meeting (held on 25 January) is described as a meeting in
public.’ However, the meeting had a start time during the working day and the school
day, a requirement for two days’ notice of any questions, and public questions at the
very end of the agenda, after all business is finished.
A. Our Governing Body meetings are held in public bi-monthly and are set a year in
advance. The CCG moves the Governing Body meeting from town to town across
Bedfordshire to give people the opportunity to attend, should they wish. Engagement events
are held at weekends and in the evenings to give those who are unable to attend a daytime
meeting, the opportunity to become involved in discussions. We will however review how
and where Governing Body meetings are held.
Q. The closure of the existing Walk-in Centre is causing great concern amongst
residents. Over 5,000 have already signed petitions against its closure, many more
than were consulted in your survey. Your proposal to close the walk-in centre will
leave other areas of the health service under even greater pressure than they are
currently and even more worryingly could leave patients not seeking the medical help
they need. Will you think again about withdrawing this crucial local service?
A. The Walk in Centre will continue to operate until 30 September when the new Urgent
Treatment Centre and GP Extended Hours service will take over. This will provide an
enhanced service, with care being delivered closer to home. We do not expect this to add
pressure to existing services.
Q. Where are the people going to go if there is a six month wait before the new walk-in
open in Bedford Hospital? Should you not keep Putnoe open till the new one is
ready?
A. Yes. The Putnoe Walk in Centre will be open until 30 September, when the Extended GP
Service and Urgent Treatment Centre will take over.
Q. In Central Bedfordshire there continues to be a flow of new developments, many of
over 100 houses at a time. I note from the applications that the BCCG has been
contacted and have no objection to the application. In many villages of rural
Bedfordshire local surgeries struggle with access due to a shortage of clinicians both
doctors and nurses. My local practice has almost 18,000 patients and those seeking
access often queue outside the premises from before 8am to obtain an appointment
and many are unsuccessful. Phone and on-line bookings are also a problem. When
this is discussed with the managing partner the response is that BCCG do not consult
the practice. The result is that new residents fight for access and the consequence is
that there is a deterioration affecting existing patients. The situation is the same with
NHS dental practice access. I appreciate that practices gain more money if they have
more patients but there should be some balance and not a continued reduction in the
quality of medical care.
A. NHS funding is provided after patients move to a practice, which means it’s very difficult
for the CCG to plan ahead. However, we are working hard with councils to improve planning,
so that we know where developments are going to be. This will help us to better plan for the
area. This is starting to work and for example in Central Bedfordshire, we are working with
the Council to develop a Health and Social Care Hub at the Biggleswade hospital site.
Q. Are you able to confirm what is happening with the walk in centre that runs out of
the medical centre? There seem to be a lot of rumours floating around that it is going
to shut in March, which is very concerning as it’s an extremely useful facility.
A. The CCG has signed a new contract with the partners of the Putnoe Medical Practice
from 1 April – 30 September 2018. The Walk in Centre will continue to operate until 30
September when the new Urgent Treatment Centre and GP Extended Hours service will
take over. This will provide an enhanced service, with care being delivered closer to home.
We do not expect this to add pressure to existing services.
Q. Does this mean that the surgery will remain a walk in surgery or will it be for
registered patients?
A. The Walk in Centre will continue to operate until 30 September, residents can continue to
use local services as they always have. From 1 October however, only patients that are
registered at Putnoe Medical Centre, or wish to register, will be able to access the six day
service provided by the practice.
Q. I’m given to understand that the above walk in centre in Putnoe is closing. What is
the rationale behind the decision? In what other way will the demand for the service
be met?
A. The Walk in Centre will continue to operate until 30 September when the new Urgent
Treatment Centre and GP Extended Hours service will take over. This will provide an
enhanced service, with care being delivered closer to home. We do not expect this to add
pressure to existing services.
Q. With regards to the proposed closure of Putnoe walk in centre, this is an important
function in our town. These days being able to see our doctor is very difficult, going
to A &E is frowned upon and out of hours doctors are stretched. Please could I have
some information as to why this is closing and the rationale?
A. The Walk in Centre will continue to operate until 30 September when the new Urgent
Treatment Centre and GP Extended Hours service will take over.
The Urgent Treatment Centre will perform a different function to the emergency department.
The centre will treat minor illness and injury and reduce pressure on the over stretched A&E
department. Alongside this GP Extended Hours service will improve access to appointments.

Update on Putnoe Walk-in Centre Closure
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