Response to Hammersmith and Fulham Clinical Commissioning Group (CCG) Consultation on Primary and Urgent Care Changes.

Healthwatch Central West London (CWL) and its H&F Committee welcome the opportunity
to comment on Hammersmith and Fulham Clinical Commissioning Group (CCG) Consultation
on Primary and Urgent Care Changes.

Healthwatch H&F Local Committee had an input in the design of the consultation document during the pre-consultation period through meetings with CCG representatives.

The meetings aimed to ensure that the document is written in clear and simple language, jargon free, provides the necessary information and its design is user friendly. We welcome that H&F CCG took our recommendations into account in the final consultation document.

However, we are concerned about how the suggested changes will fit into the wider healthcare landscape both locally and nationally with the upcoming changes with the reconfiguration of the Primary Care Networks. We would like to suggest that H&F CCG does not consider the responses to the proposed changes in the consultation document in isolation. Instead, it should consider the likely impact on patients of these changes in conjunction with further changes expected through the move to Primary Care Networks.

Patients experience the health system in a holistic and not fragmented way and we expect H&F CCG to take this into account, and evidence that they have, when taking decisions on implementation of changes to local provision.

We are concerned that these changes are mainly driven by H&F CCG’s difficult financial position and not based on quality of healthcare for patients. We are further concerned about future changes that could occur, as the local NHS is not supported nationally to deal with the constantly increasing financial pressure because of the success of the GP at Hand service.

Comments on Proposals for Hammersmith Urgent Care Centre
We oppose the proposed closure of the Hammersmith Hospital Urgent Care Centre from midnight to 8am, as our local intelligence based on conversation that Local Committee members and staff have with residents shows:

  • Low attendance is identified as mainly due to lack of available information and shared knowledge of existence of the UCC. This includes lack of awareness of how to access services and not lack of need. The consultation has increased awareness of these services and clearly indicates that increased footfall and take up could reasonably now be anticipated and the existing data could cease be current.
  • The alternative of travelling to Charing Cross Hospital is problematic because:
    a) It is not safe to wait for the bus at this time at night especially for women, but also for marginalised groups that might be targeted. We note that midnight is the time that a lot of pubs close as well.b) There are no frequent buses.
    c) People might not be able to afford the bus ticket.
  • The UCC is in a deprived and disadvantaged area that has high levels of knife crime and not enough health infrastructure. For those who are already accessing the UCC during the proposed night times this might be the only access to healthcare services in the area. We note that UCCs are part of primary care and not secondary care and having a UCC gives the opportunity to people to register with a GP that were not
    aware of this.


Comments on proposals for GP Hubs

We oppose the reduction of the GP Hubs for the following reasons that our local intelligence based on conversation that Local Committee members and staff have with residents shows.

  • Low use of the GP Hubs services is due to lack of information of how to access the
    GP Hub Service and not because of lack of need.
  • Residents keep saying that it is already very difficult to book an appointment with a GP in the Borough. The clear message that comes from the local and national NHS is that patients need to use alternative methods instead of using A&E services. However, we feel that the potential implementation of the proposed changes is taking away more resources from primary care and there is a risk that there will be an increase in the use of
    ambulance services.
  • The existing way of accessing GP Hub appointments (through your own GP or 111) and the restricted referral system are bureaucratic. This adds to patient confusion when trying to access services.

As clearly outlined in our response, lack of clear, accessible information of existing services  and how to access them is identified as a major issue. We would urge H&F CCG that regardless of the outcome of the consultation it should work to ensure that all patients know how to access and use local urgent care services in H&F such as Hubs, UCC, evening and weekend GP appointments at another practice etc when they cannot get an appointment at their own GP practice.

Olivia Clymer, Chief Executive of Healthwatch Central West London
Keith Mallinson, Chair of Healthwatch Hammersmith and Fulham Local Committee

YOU CAN READ THE ORIGINAL LETTER, IN FULL, HERE: Healthwatch CWL and H&F Local Committee Response to the H&F CCG Consultation