Appropriate Service Review

Healthwatch East Riding of Yorkshire received feedback obtained from local residents, who state that following to changes made to services is April 2018, access to local urgent care services is becoming increasingly difficult across the East Riding. Healthwatch wanted to determine if the feedback we were receiving was reflective of the wider experiences of East Riding communities, or more centred around specific pockets of the East Riding.  They held engagement events, focus groups and ran a survey.  At least 1,442 people responded during the period August to December 2019.

Local residents continue to report that they do not feel that access to urgent care services are meeting their needs, particularly in more isolated communities. Those communities who have retained an urgent care service with walk in facilities are more satisfied with the changes than those areas who have more restrictions or travel distances in accessing such care. Despite extensive public engagement by providers with the public, there are residents who believe, or had other expectations, that there was a commitment to the provision of certain services that they do not feel are being delivered. These thoughts were particularly voiced by residents in the Withensea and Driffield areas, where the former MIU units have changed to a pre-booked 8-8 Centre.

Across all urgent care services, Healthwatch received repeated examples of people being unclear as to how and when each service should be accessed. In the absence of this understanding, members of the public will therefore access services inaccurately. People had gone to A&E inappropriately, because it was easy to access and they were unaware of alternatives.

Travel and access to transport to the 8 – 8 Centres emerged once more as a key area of concern. Whilst this is a well recognised ongoing issue within the East Riding, it has further heightened frustrations of particular residents who have closer facilities that they are not being directed to. In terms of support and costs in relation to travel, although there is a transport scheme for HU19 residents and financial support for certain residents travelling to UTCs, there were residents who did not fall in these criteria but were in need of support and felt disadvantaged by way of their postcode. People also raised that some urgent care sites offered free parking, whilst others charged.  

A significant number of the people engaged with had not consulted with NHS 111 before accessing a service. Some of those who had contacted NHS 111 beforehand said they had been directed out of area or further afield than needed. The use of language and terminology used by NHS 111 call handlers is causing confusion and frustration for some patients who are sometimes being told ‘the service does not exist’ when it does not appear on the NHS 111 algorithm. Due to these negative experiences, some patients don’t want to use the NHS 111 service in future.

Residents continued to report difficulties accessing GP appointments. Issues raised varied from wishing to see a named GP, being seen closest to home, or being able to access an appointment within a reasonable timeframe and so resulting to other urgent care services instead.

The report contains 6 recommendations about access to urgent care services; better communication about the services available and training for staff.