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Walk-in centre decision reached 

Following a review into redesigning urgent care services, Bolton Clinical Commissioning Group (CCG) has decided to close the walk-in centre based at Lever Chambers.

The nurse-led walk-in centre was opened in 2003 for patients with minor ailments to help cut waiting times at Accident and Emergency (A&E). However, the demand on A&E at Royal Bolton Hospital has continued to rise, despite improved access to GP appointments and extending GP opening hours.

Most patients visiting the walk-in centre are doing during the day and early evening when they could be seen by their own GP practice, or could have sought advice from a pharmacy. Of the people seen at the walk-in centre, almost half are told to get additional care from their GP and more than 2,000 a year are sent on to A&E.

As part of this review into urgent care, Bolton CCG engaged with the public and patients last summer to understand why and how people use services. In November 2011, Bolton CCG and Bolton NHS Foundation Trust launched a consultation with the public, GPs and our partners to understand the impact changing services would have on them.

People have said they found the current system confusing, did not know where to go for different types of illnesses, and often contacted services that turned out not to be the best service for them.

In order to address these challenges, Bolton CCG and Bolton NHS FT are working together to redesign urgent care services. Closing the walk-in centre will help simplify and improve urgent care services in Bolton as we believe that having so many different choices causes confusion and possible risk. It will allow a more integrated service to be delivered from A&E, ensuring patients get the treatment they need from the right professional.

A public awareness campaign will assist people to understand their best urgent care option prior to the centre’s closure. The campaign’s simple message is that if people cannot self care with the support of local pharmacies, their first contact should be with their GP.

The walk-in centre is scheduled to close by end of July. The highly qualified nurses from the walk-in centre will boost current staff numbers at A&E in order to help relieve the pressure on the service. The new service will combine the expertise of nurse practitioners, junior and senior doctors, as well as therapists.

Dr Wirin Bhatiani, Chair of Bolton CCG, said: “We recognise the walk-in centre is popular with patients, but the GP Practice is the right first place of contact for most conditions. GPs know their patients’ medical history, have access to their medical records, and play a vital role in improving the health of their local populations. We will work together with local GPs, pharmacists, and the local hospital to help patients access the right care, at the right time in the right place.

“Bolton CCG is committed to working with GP practices to improve access to see a GP quickly. We are working with all our GP practices to improve same day access; for example encouraging rapid access for children and practice staff will take part in customer care training to help improve the patient’s experience.”

If patients turn up to the hospital with an urgent care need, they will be helped. However, A&E is not an alternative to seeing your GP or visiting a pharmacy. Patients that turn up at A&E inappropriately – for instance with a minor, non-urgent problem – will be redirected to their GP practice or pharmacy. A&E is for emergency and urgent problems only.

Lesley Doherty, Chief Executive of NHS Bolton Foundation Trust, said: “We’re fully supportive of the CCG’s decision to close the walk-in centre and transfer the staff and their skills to A&E.

“This, together with improved access to GPs in the community, will mean that at the Royal Bolton Hospital we can concentrate on the most serious illnesses and conditions, which is what the department is primarily there for.”