Leeds NHS WalkinCentre

1
The Leeds Jubilee NHS Walk-in-Centre
2
Background

• Opening November 2005.
• 1m Department of Health funding.
• 1.4m joint revenue funding from Health Economy.
• 15 new members of staff.
• 53,000 patients per year from 110,000 AE
  attendances.
• Incorporating Minor Injuries Unit.
• Open 24 / 7.
• Paper light administration process.
• Integration with other Urgent Care services.
• Commuter Walk-in-Centre scheduled for 2005.

3
A New Model

• Building on the original Walk-in-Centre
  typologies.
• Primary objective to proactively manage AE
  demand.
• One front door for Walk-in-Centre and Emergency
  Department.
• Enables effective streaming.
• Allows resources to be focused appropriately.

4
EMERGENCY DEPARTMENT OF THE FUTURE OUTLINE
MODEL AND PATIENT FLOWS
D I A G N O S T I C S

D I A G N O S T I C S
EMERGENCY VILLAGE FIRST POINT OF
CONTACT Ambulance Arrivals Clinical
Sieve Ambulatory Arrivals None Clinical and
Clinical Sieve
Refer or re-route to other service provider

Discharge
EMERGENCY DEPARTMENT
WALK IN CENTRE Adult Paed Paediatric
facilities including walking play
Paediatric Area
Adult Area
Discharge

Discharge
Adult Observational Medicine (CDU Observation)
Adult Multi-Speciality Assessment Area
Paediatric GP Referral/ Assessment area
Paediatric Observation
Adult Mental Health observations and assessment
facility (CDU Observation)
PAEDIATRIC IN-PATIENT FACILITIES
ADULT IN-PATIENT FACILITIES
ADULT PATHWAYS
PAEDIATRIC PATHWAYS
5
The Challenges (so far . . .)
6
Dog bites 27
Chest Pain 473
Depressed 39
RTA 599
Ankle injuries 117
Drunk Bleach 1
Overdose 90
Dental Problems 43
Assault 265
Abdo Pain 619
GP Letter. Spot on bottom. . .
7
Sorting Individuals in the Emergency Village
Environment (SIEVE)

• Non-clinical and clinical SIEVE process
• Senior decision making at the door.
• Protocol driven.
• Regular audit, review and change.

8
Developing the Workforce

• Need to develop consistent skills set.
• Takes time to grow your own.
• Role of Emergency Care Practitioners.
• Rotational models.

9
Cultural Organisational Barriers

• Our funding comes from a range of organisations
• attached to a range of expectations.
• Oh, and most GPs dont want to manipulate
  fractures
• There are pitfalls in multi organisational
  clinical governance.

10
(No Transcript)
11
Mixed Messages
Access
Unscheduled
Choice
Convenient
Emergency?
Urgent
12
Challenges for the Future.

• Centralisation of trauma services in 2006.
• Relations with independently provided Commuter
  Walk-in-Centre.
• Transition of 3 satellite Minor Injuries Units to
  Walk-in-Centres.
• Making Leeds Better 2012.
• Impact of Commissioning a Patient Led NHS
• Impact of plurality in Urgent Care.
• Payment by Results.