Success for walk-in centre easing pressure on A&E as waiting times soar

Waiting times at Wigan Infirmary’s A&E department have soared in recent months, with the latest figures showing more than a third of people had to wait more than four hours to be seen.

By Gaynor Clarke
Friday, 8th March 2019, 2:47 pm
Updated Friday, 8th March 2019, 3:53 pm
The walk-in centre in Leigh
The walk-in centre in Leigh

Hospital bosses have repeatedly urged patients to seek medical treatment elsewhere if their condition is not serious or life-threatening.

Other news: Friends rally for young man killed in motorbike accidentOne alternative source of help is Leigh Walk-In Centre, which is based on the Leigh Infirmary site and serves patients from across the borough and beyond.

The unit sees patients with minor illnesses and injuries, which can include sore throats, coughs, colds, earache, sinusitis, rashes, fevers, bruises and minor back and neck injuries.

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X-rays can also be carried out, meaning patients with suspected broken bones can be seen too.

Cath Partington, clinical service manager for both the walk-in centre and Wigan’s GP out-of-hours service, said: “Walk-in centres are very successful because they are placed in areas where there isn’t an A&E so it’s more local for people who live nearby.

“Our waiting times are lower than at A&E. This allows A&E to focus on more serious accidents and emergencies.

“A lot of people have difficulty getting time off work and we have longer opening hours and open every single day of the week, so people who can’t go to a GP appointment in their working hours can come here in the evening or weekend.”

The walk-in centre has the same four-hour target as A&E units across the country, which are supposed to see 95 per cent of patients within that time.

While Wigan’s A&E is struggling to see many people in this time, the walk-in centre treats nearly all patients within four hours.

Its performance was 99.4 per cent in February, with just 16 patients waiting for longer than expected, and it scored 99.7 per cent in both January and December.

On average, most people are treated in between one and two hours.

Mrs Partington said “We saw an average for February of 128 patients per day. People self-present at the reception and we aim to have them triaged, using the Manchester triage system, by a clinician within 15 minutes of arrival. Sometimes we don’t meet that because we get 20 people at once, but that’s what we aim for.

“Dependant on the Manchester triage category, that gives us an indication of a safe time for that patient to wait.

“If someone presents here that shouldn’t have been here, like with central crushing chest pain, then the reception staff bring them straight through to be seen by a clinician. The next category is we would see them in 20 minutes and the next is one hour and then it’s two hours and up to four hours.”

Sometimes there are longer waits when a large number of people attend at once.

Mrs Partington said: “Occasionally it takes more than four hours because we get surges of attendance across a time span. We could be quiet for the first three hours and then suddenly 40 people book in all at the same time.”

Traditionally health services face more pressure during the winter months, but the walk-in centre appears to be managing well.

Last Monday, 169 people attended during its opening hours - 7am to 9pm - and everyone was seen within four hours. Mrs Partington said: “It’s been very busy. We have seen an increase in activity and we are seeing an average of 128 people per day compared to late autumn when we saw 107 a day.

“Because the weather hasn’t been really awful, because it’s been quite mild, we haven’t seen the surge in respiratory conditions that we normally get.

"We have had some, but not what we would expect. We have seen quite a lot of norovirus, we have seen a lot of unwell children with viral and some bacterial illnesses.”

The centre is staffed by nurses and paramedics, with a GP who can see patients when not carrying out home visits for the ambulance service.

Between 25 and 30 per cent of patients are children under 13, so efforts have been made in the past 18 months to recruit more paediatric-registered nurses. It is also hoped a separate waiting area for children will be set up later this year.

The walk-in centre is the first port of call for the vast majority of the patients, but there are four GP appointments available to book each day, which can be done via NHS 111.

Staff work closely with the ambulance service, which can request home visits by the GP if they believe a patient who has called 999 does not need to go to hospital. Alternatively, ambulances do sometimes take patients to the walk-in centre, such as if someone has a limb injury and cannot get in a taxi.

The unit also works with the Acute Patient Assessment Service (APAS), helping people who contact NHS 111 who may benefit from treatment from a clinician in the community. They speak to the patient by phone and can advise them to go to the centre, their GP or A&E if needed.

While the message coming from A&E chiefs is to seek help elsewhere if possible, Mrs Partington emphasised that people should still go to casualty if their condition is serious.

She said some patients do not realise how poorly they are or go to the walk-in centre as they still think there is an A&E unit on the Leigh Infirmary site, despite it closing in 1995.

Anyone needing emergency care is given first aid and stabilised by medical staff at the centre, before being taken to A&E in an ambulance.

Mrs Partington said: “At least 11 per cent of our attendances every day are people that shouldn’t be attending a walk-in centre.

“We get central crushing chest pain, possible heart attacks, people who have had strokes or mini strokes, very unwell children, people who have collapsed, people with acute shortness of breath. Those are the sort of things that should go to A&E or phone an ambulance, rather than coming here because we need to transfer them on.”

Among the patients attending the walk-in centre was 35-year-old Nicola Jolley, from Leigh.

She waited for less than an hour for treatment and was pleased with the service.

She said: “It’s convenient and every time I have come here in the past or now, they have been able to deal with the situation I have come with or been able to refer me and put into place what needs to be done.”