Accrington Victoria Walk-in Centre

Graham P Jones Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Graham P. Jones (Hyndburn) (Lab)]

I should like to raise the not-so-small matter of the closure of Accrington Victoria walk-in centre, a valuable community health asset and a huge support to those in and around my constituency. The people of the area have, with great affinity, taken to their local healthcare services over many decades, and in years gone by, through paying a penny a week, they have funded the local hospital. Yet every decade unelected bodies, supported by the Government, seek to reduce healthcare provision in the area—with the exception of the last Labour Government, who invested in three new health centres, among other things, and rebuilt the local hospital at Blackburn.

“I am grateful for the opportunity to raise the subject of the future of Victoria hospital, Accrington.”

Those are not my words, but those of former Hyndburn MP the hon. Ken Hargreaves, who like his successor, Greg Pope MP—my predecessor—and me, have fought for better healthcare facilities in Hyndburn, particularly the retention of vital NHS services at Accrington Victoria, and in this case today, the GP walk-in centre at that hospital.

On 28 November 1989, under the previous Conservative Government, the honourable and much liked Mr Hargreaves spoke in this Chamber from the Government Benches, stating:

“Thousands of people have signed the petitions and written to their Members of Parliament and to the Secretary of State…we are fighting the same battle now that we fought 11 years”

previously.

“It is equally clear that the people of Hyndburn wish to unite and fight.”—[Official Report, 28 November 1989; Vol. 162, c. 685.]

On the second of this month, I too presented a petition to this place, like my predecessor, with some 24,000 names on it. I can update the House: the petition now stands at 26,000 petitioners. The truth is, the public are not listened to by Governments and unelected bodies, and the people of Hyndburn are, as the former hon. Member Ken Hargreaves described, uniting and fighting once again.

This popular walk-in centre has already survived five attempts to close it. On 16 June, the health authorities—I do not exonerate the Government from this dreadful decision—are going to try to close the Accrington walk-in centre once again. We have a decision that makes little sense and a consultation that was a sham.

My own story sums up why this is the wrong decision. I contracted acute bronchitis—a serious enough illness. I was unaware of it other than feeling very ill. I struggled on until I eventually realised that it was a little more serious than a chesty cough and walked into my local GP surgery. The very helpful staff told me that there was a considerable wait to get a doctors’ appointment—a situation repeated nationally. The average wait to see a GP in the region is 13 days, I am told. If someone needs GP healthcare but cannot get an appointment, what do they do? My constituents widely share my frustration at the lack of GP access. Ringing up the GP first thing in the morning, the person is probably told that they are No. 8 in the queue, and they finally get through to a receptionist only to be told that all the appointments for that day are gone, with the next available slot being at the end of the next week.

The receptionist at my GP surgery helpfully rang through to the new extended-hours GP service to get me an urgent appointment. She told me that unfortunately all the appointments had been filled that weekend. Coughing badly, I had two choices: A&E or the walk-in centre. I went to the walk-in centre, where, following a two-hour wait, my condition was diagnosed. Notes were then sent to my GP and added to my health records. Without the assistance of GPs at the walk-in centre, my health could have deteriorated. I certainly would not have waited 10 days for a GP appointment; I would have gone to A&E.

The value and scale of the service provided by the Accrington Victoria walk-in centre cannot be overestimated. It has received an incredible 42,000 patient visits in the past 12 months. They were people like me who could not get an urgent GP appointment. If it closes, many of those patients will simply go to A&E. This was clearly my next option had the walk-in centre not been open. In fact, figures from the Bury walk-in centre reveal that about 22% of patients will head to A&E—in our case, the A&E at Royal Blackburn Hospital, one of the busiest in the country. This will add considerably to the problems that the A&E already faces, adding some 9,000 extra patient visits at a time when it is overstretched, with ambulances parked outside waiting to refer patients for care. There are financial implications to this, too. An average patient visit to A&E costs about £124 compared with an average patient visit to the walk-in centre that costs about £60.

Mine is not the only story. In fact, the campaign has received hundreds of similar stories through its “SAVE Accrington Walk-in centre” Facebook page. Some of those real-life stories from the people who have benefited from the walk-in centre are incredible. They include people who had to be rushed immediately from the walk-in centre to the Royal Blackburn for life-saving interventions. I must thank the local people for backing this campaign in such huge numbers. I must also thank the three leading campaigners—Chris Reid, Shahed Mahmood and Kimberley Whitehead—for pursuing a more consultative and informative debate than that offered by the clinical commissioning group. I would also like to place on record my thanks to the two local papers: the Accrington Observer, which has been at the forefront of the campaign; and the Lancashire Telegraph. This walk-in centre service means an awful lot to local people. The campaign has included petitions, walks, polls and articles, and has gathered huge support. It has also included letters to GPs.

Since the phased closure started in April, it has been revealed that only 658 people responded to the East Lancashire clinical commissioning group’s consultation—1.6% of the 42,000 patients who have visited. Members should compare that with the 26,000 local residents who signed the petition against the closure.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for giving way; I spoke to him beforehand about this. We cannot ignore his fantastic work on this issue, and I congratulate him on his 26,000-strong petition, which far outstrips the 658 responses that the consultation on this closure garnered. Does he agree that more weight should be given to those opposing the closure, who are 60 times greater in number than those who responded to the consultation, and that the Government should listen to those 26,000 people and not ignore them?

[Graham P. Jones]

The hon. Gentleman makes a valuable contribution. I have yet to meet anyone who filled in the CCG’s consultation, and I will return to the issue of guidelines on NHS consultations and listening to the people.

I want to reflect on the CCG’s consultation. I have grave doubts over its credibility and reliability. To my mind, consulting just 658 invisible people with dubious questions is not a consultation. The CCG asked the public whether they wanted extra GP hours. Just to compare, the walk-in centre provides 88 hours per week. The CCG says that the walk-in centre will be replaced by the new extended-hours GP service, which provides just 19 extra hours’ GP access. That is an 80% reduction in GP access.

In the CCG’s foggy consultation, it said that 61% of people were “in support of” its plans for more GP hours. Which resident is not going to say yes to more GP hours? That is not the same as 61% of people saying, “Yes, and also please close my walk-in centre.” This was a devious consultation. The results of it are grossly misleading, and it is important that the Minister takes that point on board.

In response, I ran my own Facebook poll, reaching out to the four corners of my constituency, and an amazing 6,200 people voted. Unlike the CCG’s consultation question, mine was simple: “Do you want the walk-in centre to remain open?” with an explanation about the 19 extended hours of GP access. Of the 6,200 people who voted, 98% voted to keep the walk-in centre open. That poll reflects the true extent of public opinion in my constituency—98%.

The Minister must stop this closure and ask for a new consultation. She knows that consultation and the views of the public are key to the provision of NHS services. She will know that in national surveys, over 40% of the public say they want to be more involved in decisions about their care. I remind the Minister of the 26,000 people who have signed this local petition to keep the walk-in centre open.

The question is: how has this proposed closure put patients first? Under the Health and Social Care Act 2012, CCGs and NHS England have a duty to promote the involvement of patients in their own health and care. The Minister knows that the guidance is statutory and that CCGs must have regard to it. NHS England’s statutory guidance emphasises to CCGs in the NHS England document “Involving people in their own health and care” that patients must be central to decision making. Clearly they have not been in this case.

The Minister will also know that her Government’s health and social care NHS White Paper included a section entitled “Putting patients and the public first” and promised an NHS that is

“genuinely centred on patients and carers”

and

“gives citizens a greater say in how the NHS is run”.

It embraces the principle of shared-decision making, under which patients make joint decisions about their care with their clinicians. That is clearly not the case with the Accrington Victoria walk-in centre. Notably, the statutory guidance is clear in its description of shared decision making, saying:

“shared decision making is a conversation, or series of conversations, that should include evidence-based information about all reasonable options”,

such as a loss of GP hours. The loss of hours and the walk-in centre were never mentioned.

As pertinent is the recent publication of long-awaited guidance by NHS England, which lays out the future of urgent care services and expectations for local NHS commissioners. The guidance, which the NHS has released early, contains a clear expectation and commitment to retain walk-in centres as part of local integrated health services. I note the reassurances given in it that walk-in centres will remain a vital component of health service provision. The new guidance commits to the establishment of GP-led urgent treatment centres, open at least 12 hours a day, with nurses and other clinicians also available, along with a range of simple diagnostic facilities—a walk-in centre by another name, offering the same services currently offered by Accrington Victoria walk-in centre.

In conclusion—I just want to make a final point, Mr Speaker—patients will be able to book appointments in the new urgent care units using the NHS 111 service, through their GP or, crucially, as at the walk-in centre, simply walk in. NHS England wants these new centres to be co-located where possible alongside other health services, such as Accrington Victoria Hospital. If the Minister wants to put patients first, have a meaningful consultation and roll out the urgent care units, she will see that this closure meets none of those or her Government’s ambitions. I hope the Minister has listened, and will not just defend the decision or simply defer it to the powers of East Lancashire CCG, but accept that this closure runs counter to the NHS England guidance.

Finally, I very gently remind the Minister that thousands of Conservative voters backed the hon. Ken Hargreaves’s campaign to save Accrington Victoria services and today thousands of Conservative voters are backing this campaign once again to save one of the most vital services at Accrington Victoria. I hope she recognises that, were he here today, this cross-party campaign would certainly have been led by my honourable predecessor, Ken Hargreaves. He would want the walk-in centre to stay open, and we would be united in that ambition. I look forward to the Minister’s reply.

[The Minister for Care (Caroline Dinenage)]

I congratulate the hon. Member for Hyndburn (Graham P. Jones) on securing the debate. He made a very powerful case on behalf of his constituents and very carefully set out the enormous strength of feeling in his constituency, as of course he should as the local Member of Parliament. I am grateful to him for articulating his case so powerfully.

Following a three-month public consultation, the East Lancashire clinical commissioning group made the decision to close Accrington walk-in centre from Sunday 17 June. Other services provided from the Accrington Victoria Community Hospital, such as the minor injuries unit, and X-ray and in-patient and out-patient services, are not affected by the changes and will of course remain available. I understand that there has in fact been a delay in the closure taking place, as the walk-in centre was due to close in the spring. However, following consultation, the CCG has decided to close Accrington walk-in centre on Sunday 17 June. This extension to the originally planned closure date was made to ensure that there is a smooth transition to the new models of care, once the walk-in centre closes.

East Lancashire CCG has implemented an extended access service in Hyndburn as a new model of service provision. This service is being provided under contract by a local GP provider organisation, the East Lancashire Union of GPs. The contract is for 12 months from 11 December 2017, and the extended access GP scheme in Hyndburn has been operating since December. It is important to note that while the extended access service in Hyndburn is a new model of service provision, it is not meant directly to replace the walk-in centre per se.

GP services are accessible to patients through their own GP practice from 8 am until 6.30 pm, Monday to Friday, as usual. Pre-bookable appointments will also be available in the new extended GP service after 6.30 pm on weekdays and at the weekend. These appointments will be booked through the patient’s own GP practice. This new model of extended GP access meets the principles that were tested and supported by local people through a formal consultation process. In addition, the NHS 111 service can signpost patients to the most appropriate services, including an appointment with an out-of-hours GP, if required. We understand and appreciate that this is a real change for patients who are used to being able to walk in and see a GP, rather than phoning up for an appointment.

[Graham P. Jones]

Does the Minister accept that the consultation had flaws, and will she look at that? Does she accept that replacing 88 hours in a walk-in centre with 18 and a half or 19 hours of extended GP opening hours is a reduction in GP access, which goes counter to what was said in the consultations run by me and the CCG?

[Caroline Dinenage]

I take on board what the hon. Gentleman says about the consultation and also the consultation that he ran on Facebook. I know how worrying it must be for local people when a service closes, but it is the responsibility of the local NHS to follow the Government’s guidelines. The Government’s four tests for any service change are that it should have support from GP commissioners, be based on clinical evidence, demonstrate public and patient engagement, and consider patient choice. The Lancashire overview and scrutiny committee alone has the power to refer the decision to the Secretary of State or the Independent Reconfiguration Panel, and it was minded not to. That is the unfortunate situation.

Alongside improving and extending GP access, East Lancashire CCG has invested significant sums in social prescribing and care navigation. Those additional services are helping to guide patients and co-ordinate their journey through the health and care system to get the right help and support quickly.

There are benefits from the Hyndburn extended access service, including the provision of seven-day access to GP care, the addition of a minimum of 49 additional delivery hours per week, and 162 additional appointments per week. The facilities are linked to the out-of-hours service, with the ability to secure urgent GP appointments at weekends. I understand that that provision is for Hyndburn patients only until the walk-in centre closes in June, but it will then be expanded to cover patients from the wider east Lancashire area.

The extended access service run by the East Lancashire Union of GPs already has robust information-sharing arrangements in place with Hyndburn practices to ensure continuity of care for patients utilising an electronic record. That level of record sharing has not been available to patients attending the walk-in centre. The patient and public involvement network in Hyndburn has been fully consulted, and has assisted in the production of communication materials to ensure that local patients have been informed of the changes and have the information they need to direct them to the most appropriate service for their health needs.

The extended access service will have the ability to generate electronic referrals that core GP practices can review and progress. The service will collate monthly data, including patient profiles and the reasons why people access the service, to shape service redesign and help to build a clear picture of patient health needs locally. That service will be delivered from an existing modern LIFT—local improvement finance trust—building, which is on a local bus route and easily accessible to the public. Use of the service has been building progressively and is being closely monitored by the CCG.

I thank the hon. Gentleman again for bringing this debate to the House and for his ongoing support for his constituents in Hyndburn.

Question put and agreed to.