September 2007
Reforming community services in Wiltshire
Step by step
The NHS in Wiltshire is changing. Wiltshire Primary Care Trust is
leading a series of reforms and improvements, which affect a number
of NHS services in towns and villages across the county. This regular
newsletter will keep you up-to-date with progress and plans.
Changes to Minor Injury
Services
From 1 October 2007, there will be two minor
injury units (MIUs) in Wiltshire:
• Trowbridge, open 24-hours, seven
days a week
• Chippenham, open 7am – 1am, seven
days a week.
The PCT has produced leaflets and posters for
Minor injury services will also be available
the public. These have been distributed widely,
from the Clover Unit adjacent to the Great
including to GP surgeries, pharmacies, health
Western Hospital in Swindon, as well as at
centres and community hospitals, schools and
Andover MIU, at the Walk-in Centres in Bath
colleges, libraries and leisure centres.
and Swindon, and a range of other locations.
They have been written to help people choose
Minor Injury Units currently located at
the most appropriate place to go for
Devizes, Savernake, Warminster and
healthcare.
Melksham hospitals, and at Eastleigh Surgery
in Westbury, will close on 30 September
NHS Direct also advises people about where
2007.
to seek treatment and the PCT has been in
touch with NHS Direct to ensure that their
Managing Director of Wiltshire Community
staff are able to advise and direct patients
Health Services, Jenny Barker, said:
within Wiltshire to the appropriate place. We
“The new arrangements will ensure safe, high
have also placed advertisements and
quality care consistently, as the public, patients
information in the local press and on local
and health staff will know what is available and
radio.
when.”
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Where we are now – neighbourhood
teams
There’s been a lot of talk in the media recently about Neighbourhood Teams and what
happens next. Step by Step updates you on the current position and what is planned
over the next few months as Neighbourhood Teams continue to develop.
Talking it through Individual Neighbourhood Teams will
One-to-one interviews with staff took organise their own rotas to help ensure
place in July and August. 361 staff, that staff’s home and family commitments
more than 98% of staff affected by the are considered alongside the requirement
introduction of Neighbourhood Teams, to deliver the service which our patients
opted for an interview. It is clear that need.
staff remain committed to the model of
Neighbourhood Teams, and (with the Working with GPs
exception of Malmesbury) there are Members of the PCT senior management
sufficient nurses and therapists in every team, and the Reforming Community
area to staff the teams, on paper. Services in Wiltshire programme, have
met with the Practice Based
The consultation process identified a Commissioning consortia in the north,
variety of issues and concerns, east and west of Wiltshire to hear about
including the pace of bringing the GPs’ experiences of the new teams and
Neighbourhood Team model into being; to answer questions.
the number of staff and range of skills
available in each team; the shift Neighbourhood Team coordinators are
patterns, particularly in relation to meeting with practices covered by their
working at night and working after team to develop local working
7.30pm; lone working; disposal of relationships. Details of the staff within
clinical waste and requests for further Neighbourhood Teams and the link
clarity in the job descriptions. person for each practice will be circulated
to all practices in early October.
Staffing levels in each area are being
scrutinised further and recruitment
advertisements have been placed for Service Development
therapists where there are individual The Neighbourhood Team coordinators
gaps in the daytime hours. recently held an ‘awayday’ which gave
them an opportunity to work together to
In future the Neighbourhood Teams will clarify the scope of the teams’ role and to
operate from 7am to 6pm. Services understand and improve the internal part
from 6pm to 10pm will be provided in of the referral process. Work is taking
three locality areas across Wiltshire. A place on training needs analysis and
separate night duty service will operate developing ‘self-rostering’.
from 10pm to 7am. Implementation of Representatives from each team meet
the night duty service will be phased fortnightly with Jenny Barker, Managing
across the county with the first phase in Director, which gives an opportunity to
west Wiltshire to support the planned voice any concerns and make
changes to inpatient services. suggestions.
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Where we are now – inpatient services
There will always be some patients who need to be cared for in an inpatient bed,
even if this is only for a day or two. Step by Step updates you on how inpatient
services are changing to ensure the best arrangement of care for patients
Inpatient Development Manager
Madelyn Griffiths has been appointed to
this role having previously worked with
the Reforming Community Services in
Wiltshire programme team. Madelyn is
an experienced nurse and her role is to
make the vision and strategy for the
inpatients care a reality.
Madelyn will work closely with the ward
managers and matrons, and with other
The timetable for changes to the provision parts of Wiltshire Community Health
of inpatient beds across Wiltshire is being Services – the neighbourhood teams,
reviewed to reflect the changes to the Minor Injuries Units and Access to Care.
implementation of Neighbourhood Teams. Madelyn’s role also includes working
The PCT is committed to continuing to with the inpatient operational managers
provide sufficient beds for patients during in the local acute hospitals to achieve
the continued development of the improvements in delayed transfers and
Neighbourhood Teams. in reducing length of stay.
New timetable
The reduction in the number of inpatient
beds at Chippenham and Melksham
hospitals has been delayed until the end
of October 2007.
This will allow us to continue to provide
safe care to our patients and to allow staff
to move into their new roles in the
Neighbourhood Teams at the right times.
Keeping staff informed
A programme of meetings for inpatient staff will take place during October, giving staff the
opportunity to hear more about the arrangements for transition, the workforce model and the
future of inpatient services.
Staff are encouraged to read and to post questions on the Question and Answer section of
the PCT’s intranet, and to speak with their team leader or modern matron.
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Spotlight on …
Access to Care
Access to Care is the ‘gateway’ for health Shift times and patterns are under review
and social care professionals in north, west to ensure the optimum number of staff on
and east Wiltshire to access the new duty to meet the demands on the service.
Neighbourhood Teams and Community
Hospital beds.
Access to Care is provided by a
partnership between Wiltshire Medical
Services (WMS) and Wiltshire Community
Health Services. WMS manages the day-
to-day service.
How to refer
Health and social care professionals can
refer to Access to Care by fax, phone or
e-mail.
Did you know...
Each referral is logged by administrative
staff and, in all but the simplest of cases, In the first few weeks of operation Access
the referral is passed to one of the Access to Care received approximately 100 GP
to Care clinicians for further assessment in referrals each week.
order to obtain an accurate clinical picture
of the patient. By early September, this figure had
increased to approximately 300 GP
The Access to Care clinician then decides referrals per week.
the most appropriate pathway and refers
the patient on to the relevant professional
and service by phone, fax or e-mail.
Accessing the service
Access to Care has been in operation for
three months and is still a new service.
The volume of referrals at different times of
day is still being assessed. Where possible
health and social care professionals are
asked to make non-urgent referrals by
email or fax. This will leave more capacity
for urgent telephone referrals.
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