'Massive learning curve' for after hours Middlesbrough GP service

PICTURE the scene. You feel rotten, your GP hasn’t got any appointments for a fortnight at least and you need help. You’ve been to the pharmacy and they’ve offered you some advice and painkillers but your problems simply aren’t going away. This is where STAR GP Hubs are designed to kick in.

South Tees Access and Response hubs were launched two years ago to try and ease demand on accident and emergency department, and give people access to a doctor or health professional in the evening, or when their GP was unavailable.

These after hours hubs replaced walk-in centres in 2017 – a move which wasn’t welcomed by everyone.

But June Johnson, who looks after the Bluebell Hub, in Acklam, Middlesbrough, says the number of patients using the service has picked up and its team has learned a lot.

In the day, the modern hub on Trimdon Avenue acts like many other GP surgeries in the borough – keeping appointments and treating patients.

But as things wind down at 6pm, one corner of the building stays open.  

A new shift begins and Ms Johnson shows me around before patients begin arriving.

“It’s like a well-oiled machine,” she says. “It closes at 6pm and re-opens at 6.30pm. We have half an hour to get our services up so it can be a bit busy. But we manage to do it every night.”

The STAR team moved into the building last September. The space it uses is only small – one narrow corridor of rooms joined on to the reception and waiting area keeps the operation simple.

One GP works on shift alongside one nurse practitioner, a treatment nurse and a healthcare assistant. Slot bookings of 15 minutes come through for the three-hour spell with help from reception.  

Ms Johnson adds: “The service has been up and running for two years – it used to be from the Park Surgery on Linthorpe Road but this is brand new and purpose built and we felt it was more secure here."

Problems with inappropriate attendances at A&E have been highlighted north and south of the Tees in the past 12 months.

People have turned up with sore legs after a shift at work or just to pick up their prescriptions.  

However, Ms Johnson says staff in the emergency room are now helping redirect patients towards the after hours hub, and six slots an hour are kept open for that purpose.

She adds: “Even if the six slots have been filled, we try and offer an appointment wherever possible.”

The four STAR centres are based at North Ormesby Health Village, Redcar Primary Care Hospital, and East Cleveland Hospital, in Brotton, as well as the Blue Bell in Acklam.

Patients are urged to try and book an appointment with their GP in the first place, and if space is short, they are then redirected to one of the hubs.

Ms Johnson reveals that the centres are now starting to see patients book directly with the service.

Other than referrals from GP surgeries in the South Tees CCG area or A&E, appointments come in via 111 or through an online form, and the message urging people not to just wander in seems to have got through.

She adds: “When we started were preparing ourselves to turn thousands of patients away but there was just one patient who arrived that day.

“On average we get maybe six patients a week who just walk in – but things happen.

“If you’re walking along you might fall down and not be able to get to the hospital so it’s common sense to help those people.”

Rachael Wilson is one of the nurses on hand to help this evening. “It’s amazing the amount of patients who cannot get an appointment with their own GP,” she says.

“Some can’t get appointments for three or four weeks – it’s crazy when you think about it.”

But Ms Johnson says the service has come a long way since it started – even picking up awards for its efforts.

She adds: “We were a group of GP practices at a very early stage and it was quite a privilege to win two awards recently.

“We’ve had an additional 83,000 appointments between 6pm and 10pm from Monday to Friday and 8pm to 10pm on Saturdays, Sundays and Bank Holidays.

“A lot of patients have moved to this service because it’s in a good area – and there are new houses coming just off Low Lane. It’s the perfect set up really.”

Ms Johnson has plenty of experience in health, primary care and overseeing GP surgeries.

And chatting from the hub’s back office, she admits it was a surprise when the CCG contract was awarded to ELM Alliance Limited to run the service in April 2017.

The service weathered a rocky period after it was put into special measures by the CQC (Care Quality Commission) in July 2017.

But the Bluebell Hub and after hours service was rated good in all areas by the watchdog at an inspection in March this year.

“It’s been a massive learning curve,” says Ms Johnson. “We were quite an embryonic organisation so getting the infrastructure right was important so we could build on our foundations. I think we have got there now.”