Concerns raised over changes to extended access to GP services in County Durham

Last month, Durham Dales, Easington and Sedgefield’s Clinical Commissioning Group (DDES CCG) backed plans for an overhaul of "seven-day services."

In recent years, nine "hubs" across the area provided additional appointments with patients directed through the NHS 111 phone service.

But revised plans by health bosses aimed to reduce the number of hubs as some were “significantly underused.”

The new structure includes extended access services in Bishop Auckland, Spennymoor /Newton Aycliffe and Sedgefield and services covering Easington, Peterlee and Seaham but scraps hubs in Barnard Castle and Stanhope.

On June 11, a special meeting of Durham County Council’s Adults, Wellbeing and Health Overview and Scrutiny Committee was called to discuss the planned changes, which are to be put in place this autumn.

A letter from Bishop Auckland MP, Helen Goodman, was also read to councillors raising concerns about patient transport.

In response to public concerns raised during consultation, health bosses said they will “remove financial restrictions” around travel, including introducing a taxi service.

The service will focus on patients who struggle to access normal GP services, particularly in areas that no longer have a hub.

And a new outreach service will also be introduced for vulnerable patients – with health professionals making visits to deliver care.

However, some councillors slammed the NHS 111 service for misdirecting patients away from hubs and blamed poor usage on lack of promotion, while others weren’t convinced the wider service changes would benefit patients.

Cllr Richard Bell, who represents the Barnard Castle West Division, said the changes would have a “knock-on effect” on Teesdale residents.

He added: “I won’t go so far as to say this has been set up to fail, which it wasn’t, I will say it hasn’t been set up to succeed and I think that’s very sad.”

Cllr Jude Grant also criticised the name of the CCG consultation – "improving seven-day access to primary care services."

She said: “People would have responded more if it said 'reducing’ because basically that what happens, it isn’t improving access at all.

“It might be improving in terms of your budget but it isn’t improving access for people.”

Sarah Burns, director of commissioning for DDES CCG, admitted work needed to be done to tackle “polarised opinions” around the NHS 111 service.

In practice, she said, it functions as a “gateway to direct people into services” and helps people use NHS services responsibly.

And more serious cases, a 111 operator would flag an appropriate level of response for the patient – such as an emergency ambulance.

On the extended access changes, she said: “The amount of work that went into developing and delivering these services, the staff are NHS staff who have great pride in making a success of what they do.

“It’s absolutely in no one’s interest to set up a service to fail but what we do look at is, are the services we have most effectively meeting needs?

“Having staff sat there not seeing patients is not a good use of NHS resources, by combining staff in a central hub in the dales area we can make sure the staff are used effectively.”

She added: “We think by having a smaller number of hubs we can better respond to rising demand.

“If we had nine hubs and demand rose and we had to increase staff in each one, there would be a challenge in terms of workforce but still underutilisation of capacity. It’s easier to build staffing onto a smaller number of hubs and to make sure it is being well utilised.”

Following debate, councillors called for more details on the planned transport changes and outreach services.

Cllr Rob Crute added that the performance of the new hub structure should be kept in check, specifically around the demands of new housing in the county.

“I know the CCG take our comments on board but I think we need to look at how this pans out over a set period – six months to two years – to make sure there’s capacity to react to any potential changes from where we are now,” he said.

While there have been changes to the number of hubs available, patients in these areas will be able to access the service from a “neighbouring hub”.

Additional appointments are available at following hubs but can only be accessed by calling NHS 111.

Durham Dales

Additional appointments will be available from 12 noon – 8pm during the week and 10am – 2pm on a weekend in Bishop Auckland.

Easington area

Appointments will be available from 12 noon–8 pm during the week and 8am – 1pm on a weekend in Peterlee and in Seaham from 6-8pm during the week and 8am – 1pm on a weekend.

Sedgefield area.

Additional appointments will be available 12 noon – 8pm during the week and 10am-2pm on weekends from Newton Aycliffe

In addition, Spennymoor will provide appointments from 6-8pm during the week and 10am-2pm on a weekend and in Sedgefield from 10am-2pm on a weekend only.