A GP practice has overseen both a decrease in A&E admissions and an increase in patient satisfaction since introducing a minor injuries walk-in clinic 18 months ago.
Roundwood Surgery in Mansfield, Nottinghamshire, started the initiative on 1 April 2014 in response to a review of information about A&E attendances. ‘When we looked at the data that came back, what people were going for, we knew that we could do that at practice level. That’s when we started,’ practice manager Gillian Slack explains.
The walk-in clinic runs every morning Monday to Friday and is staffed by one of the practice nurses, who went on extra training before starting it up. When the nurse is on leave the clinic is covered by one of the practice’s GPs.
The clinic offers treatment for lacerations, minor head injuries, minor burns, eye injuries, knee to foot injuries and elbow to hand injuries.
‘These are the things that shouldn’t be going to A&E, they can be being dealt with at primary care level,’ says Ms Slack.
In a context of cuts and setbacks to GPs, there is of course the question of finance. The clinic is funded by the CCG, which puts money toward practices that provide the service. The practice is paid per patient for ‘whatever they come in for, subject to their strict timeframe on treatment - anything that happened over 48 hours isn’t classed as a minor injury,’ explains Ms Slack.
The clinic sees both patients registered at the practice and those registered at other practices in the area. In a 12-month period the clinic reduced A&E attendance by 100 people.
The surgery has gained significant plaudits for the initiative. Ms Slack says patient satisfaction is the clinic’s main achievement. The initiative is largely self-promoted through the practice’s website and leaflets, and has been extremely popular with patients.
‘Instead of going up to A&E and waiting for four hours they can be seen locally here. We’ve had people that have trapped their finger in the car door and then seen that we have a walk-in on our front door so they just pop in,’ Ms Slack says. ‘They might not be seen straight away, but it is still less than a four-hour wait. Nobody has ever waited that long.’
CQC outstanding practice
Acclaim for the clinic extends from beyond patients. After an inspection in March of this year, the CQC awarded Roundwood Surgery an ‘outstanding’ rating, mentioning the minor injuries clinic as an example of outstanding practice in its report.
Janet Williamson, deputy chief inspector of general practice and dentistry in CQC’s Central region, said: ‘It is clear that Roundwood Surgery is providing an effective, responsive and well led service which is a real asset to the people living in this part of Nottinghamshire… Staff went above and beyond their level of duty to care for patients.’
Ms Slack says that achieving the outstanding rising in the current climate of rising demand and falling resources for general practice is all down to the commitment of practice staff.
She also believes that minor injuries clinics could be run in more practices. ‘You’re taking the pressure of A&E and it brings in extra funding. At a practice level we need to push more and more to try and get services that can put money into the practice because we’re being cut left, right and centre. You’ve got to think outside the box sometimes.’