A Kent trust is struggling to find GPs to staff a 24/7 urgent care centre which is being set up to replace its emergency unit in Canterbury.
The urgent care centre at the Kent and Canterbury Hospital is expected to see a limited range of patients and will run alongside an existing minor injuries unit and an acute medical unit. It is due to open on 6 July.
However, a report to Kent County Council’s health overview and scrutiny committee this week says there is a significant risk “that recruitment and availability of GPs to staff the urgent care centre are not available to provide a consistent service 24/7”.
East Kent Hospitals University Foundation Trust said it was working with primary care providers on creating the proposed GP-led service, but that it may require the use of trust and locum doctors to fill gaps.
“Our overnight rota is the main challenge and we will work with the out of hours provider to ensure a solution is in place,” it added.
The service will replace an emergency care centre which was set up following a major reconfiguration more than a decade ago. Over the years, this started to see a wider range of patients, blurring the lines between it and a full A&E service. This meant medical trainees have played a key role in providing the service at weekends and overnight, and sometimes saw patients who needed a surgical opinion without general surgeons being available.
Health Education Kent, Surrey and Sussex threatened to remove medical trainees from the Kent and Canterbury site unless changes were made. Late last year, the trust introduced interim measures, boosting consultant physician presence and senior surgical review.
It also worked with the ambulance service to ensure patients were taken to A&E in either Margate or Ashford where necessary.
The proposed next stage in meeting HEKSS’s conditions is to set up the primary care led urgent care centre.
The planned urgent care centre would free up juniors for other work while still allowing less serious cases to be treated in Canterbury. Patients arriving by ambulance who are severely inebriated, require acute general surgical assessment or have a mental health condition that does not require any medical treatment will be taken to an A&E. If these patients self-present they will be seen and then transferred.
The trust says that the services will remain unchanged for the vast majority of the general public as ambulances already take these groups straight to Margate or Ashford. However, it has not communicated the changes widely because of concerns that “additional attendances may occur due to the availability of a 24 hour service”.
The report also warns there is a “very real risk” that HEKSS may still feel that training conditions are unsatisfactory, and potentially seek to remove medical trainees. It says services at the hospital “remain very fragile” and that if medical trainees are taken away it would mean the trust had to take emergency measures including taking all unselected medical admissions elsewhere. This would lead to the loss of acute medical support for other services on the site and means many services would have to be located elsewhere, leaving only a few low risk medical patients.