Published: 08/12/2005 Volume 115 No. 5985 Page 34

Wendy Baker is director of service integration and Sarah Sah is urgency care/out-of-hours services manager at Easington PCT.

HSJ readers more information on this article at www.goodmanagement-hsj. co. uk/ unscheduledcare

Over the past 18 months, Easington primary care trust has worked with North Tees and Hartlepool trust to redesign local unscheduled care services for a deprived population with no general hospital in the district.

The development of a 24-7 walkin urgent care centre in Peterlee has been central to this. The unit opened last October. Initially, it served patients out of hours, only moving to 24-7 walk-in status at the end of March. Since then, 26,000 patients have been treated.

The centre was designed to improve patient access and provide high-quality, cost-effective services closer to home. Services include assessment of minor injuries and illnesses, radiology, medicines supply and mental health crisis resolution.

The development has broken new ground in a number of ways by:

Introducing new roles, particularly emergency care practitioners.

Being based in a community setting.

Developing specific services to support care homes and schools.

One outcome was a reduction in accident and emergency attendances from Easington residents. One department used by local people has seen a 34 per cent drop in attendance in October 2005 compared to October 2004, while neighbouring PCTs are experiencing around an 11 per cent increase. The two main A&E departments, which serve almost all patients in the district, achieved the 98 per cent four-hour wait target for 200405.

The centre also shows good value for money - costs are around£60 per case.

Strong partnership-working was central to the success of this initiative.

Joint-working has been established at all levels, from the formal reforming emergency care working group meetings for the district through to 'on the ground' clinical collaboration.

The centre could not have succeeded without this high degree of trust and collaboration.

The PCT has just opened a second in-hours centre.