Urgent Treatment Centres (UTC) Listening Event Report - December 2023

Introduction

We visited the Urgent Treatment Centres (UTC) in South Liverpool (Garston) and Old Swan in December 2023 to find out from patients what they thought of the service, where it worked well and where improvements could be made.

We visited the South Liverpool UTC on a Tuesday morning and spoke with 30 patients and 4 relatives or friends. In Old Swan UTC we spoke with 25 patients and 2 relatives/ friends on a Thursday morning. 

We used a survey to ensure we asked everyone the same questions. Some people were called in before they could fully complete the survey. In this report we have separated the feedback as much as possible by South Liverpool and Old Swan Urgent Treatment Centre site to make the information more useful to the service.

The Urgent Treatment Centre's are managed by Mersey Care NHS Foundation Trust. Until recently both the Old Swan and South Liverpool sites provided a nurse-led Walk-in Centre service from 8am-8pm 7 days per week. In October 2023 this changed to a GP-led Urgent Treatment Centre. Mersey Care explains the difference thus:

“In addition to treating minor injuries and illnesses that are not an emergency, the new UTCs are aiming to include diagnostics, urine tests and x-rays, and prescribe medication and issue prescriptions for some conditions. They will also be able to refer patients to other urgent care services within the community and hospitals.”  (https://www.merseycare.nhs.uk/our-services/liverpool/walk-in-centres)

Services at each centre vary to some extent, e.g. there are currently no x-ray facilities at Old Swan UTC, while at South Liverpool UTC patients have been able to get an x-ray for many years.

We would like to thank the patients we spoke to for their time and feedback. We would also like to thank Mersey Care staff for their support with our visits.

Key findings

•  Nearly 1/3 of people we spoke to had been advised to attend the UTC by another NHS service.
• 1/4 of people we spoke to said they had come because it was convenient, or because it was the right thing to do.
• In South Liverpool most people we spoke to had not been to a Walk in Centre (WiC) or UTC in the past year. Most people we spoke to in Old Swan UTC had been there before in the previous year.
• The main improvement people wanted to see were the waiting times, although many understood there were pressures.
• In South Liverpool most positive comments were about the convenience and accessibility, and in Old Swan most positive comments were about it being local.
• Most people with additional support needs felt they were well supported, but some people said they were not well supported by the service.

Conclusion

We are aware that many - if not most - NHS services are under pressure. This was also reflected by the number of people who told us that they had come to the Urgent Treatment Centre because other NHS services had advised them to, including NHS111, pharmacy or hospital staff. In addition, several people told us they had come to the UTC because they could not get through to their GP practice. Others assumed that they would not be able to get a GP appointment.

It was clear that both Urgent Treatment Centres we visited experienced high demand and pressures too which increased throughout the visit. In Old Swan this led to patients being told that it would be a ‘triage only’ service. Not all patients understood what that meant.

Most of the feedback we received at both centres was positive. People especially liked that the service was easily accessible, i.e. they could walk in and be seen by a health professional, and that it was local. 

Expected waiting times varied from 1-2 hours when we first arrived but had changed to 4 hours at both UTCs by the time we left at midday. Patients we spoke to at both UTCs mostly understood the pressures and reacted reasonably to the fact that there would be a wait. However, we found that people did not always know that they would be triaged first, which was mostly done quickly. That there might be a much longer wait afterwards depending on the triage assessment was not always clear to people. 

A couple of people mentioned having been triaged before at the same or another centre. For example, someone who initially attended Halewood WiC had been advised to go to South Liverpool UTC as X-rays could be done there. This person was told they had to be triaged and start their treatment process all over again at South Liverpool UTC.

During our visit to Old Swan UTC information about expected waiting times was not provided regularly at first. Several patients left when they were told by a member of staff that the expected wait would be 4 hours.

At both centres we received feedback from people who were neurodivergent or had a learning disability and/or their families. They questioned how accessible the environment at the centres was for people who are neurodivergent or have a learning disability. 

Recommendations

1. Demand for the Urgent Treatment Centres is likely to continue to be high - and increase - as it is a popular, accessible service in a national health service that is often stretched. Ideally, staffing levels will need to increase too to deal with this, which may be a system-wide issue and not solely for this Trust.
2. Ensure that estimated waiting times are clearly and regularly communicated to help manage patient expectations. During triage explain that the wait for treatment may be substantially longer.
3. On occasions where due to demand the service becomes ‘triage only’ clearly explain what that means to people in the waiting area.
4. Ensure that all staff including reception staff have at least basic awareness of Neurodiversity and Learning Disability (Oliver McGowen training). Explore if there are ways at each centre to make the experience (from the environment to staff) more Neurodivergent- and Learning Disability-friendly where practicably possible.
5. There may be good clinical reasons for asking patients to go through triage again if they have been referred by another UTC or WiC, in which case we recommend that this is explained clearly to the patient.
6. Both centres displayed signs about triage. Display additional signs that explain the system in easy-to-understand language and formats (e.g. not everyone we spoke to knew what ‘triage’ was, but understood what ‘assessment’, ‘being assessed’ or ‘first/ initial check/ look’ was).