111 for advice - wanted to send an ambulance and send me to A&E when I only had a chest infection. Is there any provision to improve this service as every time I contact they try to send me to A&E or Walk in Centre? The 111 call handlers are typically non clinical and they use a strict set of clinically devised algorithms to determine the advice given to the patients. Since September 2017 in St Helens for certain conditions patient will get a call back from the Out Of Hours GP instead of being advised to go to A&E. From March 2019 111 will be able to book patients into walk in centres and Out Of Hours GP directly to avoid any waiting.
Is NHS 111 available if you are under 18 years? Yes it is however some minors are more mature than others and the quality of the conversation will be dependent on how effectively the minor can converse with the call handler. Common sense should be applied here and in some cases it will be appropriate for parents / guardians to make the call.
Why aren’t many people aware of NHS 111 and ways to treat yourself? 111 is a national number that is advertised nationally. In a typical calendar month 1140 St Helens patient’s call 111, it is an ongoing process to encourage usage. People living in Merseyside can now access urgent medical advice online, following the launch of the NHS111 online service at www.111.nhs.uk. The new free service provides members of the public with health advice and signposting to other urgent care services straight from their smartphone, laptop or other digital device.
Why are the waiting times so long when you access the walk in centre - more inclined to go A&E as a result. The Walk In Centre must adhere to the same 4 hour target as A&E. WIC waiting times vary depending on many factors such as time of day, number of people in waiting room and seriousness or acuity of patients being dealt with. In December 17 the mean waiting time for the Walk In Centre was 72 minutes which then decreased to 61 minutes in January 18. 100% of patients were seen within 4 hours.
X-Ray stops at 9pm at the Qalk in Centre - why is this the case. Difficulties in getting to Whiston after 9pm. There is a significant national project taking place currently and it expected that all Walk In Centres are upgraded to become urgent treatment centres by march 2019. Access to diagnostics for the duration of opening hours will be considered as part of this work. It is always worth visiting the Walk In Centre in the first instance with a minor injury.
Would there be a way to expand the children’s services in A&E and in the Walk in Centre sort the waiting times out? Our data tells us that often A&E and the Walk In centre is misused by the public who could often see their GP or a pharmacist about their complaint. For those patients they will typically wait the longest for care. Wait times vary depending on demand. The triage process ensures that those with greatest clinical need will be seen appropriately.
Why is the waiting time at A&E so long? I have only been 3 times but each time the waiting time was very long Our data tells us that often A&E and the Walk IN centre is misused by some of the public who could often see their GP or a pharmacist about their complaint. For those patients they will typically wait the longest for care. Wait times vary depending on demand. The triage process ensures that those with greatest clinical need will be seen appropriately. In addition we have seen more demand on our A&E department than ever before. In addition to the wainting area the trust typically receives approximately100 ambulances on a typical day. Waiting times vary depending on many factors such as time of day, number of people in waiting room and seriousness or acuity of patients being dealt with.
111 helpline, some symptoms can be self treated or be dealt with my a pharmacist. However on a few occasions, our children have had high temperatures and we have been advised to go to A&E which put further pressure on an already stretched service. 111 have introduced a clinician at the front end for all under 5’s ( CAFÉ) . for the non-clinical call handlers they use a set of algorithms to determine the safes t and most appropriate disposition for the child.
What is the proportion of antibiotic used to treat health care acquired infections of non-health care acquired infections? The antibiotic prescribing data we receive from NHSBSA does not distinguish between those antibiotics prescribed for a non-health care acquired infection and a health care acquired infection. To obtain this data accurately an audit would have to be undertaken in every GP practice.
How is the above comparison measured? We do not currently measure the comparison.
What plans with timescales are there to significantly reduce the ‘ high rate of health care acquired infections’ ? Nationally there is a aim for all CCG’s to reduce E-coli blood stream infections by 10% by the end of March 2018. The CCG has worked effortlessly to reduced its rate of MRSA blood stream infections by 33%, E-Coli blood stream infection by 4% and Clostridium Difficle (C-Diff) infection by 5% since last year. We continually review our infection control processes in our acute providers, community and primary care organisations and support infection control awareness and training through our infection control community team. We work in partnership with medicines management teams to support appropriate prescribing of antibiotics in primary care. The CCG supports a multidisciplinary anti-microbial stewardship group who monitors and reviews actions from all partnership organisations in St Helens.
What plans with timescales are there to significantly reduce the use of antibiotics in the treatment of non-health care acquired infections? The CCG has been working with prescribers on the reduction in prescribing of unnecessary antibiotics for many years now and will continue to do so for the foreseeable future. In terms of the public, public health will promote messages via the media including television and radio.
How long does it take for bacteria to become resistant? Bacterial resistance can happen very quickly. Bacterial resistance can occur due to random changes or mutations in the genes of individual bacterial cells. Some mutations protect the bacterial cell from the effects of the antibiotic. The antibiotic resistant gene can transfer from one bacterium to another.
Why don’t we know about antibiotics? This year’s campaign has been on television and the radio .
Why can’t you use other people’s paracetamol? https://www.nhs.uk/conditions/paracetamol/ Not everyone can take paracetamol.
Is paracetamol the same for everyone? https://www.nhs.uk/conditions/paracetamol/ Not everyone can take paracetamol.
What’s the difference between a cold and flu? Please see the information below from NHS Choices website
Are there intentionally fewer GPs and more advanced nurses to offer treatment? There is a National shortage of GPs, therefore regionally and Nationally wider members of the primary care team are being utilised effectively within primary care this includes the use of APNPs and clinical pharmacists amongst other skill mix.
Not enough accountability for access to services around carers times, what can be done to address this? - Services to support Carers in St Helens are commissioned by St Helens Council and NHS St Helens CCG. The services on offer are primarily arranged and provided via the Carers Centre which has two town centre bases and a hospital presence. The services are monitored and measures outcomes and there is regular consideration as to the effectiveness of the offer for carers in the borough. There is an intention to develop a Carers Strategy for St Helens linking with all relevant users of services, partners and stakeholders.
Is the NHS going to be privatised in the near future, why are we in such a mess i.e operations- As far as we are concerned locally, the NHS will not be privatised. We work closely with our local NHS providers to deliver quality NHS services, free at the point of access, to all NHS patients and in st helens we perform really well with access to treatment such as operations.
I have seen the leaflet about using the right service and 100% get it, there is a massive education process to be done. What about an app on the phones that a huge percentage of the public can access via smart phones? - This is a great idea and is something that the NHS as a whole is working towards. In the near future, the NHS expects to be able to begin using online platforms and apps more when helping people to make the right choice for their treatment.