Ernie Clark. Hilperton Division, Wiltshire Council.

How the service will change from 1st April.

As Chairman of the Trowbridge Area Board, I have received the following letter. As it isn't marked 'Confidential' I am presuming that the information is 'public'.

"Provision of Out-of-hours medical/dental and Single Point of Access Services.

Dear colleagues,

We are writing to inform you about the new, Wiltshire-wide service for Out-of-hours urgent medical and dental treatment. From 1 April, Wiltshire Medical Services will provide a single service across the county. We are confident that this will represent a more robust, consistent and high-quality service for patients, and wanted to let you know the background to the change and what it will mean for Wiltshire people.

Enclosed with this letter, you will find a leaflet we have produced to encourage Wiltshire people to choose the NHS service that is right for them when they need treatment outside their doctor’s normal working hours. This is being distributed throughout GP practices, pharmacies, libraries and other public buildings as part of a major campaign to inform the public of the changes.

Background. In 2004, the government renegotiated the national contract for GP services and separated responsibility for out-of-hours care from in-hours care. GP practices are responsible for the care of their patients from 08.00-18.30 Monday to Friday. Outside these hours, the PCT is responsible for commissioning a service to provide urgent primary care advice and treatment.

In Wiltshire, the predecessor organisations to NHS Wiltshire had established three separate contracts for out-of-hours provision. One of these was concluded in April 2009, when the service for residents of Downton and Whiteparish transferred to the main provider for the south of the county. The other two contracts come to an end on 31 March 2010.

The new service. The PCT has conducted a procurement process to identify a new provider for a service across the county. The successful bidder, Wiltshire Medical Services, will commence providing the service across the whole county from 1 April 2010.

Wiltshire Medical Services was set up by a group of Wiltshire GPs in 2004 to provide out-of-hours care to the North, West and Kennet areas. Many doctors from other GP practices in the county work shifts with the service and the quality monitoring for the last five years has indicated a consistently high level of service provision.

The services to be provided include:

Urgent primary care advice and treatment.

Patients will ring their normal GP surgery telephone number and be redirected to the OOH service. The OOH telephone line will be staffed by nurses and doctors who will:

• Advise patients on how to look after their condition

• Arrange for patients to come to one of eight sites across the county to be seen

• Arrange for a home visit

Patients may also choose to ring the out-of-hours service direct: 0300 111 5717

The service will be available from eight sites across the county – an increase of two on the existing level of provision. The bases have been chosen to provide a good geographical spread: Amesbury, Savernake, Salisbury, Swindon (new), Warminster (new), Chippenham, Trowbridge, Shaftesbury

As now, the service is available on a ‘booked’ basis so patients or their carers will have the opportunity to discuss with a nurse or doctor what option is best for them.

Patients will be offered the choice of which centre they visit and all centres will be available to all patients. For example, in the past, patients from the areas of Pewsey, Burbage and Ludgershall have not been able to use the service at Amesbury but will under the new arrangements be offered this choice.

Travel distances for rural patients are reduced by providing the service at Warminster, Shaftesbury, Amesbury, Savernake and Swindon.

Urgent dental advice and treatment Patients with urgent dental needs will be able to telephone the out-of-hours service for advice. At the weekends, urgent dental clinics will be held in: Chippenham, Swindon, Salisbury, Westbury.

As now, this service is available on a ‘booked’ basis via the telephone service.

Overnight nursing service. Following the successful pilot in West Wiltshire, the service will provide the overnight response to patients who are currently being cared for by the neighbourhood teams. The demand for such care overnight (ie after 10pm and before 7am) is very low. An integrated service makes best use of the doctors, nurses and emergency care practitioners whilst ensuring complete coverage in our rural county.

Single point of access. WMS will continue to provide the Single Point of Access (SPA) for health professionals to refer patients to community services. The SPA will be extended to include the south of the county.

Communication with GPs, dentists and other health professionals commenced in the week beginning 21 February. A public communication plan will start in mid-March. WMS and the PCT have deferred the start of the public campaign to avoid the potential for confusing patients who need to continue to use the existing OOH service until 31 March 2010.

Yours sincerely, Alison Knowles, Director of Strategy and Communications.