Chipping Norton First Aid Unit

Chipping Norton First Aid Unit (FAU) has been running since 2011.  It is staffed by a team of highly qualified Specialist Practitioners (both Paramedics and Nurses) with experience and expertise in the treatment of minor injuries.  The service is provided by NHS South Central Ambulance Service Foundation Trust (SCAS).  The FAU currently treats the following types of injuries:

  • Simple injuries that cannot be treated/managed with a home first aid kit
  • Cleaning and simple stitching of wounds
  • Insect bites and stings
  • Minor burns and scalds
  • A foreign body in the eye
  • Bumps to the head where there has been no loss of consciousness
  • Bruises
  • Sprains

The FAU operates mainly out of hours:

  • 00pm – 9.00pm Monday to Friday
  • 00am – 9.00pm weekends and Bank Holiday

Currently, the Chipping Norton FAU operates out of the Chipping Norton Community Hospital Building. The proposal is for the service to move and to be provided from the Chipping Norton Health Centre that is on the same site, opposite the hospital building.

In 2015, Chipping Norton Health Centre relocated to be on the same site as Chipping Norton Community Hospital. Prior to this, the practice operated out of a town centre building.

Why the need to change?

The wide variation in services provided across the country in minor injuries units, urgent care centres, first aid units and others have led to confusion amongst the public about what services offer and how best to use local services. To reduce confusion, NHS England has issued guidance[1] to reduce the variation that now requires urgent care to be designated as either:

  • Accident and Emergency – full hospital department operating 24/7

or

  • Urgent Treatment Centre (open for 12hrs every day) providing treatment and diagnostics, GP-led

Other urgent access health services need to be part of primary or community care services; this includes first aid units. The guidance advises as follows:

Paragraph 13

Commissioners, supported by NHS England, should review current provision, impact and local health needs assessments against the below standards and make a plan for each existing facility, alongside current provision and plans for extended GP access, subject to local consultation and following proper procurement process where appropriate. We know that many services will already offer, or be close to offering, this level of service, and others will need local investment to meet the standards. Other services, that will not meet the new standards, may become an alternative new community service; this may be a GP access hub.

OCCG must now make sure Oxfordshire is compliant with this new guidance and is keen to ensure valued services are retained in local communities wherever possible. By moving services into a primary care setting, we can avoid any requirements to close walk-in services.

The way urgent care services are monitored nationally is changing from 31st December 2019.

The proposal for Chipping Norton FAU to move from Chipping Norton Hospital building to the Health Centre building would ensure the service could continue and remain compliant with national delivery of urgent care pathways. Thereby we can preserve this valued local service for people in the Chipping Norton area.

The CCG directly approached Chipping Norton Health Centre to assist us in finding a means to retain the local service.  The practice have been very helpful and are asking for no additional resources. The CCG are most grateful to the practice and the ambulance service for offering to find a solution as without their help we would need to look to close this service. 

This change will be tested and reviewed as a means to deliver a nationally compliant way of securing the local first aid/injury services we wish to preserve. We will test the benefits we can gain for patients and we will be closely monitoring and using the learning to roll out to other relevant sites.

The service itself will not change and will continue to be provided by the same highly skilled clinicians, with the same opening hours and will continue to be open to anyone – regardless of which GP practice a patient is registered with.

Benefits of the change

Although the need for this change comes from national guidance, there will be clear benefits for patients with the co-location of the FAU with the Chipping Norton Health Centre and the on-site pharmacy.  The clinicians working in the FAU, local GPs and pharmacists are all supportive and are keen to see the First Aid Unit services continue to provide a service to local people and to explore what further benefits can be achieved.

Bringing the FAU under the same roof as the GP practice will deliver benefits from the start with many more being anticipated as the clinicians working in the FAU, Health Centre and Pharmacy explore opportunities.

The clinicians working in the First Aid Unit are enthusiastic about this move. The benefits will be for patients and those working in the service including:

  • Following the move, the clinicians at the FAU could have access to patients’ notes (subject to governance arrangements) which will improve communication help to improve safety, efficiency and patient care. Initially this would be for patients registered at Chipping Norton Health Centre but this could be expanded using the EMIS hub facility to any patient registered with a GP practice in Oxfordshire.
  • There are already plans for further joint working, which might include a Saturday dressing clinic.

 GPs at Chipping Norton Health Centre believe this move will see the following benefits for their patients and patients of other GP practices:

  • In addition to the FAU clinicians having access to a wider range of dressings and medical equipment, a good example of where the service would improve would be point of care blood testing at the Health Centre. This would be available for patients attending the FAU. This can be used to identify CRP (marker of infection), to conduct a full blood count and to measure serum electrolytes. This would not typically be available in an FAU and will allow more complex patients to be managed by the paramedic if needed. This would be available regardless of whether the practice was open and the paramedic will be able to do point of care tests and speak to the out of hours GP and manage cases with telemedicine.
  • Easy access to pharmacy for patients to additional advice, medication and equipment if required.
  • The risks associated with lone working will be significantly reduced. Currently the FAU service is delivered within a building where there is no other consistent out of hours service. The pharmacy is open for the majority of the opening hours of the FAU and a pharmacist will be on site to provide additional advice and support if needed.
  • Better collaboration is being planned between the teams during the cross over time when both the health centre and the FAU are operating, GPs will be able to help SCAS with advice, prescription and support where needed. Having the FAU within the health centre will allow patients who are suitable to be seen by the FAU but not able to attend before 6.30pm to be smoothly handed over to the FAU team.
  • There are opportunities for shared learning and training between SCAS and the health centre staff, for example advanced life support to better care for patients.

Future proposal

Currently the FAU is located within the Community Hospital Building. The Chipping Norton Health Centre is located on the same site, adjacent to the hospital. The proposal is for the FAU to be relocated within the health centre which will have no impact on patients’ ability to access the service. 

There will be no change to the current opening times and SCAS will continue to provide the service.

The FAU will be accessible to all patients, regardless of which GP practice they are registered with.

OCCG, SCAS, the GP practice and pharmacy are supporting this change as a way to preserve this service for local people. They will be exploring what more can be achieved to enhance the care of patients.

 

[1] https://www.england.nhs.uk/wp-content/uploads/2017/07/urgent-treatment-centres%E2%80%93principles-standards.pdf